Subjects -> MEDICAL SCIENCES (Total: 8669 journals)
    - ANAESTHESIOLOGY (120 journals)
    - CARDIOVASCULAR DISEASES (338 journals)
    - DENTISTRY (294 journals)
    - ENDOCRINOLOGY (151 journals)
    - FORENSIC SCIENCES (42 journals)
    - HEMATOLOGY (157 journals)
    - HYPNOSIS (4 journals)
    - INTERNAL MEDICINE (176 journals)
    - MEDICAL GENETICS (58 journals)
    - MEDICAL SCIENCES (2406 journals)
    - NURSES AND NURSING (367 journals)
    - OBSTETRICS AND GYNECOLOGY (207 journals)
    - ONCOLOGY (385 journals)
    - OTORHINOLARYNGOLOGY (83 journals)
    - PATHOLOGY (100 journals)
    - PEDIATRICS (275 journals)
    - PSYCHIATRY AND NEUROLOGY (833 journals)
    - RESPIRATORY DISEASES (104 journals)
    - RHEUMATOLOGY (79 journals)
    - SPORTS MEDICINE (81 journals)
    - SURGERY (406 journals)

MEDICAL SCIENCES (2406 journals)            First | 1 2 3 4 5 6 7 8 | Last

Showing 201 - 400 of 3562 Journals sorted alphabetically
Asian Biomedicine     Open Access   (Followers: 2)
Asian Journal of Cell Biology     Open Access   (Followers: 6)
Asian Journal of Health     Open Access   (Followers: 3)
Asian Journal of Medical and Biological Research     Open Access   (Followers: 5)
Asian Journal of Medical and Pharmaceutical Researches     Open Access   (Followers: 2)
Asian Journal of Medical Sciences     Open Access   (Followers: 2)
Asian Journal of Medicine and Health     Open Access   (Followers: 1)
Asian Journal of Research in Medical and Pharmaceutical Sciences     Open Access   (Followers: 1)
Asian Journal of Scientific Research     Open Access   (Followers: 3)
Asian Journal of Transfusion Science     Open Access   (Followers: 1)
Asian Medicine     Hybrid Journal   (Followers: 5)
Asian Pacific Journal of Cancer Prevention     Open Access  
Asian Pacific Journal of Health Sciences     Open Access   (Followers: 10)
ASPIRATOR : Journal of Vector-borne Disease Studies     Open Access  
Astrocyte     Open Access  
Atención Familiar     Open Access  
Atención Primaria     Open Access   (Followers: 2)
Atención Primaria Práctica     Open Access   (Followers: 1)
Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche     Open Access  
Audiology - Communication Research     Open Access   (Followers: 10)
AUP Advances     Open Access   (Followers: 7)
Auris Nasus Larynx     Full-text available via subscription  
Australasian Journal of Ultrasound in Medicine (AJUM)     Hybrid Journal   (Followers: 1)
Australian Coeliac     Full-text available via subscription   (Followers: 2)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Journal of Medical Science     Full-text available via subscription   (Followers: 3)
Autopsy and Case Reports     Open Access  
Avicenna     Open Access   (Followers: 3)
Avicenna Journal of Clinical Medicine     Open Access  
Avicenna Journal of Medicine     Open Access   (Followers: 1)
Bangabandhu Sheikh Mujib Medical University Journal     Open Access   (Followers: 1)
Bangladesh Journal of Anatomy     Open Access   (Followers: 2)
Bangladesh Journal of Bioethics     Open Access  
Bangladesh Journal of Medical Biochemistry     Open Access   (Followers: 4)
Bangladesh Journal of Medical Education     Open Access   (Followers: 2)
Bangladesh Journal of Medical Microbiology     Open Access   (Followers: 4)
Bangladesh Journal of Medical Physics     Open Access   (Followers: 1)
Bangladesh Journal of Medical Science     Open Access  
Bangladesh Journal of Medicine     Open Access   (Followers: 1)
Bangladesh Journal of Physiology and Pharmacology     Open Access  
Bangladesh Journal of Scientific Research     Open Access   (Followers: 1)
Bangladesh Medical Journal     Open Access  
Bangladesh Medical Journal Khulna     Open Access  
Basal Ganglia     Hybrid Journal  
Basic Sciences of Medicine     Open Access   (Followers: 1)
Batı Karadeniz Tıp Dergisi / Medical Journal of Western Black Sea     Open Access  
Baylor University Medical Center Proceedings     Hybrid Journal  
BBA Clinical     Open Access  
BC Medical Journal     Free  
Benha Medical Journal     Open Access  
Beni-Suef University Journal of Basic and Applied Sciences     Open Access   (Followers: 3)
Bijblijven     Hybrid Journal  
Bijzijn     Hybrid Journal   (Followers: 1)
Bijzijn XL     Hybrid Journal  
Bio-Algorithms and Med-Systems     Hybrid Journal   (Followers: 2)
BioDiscovery     Open Access   (Followers: 2)
Bioelectromagnetics     Hybrid Journal   (Followers: 2)
Bioelectronic Medicine     Open Access   (Followers: 1)
Bioengineering & Translational Medicine     Open Access  
Bioethics     Hybrid Journal   (Followers: 19)
Bioethics Research Notes     Full-text available via subscription   (Followers: 15)
Biologics in Therapy     Open Access  
Biology of Sex Differences     Open Access   (Followers: 2)
Biomarker Research     Open Access   (Followers: 3)
Biomarkers in Medicine     Hybrid Journal   (Followers: 2)
BioMed Research International     Open Access   (Followers: 5)
Biomédica     Open Access  
Biomedical & Life Sciences Collection     Full-text available via subscription   (Followers: 3)
Biomedical and Biotechnology Research Journal     Open Access   (Followers: 1)
Biomedical Engineering     Hybrid Journal   (Followers: 16)
Biomedical Engineering and Computational Biology     Open Access   (Followers: 13)
Biomedical Engineering Letters     Hybrid Journal   (Followers: 6)
Biomedical Engineering Research     Open Access   (Followers: 7)
Biomedical Informatics Insights     Open Access   (Followers: 9)
Biomedical Journal     Open Access   (Followers: 4)
Biomedical Materials     Hybrid Journal   (Followers: 7)
Biomedical Microdevices     Hybrid Journal   (Followers: 9)
Biomedical Optics Express     Open Access   (Followers: 6)
Biomedical Photonics     Open Access  
Biomedical Reports     Full-text available via subscription  
Biomedical Research Reports     Full-text available via subscription   (Followers: 2)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 9)
Biomedical Science and Engineering     Open Access   (Followers: 7)
BioMedicine     Open Access  
Biomedicine Hub     Open Access  
Biomedicines     Open Access   (Followers: 1)
Biomedika     Open Access  
Biomolecular and Health Science Journal     Open Access   (Followers: 1)
Biophysics Reports     Open Access  
BioPsychoSocial Medicine     Open Access   (Followers: 8)
Biosafety and Health     Open Access   (Followers: 2)
Biosalud     Open Access   (Followers: 1)
Biostatistics & Epidemiology     Hybrid Journal   (Followers: 2)
Birat Journal of Health Sciences     Open Access  
BIRDEM Medical Journal     Open Access   (Followers: 1)
Birth Defects Research     Hybrid Journal  
Birth Defects Research Part A : Clinical and Molecular Teratology     Hybrid Journal   (Followers: 3)
