Computer-assisted versus oral-and-written family history taking for identifying people with elevated risk of type 2 diabetes mellitus

Pappas, Yannis; Wei, Igor; Car, Josip; Majeed, Azeem; Sheikh, Aziz

doi:10.1002/14651858.cd008489.pub2

Cited by 8 publications

(4 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A purposeful sample of articles was included based on relevance to build the Results and Discussion section. Robust evidence regarding CAHT and DMIA systems and their impact on the medical consultation was limited, as most studies evaluating these systems focused on other aspects, such as acquiring dietary or family history to estimate risk for diabetes, studies evaluating computer-assisted data collection for specific populations or related to screening, studies evaluating the test-retest reliability of computer-based medical histories, or efforts to generally computerize medicine, just to give some examples [13][14][15][16][17][18].…”

Section: Methodsmentioning

confidence: 99%

Improving the Primary Care Consultation for Diabetes and Depression Through Digital Medical Interview Assistant Systems: Narrative Review (Preprint)

Jiménez¹,

Tyagi²,

Osman³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

BACKGROUND Digital medical interview assistant (DMIA, also known as computer-assisted history taking (CAHT)) systems have the potential to improve the quality of care and the medical consultation by exploring more patient-related aspects without time constraints, and therefore acquiring more and better quality information, prior to the face-to-face consultation. The consultation in primary care (PC) is the broadest in terms of the amount of topics to be covered and, at the same time, the shortest in term of time spent with the patient. OBJECTIVE To explore how DMIA systems may be used specifically in the context of PC, to improve the consultations for diabetes and depression, as exemplars of chronic conditions. METHODS A narrative review was conducted focusing on (1) the characteristics of the PC consultation in general and for diabetes and depression specifically, and on (2) the impact of DMIA/CAHT systems on the medical consultation. Through thematic analysis, we identified the characteristics of the PC consultation that a DMIA system would be able to improve. Based on the identified PC consultation tasks and the potential benefits of DMIA systems, we developed a sample questionnaire for diabetes and depression to illustrate how such a system may work. RESULTS A DMIA system, prior to the first consultation, could aid in the essential PC tasks of case finding/screening, diagnosing and, if needed, timely referral to specialists or urgent care. Similarly, for follow-up consultations, it could aid with the control/monitoring of these conditions, help check for additional health issues and for updating the PC provider about visits to other providers or further testing. Successfully implementing a DMIA system for these tasks would improve the quality of the data obtained, which means earlier diagnosis and treatment; would improve the use of face-to-face consultation time, streamlining the interaction and allowing the focus to be the patient's needs, which ultimately would lead to better health outcomes and patient satisfaction. However, for such a system to be successfully incorporated, there are important considerations to be taken into account, such as the language to be used and the challenges for implementing eHealth innovations in PC and healthcare in general. CONCLUSIONS Given the benefits explored here, we foresee that DMIA systems could have an important impact in the PC consultation for diabetes and depression and, potentially, for other chronic conditions. Earlier case finding and a more accurate diagnosis, due to more and better-quality data, paired with improved monitoring of disease progress, should improve the quality of care and keep the management of chronic conditions at the primary care level. A somewhat simple, easily scalable technology could go a long way to improve the health of the millions of people affected with chronic conditions, especially if working in conjunction with already established health technologies such as EMRs and CDSS. CLINICALTRIAL

show abstract

Section: Methodsmentioning

confidence: 99%

Improving the Primary Care Consultation for Diabetes and Depression Through Digital Medical Interview Assistant Systems: Narrative Review (Preprint)

Jiménez¹,

Tyagi²,

Osman³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…13 Observational data also show that empathic communication can modify more objective clinical outcomes such as HBA1c. 14,15 Studies also show that enhanced empathy makes a positive difference in both deprived and affluent populations. 16 This is important in the context of the inverse care law.…”

Section: Does Empathy Make a Difference?mentioning

confidence: 99%

“…Yet, for example, computer-aided history-taking, long available, is underused. 14 The spread of alternatives to faceto-face consultations is still in its infancy, as is our understanding of when a machine will do and when a person-to-person relationship is needed evolves.…”

Section: Supporting Empathic Carementioning

confidence: 99%

Overthrowing barriers to empathy in healthcare: empathy in the age of the Internet

Howick¹,

Rees²

2017

J R Soc Med

View full text Add to dashboard Cite

show abstract

“…However, most strategies are targeting health education, mainly to raise the awareness for early HIV testing. Health education, especially the top-down perspective, has been criticized for its preaching style and lack of target population insight [ 33 , 34 ]. Other strategies like HIV self-testing decrease the barriers to HIV testing uptake but are not able to motivate those who think it is unnecessary to have HIV testing.…”

Section: Introductionmentioning

confidence: 99%

Increasing the HIV testing among MSM through HIV test result exchange mechanism: study protocol for a cluster randomized controlled trial

et al. 2021

View full text Add to dashboard Cite

Background HIV testing is an essential gateway to HIV prevention and treatment thus controlling the HIV epidemic. More innovative interventions are needed to increase HIV testing among men who have sex with men (MSM) since their testing rate is still low. We proposed an online HIV test results exchange mechanism whereby the one without a certified online HIV report will be asked to test HIV for exchanging HIV report with others. The exchange mechanism is developed as an extension to the existing online HIV testing service system. Through the extended system, MSM can obtain certified online HIV reports and exchange their reports with friends via WeChat. This study aims to assess effectiveness of the exchange mechanism to increase the HIV testing rate among MSM. Methods This study will use a cluster randomized controlled trial (RCT) design. Participants are recruited based on the unit of individual social network, the sender and the receivers of the HIV report. An individual social network is composed of one sender (ego) and one or more receivers (alters). In this study, MSM in an HIV testing clinic are recruited as potential egos and forwarded online reports to their WeChat friends voluntarily. Friends are invited to participate by report links and become alters. Ego and alters serve as a cluster and are randomized to the group using the certified online HIV report with exchange mechanism (intervention group) or without exchange mechanism (control group). Alters are the intervention targeting participants. The primary outcome is HIV testing rate. Other outcomes are sexual transmitted infections, sexual behaviors, HIV testing norms, stigma, risk perception and HIV report delivery. The outcomes will be assessed at baseline and follow-up questionnaires. Analysis will be according to intention to treat approach and using mixed-effect models with networks and individuals as random effects. Discussion This is the first study to evaluate the effectiveness of an HIV test result exchange mechanism to increase the HIV testing among MSM. This assessment of the intervention will also provide scientific evidence on other potential effects. Findings from this study will yield insights for sustainability driven by communities' intrinsic motivation. Trail registration: ClinicalTrials.gov NCT03984136. Registered 12 June 2019.

show abstract

Computer-assisted versus oral-and-written family history taking for identifying people with elevated risk of type 2 diabetes mellitus

Cited by 8 publications

References 30 publications

Improving the Primary Care Consultation for Diabetes and Depression Through Digital Medical Interview Assistant Systems: Narrative Review (Preprint)

Improving the Primary Care Consultation for Diabetes and Depression Through Digital Medical Interview Assistant Systems: Narrative Review (Preprint)

Overthrowing barriers to empathy in healthcare: empathy in the age of the Internet

Increasing the HIV testing among MSM through HIV test result exchange mechanism: study protocol for a cluster randomized controlled trial

Contact Info

Product

Resources

About