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The Convergence of Digital Health Technologies: The Role of Digital Therapeutics in the Future Healthcare System
Published in Oleksandr Sverdlov, Joris van Dam, Digital Therapeutics, 2023
Joris van Dam, Justin Wright, Graham Jones
This inherent potential to personalize therapeutic recommendations and interventions for maximum effect does not only pertain to an individual patient. Since all patients use software applications connected through the cloud, improvements can also be made across patients, detecting similarity in treatment response across patients, geography, and time. This connectivity of digital therapeutics offers an unprecedented opportunity for “mass customization” of clinical care (Minvielle, 2018).
Professional identity and competence to practise in medicine
Published in Roger Ellis, Elaine Hogard, Professional Identity in the Caring Professions, 2020
Overall the Furnham studies showed a strong matching or similarity effect: people preferred practitioners like themselves: same sex, age group and nationality. The results beg the bigger question of whether client/expert similarity has an effect on therapeutic outcome. It is difficult to conduct appropriate studies looking at the efficacy of different therapeutic interventions, and most of these studies have compared various types of therapy against one another. Few have examined whether practitioner and client factors (notably demographics) have a direct or even placebo effect on outcomes.
Introduction
Published in Arvind Kumar Bansal, Javed Iqbal Khan, S. Kaisar Alam, Introduction to Computational Health Informatics, 2019
Arvind Kumar Bansal, Javed Iqbal Khan, S. Kaisar Alam
Health informatics requires similarity-based comparison to compare to find similar radiology images or similar feature-values in pathology reports to find out similar disease states. Hence, any content-based search mechanism should incorporate similarity-based matching. The search can also be initiated using temporal logic such as “ECG two years before myocardial infarction.” Hence, the search should be capable of handling abstract temporal information and match the record time with the query using temporal abstraction.
Development of reference charts for monitoring quadriceps strength with handheld dynamometry after total knee arthroplasty
Published in Disability and Rehabilitation, 2022
Jeremy Graber, Elizabeth Juarez-Colunga, Charles Thigpen, Dawn Waugh, Michael Bade, Jennifer Stevens-Lapsley, Andrew Kittelson
The overall quadriceps strength recovery trajectories in our reference charts are comparable to previous work conducted with different strength assessment techniques [5,25,32]. This includes our observation that males appeared to demonstrate greater strength and a more rapid recovery than females [25,32]. The reference charts developed by Pua and colleagues in Singapore are the closest comparison for our results [32]. Pua et al. measured quadriceps strength isoinertially on a seated knee extension machine instead of isometrically via HHD but had similar findings. Both our reference chart and Pua’s reference chart for females appear to demonstrate similar trajectories and close agreement across centiles over time. The charts for males also look similar, but the slope and relative strength values appear to be greater across centiles in the chart developed by Pua et al. This difference could be explained by the tendency for HHD to underestimate force output at higher force levels compared to alternative strength assessment techniques [19,20,33,34]. Overall, the similarity between study results supports the generalizability and potential utility of our findings for clinical practice.
Considerations related to comparative clinical studies for biosimilars
Published in Expert Opinion on Drug Safety, 2021
Anurag S. Rathore, James G. Stevenson, Hemlata Chhabra
The proposed biosimilar and reference products did not exhibit statistically significant differences in HbA1C levels at 24 weeks. However, the results substantially favored the Humulin reference product for all patients, with some exception in type 2 diabetics. The Marvel insulins acted in a similar manner to the Humulin insulins for the first 12 weeks, but lost efficacy between weeks 12 and 24 raising objections about the long-term efficacy of the proposed biosimilars. Moreover, there was insufficient information provided to underpin the claim of comparable doses administered in patients of reference and test groups. Even if the outcome of the clinical study showed similarity, it would be difficult to conclude the similarity between products if the administered doses are different. Furthermore, a higher percentage of withdrawals were observed in Marvel groups (12%) as compared to reference groups (7%) which were connected to patient’s request, noncompliance, and adverse drug reactions indicating worse tolerability of the products.
The impact of clinical heterogeneity on conducting network meta-analyses in transthyretin amyloidosis with polyneuropathy
Published in Current Medical Research and Opinion, 2020
Imtiaz A. Samjoo, Elizabeth M. Salvo, Diana Tran, Leslie Amass, Michelle Stewart, Chris Cameron
Systematic differences between treatment groups may compromise the validity of an NMA; therefore, it was prudent to assess the degree of heterogeneity in patient characteristics and study design between trials. Specifically, differences in plausible treatment effect modifiers were evaluated across trials. Clinical heterogeneity in terms of treatment and outcome characteristics, and the study and patient characteristics were assessed to ensure similarity. All primary and secondary outcomes evaluated in the pivotal tafamidis (Fx-005), patisiran (APOLLO) and inotersen (NEURO-TTR) trials were of interest10–12. These outcomes included measures of neuropathy impairment, quality of life, nutritional status and safety (Supplementary Table 1). For neuropathy assessments, only total scores were considered in this feasibility assessment. Evidence network diagrams illustrating the structure of the network for each clinical outcome of interest were developed and differences were assessed in terms of baseline risk within and between trials.