Birth Defects Research Part C : Embryo Today : Reviews     Hybrid Journal  
BJR|Open     Open Access   (Followers: 1)
BJS Open     Open Access   (Followers: 1)
Black Sea Journal of Health Science     Open Access  
BLDE University Journal of Health Sciences     Open Access  
Blickpunkt Medizin     Hybrid Journal  
BMC Biomedical Engineering     Open Access  
BMC Medical Ethics     Open Access   (Followers: 22)
BMC Medical Research Methodology     Open Access   (Followers: 9)
BMC Medicine     Open Access   (Followers: 14)
BMC Obesity     Open Access   (Followers: 7)
BMC Proceedings     Full-text available via subscription   (Followers: 2)
BMC Research Notes     Open Access   (Followers: 4)
BMC Sports Science, Medicine and Rehabilitation     Open Access   (Followers: 34)
BMH Medical Journal     Open Access   (Followers: 2)
BMI Journal : Bariátrica & Metabólica Iberoamericana     Open Access  
BMJ     Hybrid Journal   (Followers: 1886)
BMJ Case Reports     Hybrid Journal   (Followers: 28)
BMJ Evidence-Based Medicine     Hybrid Journal   (Followers: 4)
BMJ Global Health     Open Access   (Followers: 3)
BMJ Innovations     Hybrid Journal   (Followers: 6)
BMJ Leader     Hybrid Journal  
BMJ Open     Open Access   (Followers: 44)
BMJ Open Quality     Open Access   (Followers: 19)
BMJ Open Science     Open Access   (Followers: 1)
BMJ Sexual & Reproductive Health     Hybrid Journal   (Followers: 2)
BMJ Surgery, Interventions, & Health Technologies     Open Access  
Bodine Journal     Open Access  
Boletín del Consejo Académico de Ética en Medicina     Open Access  
Boletín del ECEMC     Open Access  
Boletin Médico de Postgrado     Open Access  
Boletín Médico del Hospital Infantil de México     Open Access  
Bone     Hybrid Journal   (Followers: 18)
Bone and Tissue Regeneration Insights     Open Access   (Followers: 2)
Bone Marrow Research     Open Access   (Followers: 2)
Bone Reports     Open Access  
Bosnian Journal of Basic Medical Sciences     Open Access  
Bozok Tıp Dergisi / Bozok Medical Journal     Open Access  
Brachytherapy     Full-text available via subscription   (Followers: 6)
Brain and Development     Full-text available via subscription   (Followers: 5)
Brain Communications     Open Access   (Followers: 2)
Brain Connectivity     Hybrid Journal   (Followers: 5)
Brain Impairment     Full-text available via subscription   (Followers: 2)
Brazilian Journal of Medical and Biological Research     Open Access  
Brazilian Journal of Medicine and Human Health     Open Access  
Brazilian Journal of Pain (BrJP)     Open Access  
Brazilian Journal of Physical Therapy     Open Access   (Followers: 2)
Breastfeeding Review     Full-text available via subscription   (Followers: 19)
British Journal of Biomedical Science     Full-text available via subscription   (Followers: 7)
British Journal of General Practice     Full-text available via subscription   (Followers: 39)
British Journal of Hospital Medicine     Full-text available via subscription   (Followers: 16)
British Medical Bulletin     Hybrid Journal   (Followers: 6)
Buddhachinaraj Medical Journal     Open Access  
Bulletin Amades     Open Access  
Bulletin de la Société de pathologie exotique     Hybrid Journal   (Followers: 1)
Bulletin of Legal Medicine     Open Access  
Bulletin of Medical Sciences     Open Access  
Bulletin of the History of Medicine     Full-text available via subscription   (Followers: 21)
Bulletin of the Menninger Clinic     Full-text available via subscription  
Bulletin of The Royal College of Surgeons of England     Free  
Bulletin of the Scientific Centre for Expert Evaluation of Medicinal Products     Open Access  
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz     Hybrid Journal   (Followers: 6)
Burapha Journal of Medicine     Open Access  
Burns     Hybrid Journal   (Followers: 10)
Cadernos de Naturologia e Terapias Complementares     Open Access   (Followers: 1)
Calcified Tissue International     Hybrid Journal   (Followers: 2)
Canadian Bulletin of Medical History     Hybrid Journal  
Canadian Family Physician     Partially Free   (Followers: 13)
Canadian Journal of Pain     Open Access   (Followers: 2)
Canadian Journal of Rural Medicine     Full-text available via subscription   (Followers: 1)
Canadian Medical Association Journal     Open Access   (Followers: 18)
Canadian Medical Education Journal     Open Access   (Followers: 10)
Canadian Prosthetics & Orthotics Journal     Open Access  
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 1)
Cardiac Electrophysiology Clinics     Full-text available via subscription   (Followers: 1)
Care Management Journals     Hybrid Journal   (Followers: 5)
Case Reports     Open Access  
Case Reports in Acute Medicine     Open Access   (Followers: 2)
Case Reports in Clinical Medicine     Open Access   (Followers: 2)
Case Reports in Clinical Nutrition     Open Access   (Followers: 1)
Case Reports in Clinical Pathology     Open Access   (Followers: 1)
Case Reports in Medicine     Open Access   (Followers: 3)
Case Reports in Transplantation     Open Access  
Case Reports in Vascular Medicine     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
Case Study and Case Report     Open Access   (Followers: 5)
CASUS : Revista de Investigación y Casos en Salud     Open Access   (Followers: 1)
CBU International Conference Proceedings     Open Access   (Followers: 3)
Cell & Bioscience     Open Access   (Followers: 6)
Cell Adhesion & Migration     Open Access   (Followers: 9)
Cell and Molecular Response to Stress     Full-text available via subscription   (Followers: 2)
Cell and Tissue Transplantation and Therapy     Open Access   (Followers: 2)
Cell Cycle     Full-text available via subscription   (Followers: 6)
Cell Death and Differentiation     Hybrid Journal   (Followers: 8)
Cell Death Discovery     Open Access   (Followers: 1)
Cell Health and Cytoskeleton     Open Access   (Followers: 1)
Cell Medicine     Open Access   (Followers: 6)
Cell Research     Hybrid Journal   (Followers: 8)
Cell Transplantation     Open Access   (Followers: 4)
CEN Case Reports     Hybrid Journal  
Central African Journal of Medicine     Full-text available via subscription  
Cephalalgia Reports     Open Access   (Followers: 2)
Ceylon Journal of Medical Science     Open Access  

  First | 1 2 3 4 5 6 7 8 | Last

Similar Journals
Journal Cover
BMJ Innovations
Journal Prestige (SJR): 0.491
Citation Impact (citeScore): 1
Number of Followers: 6  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Online) 2055-642X
Published by BMJ Publishing Group Homepage  [68 journals]
  • Second generation of intrauterine balloon tamponade: new perspective
    • Authors: Bakri, Y; B-Lynch, C, Alouini, S.
