Research on the sharing mechanism of drug price information in China- from the perspective of intergovernmental information sharing

Establishment of sharing mechanism for drug price information to guarantee the construction of a unified cross-departmental price information platform is a new national policy after Chinese government abandoned drug price control. Based on the theory of intergovernmental information sharing, this study aimed to investigate the drug price information sharing mechanism in China through literature research and stakeholder interviews, which included institution guarantee mechanism, department coordination mechanism and technical support mechanism.     

Cancer-salient messaging for Human Papillomavirus vaccine uptake: A randomized controlled trial

Background and objectivesVaccination with Human Papillomavirus (HPV) vaccine is recommended for 11–12 years-old, but uptake is suboptimal. Current messaging focuses on HPV infection transmission and prevention. Parents and providers are often uncomfortable discussing sexual practices of adolescents, contributing to the delay/refusal of vaccine. We created a cervical cancer-salient message encouraging HPV vaccination, emphasizing disease salience and disease threat, while promoting self-efficacy. We hypothesized this message would have greater effects on vaccine confidence and intent to vaccinate compared to Centers for Disease Control and Prevention (CDC) and non-vaccine control messages.MethodsA 3-arm randomized trial was conducted. Parents of girls aged 9–17 were eligible for the study. We measured participants’ vaccine confidence and intent to vaccinate at baseline and post intervention message. Recruitment and surveys were administered online through Amazon Mechanical Turk.Results762 participants completed both surveys. We saw modest increases in vaccine confidence when comparing cervical cancer arm and control arm, and CDC arm and control arm; estimates were not statistically significant. The odds of reporting intent to vaccinate among the cervical cancer message arm were 1.13 times the odds of reporting intent to vaccinate in the control arm (95% CI: 0.30. 4.29). Intent to vaccinate was also not statistically significantly different between CDC message arm and control arm (OR = 1.25, 95%CI: 0.66, 2.37).ConclusionNeither message had effect on intent to vaccinate, highlighting need for research to identify successful messaging strategies for HPV. Exploratory analyses suggest among parents with ‘Low’ vaccine confidence at baseline, the cervical cancer framed message may be more effective in changing intention than the CDC message or non-vaccine control. Future work should target groups with ‘Low’ or ‘Medium’ vaccine confidence at baseline - they may be more amenable to change, and more receptive to disease-salient messaging.Clinical Trial Registration: Clinicaltrials.gov, Reference #: NCT03002324.     

Comparative analysis of dental procedure mix in public and private dental benefits programs

BackgroundThere is little published research on whether public and private dental benefits plans affect the types of oral health care procedures patients receive. This study compares the dental procedure mix by age group (children, working-age adults, older adults), dental benefits type (Medicaid and Children’s Health Insurance Program, private), and level of Medicaid dental benefits by state (emergency only, limited, extensive).MethodsThe authors extracted public dental benefits claims data from the 2018 Transformed Medicaid Statistical Information System. To compare procedure mix with beneficiaries who had private dental benefits, the authors used claims data from the 2018 IBM MarketScan dental database. The authors categorized dental procedures into specific service categories and calculated the share of procedures performed within each category. They analyzed procedure mix by age, plan type (fee-for-service, managed care), and adult Medicaid benefit level.ResultsAside from orthodontic services, the dental procedure mix among children with public and private benefits is similar. Among adults with public benefits, surgical interventions make up a higher share of dental procedures than routine preventive services.ConclusionsChildren with public benefits have a procedure mix comparable with those with private benefits. There are substantial differences in procedure mix between publicly and privately insured adults. Even in states that provide extensive dental benefits in Medicaid, those programs primarily finance invasive surgical treatment as opposed to preventive treatment.Practical ImplicationsThere is a need to assess best practices in publicly funded programs for children and translate those attributes to programs for adults for more equitable benefit design and care delivery across public and private insurers.     

