Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-30 Cooperative journals: 《中国全科医学》
Abstract：
With the development of information technology, artificial intelligence shows great potentials for clinical diagnosis and treatment. Nevertheless, algorithmic bias in artificial intelligence can lead to problems such as unequal distribution of healthcare resources, which significantly affect patients’ health equity. Algorithmic bias is a technical manifestation of human bias, which is related to the process of artificial intelligence development, including data collection, model training and optimization as well as output application. Since healthcare providers have a direct impact on patients’ health, they should take measures to prevent algorithmic bias and related health equity. It is also important for healthcare providers to ensure the unbiasedness of health data, optimize the fairness of artificial intelligence, and enhance the transparency of its output application. In addition, healthcare providers also need to consider how to solve algorithmic bias and bias related health inequity in clinical practice in order to fully and properly protect patients' health equity. This paper reviews the causes and countermeasures of algorithmic bias in the health field to improve healthcare providers’ awareness and ability in identifying and addressing algorithmic bias, as well as provide empirical foundations for ensuring the health equity in the information age.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-03 Cooperative journals: 《中国全科医学》
Abstract：
Background Self-rated health is negatively related to frailty. The better the self-rated health (SRH) is, the lower the degree of frailty is. The relationship between the two conditions may be different in people suffering from apathy. Objective To explore the moderating effect of the apathy on the relationship between SRH and frailty among community-dwelling older adults. Methods A convenience sampling method was adopted. Fried Frailty Phenotype (FFP), Geriatric Depression Scale (GDS-3), Self-Rated Health (SRH), and demographic information were used to investigate the research question with 384 community-dwelling older adults. Results The strength of the relationship between SRH and frailty was moderated by apathy (B= -0.355，t= -3.074，P< 0.002), such that, apathy strengthened the predictive effect of SRH on frailty. Conclusion SRH is negatively related to frailty. Apathy plays an important positive role in strengthening the negative relationship between SRH and frailty among Chinese community-dwelling older adults.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-12-20 Cooperative journals: 《中国全科医学》
Abstract：
With the increasing aging population in China, older adults’ falls and fall-related injuries have gained increased attention, and preventive guidelines have also been developed and regularly updated. In 2022, The World Falls Guidelines Task Force assembled 96 experts from 39 countries issued the World Guidelines for Falls Prevention and Management for Older Adults. The guideline uses a person-centered approach by taking full account of the needs of older adults on the management of falls and the perceptions and experiences of caregivers and other stakeholders on preventing falls of older adults, as well as the utility of the guideline in various care settings and locations with limited resources. The guideline also incorporates the latest evidence on the use of e-health for fall prevention to provide new clinical recommendations on the screening, assessment, and management of risk for falls among community-dwelling older adults. It also promotes physical activity and falls prevention for all older adults. The current work offers an in-depth interpretation of guidelines and provides practical guidance to Chinese clinicians and community workers for prevention and management of falls in older adults.
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2022-11-16 Cooperative journals: 《中国全科医学》
Abstract：
Background Frailty is common in cancer patients, which seriously affects the prognosis of patients. Objective To identify the factors associated with frailty in cancer patients by meta-analysis, and to provide scientific basis for the design and implementation of frailty intervention program of frailty in cancer patients. Methods The databases of China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Journal Database (VIP), Wanfang, PubMed, Web of Science, Cochrane Library, CINAHL and Embase were searched to collect the studies on the associated factors of frailty in cancer patients from the inception to August 2022. A meta-analysis on the included literature was performed by using Stata 17.0 and RevMan 5.4. Results A total of 11 articles were included, including 9 cross-sectional studies and 2 cohort studies, including 2898 cancer patients, including 1025 frailty patients, involving 12 associated factors. The results of meta-analysis showed that the average incidence of frailty in cancer patients was 34%, and the associated factors were age [OR=1.16, 95%CI (1.05, 1.27), P<0.001], educational level [OR=0.78, 95%CI (0.68, 0.90)], comorbidity [OR=1.46, 95%CI (1.28, 1.67), P<0.001], body mass index (BMI) [OR=1.13, 95%CI (1.05, 