      Pages: 1 - 3
      Keywords: Open access
      PubDate: 2020-03-12T04:24:38-07:00
      DOI: 10.1136/bmjinnov-2019-000404
      Issue No: Vol. 6, No. 1 (2020)
  • Double burden or single duty to care' Health innovators perspectives
           on environmental considerations in health innovation design
    • Authors: Rivard, L; Lehoux, P, Miller, F. A.
      Pages: 4 - 9
      Abstract: ObjectivesThe healthcare sector lags behind other industries in efforts to reduce its environmental footprint. This study aims to better understand how those who design new health technologies (devices, technical aids and information technologies) perceive and address environmental considerations in their practice.MethodsWe conducted in-depth interviews with engineers, industrial designers, entrepreneurs and clinicians (n=31) involved in the design, development and distribution of health innovations in Quebec and Ontario (Canada). A qualitative thematic data analysis identified similarities and variations across respondents’ viewpoints.ResultsInnovators’ views emphasise the following: (1) the double burden of supporting patient care and reducing the environmental impact of healthcare; (2) systemic challenges to integrating environmental considerations in health innovation design, development and use and (3) solutions to foster the development of environmental-friendly health innovations. Although innovators tend to prioritise patient care over the environment, they also call for public policies that can transform these two imperatives into a single duty to care.ConclusionsHealth innovators are uniquely positioned to tackle challenges and develop creative solutions. Policymakers and regulators should, however, actively steer the healthcare industry towards a more sustainable modus operandi by giving full attention to environmental considerations in health innovation design.
      Keywords: Medical devices
      PubDate: 2020-03-12T04:24:38-07:00
      DOI: 10.1136/bmjinnov-2019-000348
      Issue No: Vol. 6, No. 1 (2020)
  • Initial experiences with virtual reality as a tool for observation in
           needs-driven health technology innovation
    • Authors: Perrone, K. H; Blevins, K. S, Denend, L, Fan, R, Huelman, J, Wall, J. K.
      Pages: 10 - 12
      Abstract: The Stanford University Biodesign Innovation Fellowship teaches a needs-based methodology for the innovation of health technologies. This involves the direct observation of patient care in a variety of settings, ranging from the hospital to the home, to identify unmet needs that can be addressed via innovative new technology-based solutions. Expanding this model to educate a larger population of undergraduate and graduate students is limited by access to real clinical observations, partly due to hospital policies and patient privacy concerns. We hypothesise that the use of virtual reality (VR) can be an effective tool to provide students access to a variety of clinical scenarios for identifying needs for innovation. In this preliminary study, two undergraduate students observed clinical care live in the operating room (OR) and using VR headsets. The students identified needs in both settings and compared the two experiences with a short survey. While VR did not offer a complete replication of the OR experience, it served as a viable tool for learning how to make observations. VR merits further investigation as an educational tool for needs finding and as a proxy for live clinical observations.
      Keywords: Medical devices
      PubDate: 2020-03-12T04:24:38-07:00
      DOI: 10.1136/bmjinnov-2018-000308
      Issue No: Vol. 6, No. 1 (2020)
  • Head and neck cancer in the digital age: an evaluation of mobile health
    • Authors: Fleming, J; Jeannon, J.-P.
      Pages: 13 - 17
      Abstract: AimThe technology of online and mobile-based symptom checkers is developing on a background of unprecedented demand for General Practioner (GP) and medical services. This study was performed to assess the performance of popular ‘artificial intelligence’ symptom checkers currently available to the public and evaluate their accuracy as a screening tool for head and neck cancer symptoms.MethodWe selected three of the most popular and previously compared mobile application (app) symptom checkers available including Babylon (London), (London) and Ada (Ada Health GmbH, Munich). A recent Pan-London Suspected Cancer Referral Guide was obtained and distilled into a list of qualifying symptoms for referral to secondary care on a 2-week wait cancer pathway. A generic patient background was devised and each symptom was passed through the selected symptom checker apps. Differential diagnoses and recommended triage times were compared.ResultsOverall a cancer diagnosis was suggested possible in the differential diagnosis in 33% of symptoms. As a screening tool, Babylon was the most accurate for including a potential cancer diagnosis in the differential diagnosis, with a sensitivity of 45% cases, Ada with 32% and 23%. Ada attempted the most diagnoses, able to provide a differential diagnosis in 95% scenarios, but was also the most risk averse triage assessor, with 55% outcomes recommending medical advice immediately or within hours.ConclusionThe ability of modern symptom checkers to promote health awareness and self-checks is promising, but we have identified a number of areas of potential improvement. At present the sensitivity of the tested symptom checker apps remains low for head and neck cancer.
      PubDate: 2020-03-12T04:24:38-07:00
      DOI: 10.1136/bmjinnov-2019-000350
      Issue No: Vol. 6, No. 1 (2020)
  • Attitudes towards digital health tools for outpatient cirrhosis management
           in patients with decompensated cirrhosis
    • Authors: Bloom, P. P; Marx, M, Wang, T. J, Green, B, Ha, J, Bay, C, Chung, R. T, Richter, J. M.
      Pages: 18 - 25
      Abstract: BackgroundTechnology represents a promising tool to improve healthcare delivery for patients with cirrhosis. We sought to assess utilisation of technology and preferred features of a digital health management tool, in patients with an early readmission for decompensated cirrhosis.MethodsWe conducted a cross-sectional study of patients readmitted within 90 days for decompensated cirrhosis. A semistructured interview obtained quantitative and qualitative data through open-ended questions.ResultsOf the 50 participants, mean age was 57.6 years and mean (range) model for end stage liver disease was 22.7 (10–46). Thirty-eight (76%) patients own a Smartphone and 62% have regular access to a computer with internet. Thirty-nine (78%) patients would consider using a Smartphone application to manage their cirrhosis. Forty-six (92%) patients report having a principal caregiver, of which 80% own a Smartphone. Patients were interested in a Smartphone application that could communicate with their physician (85%), send medication notifications to the patient (65%) and caregiver (64%), transmit diagnostic results and appointment reminders (82%), educate about liver disease (79%), regularly transmit weight data to the doctor (85% with ascites) and play a game to detect cognitive decline (67% with encephalopathy). Common themes from qualitative data include a desire to learn about liver disease and communicate with providers via digital tools.ConclusionAmong patients with cirrhosis with an early readmission for decompensation, most have Smartphones and would be willing to use a Smartphone to manage their disease. Future digital health management tools should be tailored to the use patterns and preferences of the patients with cirrhosis and their caregivers.