信息搜索中用户学习行为内在机理研究

阐述了信息搜索用户学习行为的核心概念,梳理了信息搜索和学习行为的研究进展。以意义建构理论、认知风格理论和行为科学理论为切入点,将信息搜索中用户的学习行为过程抽象为“学习搜索需求-学习搜索认知-学习搜索思考”的用户认知结构改变和行为调整过程,并以此揭示用户搜索决策行为的外在表现特征和内在心智特征,剖析信息搜索中学习行为的内在机理。为今后信息搜索用户学习行为相关研究和实践提出了促进用户认知能力发展、优化搜索系统、提升信息服务水平等建议。     

新信息环境下专业图书馆的定位

介绍了目前专业图书馆信息服务面临的困境,分析了社会、专业图书馆自身和其用户对专业图书馆的定位及其自身定位与其用户定位不同的原因,从馆藏资源、馆舍空间、技术团队、核心竞争力等4方面对专业图书馆定位提出相关建议。     

PDCA循环在复杂背景下信息处理的追踪和反馈中的应用研究

随着医院网络办公的不断发展,医院信息传递的手段逐渐增多,信息传递的背景变得越发复杂。本文以某三级医院的办公室为例,对复杂信息来源、复杂处理渠道进行分析,剖析导致办公室信息处理效率及质量不高的根本原因,并提出解决方法。通过鱼骨图分析法,从医院、部门、个人和其他4个维度,总结出影响办公效率的14个要素;通过使用PDCA循环管理工具,从P(计划)、D(实施)、C(检查)、A(处理)4个阶段入手,制定改进方案,建立常态长效机制,2020年第一季度的漏办率较去年同期降低3%,3 d以内事项办结率由69.38%提升到95.00%,行政办公效率得到显著提高。使用PDCA循环对信息处理的追踪和反馈过程进行了完善和升级,保证了办公室需要处理的事务事事有回应,件件有落实,并提高了信息传输的效率及处理速度,在复杂的信息环境中切实提升了医院办事的效率。      

Application of Bayesian networks to generate synthetic health data

ObjectiveThis study seeks to develop a fully automated method of generating synthetic data from a real dataset that could be employed by medical organizations to distribute health data to researchers, reducing the need for access to real data. We hypothesize the application of Bayesian networks will improve upon the predominant existing method, medBGAN, in handling the complexity and dimensionality of healthcare data.Materials and MethodsWe employed Bayesian networks to learn probabilistic graphical structures and simulated synthetic patient records from the learned structure. We used the University of California Irvine (UCI) heart disease and diabetes datasets as well as the MIMIC-III diagnoses database. We evaluated our method through statistical tests, machine learning tasks, preservation of rare events, disclosure risk, and the ability of a machine learning classifier to discriminate between the real and synthetic data.ResultsOur Bayesian network model outperformed or equaled medBGAN in all key metrics. Notable improvement was achieved in capturing rare variables and preserving association rules.DiscussionBayesian networks generated data sufficiently similar to the original data with minimal risk of disclosure, while offering additional transparency, computational efficiency, and capacity to handle more data types in comparison to existing methods. We hope this method will allow healthcare organizations to efficiently disseminate synthetic health data to researchers, enabling them to generate hypotheses and develop analytical tools. ConclusionWe conclude the application of Bayesian networks is a promising option for generating realistic synthetic health data that preserves the features of the original data without compromising data privacy.     

做个好的信息导航员 为护理人员服务

目的探讨图书馆员更好地为护理人员服务的工作方法。方法重视护理专业馆藏建设；开展对护理人员的培训；鼓励帮助护理人员撰写论文；传送信息到临床科室。结果护士与图书馆的联系越来越密切。结论图书馆员做好信息导航员，提高了护理人员专业素质，也提高了图书馆馆藏利用率。     

The Internet: What are our patients exposed to when considering breast reconstruction following mastectomy?

BackgroundThe exponential increase in internet use has transformed the healthcare provider-patient relationship. There is a need to guide patients. This study analyses the information available, clinicians approach and patients' experiences.MethodsAn internet search, “breast reconstruction after mastectomy” was performed on Google and Bing search engines. The first 100 sites on each search were analysed. Target audience, provider and readability were assessed. Modified Health on the Net criterion was used to assess quality. Additionally clinicians and patients were surveyed about their experiences.ResultsPrivate companies dominated, accounting for 67% of sites, the majority advertised private healthcare groups. Of “information pages”, 16% were government sites and 9% were from professional bodies but 28% were private. Blogs had high rates of surreptitious advertising. Patients wanted guidance on which sites to use. Endorsed sites were commonly recommended and used despite only accounting for 13 of the 100 sites.ConclusionThe internet is a powerful tool for disseminating information. There is a wide variety of information presented on breast reconstruction following mastectomy from a range of providers with different interests. Patients should not only be provided with a list of internet resources but also counselled on the types of information they may encounter.