Electronic Versions Research Articles

Psychometric Properties of the AUDIT, AUDIT-C, CRAFFT and ASSIST-Y among Swedish Adolescents

Background/Aims: Not enough is known about the psychometric properties of screening instruments for problematic alcohol consumption among adolescents. The aim of the current study was to evaluate and compare the performance of the screening instruments: Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, CRAFFT, and the alcohol domain of Alcohol, Smoking and Substance Involvement Screening Test-Youth (ASSIST-Y) among adolescents and to suggest optimal cut-offs indicating problematic use. Methods: Data was collected from a general population sample (n = 1,421) and a treatment-seeking sample (n = 59) using electronic versions of the instruments. Results: The internal consistencies for the instruments were fair (alpha’s AUDIT 0.74, AUDIT-C 0.75, CRAFFT 0.67, ASSIST-Y 0.62), and test-retest reliabilities were good to excellent (intraclass correlation coefficients AUDIT 0.86, AUDIT-C 0.93, CRAFFT 0.77, ASSIST-Y 0.63). The CRAFFT and ASSIST-Y demonstrated reasonable construct validities while factor solutions for AUDIT and AUDIT-C could not be determined. The optimal cut-off score was 2 for both CRAFFT and ASSIST-Y (61 and 73% sensitivities and 79 and 65% specificities, respectively), while sensitivity scores were poor for AUDIT and AUDIT-C. Conclusion: Based on the current sample, ASSIST-Y and the CRAFFT performed better than AUDIT and AUDIT-C. Health-care clinics working with adolescents should carefully consider their choice of screening instruments.

Online Qualitative Data Sources for Federal Regulatory Policy Studies

Although policy studies frequently focus on legislation, researchers should not overlook the importance of regulations in their analyses. This article introduces policy researchers to a variety of online data sources available for studying federal regulatory policy. Sources range from electronic versions of federal periodicals to online repositories of public comments to more interactive Internet resources, all of which provide rich data for understanding regulatory policy. This article also explores how qualitative methodologists have conceptualized online research methods and provides a template for an online data source research protocol that may be useful for policy researchers. Finally, this article uses the U.S. Department of Education’s Borrower Defense Rule as an application case to illustrate how to make use of online data sources in regulatory policy studies.

Фразеологический потенциал рекламных слоганов

<p>Artykuł poświęcono sloganom reklamowym jako jednemu ze źródeł nowych jednostek frazeologicznych. Celami badania są przegląd uwarunkowań przejścia sloganów do grupy frazeologizmów reklamowych i analiza specyfiki funkcjonowania sloganów reklamowych we współczesnej prasie rosyjskiej. Materiał źródłowy stanowi autorska kartoteka frazeologizmów zebrana metodą przypadkowego wyboru z publikacji współczesnej rosyjskiej prasy (w tym również elektronicznych wersji periodyków) z lat 2000–2010. Wykorzystano następujące metody: opisową, analizy definicji słownikowych i analizy kontekstualnej. Sfrazeologizowane slogany reklamowe są produktywnym źródłem nowych frazeologizmów współczesnego języka rosyjskiego. Wchodzą do potocznego obiegu użytkowników języka i zaczynają być aktywnie wykorzystywane w różnych sytuacjach komunikacyjnych, podobnie jak inne stałe połączenia wyrazowe (paremie, aforyzmy, skrzydlate słowa).</p>

Modern Russian textbooks for schools in Czech Republic: advantages and disadvantages

The article analyses the current state of the Russian language teaching materials in the Czech secondary and high school. The Russian language is taught at Czech schools as the second and third foreign language. This naturally influences aims, contents and methodological concept of study packs used in the foreign language teaching. The authors point out the requirements for modern Russian language school textbooks, fundamental criteria for assessing them, the particularities of learning Russian in a closely-related language environment. Among the so-called coursebooks of a “new type” the authors determine electronic and interactive versions of textbooks which started to appear in classrooms recently. However, not all of them meet modern requirements. The article analyses the study packs used in Czech Republic in order to reveal their advantages and disadvantages. The conclusions are proved by the results of the survey carried out among Russian language teachers at Czech schools.

