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Conference paperPatel N, Kogkas A, Ben Glover AD, et al., 2019,
EYE GAZE-CONTROLLED ROBOTIC FLEXIBLE ENDOSCOPY: A FEASIBILITY STUDY
, Annual Meeting of the British-Society-of-Gastroenterology (BSG), Publisher: BMJ PUBLISHING GROUP, Pages: A38-A39, ISSN: 0017-5749- Author Web Link
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- Citations: 2
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Journal articleMartin G, Clarke J, Liew F, et al., 2019,
Evaluating the impact of organisational digital maturity on clinical outcomes in secondary care in England
, npj Digital Medicine, Vol: 2, ISSN: 2398-6352All healthcare systems are increasingly reliant on health information technology to support the delivery of high-quality, efficient and safe care. Data on its effectiveness are however limited. We therefore sought to examine the impact of organisational digital maturity on clinical outcomes in secondary care within the English National Health Service. We conducted a retrospective analysis of routinely collected administrative data for 13,105,996 admissions across 136 hospitals in England from 2015 to 2016. Data from the 2016 NHS Clinical Digital Maturity Index were used to characterise organisational digital maturity. A multivariable regression model including 12 institutional covariates was utilised to examine the relationship between one measure of organisational digital maturity and five key clinical outcome measures. There was no significant relationship between organisational digital maturity and risk-adjusted 30-day mortality, 28-day readmission rates or complications of care. In multivariable analysis risk-adjusted long length of stay and harm-free care were significantly related to aspects of organisational digital maturity; digitally mature hospitals may not only deliver more harm-free care episodes but also may have a significantly increased risk of patients experiencing a long length of stay. Organisational digital maturity is to some extent related to selected clinical outcomes in secondary care in England. Digital maturity is, however, also strongly linked to other institutional factors that likely play a greater role in influencing clinical outcomes. There is a need to better understand how health IT impacts care delivery and supports other drivers of hospital quality.
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Journal articleWarren L, Clarke J, Arora S, et al., 2019,
Transitions of care across hospital settings in patients with inflammatory bowel disease
, World Journal of Gastroenterology, Vol: 25, Pages: 2122-2132, ISSN: 1007-9327BACKGROUNDInflammatory bowel disease (IBD) is a chronic, inflammatory disorder characterised by both intestinal and extra-intestinal pathology. Patients may receive both emergency and elective care from several providers, often in different hospital settings. Poorly managed transitions of care between providers can lead to inefficiencies in care and patient safety issues. To ensure that the sharing of patient information between providers is appropriate, timely, accurate and secure, effective data-sharing infrastructure needs to be developed. To optimise inter-hospital data-sharing for IBD patients, we need to better understand patterns of hospital encounters in this group.AIMTo determine the type and location of hospital services accessed by IBD patients in England.METHODSThis was a retrospective observational study using Hospital Episode Statistics, a large administrative patient data set from the National Health Service in England. Adult patients with a diagnosis of IBD following admission to hospital were followed over a 2-year period to determine the proportion of care accessed at the same hospital providing their outpatient IBD care, defined as their ‘home provider’. Secondary outcome measures included the geographic distribution of patient-sharing, regional and age-related differences in accessing services, and type and frequency of outpatient encounters.RESULTSOf 95055 patients accessed hospital services on 1760156 occasions over a 2-year follow-up period. The proportion of these encounters with their identified IBD ‘home provider’ was 73.3%, 87.8% and 83.1% for accident and emergency, inpatient and outpatient encounters respectively. Patients living in metropolitan centres and younger patients were less likely to attend their ‘home provider’ for hospital services. The most commonly attended specialty services were gastroenterology, general surgery and ophthalmology.CONCLUSIONTransitions of care between secondary care sett
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Journal articleAufegger L, Shariq O, Bicknell C, et al., 2019,
Can shared leadership enhance clinical team management? A systematic review
, Leadership in Health Services, Vol: 32, Pages: 309-335, ISSN: 1751-1879PurposeResearch in psychology or management science has shown that shared leadership (SL) enhances information sharing, fosters participation and empowers team members within the decision-making processes, ultimately improving the quality of performance outcomes. Little has been done and, thus, less is known of the value and use of SL in acute healthcare teams. The purpose of this study is to (1) explore, identify and critically assess patterns and behaviour of SL in acute healthcare teams; and (2) evaluate to what extent SL may benefit and accomplish safer care in acute patient treatment and healthcare delivery.Design/methodology/approachThe authors conducted a review that followed the PRISMA-P reporting guidelines. A variety of sources were searched in April 2018 for studies containing primary research that focused on SL in acute healthcare teams. The outcome of interest was a well-specified assessment of SL, and an evaluation of the extent SL may enhance team performance, lead to safer patient care and healthcare delivery in acute healthcare teams.FindingsAfter the study selection process, 11 out of 1,383 studies were included in the review. Studies used a qualitative, quantitative or mixed-methods approach. Emerging themes based on behavioural observations that contributed to SL were: shared mental model; social support and situational awareness; and psychological safety. High-performing teams showed more SL behaviour, teams with less seniority displayed more traditional leadership styles and SL was associated with increased team satisfaction.Research limitations/implicationsEvidence to date suggests that SL may be of benefit to improve performance outcomes in acute healthcare team settings. However, the discrepancy of SL assessments within existing studies and their small sample sizes highlights the need for a large, good quality randomized controlled trial to validate this indication.Originality/valueAlthough studies have acknowledged the relevance of SL in he
