Application of biomedical informatics to chronic pediatric diseases: a systematic review

Abstract

BackgroundChronic diseases affect millions of children worldwide leading to substantial disease burden to the children and their families as well as escalating health care costs. The increasing trend in the prevalence of complex pediatric chronic diseases requires innovative and optimal delivery of care. Biomedical informatics applications play an important role in improving health outcomes while being cost-effective. However, their utility in pediatric chronic diseases has not been studied in a comprehensive and systematic way. The objective of this study was to conduct a systematic review of the effects of biomedical informatics applications in pediatric chronic diseases.MethodsA comprehensive literature search was conducted using MEDLINE, the Cochrane Library and EMBASE databases from inception of each database to September 2008. We included studies of any methodological type and any language that applied biomedical informatics to chronic conditions in children and adolescents 18 years of age or younger. Two independent reviewers carried out study selection and data extraction. Quality assessment was performed using a study design evaluation instrument to appraise the strength of the studies and their methodological adequacy. Because of heterogeneity in the conditions and outcomes we studied, a formal meta-analysis was not performed.ResultsBased on our search strategy, 655 titles and abstracts were reviewed. From this set we identified 27 relevant articles that met our inclusion criteria. The results from these studies indicated that biomedical informatics applications have favourable clinical and patient outcomes including, but not limited to, reduced number of emergency room visits, improved knowledge on disease management, and enhanced satisfaction. Seventy percent of reviewed papers were published after year 2000, 89% of users were patients and 11% were either providers or caregivers. The majority (96%) of the selected studies reported improved outcomes.ConclusionPublished studies suggested positive impacts of informatics predominantly in pediatric asthma. As electronic tools become more widely adopted, there will be opportunities to improve patient care in a wide range of chronic illnesses through informatics solutions.

Facilitators and barriers to quality of care in maternal, newborn and child health: a global situational analysis through metareview

“…In addition, users’ and community's perception of quality of healthcare20 47 and their past experiences,25 lack of effective interpersonal communication23 24 37 38 43 51 and poor relationship between providers and users38 52 were other important barriers. Power difference between users (women, parents and carers of children) and healthcare providers prevented active engagement of users in decision-making and was an important hurdle in patient and population engagement 30 53.…”

“… 42 Two reviews found that regular frequent discussions with healthcare providers were more effective than a one-off contact. 27 35 Active communication between providers and parents using biomedical informatics 43 was more effective than passive ones such as video games and text messaging services. 34 44 45 Interactive workshops and educational meetings were shown to be more beneficial in improving provider compliance to standard guidelines compared to receiving information leaflets and didactic lectures.…”

A Brief Review on Multimedia-Based Health Education Applications: Current Trend and Future Potential

“…These programmes have been shown to enhance knowledge about certain conditions and to promote positive attitudes from the respondents [3]. As expected, modern technologies can actually help to improve QoL for both patients and their caregivers because the modules facilitated their support within the community [11,37].…”

“…These comprehensive applications were effective in engaging respondents and in improving their health and well-being regardless of the mode of multimedia since all studies demonstrated positive effects on their behavioural activities. Interestingly, when effective and coordinated care was received, the needs for hospital visits were significantly reduced [37].…”

Development of a Questionnaire and Cross-Sectional Survey of Patient eHealth Readiness and eHealth Inequalities

“…There is evidence that direct use of the Internet by patients can benefit patients [ 9 ]. For example, systematic reviews show improvements in health-related knowledge, attitudes, intentions and behaviors [ 10 , 11 ], and reduced health service use [ 12 , 13 ]. Studies showing the benefits of patient eHealth interventions, however, are nearly always carried out on populations of Internet users and the effectiveness of any intervention may depend on the skills and opportunities of the population recruited [ 10 ].…”