СТОРІТЕЛІНГ ЯК ПОЛІФУНКЦІОНАЛЬНИЙ ІНСТРУМЕНТ СУЧАСНОЇ КОМУНІКАЦІЇ: МОВНОСТИЛІСТИЧНІ ОСОБЛИВОСТІ

The article analyzes media instrument of modern communication, i.e. storytelling, which is widely used for commercial, advertising and corporate purposes to influence recipient's emotions, cognition and motivations. At the same time, storytelling based on real life facts is one of the most effective learning techniques that promotes linguistic competence and enables various communication tasks to be solved. Analysis of storytelling showed that it gained particular relevance due to the principles of submission the information in implicit form, unobtrusively influencing the audience, gaining its trust and loyalty, resulting in the recipients make their own decisions and draw appropriate conclusions. It is established that to reach a high level of influence on the target audience, a story must be true, emotional, relevant and new, contain an idea, a bright character or image, have a dynamic plot, often with a surprise effect, logical conclusion, intrigue till the end and (for electronic versions)be accompanied by quality content. Despite defined algorithms for story-building and typical content structures of its plot, there is a tendency to create storytelling outside the box. The main principle that determines the theme, ideas, specifics of language organization of stories is adaptation to the target audience. Separate analysis of direct-acting storytelling which has recently spread in social networks is given. Its purpose is to draw the reader's attention to current problems, influence the recipient's emotions and behavior with the help of verbal and non-verbal means. An example of such storytelling in Ukraine is the Ukraїner Media Project which helped to represent our country in a new way and realize the dreams of many ordinary citizens. The studying of different stories showed that storytelling uses such linguistic and stylistic means as emotionally coloured vocabulary which is typical for literary, mass media and colloquial functional styles, foreign words, jargon, slang expressions, phraseologisms, metaphors, personifications, rhetoric constructions etc. As for parts of speech, verbs are more frequently used because they intensify and dynamize the narrative.

The role of suggestion in public opinion shaping of the audience of the Internet editions

Introduction. Mass-and socially communicative technologies, that produce the content of modern mass media, are aimed at changing the beliefs, worldview, value orientations of the society, formation of certain behavioral patterns, and transformation of public opinion. Consumers of information, in particular, the audience of Internet editions, become an object of external influences and information aggression. Thus, a comprehensive study of the influence of semantic and structural organization of the content of the modern mass media on public opinion formation is really an actual and urgent task. The purpose of our research is to determine the role of such kind of manipulative technology as a suggestion in shaping the public opinion of the content consumers of the Internet editions (on the material of the electronic versions of the popular newspapers «The Guardian», «USA Today», «China Daily», «The Day», «Moscow Times»). In addition to theoretical, the basic methods of research were also empirical, in particular sociological research, for which the questionnaire was compiled. The respondents were offered to answer 13 questions, 10 of which were of a closed type and 3 questions on an assessment by a scale from 1 to 10. The questionnaire consisted of two blocks. The first block «Target Survey» contained 5 questions, the second block «Associative experiment» – 8 questions Anonymous survey was conducted in December 2018 – March 2019. The audience of the survey consisted of postgraduate students of different specialties, lecturers, and students of the departments of Germanic philology, journalism, and philology at Sumy State University (1st, 2nd, and 3d year students). According to the results of the survey, the most popular sources of information are social networks and electronic information portals, and newspapers. The level of confidence in the popular mass media is 75 %, while most consumers trust electronic information portals and newspapers. The level of influence on the personal opinion of the consumers of information is 60 %. The overall efficiency of the suggestion is 80 %. By the level of influence in its initial effect on the change and formation of reactions, the most effective instruments of suggestion at the lexical level are irony, emotionally-marked vocabulary, contrasts, set-expressions, metaphor-symbols, and also the instruments at the communicative-strategic level (emotionally-evaluative judgments). Keywords: public opinion, Internet editions, content, suggestion, survey.