1.21), P<0.001], albumin [OR=0.33, 95%CI (0.12, 0.90), P=0.03], nutritional status [OR=2.77, 95%CI (1.27, 6.06), P=0.01], syndrome group [OR=1.07，95%CI（1.04，1.09），P<0.001]，depression [OR=1.27, 95%CI (1.12, 1.44), P<0.001], instrumental activities of daily life (IADL) [OR=0.50, 95%CI (0.42, 0.59), P<0.001), while gender [OR=0.81, 95%CI (0.54, 1.21), P=0.30], marital status [OR=0.21, 95%CI (0.02, 2.31), P=0.20] and hemoglobin [OR=0.51, 95%CI (0.22, 1.22), P=0.13] was not related to the frailty of cancer patients. Conclusion The available research evidence suggests that age, education level, comorbidity, BMI, albumin, nutritional status, syndrome group, depression and IADL are the associated factors of frailty in cancer patients. Cancer patients with advanced age, low education level, combined with other diseases, High BMI, albumin level < 35 g/L, poor nutritional status, with symptoms group, depression and low activities of daily living are the priority population we need to pay attention to.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-10-13 Cooperative journals: 《中国全科医学》
Abstract： BackgroundWith the growing problem of obesity, the demand for bariatric surgery has increased these years. Patients still need to maintain good living habits after surgery to consolidate the weight loss effects.While the behavioral guidelines are relatively mature, patient’s behavioral compliance is not ideal, resulting in a higher rate of re-obesity postoperative. We can depend onstrategies to promote dietary and physical activity behaviors in patients from theperspective of cognitive factors.ObjectiveSystematic coding of dietary and physical activity behavior promotion strategies after bariatric surgery from the perspective of cognitive factors.Methods The Whittemore&Knafl integrative review method was used. The database of PubMed、Web of Science、Cochrane、CINAHL、CNKI and Wanfang Data were searched for studies related to diet and physical activity behavior promotion strategies after bariatric surgery from January 1994 to June 2022.The 2016 version of the Critical Appraisal Skills Program (CASP) was used to evaluate the quality of the literatures.Studies met the inclusion criteria were included, and the strategies were uniformly coded and merged according to CALO-RE taxonomy.Results A total of 25 studies were included, including 17 randomized controlled trials, 4 observational studies, and 4 reviews.After coding, all strategies were covered by CALO-REtaxonomy, involving 25kinds of strategies, mainly including behavior monitoring, social support, goal setting, obstacle recognition, etc.A total of 46 strategies were obtained in the “behavioral promotion strategies of diet and physical activity after bariatric surgery”.ConclusionsThrough the application of the integrative review method and the guidance of CALO-REtaxonomy, a systematic, comprehensive and standardized integration of dietary and physical activity behavior promotion strategies from the perspective of cognitive factors was achieved for post-bariatric patients.This study provided a technical reserve for behavior management after bariatric surgery, and are expected to further improve patients’ dietary and physical activity behavior status, thereby consolidating the effect sof bariatric surgery.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-10-13 Cooperative journals: 《中国全科医学》
Abstract： Background Frailty can increase the risk of negative health-related outcomes in older adults, and protein supplementation may be an effective way to improve frailty, but there is disagreement about the effects of protein supplementation on frailty. Objective To systematically evaluate the effects of protein supplementation on muscle mass, strength, and physical function in frail older adults. Methods PubMed, Embase, Web of Science, Cochrane Library, CINAHL, Medline, China Knowledge Network, Wanfang, and Wipu databases were retrieved by computer for randomized controlled trials of the effects of protein supplementation on muscle mass、strength and physical function in frail older adults published from the establishment of the database to June 2022. The literature was independently screened and quality evaluated by 2 researchers based on inclusion and exclusion criteria, and data were extracted and Meta-analysis was performed using Review Manger 5.4. Results A total of 12 articles were included, with a total of 833 patients(422 in the protein supplementation group and 411 in the control group). Meta-analysis results showed that protein supplementation improved walking speed (MD=0.03, 95% CI0.00-0.06, P=0.05), but had no significant advantages in improving muscle mass (appendicular lean mass ALM), muscle strength (grip strength), other physical functions [balance test, time up to go test, Short Physical Performance Battery(SPPB) ] and frailty scores, and the combined effect was not statistically significant (P>0.05). Conclusion Protein supplementation may improve walking speed in frail older adults, but it did not show a significant advantage in improving their muscle mass 、muscle strength and other physical functions. More studies with larger samples and longer duration of intervention are still needed for validation.
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