Examinando por Autor "Rimassa, Carla"
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Ítem A Technological Framework to Support Asthma Patient Adherence Using Pictograms(Multidisciplinary Digital Publishing Institute (MDPI), 2024-08) Figueroa, Rosa; Taramasco, Carla; Lagos, María Elena; Martínez, Felipe; Rimassa, Carla; Godoy, Julio; Pino, Esteban; Navarrete, Jean; Pinto, Jose; Nazar, Gabriela; Pérez, Cristhian; Herrera, DanielBackground: Low comprehension and adherence to medical treatment among the elderly directly and negatively affect their health. Many elderly patients forget medical instructions immediately after their appointments, misunderstand them, or fail to recall them altogether. Some identified causes include the short time slots allocated for appointments in the public health system in Chile, the complex terminology used by healthcare professionals, and the stress experienced by patients during appointments. One approach to improving patients’ adherence to medical treatment is to combine written and oral instructions with graphical elements such as pictograms. However, several challenges arise due to the ambiguity of natural language and the need for pictograms to accurately represent various medication combinations, doses, and frequencies. Objective: This study introduces SIMAP (System for Integrating Medical Instructions with Pictograms), a technological framework aimed at enhancing adherence among asthma patients through the delivery of pictograms via a computational system. SIMAP utilizes a collaborative and user-centered methodology, involving health professionals and patients in the construction and validation of its components. Methods: The technological framework presented in this study is composed of three parts. The first two are medical indications and pictograms related to the treatment of the disease. Both components were developed through a comprehensive and iterative methodology that incorporates both qualitative and quantitative approaches. This methodology includes the utilization of focus groups, interviews, paper and online surveys, as well as expert validation, ensuring a robust and thorough development. The core of SIMAP is the technological component that leveraged artificial intelligence methods for natural language processing to analyze, tokenize, and associate words and their context to a set of one or more pictograms, addressing issues such as the ambiguity in the text, the cultural factor that involves many ways of expressing the same indication, and typographical errors in the indications. Results: Firstly, we successfully validated 18 clinical indications along with their respective pictograms. Some of the pictograms were redesigned based on the validation results. However, in the final validation, the comprehension percentages of the pictograms exceeded 70%. Furthermore, we developed a software called SIMAP, which translates medical indications into previously validated pictograms. Our proposed software, SIMAP, achieves a correct mapping rate of 96.69%. Conclusions: SIMAP demonstrates great potential as a technological component for supplementing medical instructions with pictograms when tested in a laboratory setting. The use of artificial intelligence for natural language processing can successfully map medical instructions, both structured and unstructured, into pictograms. This integration of textual instructions and pictograms holds promise for enhancing the comprehension and adherence of elderly patients to their medical indications, thereby improving their long-term health.Ítem Architecture Assessment of the Chilean Epidemiological Surveillance System for Notifiable Diseases (EPIVIGILA): Qualitative Study(JMIR Publications Inc., 2023) Taramasco, Carla; Rimassa, CarlaBackground: To fulfill their epidemiological vigilance function, authorities require valid, complete, timely, precise, and reliable information. Advancements in new technologies have facilitated public health control through vigilance systems for notifiable diseases; these systems can gather large numbers of simultaneous notifications, process a wide array of data, and deliver updated information in real time to relevant decision-makers. A large worldwide deployment of new information technologies was seen during the COVID-19 pandemic; these technologies proved to be efficient, resourceful tools . Platform developers should seek self-evaluation strategies to optimize functionality or improve the capacity of national vigilance systems. These tools exist in the Latin American region at various development stages, although publications reporting architectural characteristics of these tools are scarce. International publications are more abundant a nd serve as a basis for comparing the standards that need to be met. Objective: This study aimed to assess the architecture of the Chilean epidemiological surveillance system for notifiable diseases (EPIVIGILA), as compared to that of the international systems reported in scientific publications. Methods: A search for scientific publications was conducted to identify systematic reviews that documented the architectural