Виховання співаків спеціальності «Академічний вокал» в умовах інклюзивної освіти

Education of singer is a rather difficult task. It requires a lot of effort from the performer, constant control by his teacher. In recent years, the number of problems with deterioration of vision has increased. One of the cornerstones for pupils with certain pathologies associated with vision is the difficulty of obtaining information. At present, there is a shortage of musical notes recorded on the Braille system. Not every educational institution has such scores, which poses a number of difficulties for the implementation of full-fledged inclusive education. It should be noted that in recent years there has been a lot of money for the creation of notes on this system related to programs that can translate digital text into notes; there are not enough printers to print such text.The works of modern composers, as a rule, are not recorded by the Braille system. When mastering them, it is necessary to implement other approaches to their development. When studying works, the importance of working with a specialist teacher and a concertmaster is increasing, this should help at all stages. Particularly important is the stage of parsing the product, the thorough processing of all components of musical tissue, the correction of certain problem items. Extremely important is not only the individual development and independent work of the student, but also his ability to participate in collective projects - concerts, opera performances. Vocal performance requires the ability to reproduce a large number of emotional shades that should reveal the artistic image resulting from the composer and performer's co-creation. This result is formed when the singer interacts with other participants in the music process - other vocalists, orchestras.The introduction of inclusive education in modern institutions of artistic orientation is one of the most urgent tasks of native pedagogy. The education of the performers of the direction of "academic singing" in the framework of inclusiveness requires the development of new techniques that would be designed to disclose the creative potential of students. There are electronic versions of music texts on the Internet, but mostly classical works that do not contain vocal-instrumental opuses by composers of the second half of the XX-XXI century. Actuality acquires the study of works through various audio versions, which should be analyzed in order to choose a more expedient option. An extremely important task is to work with teachers, whose goal is to create the latest techniques, which would be broadly included in the learning of the achievements of media culture - computer equipment, software, electronic resources available on the Internet. Another promising area for further research is the outline of aspects of psychological readiness for the teaching process, both for teachers and students.

Privacy-Preserving Electronic Ticket Scheme with Attribute-Based Credentials

Electronic tickets (e-tickets) are electronic versions of paper tickets, which enable users to access intended services and improve services' efficiency. However, privacy may be a concern of e-ticket users. In this paper, a privacy-preserving electronic ticket scheme with attribute-based credentials is proposed to protect users' privacy and facilitate ticketing based on a user's attributes. Our proposed scheme makes the following contributions: (1) users can buy different tickets from ticket sellers without releasing their exact attributes; (2) two tickets of the same user cannot be linked; (3) a ticket cannot be transferred to another user; (4) a ticket cannot be double spent; (5) the security of the proposed scheme is formally proven and reduced to well known (q-strong Diffie-Hellman) complexity assumption; (6) the scheme has been implemented and its performance empirically evaluated. To the best of our knowledge, our privacy-preserving attribute-based e-ticket scheme is the first one providing these five features. Application areas of our scheme include event or transport tickets where users must convince ticket sellers that their attributes (e.g. age, profession, location) satisfy the ticket price policies to buy discounted tickets. More generally, our scheme can be used in any system where access to services is only dependent on a user's attributes (or entitlements) but not their identities.

The images of politicians in the language consciousness performed in the English and German newspaper and journalistic discourses

In the modern era of mass politicization of the public consciousness of the media, in addition to forming an opinion on political events, it also performs the function of manipulating the public consciousness. Of particular interest in this influence are the images of leading politicians. Images of politicians in the media influence the formation of opinions about the political situation in the country and in the world as a whole. In order to analyze the images of politicians in the media and to identify the deep meaning in the presentation of images of politicians, the authors of the article turn to text materials of electronic versions of social and political newspapers and magazines (The Guardian, Daily Mail, Telegraph, Focus, Zeit, Spiegel), using the conceptual method analysis and contextual analysis method. The presentation of images of politicians reveals value meanings of sympathy and antipathy. The authors of the article attempt to identify moments in the representation of the images of politicians, where they generate additional meaning that has an emotional impact on public opinion.