      PubDate: 2020-03-12T04:24:38-07:00
      DOI: 10.1136/bmjinnov-2019-000369
      Issue No: Vol. 6, No. 1 (2020)
  • Can Alexa, Cortana, Google Assistant and Siri save your life' A
           mixed-methods analysis of virtual digital assistants and their responses
           to first aid and basic life support queries
    • Authors: Picard, C; Smith, K. E, Picard, K, Douma, M. J.
      Pages: 26 - 31
      Abstract: BackgroundVirtual digital assistants are devices that interact with the user through natural language processing and artificial intelligence. They can respond to verbal requests for first aid information. This study analyses the responses provided by the four most common devices.MethodsThis mixed-methods study employs structured interviews of the virtual digital assistants (Alexa, Cortana, Google Home and Siri) as well as descriptive statistical analyses. One hundred and twenty-three interview questions, based on 39 first aid topics, were employed. Responses were analysed for recognition and quality. Detection of query acuity was performed according to triage guidelines and response complexity was calculated.ResultsDevice performance was highly variable. Alexa and Google Home demonstrated high rates of recognition (92% vs 98% (p=0.03)) and low-to-moderate congruence with guidelines (19% vs 56% (p=0.04)). They appropriately recommended emergency response system activation 46% of the time vs 16% (p=0.01) of the time, respectively. The overall low quality responses of Cortana and Siri prohibited their analysis. Mean response complexity for Alexa was ‘grade 10’ vs ‘grade 8’ for Google Home (p
      PubDate: 2020-03-12T04:24:38-07:00
      DOI: 10.1136/bmjinnov-2018-000326
      Issue No: Vol. 6, No. 1 (2020)
  • Electronic notifiable disease reporting system from primary care health
    • Authors: Syed, M. A; Al Mujalli, H, Kiely, C, A/Qotba, H. A, Elawad, K, Ali, D, Idries, A. M, Vilakazi, B.
      Pages: 32 - 38
      Abstract: Communicable disease outbreaks can spread rapidly, causing enormous losses to individual health, national economies and social well-being. Therefore, communicable disease surveillance is essential for protecting public health. In Qatar, electronic reporting from primary health centres was proposed as a means of improving disease notification, replacing a paper-based method of reporting (via internal mail, facsimile, email or telephone), which has disadvantages and requires active cooperation and engagement of staff. This study is a predescriptive and postdescriptive analysis, which compared disease notifications received from electronic and paper-based systems during 3-month evaluation periods (quarter 2 in 2016 and quarter 2 in 2018 for paper-based and electronic reporting, respectively) in terms of comprehensiveness, timeliness and completeness. For the 23 notifiable diseases included in this study, approximately twice as many notifications were received through the electronic reporting system as from the paper-based reporting system, demonstrating it is more comprehensive. An overall increase in notifications is likely to have a positive public health impact in Qatar. 100% of electronic notifications were received in a timely manner, compared with 28% for paper-based notifications. Findings of the study show that electronic reporting presents a revolutionary opportunity to advance public health surveillance. It is recommended that electronic reporting be rolled out more widely to improve the completeness, stability and representativeness of the national public health surveillance system in Qatar as well as other countries.
      Keywords: Assistive technologies
      PubDate: 2020-03-12T04:24:38-07:00
      DOI: 10.1136/bmjinnov-2018-000329
      Issue No: Vol. 6, No. 1 (2020)
  • Switching among branded and generic medication products during ongoing
           treatment of psychiatric illness
    • Authors: Habert, J; Margolese, H. C, Wilson, A, Boucher, M, Blier, P.
      Pages: 39 - 43
      Abstract: Switches between branded (reference) medications and the corresponding generic medications or between two different corresponding generic medications occur commonly during the treatment of central nervous system disorders. Prescribing a generic product in place of a reference product can reduce patient and pharmacy costs. But there can be implications. Planned or unplanned switches from one product to another during ongoing treatment may introduce variability in drug exposure which could in turn compromise efficacy and/or tolerability. Studies comparing the initiation of reference versus generic products do not provide clear evidence of the superiority of reference or generic products generally, whereas several studies examining a switch between reference and generic products suggest that reductions in efficacy or medication adherence and persistence may be associated with generic substitution. Clinicians should work with patients to facilitate a consistent supply of reference or generic drug product that provides stable exposure to avoid clinical deterioration or poor tolerability.
      Keywords: Open access
      PubDate: 2020-03-12T04:24:38-07:00
      DOI: 10.1136/bmjinnov-2019-000370
      Issue No: Vol. 6, No. 1 (2020)
  • Administration of aspirin tablets using a novel gel-based swallowing aid:
           an open-label randomised controlled cross-over trial
    • Authors: Wright, D. J; Potter, J. F, Clark, A, Blyth, A, Maskrey, V, Mencarelli, G, Wicks, S. O, Craig, D. Q. M.
      Pages: 113 - 119
      Abstract: IntroductionTo ease administration of medicines to people with dysphagia we developed and patented a gel formulation within which whole tablets could be inserted. The aim was to determine whether the gel would affect bioequivalence of uncoated aspirin tablet.MethodA gel containing gelatin, hydroxypropylmethylcellulose, citric acid, potassium sorbate and water was developed to maintain structure on tablet insertion and increase saliva production to lubricate the swallow.In an open-label cross-over trial 12 healthy male volunteers were administered a 300 mg uncoated aspirin tablet with and without gel with a 7-day washout period. Blood salicylate levels, platelet activity and patient satisfaction were measured over 2 hours. Analysis was based on a random effects cross-over model.ResultsThe estimated mean ratio (90% CI) of effect on salicylate levels when comparing administration with and without gel was 0.77 (90% CI 0.40 to 1.47) for amount absorbed and 0.76 (90% CI 0.44 to 1.31) and on total ASP-arachidonic acid platelet activity 1.16 (90% CI 0.88 to 1.53) and maximum ASP-arachidonic platelet activity 0.98 (90% CI 0.79 to 1.22). These results are outside of the range allowable for the assumption of bioequivalence. Participants rated the taste of aspirin tablets significantly better when encapsulated in the gel (p
      Keywords: Open access, Medical devices
      PubDate: 2019-12-26T03:25:20-08:00
      DOI: 10.1136/bmjinnov-2018-000293
      Issue No: Vol. 5, No. 4 (2019)
  • Usability testing of a smartphone-based retinal camera among first-time
           users in the primary care setting
    • Authors: Li, P; Paulus, Y, Davila, J, Gosbee, J, Margolis, T, Fletcher, D, Kim, T.