characteristics of disease notification and vigilance systems. EPIVIGILA was compared to other systems from countries in Africa, the Americas, Asia, Europe, and Oceania. Results: The following aspects of the architecture were identified: (1) notification provenance, (2) minimum data set, (3) database users, and (4) data quality control. The notifying organizations, including hospitals, clinics, laboratories, and medical consultation offices, were similar among the 13 countries analyzed; this contrasted with Chile, where the reporting agent is the physician who can belong to an organization. The minimum data set include patient identification, disease data, and general codifications. EPIVIGILA includes all these elements, in addition to symptomatology, hospitalization data, type of medicine and treatment result, and laboratory test types. The database users or data analyzers include public health organizations, research organizations, epidemiological organizations, health organizations or departments, and the Centers for Disease Control and Prevention. Finally, for data quality control, the criteria most often used were completeness, consistency, validity, timeliness, accuracy, and competencies. Conclusions: An efficient notification and vigilance system must be capable of promptly identifying probable risks as well as incidence and prevalence of the diseases under surveillance. EPIVIGILA has been shown to comply with high quality and functionality standards, at the level of developed countries, by achieving total national coverage and by providing timely, trustworthy, and complete information at high-security levels, thus obtaining positive assessment from national and international authorities. © 2023 Universidade Estadual de Londrina. All rights reserved.Ítem Co-design of a mobile app for engaging breast cancer patients in reporting health experiences: Qualitative case study(JMIR Publications Inc., 2023) Taramasco, Carla; Rimassa, Carla; Noël, René; Bravo Storm, María Loreto; Sánchez, CésarBackground: The World Health Organization recommends incorporating patient-reported experience measures and patient-reported outcome measures to ensure care processes. New technologies, such as mobile apps, could help report and monitor patients adverse effects and doubts during treatment. However, engaging patients in the daily use of mobile apps is a challenge that must be addressed in accordance with the needs of people. Objective: We present a qualitative case study documenting the process of identifying the information needs of breast cancer patients and health care professionals during the treatment process in a Chilean cancer institution. The study aims to identify patients information requirements for integration into a mobile app that accompanies patients throughout their treatment while also providing features for reporting adverse symptoms. Methods: We conducted focus groups with breast cancer patients who were undergoing chemotherapy (n=3) or who completed chemotherapy between 3 months and 1 year (n=1). We also surveyed health care professionals (n=9) who were involved in patient care and who belonged to the oncology committee of the cancer center where the study took place. Content analysis was applied to the responses to categorize the information needs and the means to satisfy them. A user interface was designed according to the findings of the focus groups and was assessed by 3 trained information system and user interaction design experts from 2 countries, using heuristic evaluation guidelines for mobile apps. Results: Patients information needs were classified into 4 areas: An overview of the disease, information on treatment and day-To-day affairs, assistance on the normality and abnormality of symptoms during treatment, and symptoms relevant to report. Health care professionals required patients to be provided with information on the administrative and financial process. We noted that the active involvement of the following 4 main actors is required to satisfy the information needs: patients, caregivers, social network moderators, and health professionals. Seven usability guidelines were extracted from the heuristic evaluation recommendations. Conclusions: A mobile app that seeks to accompany breast cancer patients to report symptoms requires the involvement of multiple participants to handle the reports and day-To-day information needs. User interfaces must be designed with consideration of the patient s social conventions and the emotional load of the disease information. © 2023 Journal of Medical Internet Research. All rights reserved.