СОЗДАНИЕ ЭЛЕКТРОННОЙ ВЕРСИИ МАСШТАБНЫХ ПЛАНОВ ЖЕЛЕЗНОДОРОЖНЫХ СТАНЦИЙ

This article describes the stages of creating electronic versions of scale plans of stations, using measurements obtained by various geodetic tools and complexes. The features of processing of ma-terials obtained by complex "Profile"are described. The General algorithm of formation of the scale plan of railway stations is shown. In the course of all processing of materials the railway way is con-sidered as the uniform massif consisting of points of an axis of the way having both planned posi-tion, and high-rise. This approach allows you to fully analyze the plan and profile of the station path as a separate element of the station, and its relationship with other objects. Perform automatic calcu-lation of picketage, spacing and dimensions of buildings.мThe problems of data export to the geoin-formation database of the West Siberian railway are indicated.

The Issue of Classification of Hate Speech Against Migrants (the Case Study of the Republic of Mordovia)

Introduction. The performed analysis of coverage of migration issues in electronic media shows that hate speech against migrants is becoming common practice despite the existing regulatory restrictions on its use. This determined the choice of this issue for the research, aimed at studying the causes, forms and contexts of using hate speech against migrants (the case study of the Republic of Mordovia). Materials and Methods. Texts on migration issues published in electronic versions of regional media were used as the materials of the study; discourse analysis was used as the main method. Results. The main reason for using hate speech against migrants has been identified; it is reproduction of negative clichés and stereotypes that contribute to the perception of migrants as a source of economic, health, environmental, personal, social, political threats, etc. The authors have proposed the content and formal criteria for classification of hate speech against migrants. Recommendations on limiting the use of hate speech against migrants in public discourse have been offered. Recommendations of this kind are usually associated with a change in rhetoric at the textual and contextual levels; however the authors consider a change in coverage and perception of migration issues at the metacontextual level to be the most important factor. Discussion and Conclusion. The research materials will be useful in developing migration policies and measures to harmonize social relations in the region. The data obtained can be used by state and municipal authorities, journalists, and representatives of the educational community.

Patient-reported outcomes (PROs) in lung cancer: Experiences from a nationwide feasibility study

ObjectivesOur objectives were to examine the feasibility of a nationwide collection of patient-reported outcomes (PROs) in a lung cancer population as well as in various sub-populations, and to describe the characteristics of responders compared to non-responders. Materials and methodsAll patients diagnosed with lung cancer in Denmark are registered in the Danish Lung Cancer Registry (DLCR). The 7,295 patients registered in DLCR from 1 October 2013 until 30 September 2015 who had received treatment were eligible. Using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-LC13 questionnaires, we employed two different methods of delivery, resulting in two different project parts. In project part 1, the baseline questionnaire was handed out at the hospital departments before treatment. The following questionnaires were sent out as paper versions three times within one year. In project part 2, all questionnaires were electronic versions delivered in association with planned hospital visits. ResultsOf the 7,295 lung cancer patients 4,229 (58%) completed at least one questionnaire, and 2,459 completed two or more. Only 562 baseline questionnaires were returned before treatment (7.7%), whereas 43.4%–57.4% of the potential responders completed the following questionnaires. The best response rates were achieved among patients treated with surgery and among patients who discussed their questionnaires with health care personnel. When comparing patient characteristics, responders had a significantly better health and a higher socioeconomic position than non-responders. ConclusionA decentralised model used for delivering the initial questionnaire to the patients was insufficient. It is our estimation that sending out electronic versions of the baseline questionnaires, as was done with the following questionnaires, would result in a significantly better patient coverage. Despite the severe morbidity and high mortality rate in lung cancer, reasonable response rates were achieved at follow-ups to this method, and PRO collection in this population was feasible.

Online Bibliographic Products: Theory Issues and the Practice of the Russian State Library and the National Library of Russia

The article highlights the research work “Information and bibliographic activities in the modern electronic environment”, “Electronic bibliographic products in the structure of information resources of Federal and Central regional libraries” carried out by the Scientific research Department of bibliography of the Russian State Library in 2017 — the first half of 2018. The author considers a number of general theoretical and methodological issues: what are the library’s information resources; what is the place of bibliographic resources in their structure; and what is the type-specific structure of bibliographic resources of library, including electronic ones. The important part of the library’s information resources are bibliographic resources, including electronic of two main types (classes): innovative (bibliographic databases, electronic catalogues), and traditional (bibliographic catalogues-inventories, indexes, lists, reviews, etc.). The article presents the results of the comparative analysis of resources of the second type created in the Russian State Library and the National Library of Russia in 2009—2017.The websites of both libraries contain digital copies and electronic versions of printed bibliographic publications, as well as original bibliographic products (which have no printed analogues). Online bibliographic products have firmly taken their place in the structure of information resources of national libraries, somewhere supplementing them and somewhere replacing the printed format.