      Pages: 120 - 126
      Abstract: Smartphone-based retinal photography is a promising method for increasing accessibility of retinal screening in the primary care and community settings. Recent work has focused on validating its use in detection of diabetic retinopathy. However, retinal imaging can be technically challenging and additional work is needed to improve ease of retinal imaging in the primary care setting. We, therefore, performed usability testing of a smartphone-based retinal camera, RetinaScope, among medical assistants in primary care who had never performed retinal imaging. A total of 24 medical assistants performed first-time imaging in a total of five rounds of testing, and iterative improvements to the device were made between test rounds based on the results. The time to acquire a single ~50° image of the posterior pole of a model eye decreased from 283±60 s to 34±17 s (p
      Keywords: Medical devices
      PubDate: 2019-12-26T03:25:20-08:00
      DOI: 10.1136/bmjinnov-2018-000321
      Issue No: Vol. 5, No. 4 (2019)
  • DHOW2 score leads to significant improvement in acute stroke care
           management emergency department: a prospective analysis
    • Authors: Akhtar, N; Salam, A, Bourke, P, Kamran, S, Bhutta, Z, Joseph, S, Santos, M, Morgan, D, Thomas, S, Ajwad Butt, A, Shuaib, A.
      Pages: 127 - 134
      Abstract: BackgroundDelays in transfer of patients from emergency department (ED) to stroke ward increases medical complications. We evaluate if a new risk-score ‘DHOW2’ (dysphagia, hemiplegia, observation-required, wet (incontinence) and weight) will identify high-risk patients and whether expedited admission of ‘high-DHOW2’ score patients to SW will result in fewer complications.MethodsThe DHOW2 score was designed to determine risk of complications following acute stroke. Phase I (279 patients) tested rates of complications with increasing DHOW2. Phase II (1091 patients), evaluated if early admission to the SW of high-DHOW2 patients will lead to fewer complications. Phase III (1257 patients) monitored implementation of the DHOW2 following completion of the study.FindingsMedical complications increased with higher-DHOW2 scores during all three phases; 0%–0.8% with DHOW2 of ≤3, 3.1%–6.5% with DHOW2 of 4–5 and 10.9%–14.1% with DHOW2 of ≥6 (p=
      PubDate: 2019-12-26T03:25:20-08:00
      DOI: 10.1136/bmjinnov-2018-000340
      Issue No: Vol. 5, No. 4 (2019)
  • Correction: Paediatric neurorehabilitation: finding and filling the gaps
           through the use of the Institute for manufacturing strategic roadmapping
    • Pages: 135 - 135
      Keywords: Open access
      PubDate: 2019-12-26T03:25:20-08:00
      DOI: 10.1136/bmjinnov-2017-000202corr1
      Issue No: Vol. 5, No. 4 (2019)
  • Lifestyle medicine and use of technology in current healthcare
    • Authors: Wani R. T.
      Pages: 135 - 135
      Abstract: Lifestyle medicine is growing at a rapid pace globally and for its advent, the use of technology is still wavy. With the boom in technology, healthcare related technology has become inconspicuous and an obligatory component for improvisation of lifestyle medicine. The spread of lifestyle medicine has to go hand in hand with technology utilisation for research purpose as well as for practicing lifestyle medicine. There is a biassed opinion among masses against technology for disturbing the lifestyle of current generation. Since a lot has been written and propagated against technology in lifestyle medicine, there is a need to highlight the benefits of technology in lifestyle medicine and how it can improve the clinical practice of lifestyle medicine physicians. For this purpose, research and practice to use these devices should go together for benefit and spread of lifestyle medicine.
      PubDate: 2019-12-26T03:25:20-08:00
      DOI: 10.1136/bmjinnov-2019-000345
      Issue No: Vol. 5, No. 4 (2019)
  • Whats wrong with WhatsApp'
    • Authors: Hyder, S; Hatton, R, Tolley, K, Hillier, J.
      Pages: 67 - 69
      PubDate: 2019-12-30T22:27:54-08:00
      DOI: 10.1136/bmjinnov-2018-000290
      Issue No: Vol. 5, No. 2-3 (2019)
  • Incubator traffic light: the development of an alcohol-based hand rub
           dispenser system for neonatal incubators with visual feedback to improve
           hand hygiene compliance
    • Authors: van Gils, R. H. J; Helder, O. K, Wauben, L. S. G. L.
      Pages: 70 - 77
      Abstract: IntroductionSustained high compliance with hand hygiene prior to patient contact in a neonatal intensive care unit (NICU) could reduce the spread of pathogens and incidence of bloodstream infections of preterm infants. These infections are associated with high mortality, morbidity and additional costs. Behaviour change interventions to promote hand hygiene, such as education, have only temporary beneficial effect on compliance. Our aim is to develop a technical intervention that supports a sustainable behaviour change for appropriate hand hygiene among NICU healthcare professionals.MethodsStudents from different disciplines incrementally designed and evaluated solutions in co-creation with healthcare professionals of a NICU in a teaching hospital.ResultsA prototype of the ‘Incubator Traffic Light’ system for neonatal incubators was developed, that is, a touchless alcohol-based hand rub (ABHR) dispenser with integrated colour display and incubator door sensor with lights. The system provides visual feedback to support healthcare professionals’ compliance with the prescribed 30 s drying time for ABHR. After 30 s, green lights indicate that the incubator doors may be opened. In the event that doors are opened without dispensing ABHR or earlier than 30 s, blinking orange lights and a display message urge the person to close the doors. The system documents compliance data in a web-based database.ConclusionsWe developed a sophisticated technical intervention to support hand hygiene compliance. It is ready for clinical tests that should prove that the system contributes to sustainable hand hygiene compliance near neonatal incubators.
      Keywords: Open access, Medical devices
      PubDate: 2019-12-30T22:27:54-08:00
      DOI: 10.1136/bmjinnov-2018-000301
      Issue No: Vol. 5, No. 2-3 (2019)
  • S-Vest: a novel hybrid method to allow standardised patients to put on the
           objective physical examination findings of a disease
    • Authors: Berg, D; Berg, K.
      Pages: 78 - 81
      Abstract: BackgroundSimulation hybrids combine single modality simulation such as simulated patients (SP) with low-fidelity simulation to create a potentially more powerful set of educational tools. To make a hybrid that is credible, standardised and inexpensive remains a challenge. We describe the development of the simulation vest (S-Vest), an inexpensive, standardised teaching tool that is ‘worn’ by an SP to form a hybrid.MethodsWe have created a vest which contains a set of speakers placed in an anatomical manner and produce sounds. The sounds played from a multitrack audio player are recorded in vivo from a patient with the real disease findings. The SP provides history while the vest provides the objective palpable and auscultatory findings. The speakers are placed in the routine standardised locations taught in physical examination.ResultsWe have developed several case scenarios designed for the vest. One of these cases is an elderly patient with aortic stenosis. The aortic stenosis case audio file has four unique tracks recorded over the precordium. Each track is played at the speaker appropriate to the physical exam findings. The SP plays an elderly man with chest pain. The vest provides the sounds of a loud systolic murmur with marked diminishment of S2 and a palpable thrill.ConclusionsThe S-Vest is a low-fidelity, low-cost simulator to use in hybrid and simulation. The S-Vest can be used in a formative and summative Objective Structured Clinical Examination (OSCE) station and in skills attainment for learners in healthcare. We believe these tools will be of significant import to teaching clinical skills.