Ítem Desafíos en la vigilancia de todos los casos de cáncer en Chile: Registro Nacional de Cáncer(Medwave Estudios Ltda, 2024-01) Taramasco, Carla; Rimassa, Carla; Acevedo, JohanaEl cáncer causa millones de muertes a nivel mundial por lo que su registro es fundamental, existiendo registros clínicos, hospitalarios y poblacionales. Estos últimos son el estándar de oro para la información sobre incidencia y supervivencia de cáncer en una región definida. En Chile se cuenta con cinco registros poblacionales ubicados en ciertas zonas del país. El Registro Nacional del Cáncer chileno surge como un desafío para conformar una herramienta transversal a los tres tipos de registro con la finalidad de, al menos, conocer la cantidad de casos por tipo de cáncer. Su diseño implicó un despliegue de acciones orientadas a lograr consensos entre diversos actores respecto de la información, validación y eventos necesarios de registrar. Se identificaron cuatro etapas en el proceso de atención y el registro: sospecha de diagnóstico, confirmación morfológica (biopsia), resolución clínica (comité oncológico incluyendo la indicación de tratamiento), tratamiento y seguimiento oncológico. A su vez, el desarrollo de la plataforma (años 2018 a 2021) implicó levantamiento de información y acuerdos sobre los requerimientos para el co-diseño del registro, incluyendo un exitoso pilotaje con más de 20 establecimientos de salud del sector público y privado con registro de cerca de 7500 casos de cáncer. El despliegue y uso del Registro Nacional de Cáncer a nivel nacional depende de la autoridad sanitaria. Se trata de un sistema de información que recolecta, almacena, procesa y analiza de forma continua y sistemática datos sobre todos los casos y tipos de cánceres que ocurren en el país. En este trabajo se presenta el diseño y desarrollo de la herramienta, los desafíos abordados, sus fortalezas y debilidades.Ítem How effective are mobile apps in managing people with type 2 diabetes mellitus? A systematic literature review protocol(Public Library of Science, 2024-04-04) Taramasco, Carla; Rimassa, Carla; Garrido, María Elena Lagos; Figueroa, Rosa L.Introduction The rise of new technologies in the field of health is yielding promising results. In certain chronic conditions such as type 2 diabetes mellitus, which ranks among the top five causes of global mortality, it could be useful in supporting patient management. Materials and methods A systematic review will be conducted on scientific publications from the last 5 years (January 2019 to October 2023) to describe the effect of mobile app usage on glycated hemoglobin for the management of adult patients with type 2 diabetes mellitus who participated in randomized controlled clinical trials. The search will be carried out in the databases of MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), CENTRAL, WoS, Scopus, Epistemonikos, and LILACS. The search strategy will be constructed using both controlled and natural language. Additionally, the Cochrane filter will be applied to identify randomized controlled trials. The review will include scientific articles reporting studies that present results from randomized controlled trials, with texts in Spanish, English, or French, utilizing mobile applications for the management of adult individuals (over 18 years) with type 2 diabetes mellitus, and whose outcomes report the effects on glycated hemoglobin. The Cochrane Risk of Bias Tool will be used to assess the quality of the studies, and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology will be implemented to evaluate the certainty of the evidence. Results The analysis will be conducted by observing the value of the glycated hemoglobin levels of the participants. Given that this data is a quantitative and continuous value, it facilitates the identification of the effects of the mobile applications used for the management of type 2 diabetes mellitus (T2DM) in adults. Furthermore, if sufficient data are available, a meta-analysis will be conducted using IBM-SPSS. The effect of the intervention will be estimated by the mean difference. All point estimates will be accompanied by 95% confidence intervals. A random effects model will be used. The heterogeneity of the results will be assessed using Cochrane's Q and I2 statistics. Discussion Considering that the quality of content and functionality of certain applications in the healthcare field is highly variable, it is necessary to evaluate the scientific evidence reported on the effect of the use of this type of technology in people with T2DM.Ítem Improvement in Quality of Life with Use of Ambient-Assisted Living: Clinical Trial with Older Persons in the Chilean Population(MDPI, 2023-01) Taramasco, Carla; Rimassa, Carla; Martinez, FelipeIn Chile, 18% of the population is over 60 years old and is projected to reach 31% in three decades. An aging population demands the development of strategies to improve quality of life (QoL). In this randomized trial, we present the implementation and evaluation of the Quida platform, which consists of a network of unintrusive sensors installed in the houses of elderly participants to monitor their activities and provide assistance. Sixty-nine elderly participants were included. A significant increase in overall QoL was observed amongst participants allocated to the interventional arm (p < 0.02). While some studies point out difficulties monitoring users at home, Quida demonstrates that it is possible to detect presence and movement to identify patterns of behavior in the sample studied, allowing us to visualize the behavior of older adults at different time intervals to support their medical evaluation.