Validation of an electronic version of the Self-Awareness Questionnaire in English and Italian healthy samples.

Interoception is a general sensitivity to bodily sensations that informs motivational processes and behaviours. Interoceptive abilities seem to be impaired in several clinical conditions, and the development of new pragmatic instruments to assess subjective components of interoception are crucially needed. An easy to use paper and pencil questionnaire measuring sensitivity to bodily sensations was validated in an Italian sample (Self-Awareness Questionnaire; SAQ). In the present study, we created and evaluated an electronic version of the SAQ in Italian and English language. Psychometric properties of both electronic versions of the SAQ were validated in an Italian (n=206) and an English (n=275) sample, using factorial analyses. Differences in factorial structures observed between the two samples were discussed in terms of cultural impact on emotional regulation and bodily sensations processing. The electronic version of SAQ in English and Italian provides a pragmatic and validated tool to evaluate bodily signal sensitivity in clinical settings, informing the development of a new therapy targeting interoceptive processes, in a wide range of psychopathological conditions.

Implementing Electronic Patient-Reported Outcome Measures in Outpatient Cosmetic Surgery Clinics: An Exploratory Qualitative Study.

Patient-reported outcome measure (PROM) data are increasingly being collected over the internet or on a smart device by means of electronic versions (e-PROMs). Limited evidence exists about factors influencing e-PROM implementation in outpatient clinics. The authors sought to identify barriers to collection of PRO data from different locations (home or cosmetic surgery office) by means of different modes (paper vs e-PROM) from the perspective of patients, plastic surgeons, and clinic administrative staff; and to explore patient preferences for the design of e-PROM platforms. Semistructured interviews were conducted with 11 patients, 3 cosmetic surgeons, and administrative staff. Patients were shown 1 of the 3 PROMs (ie, the BODY-Q Satisfaction with Body scale, BREAST-Q Augmentation Module Satisfaction with Breast scale, or FACE-Q Satisfaction with Facial Appearance scale). The formats included paper and electronic (REDCap and TickiT) on a tablet and laptop computer. The interviews were audio-recorded and transcribed verbatim. Qualitative descriptive analysis was conducted. Patients and providers preferred electronic over paper format. The flexibility of the hardware, data entry point (remote location vs point-of-care), and the privacy of the data were the most recurring themes from the patient's perspective. The objective of collecting PROM data, role in peer-benchmarking, and return on investment were key to surgeons and administrative staff. The e-PROMs were well accepted in the community setting by the patients and plastic surgeons alike. The design and interface features of e-PROMs were explored in this study, which may be useful for future, mixed method studies evaluating the implementation of e-PROMs.

Responsiveness, Reliability, and Minimally Important and Minimal Detectable Changes of 3 Electronic Patient-Reported Outcome Measures for Low Back Pain: Validation Study.