      Keywords: Open access, Diagnostics
      PubDate: 2019-12-30T22:27:54-08:00
      DOI: 10.1136/bmjinnov-2018-000312
      Issue No: Vol. 5, No. 2-3 (2019)
  • Subclinical ochronosis features in alkaptonuria: a cross-sectional study
    • Authors: Cox, T; Psarelli, E. E, Taylor, S, Shepherd, H. R, Robinson, M, Barton, G, Mistry, A, Genovese, F, Braconi, D, Giustarini, D, Rossi, R, Santucci, A, Khedr, M, Hughes, A, Milan, A, Taylor, L. F, West, E, Sireau, N, Dillon, J. P, Rhodes, N, Gallagher, J. A, Ranganath, L.
      Pages: 82 - 91
      Abstract: BackgroundAlkaptonuria (AKU) is present from birth, yet clinical effects are considered to appear later in life. Morbidity of AKU, considered irreversible, is secondary to ochronosis. Age of ochronosis onset is not clearly known. Nitisinone profoundly lowers homogentisic acid (HGA), the metabolic defect in AKU. Nitisinone also arrests ochronosis and slows progression of AKU. However, tyrosinaemia post-nitisinone has been associated with corneal keratopathy, rash and cognitive impairment in HT 1. The optimal time to start nitisinone in AKU is unknown.MethodsIn an open, cross-sectional, single-site study, 32 patients with AKU were to be recruited. The primary outcome was presence of ochronosis in an ear biopsy. Secondary outcomes included analysis of photographs of eyes/ears, serum/urine HGA, markers of tissue damage/inflammation/oxidation, MRI imaging, gait, quality of life and Alkaptonuria Severity Score Index (qAKUSSI).ResultsThirty patients, with mean age (SD) 38 (14) years, were recruited. Percentage pigmentation within ear biopsies increased with age. Ear pigmentation was detected in a 20-year-old woman implying ochronosis can start in patients before the age of 20. Gait and qAKUSSI were outside the normal range in all the patients with AKU.ConclusionsOchronosis can be present before age 20 years.
      Keywords: Diagnostics
      PubDate: 2019-12-30T22:27:54-08:00
      DOI: 10.1136/bmjinnov-2018-000324
      Issue No: Vol. 5, No. 2-3 (2019)
  • Innovating in healthcare delivery: a systematic review and a
           preference-based framework of patient and provider needs
    • Authors: Salama, J. S; Lee, A, Afshin, A.
      Pages: 92 - 100
      Abstract: Healthcare innovation is becoming a popular but poorly defined option for those who are seeking new ways of reducing costs while also improving the quality of care. The process of innovating in healthcare delivery can be improved by identifying and understanding the unmet needs of patients and providers. We conducted two systematic literature reviews to identify the needs of these stakeholders throughout healthcare delivery and developed a conceptual framework for innovating in healthcare. Our results reveal tension between patients’ and providers’ preferences across three major categories—treatment and outcomes, process of care and structure of care. Therefore, innovating in healthcare may be better understood as addressing the unmet needs of each stakeholder by easing or eliminating tensions between stakeholders. This conceptual framework may serve as a useful instrument for health policymakers, payers and innovators to alike make better decisions as they invest in healthcare innovations.
      Keywords: Health IT, systems and process innovations
      PubDate: 2019-12-30T22:27:54-08:00
      DOI: 10.1136/bmjinnov-2018-000334
      Issue No: Vol. 5, No. 2-3 (2019)
  • Evaluating patient attitudes and barriers towards smart technology for
           cardiac monitoring: results from a prospective multicentre study
    • Authors: Koshy, A. N; Ko, J, Sajeev, J. K, Rajakariar, K, Roberts, L, Cooke, J, Teh, A. W.
      Pages: 101 - 107
      Abstract: ObjectivesRemote assessment of heart rate and rhythm using smart technology (ST) holds promise in screening and monitoring of atrial fibrillation (AF). However, patient engagement is paramount to the success of ST interventions.MethodsWe assessed the attitudes and potential barriers towards ST for arrhythmia monitoring in an elderly, multimorbidity cohort. Consecutive inpatients were recruited across three hospitals and administered a standardised survey regarding attitudes towards ST for arrhythmia detection.ResultsOf 363 participants (median age 68 years (IQR: 55–80 years), mean CHA2DS2VASC score 3±2), 68.9% were interested in ST for cardiac monitoring. Those with underlying AF (n=112) and younger (
      Keywords: mHealth and wearable health technologies
      PubDate: 2019-12-30T22:27:54-08:00
      DOI: 10.1136/bmjinnov-2018-000336
      Issue No: Vol. 5, No. 2-3 (2019)
  • Entrepreneurship for a meaningful clinical experience
    • Authors: Beninger, P; Li, D, Baaj, A.
      Pages: 1 - 7
      PubDate: 2019-09-09T00:18:52-07:00
      DOI: 10.1136/bmjinnov-2018-000295
      Issue No: Vol. 5, No. 1 (2019)
  • A novel device for rapid, safe and precise delivery of intravitreal
    • Authors: Waqar, S; Ayaz, A, Karamat, I, Anwar, S, McLeod, J, McLeod, A.
      Pages: 8 - 12
      Abstract: BackgroundDelivery of therapeutic agents via intravitreal (IVT) injections is well established as the mainstay of treatment for many ophthalmic conditions. High demand means that injections are increasingly being delivered either by ophthalmic nurse practitioners (UK) or by ophthalmologists in office-based settings (North America/mainland Europe). Most patients require frequent IVT injections, and there is a need to make the procedure more comfortable and safe.MethodsWe describe a novel device designed to ensure rapid, safe and precise delivery of injections while improving the patient experience. In addition, we present details of a local National Health Service pathway initiated to facilitate clinician-led innovations. It is hoped that this model can also be replicated internationally. We also present results from two sites: one, comparing outcomes of 25 patients who received the injection with the device, against 25 patients who received injections using the current standard method; the other a retrospective notes evaluation of 60 patients injected with the device.ResultsNo adverse events were noted and the device appears to be well tolerated by patients. Use of the guide did not result in a statistically significant increase in pain (p value> 0.05) but the mean score (on a unidimensional numerical rating scale) was noted to be slightly better. All patients gave very positive informal feedback.ConclusionsWe have described the design process and successful early-use results of a novel device developed to facilitate safe, precise and rapid delivery of IVT injections by both ophthalmologists and allied health professionals.
      Keywords: Medical devices
      PubDate: 2019-09-09T00:18:52-07:00
      DOI: 10.1136/bmjinnov-2018-000337
      Issue No: Vol. 5, No. 1 (2019)
  • Simple point of care continuous positive airway pressure delivery device
    • Authors: Jain, A; DiBlasi, R. M, Devgan, V, Kumari, N, Kalra, K.
