SummaryIntroduction: While studies have shown that usability evaluation could uncover many design problems of health information systems, the usability of health information systems in developing countries using their native language is poorly studied. The objective of this study was to evaluate the usability of a nationwide inpatient information system used in many academic hospitals in Iran. Material and Methods: Three trained usability evaluators independently evaluated the system using Nielsen's 10 usability heuristics. The evaluators combined identified problems in a single list and independently rated the severity of the problems. We statistically compared the number and severity of problems identified by HIS experienced and non-experienced evaluators. Results: A total of 158 usability problems were identified. After removing duplications 99 unique problems were left. The highest mismatch with usability principles was related to "Consistency and standards" heuristic (25%) and the lowest related to "Flexibility and efficiency of use" (4%). The average severity of problems ranged from 2.4 (Major problem) to 3.3 (Catastrophe problem). The experienced evaluator with HIS identified significantly more problems and gave higher severities to problems (p<0.02). Discussion: Heuristic Evaluation identified a high number of usability problems in a widely used inpatient information system in many academic hospitals. These problems, if remain unsolved, may waste users' and patients' time, increase errors and finally threaten patient's safety. Many of them can be fixed with simple redesign solutions such as using clear labels and better layouts. This study suggests conducting further studies to confirm the findings concerning effect of evaluator experience on the results of Heuristic Evaluation.
Background The most common gender-specific malignancies are cancers of the breast and the prostate. In developing countries, cancer screening of all at risk is impractical because of healthcare resource limitations. Thus, determining high-risk areas might be an important first screening step. This study explores incidence patterns of potential high-risk clusters of breast and prostate cancers in southern Iran. Methods This cross-sectional study was conducted in the province of Kerman, South Iran. Patient data were aggregated at the county and district levels calculating the incidence rate per 100,000 people both for cancers of the breast and the prostate. We used the natural-break classification with five classes to produce descriptive maps. A spatial clustering analysis (Anselin Local Moran’s I) was used to identify potential clusters and outliers in the pattern of these cancers from 2014 to 2017. Results There were 1350 breast cancer patients (including, 42 male cases) and 478 prostate cancer patients in the province of Kerman, Iran during the study period. After 45 years of age, the number of men with diagnosed prostate cancer increased similarly to that of breast cancer for women after 25 years of age. The age-standardised incidence rate of breast cancer for women showed an increase from 29.93 to 32.27 cases per 100,000 people and that of prostate cancer from 13.93 to 15.47 cases per 100,000 during 2014–2017. Cluster analysis at the county level identified high-high clusters of breast cancer in the north-western part of the province for all years studied, but the analysis at the district level showed high-high clusters for only two of the years. With regard to prostate cancer, cluster analysis at the county and district levels identified high-high clusters in this area of the province for two of the study years. Conclusions North-western Kerman had a significantly higher incidence rate of both breast and prostate cancer than the average, which should help in designing tailored screening and surveillance systems. Furthermore, this study generates new hypotheses regarding the potential relationship between increased incidence of cancers in certain geographical areas and environmental risk factors.
Background:The most common gender-specific malignancies are cancers of the breast and the prostate. In developing countries, cancer screening of all at risk is impractical because of healthcare resource limitations. Thus, determining high-risk areas might be an important first screening step. This study explores incidence patterns of potential high-risk clusters of breast and prostate cancers in southern Iran.Methods:This cross-sectional study was conducted in the province of Kerman, South Iran. Patient data were aggregated at the county and district levels calculating the incidence rate per 100,000 people both for cancers of the breast and the prostate. We used the natural-break classification with five classes to produce descriptive maps. A spatial clustering analysis (Anselin Local Moran’s I) was used to identify potential clusters and outliers in the pattern of these cancers from 2014 to 2017.Results:There were 1,350 breast cancer patients (including, 42 male cases) and 478 prostate cancer patients in the province of Kerman, Iran during the study period. After 45 years of age, the number of men with diagnosed prostate cancer increased similarly to that of breast cancer for women after 25 years of age. The age-standardised incidence rate of breast cancer showed an increase from 29.93 to 32.27 cases per 100,000 people and that of prostate cancer from 13.93 to 15.47 cases per 100,000 during 2014-2017. Cluster analysis at the county level identified high-high clusters of breast cancer in the north-western part of the province for all years studied, but the analysis at the district level showed high-high clusters for only two of the years. With regard to prostate cancer, cluster analysis at the county and district levels identified high-high clusters in this area of the province for two of the study years.Conclusions:North-western Kerman had a significantly higher incidence rate of both breast and prostate cancer than the average, which should help in designing tailored screening and surveillance systems. Furthermore, this study generates new hypotheses regarding the potential relationship between increased incidence of cancers in certain geographical areas and environmental risk factors.
Introduction: Lack of a proper method for early detection and diagnostic errors in medicine are some fundamental problems in treating cancer. Data analysis techniques may significantly help early diagnosis. The current study aimed at applying and evaluating neural networks and decision tree algorithm on breast cancer patients' data for early cancer prediction. Methods: In the current study, data from Breast Cancer Research Cancer (BCRC), ACE-CR (the Academic Center for Education, Culture and Research) were used consisting of data from 4004 patients with breast cancer risk factors. Of all records, 1642 (41%) were related to malignant changes and breast cancer and 2362 (59%) were related to benign tumors. Data were analyzed by neural networks perceptrons and decision tree algorithm and divided into two parts for training (70%) and testing (30%) using Rapid Miner 5.2. Results: For decision tree, accuracy of 81.62%, specificity of 79.80%, sensitivity of 89.49%, and for neural network, accuracy of 81.62%, specificity of 89.99%, and sensitivity of 90.80% were reported. Results showed acceptable capabilities to analyze breast cancer data for both algorithms. Conclusions: Although both models provided good results, neural network showed better diagnosis for positive cases. Database type and analysis method influenced the results. On the other hand, information about more powerful risk factors of breast cancer can provide models with high coverage.
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