BackgroundThe Roland Morris Disability Questionnaire (RMDQ), visual analog scale (VAS) of pain intensity, and numerical rating scale (NRS) are among the most commonly used outcome measures in trials of interventions for low back pain. Their use in paper form is well established. Few data are available on the metric properties of electronic counterparts.ObjectiveThe goal of our research was to establish responsiveness, minimally important change (MIC) thresholds, reliability, and minimal detectable change at a 95% level (MDC95) for electronic versions of the RMDQ, VAS, and NRS as delivered via iOS and Android apps and Web browser.MethodsWe recruited adults with low back pain who visited osteopaths. We invited participants to complete the eRMDQ, eVAS, and eNRS at baseline, 1 week, and 6 weeks along with a health transition question at 1 and 6 weeks. Data from participants reporting recovery were used in MIC and responsiveness analyses using receiver operator characteristic (ROC) curves and areas under the ROC curves (AUCs). Data from participants reporting stability were used for analyses of reliability (intraclass correlation coefficient [ICC] agreement) and MDC95.ResultsWe included 442 participants. At 1 and 6 weeks, ROC AUCs were 0.69 (95% CI 0.59 to 0.80) and 0.67 (95% CI 0.46 to 0.87) for the eRMDQ, 0.69 (95% CI 0.58 to 0.80) and 0.74 (95% CI 0.53 to 0.95) for the eVAS, and 0.73 (95% CI 0.66 to 0.80) and 0.81 (95% CI 0.69 to 0.92) for the eNRS, respectively. Associated MIC thresholds were estimated as 1 (0 to 2) and 2 (–1 to 5), 13 (9 to 17) and 7 (–12 to 26), and 2 (1 to 3) and 1 (0 to 2) points, respectively. Over a 1-week period in participants categorized as “stable” and “about the same” using the transition question, ICCs were 0.87 (95% CI 0.66 to 0.95) and 0.84 (95% CI 0.73 to 0.91) for the eRMDQ with MDC95 of 4 and 5, 0.31 (95% CI –0.25 to 0.71) and 0.61 (95% CI 0.36 to 0.77) for the eVAS with MDC95 of 39 and 34, and 0.52 (95% CI 0.14 to 0.77) to 0.67 (95% CI 0.51 to 0.78) with MDC95 of 4 and 3 for the eNRS.ConclusionsThe eRMDQ was reliable with borderline adequate responsiveness. The eNRS was responsive with borderline reliability. While the eVAS had adequate responsiveness, it did not have an attractive reliability profile. Thus, the eNRS might be preferred over the eVAS for measuring pain intensity. The observed electronic outcome measures’ metric properties are within the ranges of values reported in the literature for their paper counterparts and are adequate for measuring changes in a low back pain population.

Peer-reviewed physical education journals from Arabic-speaking countries: a regional assessment

PurposeNon-communicable diseases (NCD) such as heart disease, diabetes and overweight and obesity are associated with physical inactivity and represent the leading cause of death globally. In the Arabic-speaking region, NCD is associated with more than 2.3 million deaths annually with rates expected to increase. Professional physical education (PE) journals are important resources in the dissemination of knowledge from evidence to practice. With the growing physical inactivity problem among Arabic-speaking countries, the purpose of this paper is to assess the availability culturally relevant peer-reviewed physical education journals in this region.Design/methodology/approachAn assessment of professional PE journals within this region was conducted using four academic databases and journal directories. The electronic search generated 14 PE-affiliated journals in Arabic-speaking countries with a publication status of active, interrupted or ceased; search parameters were limited to English, Arabic and French languages.FindingsResults indicated that no professional publications identified in this review predates to 2005 within the Arabic-speaking region. Although all 14 journals within the sample offer both electronic and open access, only one provided both print and electronic versions. Iraq was over-represented with 12 PE journals; no other country offered more than one.Originality/valueSystematic analyses of PE prevalence among Arabic-speaking countries are scarce, and there are no current evaluations of peer-reviewed publications addressing PE within the Arabic-speaking region. PE capacity building and collaboration can be fostered, improved and maintained when supported by regionally and culturally congruent research.

Trail Making Test: Comparison of paper-and-pencil and electronic versions

The Trail Making Test (TMT) was adapted for the iPad by Parker-O’Brien, which uses the 2004 Tombaugh norms. This study investigated the equivalency of this electronic test by (a) examining the test–retest reliability of the iPad-TMT, and (b) calculating the concurrent validity between the two versions. The sample included 77 healthy adults. Reliability was assessed by Pearson product-moment correlation and intraclass correlation coefficient, while validity was assessed by MANOVA. Results indicate that Part A of the iPad-TMT did not demonstrate adequate test–retest reliability over 1 week (r = 0.15–0.70); Part B demonstrated adequate test–retest reliability in the majority of groups (r = 0.33–0.80). Conversely, Part A of the electronic TMT demonstrated adequate concurrent validity, whereas Part B did not; however, validity in Part A has minimal significance without adequate reliability. Handedness had a significant effect on performance, with left-handers performing slower on the electronic TMT Part A (p < .05) and the traditional TMT Part B (p < .05). Clinicians should use caution when using electronic versions of traditional tests, as they may assess different constructs. New norms should be developed. The role of handedness on TMT performance should be further assessed.