      Pages: 13 - 19
      Abstract: ObjectiveTo describe the effective pressure and FiO2 delivery to a realistic spontaneously breathing lung model using a novel, simple, inexpensive neonatal non-invasive bubble continuous positive airway pressure (CPAP) device.MethodsThis experimental bench study was conducted at Bench Testing Laboratory at a Children’s Hospital. A realistic 3D anatomic airway model of a 28-week preterm neonate was affixed to the ASL5000 Test Lung to simulate spontaneous breathing with lung mechanics that are specific to a preterm neonate. The assembly was constructed on site using easily available nasal prongs, paediatric infusion set with a graduated chamber, three-way stop cocks and oxygen tubing. The adult nasal prong was used as cannulae. However, this assembly had the limitation of the lack of humidification and inability to deliver graduated oxygen. This assembly was attached to the anatomic airway with nasal prongs. Pressure and FiO2 were measured from within the lung model at different flow settings and recorded for 10 breaths.ResultsThere was a linear increase in the mean pressure in the 10 recorded breaths as oxygen flows were increased.ConclusionsOur nasal CPAP is a simple device, as it can be easily assembled at the point of care using simple, affordable supplies by the healthcare providers and can benefit the newborns with respiratory distress in the resource constraint settings.
      Keywords: Medical devices
      PubDate: 2019-09-09T00:18:52-07:00
      DOI: 10.1136/bmjinnov-2018-000339
      Issue No: Vol. 5, No. 1 (2019)
  • Analytical accuracy of the handheld PICO monitoring device during
    • Authors: Renier, W. S; Erard, K, Sabbe, M, Hubloue, I, Verbakel, J. Y, Aertgeerts, B, Buntinx, F.
      Pages: 20 - 27
      Abstract: IntroductionGeneral practitioners (GP) use few technical devices during emergency situations. They have to recognise which patients have a life-threatening disease in order to treat or refer them appropriately. Monitoring by a wearable device could help GPs while waiting for the emergency physician to arrive. The PICO monitor is a handheld monitoring device, capable of registering five routine parameters and small enough to be carried in the GP’s bag. We aim to determine the analytical accuracy of the PICO monitor in adults, comparing the recorded vital signs and ECGs of the PICO with those of a standard emergency department (ED) monitor.MethodsAdult (≥18 years) patients, admitted on two inpatient university EDs in Belgium, were recruited. We recorded the SpO2, heart rate (HR), respiration rate (RR), temperature (T°) and 5-lead ECGs. We analysed the correlation and agreement between the continuous and dichotomous variables of the PICO and the ED monitors.ResultsWe included 226 patients (84% of 268 approached), mean age 66 years, 61% were men. The Bland and Altman analysis confirmed the good accuracy, giving a nearly perfect agreement for SpO2 (difference —0.9%), for HR (–1.5 beats), for RR between the monitors (0.1 breaths), for RR between the manually counted and the PICO or the monitor (respectively 0.2 and 0.0 breaths), also confirmed by the regression analysis (Passing-Bablok). Analysis of 219 ECG records provided a near perfect agreement between the devices (kappa respectively 0.61–0.80 and 0.81–1.00) for the most important ECG abnormalities. In none of the comparisons, differences were clinically relevant.ConclusionWe were able to confirm the analytical accuracy of the PICO monitor in comparison with the ED monitors. The PICO monitor can be considered a reliable device for monitoring patients during emergencies by GPs and even in ambulances or EDs as a mobile alternative.
      Keywords: Medical devices
      PubDate: 2019-09-09T00:18:52-07:00
      DOI: 10.1136/bmjinnov-2018-000282
      Issue No: Vol. 5, No. 1 (2019)
  • SMS behaviour change communication and eVoucher interventions to increase
           uptake of cervical cancer screening in the Kilimanjaro and Arusha regions
           of Tanzania: a randomised, double-blind, controlled trial of effectiveness
    • Authors: Erwin, E; Aronson, K. J, Day, A, Ginsburg, O, Macheku, G, Feksi, A, Oneko, O, Sleeth, J, Magoma, B, West, N, Marandu, P. D, Yeates, K.
      Pages: 28 - 34
      Abstract: BackgroundCervical cancer, although almost entirely preventable through cervical cancer screening (CCS) and human papillomavirus vaccination, is the leading cause of cancer deaths among women in Tanzania. Barriers to attending CCS include lack of awareness of CCS, affordability concerns regarding screening and travel cost. We aimed to compare the effectiveness of SMS (short message service) behaviour change communication (BCC) messages and of SMS BCC messages delivered with a transportation electronic voucher (eVoucher) on increasing uptake of CCS versus the control group.MethodsDoor-to-door recruitment was conducted between 1 February and 13 March 2016 in randomly selected enumeration areas in the catchment areas of two hospitals, one urban and one rural, in Northern Tanzania. Women aged 25–49 able to access a mobile phone were randomised using a computer-generated 1:1:1 sequence stratified by urban/rural to receive either (1) 15 SMS, (2) an eVoucher for return transportation to CCS plus the same SMS, or (3) one SMS informing about the nearest CCS clinic. Fieldworkers and participants were masked to allocation. All areas received standard sensitisation including posters, community announcements and sensitisation similar to community health worker (CHW) sensitisation. The primary outcome was attendance at CCS within 60 days of randomisation.FindingsParticipants (n=866) were randomly allocated to the BCC SMS group (n=272), SMS + eVoucher group (n=313), or control group (n=281), with 851 included in the analysis (BCC SMS n=272, SMS + eVoucher n=298, control group n=281). By day 60 of follow-up, 101 women (11.9%) attended CCS. Intervention group participants were more likely to attend than control group participants (SMS + eVoucher OR: 4.7, 95% CI 2.9 to 7.4; SMS OR: 3.0, 95% CI 1.5 to 6.2).Trial registration number NCT02680613.
      Keywords: Open access, mHealth and wearable health technologies
      PubDate: 2019-09-09T00:18:52-07:00
      DOI: 10.1136/bmjinnov-2018-000276
      Issue No: Vol. 5, No. 1 (2019)
  • Development of an online secondary prevention programme for stroke
           survivors: Prevent 2nd Stroke
    • Authors: Denham, A. M. J; Guillaumier, A, McCrabb, S, Turner, A, Baker, A. L, Spratt, N. J, Pollack, M, Magin, P, Oldmeadow, C, Collins, C, Callister, R, Wallis, M, Wynne, O, Bonevski, B.