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Journal articleGhafur S, Grass E, Jennings N, et al., 2019,
The challenges of cybersecurity in health care: the UK National Health Service as a case study
, The Lancet Digital Health, Vol: 1, Pages: e10-e12, ISSN: 2589-7500 -
Journal articleCamara M, Dawda S, Mayer E, et al., 2019,
Subject-specific modelling of pneumoperitoneum: model implementation, validation and human feasibility assessment
, International Journal of Computer Assisted Radiology and Surgery, Vol: 14, Pages: 841-850, ISSN: 1861-6429PURPOSE: The aim of this study is to propose a model that simulates patient-specific anatomical changes resulting from pneumoperitoneum, using preoperative data as input. The framework can assist the surgeon through a real-time visualisation and interaction with the model. Such could further facilitate surgical planning preoperatively, by defining a surgical strategy, and intraoperatively to estimate port positions. METHODS: The biomechanical model that simulates pneumoperitoneum was implemented within the GPU-accelerated NVIDIA FleX position-based dynamics framework. Datasets of multiple porcine subjects before and after abdominal insufflation were used to generate, calibrate and validate the model. The feasibility of modelling pneumoperitoneum in human subjects was assessed by comparing distances between specific landmarks from a patient abdominal wall, to the same landmark measurements on the simulated model. RESULTS: The calibration of simulation parameters resulted in a successful estimation of an optimal set parameters. A correspondence between the simulation pressure parameter and the experimental insufflation pressure was determined. The simulation of pneumoperitoneum in a porcine subject resulted in a mean Hausdorff distance error of 5-6 mm. Feasibility of modelling pneumoperitoneum in humans was successfully demonstrated. CONCLUSION: Simulation of pneumoperitoneum provides an accurate subject-specific 3D model of the inflated abdomen, which is a more realistic representation of the intraoperative scenario when compared to preoperative imaging alone. The simulation results in a stable and interactive framework that performs in real time, and supports patient-specific data, which can assist in surgical planning.
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Journal articleSun Y, Lo B, 2019,
An artificial neural network framework for gait based biometrics
, IEEE Journal of Biomedical and Health Informatics, Vol: 23, Pages: 987-998, ISSN: 2168-2194OAPA As the popularity of wearable and implantable Body Sensor Network (BSN) devices increases, there is a growing concern regarding the data security of such power-constrained miniaturized medical devices. With limited computational power, BSN devices are often not able to provide strong security mechanisms to protect sensitive personal and health information, such as one's physiological data. Consequently, many new methods of securing Wireless Body Area Networks (WBANs) have been proposed recently. One effective solution is the Biometric Cryptosystem (BCS) approach. BCS exploits physiological and behavioral biometric traits, including face, iris, fingerprints, Electrocardiogram (ECG), and Photoplethysmography (PPG). In this paper, we propose a new BCS approach for securing wireless communications for wearable and implantable healthcare devices using gait signal energy variations and an Artificial Neural Network (ANN) framework. By simultaneously extracting similar features from BSN sensors using our approach, binary keys can be generated on demand without user intervention. Through an extensive analysis on our BCS approach using a gait dataset, the results have shown that the binary keys generated using our approach have high entropy for all subjects. The keys can pass both NIST and Dieharder statistical tests with high efficiency. The experimental results also show the robustness of the proposed approach in terms of the similarity of intra-class keys and the discriminability of the inter-class keys.
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Journal articleSmalley K, Aufegger L, Flott K, et al., 2019,
Which behaviour change techniques are most effective in improving healthcare utilisation in COPD self-management programmes? A protocol for a systematic review
, BMJ Open Respiratory Research, Vol: 6, ISSN: 2052-4439IntroductionSelf-management interventions are often presented as a way to improve the quality of care for patients with chronic illness. However self-management is quite broadly-defined and it remains unclear which types of interventions are most successful. This review will use the Theoretical Domains Framework (TDF) as a lens through which to categorise self-management interventions regarding which programmes are most likely to be effective, and under which circumstances. The aim of this study is to (1) describe the types of self-management programmes that have been developed in chronic obstructive pulmonary disease (COPD); and identify the common elements between these to better classify the self-management. (2) Evaluate the effect that self-management programmes have on COPD patients’ healthcare behaviour, by classifying those programmes by the behaviour change techniques used. Methods and analysisA systematic search of the literature will be performed in MEDLINE, EMBASE, HMIC, and PsycINFO. This review will be limited to randomised controlled trials (RCTs) and quasi-experimental studies. The review will follow PRISMA-P guidelines, and will provide a PRISMA checklist and flowchart. Risk of bias in individual studies will be assessed using the Cochrane Risk of Bias criteria, and the quality of included studies will be evaluated using the GRADE criteria, and will be reported in a Summary of Findings table.The primary analysis will be a catalogue of the interventions based on the components of the TDF that were utilised in the intervention. A matrix comparing included behaviour change techniques to improvements in utilisation will summarise the primary outcomes. Ethics and dissemination Not applicable, as this is a secondary review of the literature.Registration detailsPROSPERO: CRD42018104753
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Journal articleGoiana-da-Silva F, Cruz-e-Silva D, Carrico M, et al., 2019,
Changing the channel: television health campaigns in Portugal
, Lancet Public Health, Vol: 4, Pages: E179-E179, ISSN: 2468-2667 -
Journal articleMoylan A, Appelbaum N, Clarke J, et al., 2019,
Assessing the agreement of 5 ideal body weight calculations for selecting medication dosages for children with obesity
, JAMA Pediatrics, ISSN: 2168-6203
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