A Comparison of Electronic Medical Record Data to Paper Records in Antiretroviral Therapy Clinic in Ethiopia: What is affecting the Quality of the Data?

BackgroundAnti-Retroviral Therapy (ART) care is a lifelong treatment, which needs accurate and reliable data collected for long period of time. Poor quality of medical records data remains a challenge and is directly related to the quality of care of patients. To improve this, there is an increasing trend to implement electronic medical record (EMR) in hospitals. However, there is little evidence on the impact of EMR on the quality of health data in low- resource setting hospitals like Ethiopia. This comparative study aims to fill this evidence gap by assessing the completeness and reliability of paper-based and electronic medical records and explore the challenges of ensuring data quality at the Anti-Retroviral Therapy (ART) clinic at the University of Gondar Referral Hospital in Northwest Ethiopia.MethodsAn institution-based comparative cross-sectional study, supplemented with a qualitative approach was conducted from February 1 to March 30, 2017 at the ART clinic of the University of Gondar Hospital. A total of 250 medical records having both electronic and paper-based versions were collected and assessed. A national ART registration form which consists of 40 ART data elements was used as a checklist to assess completeness and reliability dimensions of data quality on medical records of patients on HIV care. Kappa statistics were computed to describe the level of data agreement between paper-based and electronic records across patient characteristics. In-depth interviews were conducted using semi-structured questionnaires with ten key informants to explore the challenges related with the quality of medical records. Responses of the key informant interviews were analyzed using thematic analysis.ResultsThe overall completeness of medical records was 78% with 95% CI (70.8% - 85.1%) in paper-based and 76% with 95%CI (67.8% - 83.2%) EMR. The data reliability measured in Kappa statistics shows strong agreements on the socio-demographic data such as educational status 0.93 (0.891, 0.963), WHO staging 0.86 (0.808, 0.906); general appearance 0.83 (0.755, 0.892) and patient referral record 0.87 (0.795, 0.932). The major challenges hindering good data quality was the current side by side dual data documentation practice (the need to document both on the paper and the EMR for a single record), patient overload and low data documentation practice of health workers.ConclusionThe overall completeness of ART medical records was still slightly better in paper-based records than EMR. The main reason affecting the EMR data quality was the current dual documentation practice both on the paper and electronic for each patient in the hospital and the high load of patients in the clinic. The hospital management need to decide to use either the paper or the electronic system and build the capacity of health workers to improve data quality in the hospital.

Validation of a Sequential Organ Failure Assessment Score using Electronic Health Record Data.

The sequential organ failure assessment (SOFA) score is a scoring system commonly used in critical care to assess severity of illness. Automated calculation of the SOFA score using existing electronic health record data would broaden its applicability. We performed a manual validation of an automated SOFA score previously developed at our institution. A retrospective analysis of a random subset of 300 patients from a previously published randomized trial of critically ill adults was performed, with manual validation of SOFA scores from the date of initial intensive care unit admission. Spearman's rank correlation coefficient, weighted Cohen's kappa, and Bland-Altman plots were used to assess agreement between manual and electronic versions of SOFA scores and between manual and electronic versions of their individual components. There was high agreement between manual and electronic SOFA scores (Spearman's rank correlation coefficient = 0.90, 95% CI 0.87-0.93). Renal and respiratory components had lower agreement (weighted Cohen's kappa = 0.63, 95% CI 0.53-0.73 for renal; weighted Cohen's kappa = 0.77, 95% CI 0.70-0.84 for respiratory). The area under the receiver operating characteristic curve (AUC) for 30-day in-hospital mortality was 0.77 (95% CI 0.68-0.84) for manual SOFA scores and 0.75 (95% CI 0.66-0.83) for automated SOFA scores. Automatic calculation of SOFA scores from the electronic health record is feasible and correlates highly with manually calculated SOFA scores. Both have similar predictive value for 30-day in-hospital mortality.