      Pages: 35 - 42
      Abstract: BackgroundStroke events often result in long-term negative health outcomes. People who experience a first stroke event are 30%–40% more likely to experience a second stroke event within 5 years. An online secondary prevention programme for stroke survivors may help stroke survivors improve their health risk behaviours and lower their risk of a second stroke.ObjectivesThis paper describes the development and early iteration testing of the usability and acceptability of an online secondary prevention programme for stroke survivors (Prevent 2nd Stroke, P2S). P2S aims to address six modifiable health risk behaviours of stroke: blood pressure, physical activity, nutrition, depression and anxiety, smoking, and alcohol consumption.MethodsP2S was developed as an eight-module online secondary prevention programme for stroke survivors. Modelled on the DoTTI (Design and development, Testing early iterations, Testing for effectiveness, Integration and implementation) framework for the development of online programmes, the following stages were followed during programme development: (1) content development and design; and (2) testing early iteration. The programme was pilot-tested with 15 stroke survivors who assessed P2S on usability and acceptability.ResultsIn stage 1, experts provided input for the content development of P2S. In stage 2, 15 stroke survivors were recruited for usability testing of P2S. They reported high ratings of usability and acceptability of P2S. P2S was generally regarded as ‘easy to use’ and ‘relevant to stroke survivors’. Participants also largely agreed that it was appropriate to offer lifestyle advice to stroke survivors through the internet.ConclusionsThe study found that an online secondary prevention programme was acceptable and easily usable by stroke survivors. The next step is to conduct a randomised controlled trial to assess the effectiveness of the programme regarding behaviour change and determine the cost-effectiveness of the intervention.
      Keywords: Assistive technologies
      PubDate: 2019-09-09T00:18:52-07:00
      DOI: 10.1136/bmjinnov-2017-000257
      Issue No: Vol. 5, No. 1 (2019)
  • Co-creation of patient engagement quality guidance for medicines
           development: an international multistakeholder initiative
    • Authors: Deane, K; Delbecque, L, Gorbenko, O, Hamoir, A. M, Hoos, A, Nafria, B, Pakarinen, C, Sargeant, I, Richards, D. P, Skovlund, S. E, Brooke, N, on behalf of the PFMD Patient Engagement Meta-framework Co-creation Team
      Pages: 43 - 55
      Abstract: IntroductionMeaningful patient engagement (PE) can enhance medicines’ development. However, the current PE landscape is fragmentary and lacking comprehensive guidance.MethodsWe systematically searched for PE initiatives (SYNaPsE database/publications). Multistakeholder groups integrated these with their own PE expertise to co-create draft PE Quality Guidance which was evaluated by public consultation. Projects exemplifying good PE practice were identified and assessed against PE Quality Criteria to create a Book of Good Practices (BOGP).ResultsSeventy-six participants from 51 organisations participated in nine multistakeholder meetings (2016–2018). A shortlist of 20relevant PE initiatives (from 170 screened) were identified. The co-created INVOLVE guidelines provided the main framework for PE Quality Guidance and was enriched with the analysis of the PE initiatives and the PE expertise of stakeholders. Seven key PE Quality Criteria were identified. Public consultation yielded 67 responses from diverse backgrounds. The PE Quality Guidance was agreed to be useful for achieving quality PE in practice, understandable, easy to use, and comprehensive. Overall, eight initiatives from the shortlist and from meeting participants were selected for inclusion in the BOGP based on demonstration of PE Quality Criteria and willingness of initiative owners to collaborate.DiscussionThe PE Quality Guidance and BOGP are practical resources which will be continually updated in response to user feedback. They are not prescriptive, but rather based on core principles, which can be applied according to the unique needs of each interaction and initiative. Implementation of the guidance will facilitate improved and systematic PE across the medicines’ development lifecycle.
      Keywords: Open access, Health IT, systems and process innovations
      PubDate: 2019-09-09T00:18:52-07:00
      DOI: 10.1136/bmjinnov-2018-000317
      Issue No: Vol. 5, No. 1 (2019)
  • Mining Twitter to understand the cardiac rehabilitation barriers and
           patients perceptions
    • Authors: Krittanawong, C; Tunhasiriwet, A, Zhang, H, Aydar, M, Sun, T, Hassan Virk, H. U, Herzog, E.
      Pages: 56 - 59
      Abstract: Cardiovascular disease (CVD) is the most common cause of death worldwide. Cardiac rehabilitation (CR) is increasingly recognised as an essential part of clinical care for patients with CVD. CR is a complex intervention that encompasses a multidisciplinary approach that focuses on health education, modification of cardiovascular risk factors, exercise training, physical activity and stress management. In the current American Heart Association/American College of Cardiology guidelines, cardiac rehabilitation is a class IA recommendation for secondary prevention of acute myocardial infarction, percutaneous coronary intervention and cardiac surgery and Class II recommendation for chronic stable heart failure. Despite proven effectiveness, however, participation in traditional CR remains low. Although the reasons for participation and non-participation in CR have been well described, the use of Twitter to explore public perceptions of CR has not yet been formally reported. To the best of our knowledge, the analysis of Twitter for insights on CR is a novel investigation that is relevant for addressing significant problems related to CR awareness in the digital age.We performed data mining of Twitter to assess patients’ perceptions regarding CR and the reasons for their participation and non-participation in CR between 23 July 2015 and 22 October 2017.We analysed a total of 5515 Twitter messages. Tweets associated with CR were often used to self-report on health status either before or after participating in CR or contained emotional language with positive or negative comments, advertisements or updated news.Twitter users wrote mainly positive comments about CR, suggesting the platform has the potential to disseminate both the benefits of CR and its research to the public on the worldwide scale.
      Keywords: Health IT, systems and process innovations
      PubDate: 2019-09-09T00:18:52-07:00
      DOI: 10.1136/bmjinnov-2018-000294
      Issue No: Vol. 5, No. 1 (2019)
  • Telephone announcements encouraging common cold self-management reduce
           demand for general practice appointments
    • Authors: Kerr, R; Grainger, A, Messer, C, Kerr, H.
      Pages: 60 - 64
      Abstract: BackgroundPatients consulting with the common cold contribute to seasonal demand for general practice appointments. Seeing a community pharmacist or using self-management may have been more appropriate options. The study aimed to measure if the use of telephone announcements signposting appropriate patients with the common cold in the direction of community pharmacy or self-management reduced demand for general practice consultations.MethodsPatients telephoning a UK general practice to request an appointment between December 2017 and March 2018 heard announcements regarding management of the common cold. The percentage of callers choosing to continue to speak to a receptionist was compared with baseline data prior to the intervention. The mean waiting time to the third available routine general practice appointment during the intervention was compared with the previous year.ResultsRoutine calls continuing to reception reduced by 5.5 % (p
      Keywords: Open access, Health IT, systems and process innovations
      PubDate: 2019-09-09T00:18:52-07:00
      DOI: 10.1136/bmjinnov-2018-000328
      Issue No: Vol. 5, No. 1 (2019)
  • Correction: Accelerated in vitro model for occlusion of biliary stents:
           investigating the role played by dietary fibre
    • Pages: 64 - 64
      PubDate: 2019-09-09T00:18:52-07:00
      DOI: 10.1136/bmjinnov-2017-000209corr1
      Issue No: Vol. 5, No. 1 (2019)
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