Healthcare Research Research Articles

A Structured Literature Review on the Research and Design of Rehabilitation Environments.

This literature review is conducted to identify knowledge gaps and shape a framework for the development of guidelines and future research on programming and design of rehabilitation environments. Patients suffering from trauma, stroke, neurological or cardiopulmonary conditions, or recovering from surgery or cancer treatment require rehabilitation services. A comprehensive rehabilitation program can support continuum of care for inpatient and outpatient groups. However, within most facilities, rehabilitation environments are found to be outdated and undersized compared to other programs or lack the correct adjacencies within the facility. Unfortunately, this deficiency is echoed by limited guidelines on programming, planning, and design of these environments. General guidelines derived from healthcare environments research is not adaptable to rehabilitation environments, because the paradigm used in most healthcare environment research does not address specific needs of rehabilitation patients in regaining confidence or relearning daily life skills. We conducted a structured literature review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses as a basis for reporting the available body of work on evidence-based research in rehabilitation environments. Through analysis of the limited literature, specific mediators such as patient confidence and motivation were identified. An environment that creates a balance between privacy and social interaction can promote these mediators. Creating enriched environments through elements that engage the senses and encourage more social and physical interaction is essential for recovery. Finally, accessibility and wayfinding are of great importance in these environments due to potential limited mobility or cognitive impairments of patients.

Nature-Based Design in Stroke Rehabilitation Environments: A Scoping Review.

To identify, examine, and map the characteristics of knowledge of nature-based design in stroke rehabilitation facilities, examine how research in this field has been conducted and identify gaps in knowledge. Many stroke survivors have wide ranging impacts, resulting in long hospital stays to undertake rehabilitation. The physical environment can influence brain recovery; however, there is limited evidence to support the design of effective rehabilitation environments. Conversely, the health benefits available from connection with nature are well established. A nature-based design approach may have benefits and implications for the physical environment of inpatient stroke rehabilitation facilities; however, it is unclear what evidence exists in this field. This scoping review followed the JBI methodological guidance for the conduct of scoping reviews, with systematic searches of six databases. Twenty-eight studies were included in the review. Aims and research methods varied widely. Investigations in 19 studies related to gardens and other designed outdoor nature-based environments. Other studies explored natural analogues, nature inside, inside/outside connections, and the natural environment. Findings from the studies were spread across the fields of design, use, exposure to, and engagement in nature-based environments. The characteristics of knowledge underpinning nature-based design in stroke rehabilitation environments are highly diverse, and significant gaps exist in the evidence base. A framework developed during this review for mapping knowledge on the intentions and impacts for spaces and services in this field assisted to identify these gaps and may be applied to other areas of healthcare design research.

Differential Privacy Protections in 2020 U.S. Decennial Census Data Do Not Impede Measurement of Racial and Ethnic Disparities.

Census data are vital to health care research but must also protect respondents' confidentiality. The 2020 decennial Census employs a new Differential Privacy framework; this study examines its effect on the accuracy of an important tool for measuring health disparities, the Bayesian Improved Surname and Geocoding (BISG) algorithm, which uses Census Block Group data to estimate race and ethnicity when self-reported data are unavailable. Using self-reported race and ethnicity data as our standard, we compared the accuracy of BISG estimates calculated using the original 2010 Census counts to the accuracy of estimates calculated using 2010 data but with 2020 Differential Privacy in place. The Differential Privacy methodology slightly decreases BISG accuracy for American Indian and Alaska Native people but has little effect for other groups, suggesting that the methodology will not impede health disparities research that employs BISG and similar methods.

The use of artificial neural networks and decision trees: Implications for health-care research

Abstract The use of decision trees and artificial neural networks (ANNs) in health-care research is widespread, as they enable health-care providers with the tools they need to make better medical decisions with their patients. ANNs specifically are extremely helpful in predictive research as they can provide investigators with knowledge about future trends and patterns. However, a major downside to ANNs is their lack of interpretability. Understandability of the model is important as it ensures the outcomes are true to the dataset’s original labels and are not impacted by algorithmic bias. In comparison, decision trees map out their entire process before providing the results, which leads to a higher level of trust in the model and the conclusions it supplies the investigators with. This is essential as many historical datasets lack equal and fair representation of all races and sexes, which might directly correlate to a lesser treatment given to females and individuals in minority groups. Here, we review existing work around the differences and connections between ANNs and decision trees with implications for research in health care.

Determinants of low birth weight among newborns delivered in public hospitals of North Shewa Zone, Amhara region, Ethiopia: A case-control study (2023).

Low birth weight (LBW), defined as a birth weight less than 2500 g, irrespective of gestational age, poses a significant health concern for newborns. Despite efforts, the incidence of LBW in sub-Saharan Africa has remained stagnant over the past decade, warranting attention from healthcare providers, policymakers, and researchers. This study aimed to identify factors associated with LBW among newborns delivered in public hospitals of North Shewa Zone, Amhara Region, Ethiopia, from May 2 to June 10, 2023. An unmatched case-control study was conducted from May 2 to June 10, 2023, involving 318 participants (106 cases and 212 controls). Data were collected using pretested interviewer-administered structured questionnaires, medical record reviews, and direct anthropometric measurements. Bivariate analyses were conducted, and variables with a p-value ≤ 0.25 were included in a multivariable logistic regression model to determine significant determinants of LBW. A significance level of p < 0.05 was used. A total of 309 newborns (103 cases and 206 controls) were included, yielding a response rate of 97.2%. Among the findings, females exhibited a higher risk of LBW (adjusted odds ratio [AOR]: 3.13, 95% CI: 1.34, 7.32, p = 0.008), as did mothers aged 20 or younger (AOR: 3.42, 95% CI: 1.35, 8.66, p = 0.009). Lack of formal education was associated with increased risk (AOR: 6.82, 95% CI: 2.94, 15.3, p < 0.001), as were unplanned pregnancies (AOR: 3.08, 95% CI: 1.38, 6.84, p = 0.006) and missed antenatal care visits (AOR: 2.74, 95% CI: 1.16, 6.49, p = 0.021). No significant associations were found with residency type or maternal age above 35. Mothers aged ≤ 20 years, with inadequate minimum dietary diversity, lack of antenatal care attendance, and unplanned pregnancies, faced heightened risks of LBW. Addressing these factors is vital for reducing LBW occurrences and improving newborn health outcomes in Ethiopia.

Hospitalization of patients with nutritional anemia in the United States in 2020

BackgroundNutritional anemia is highly prevalent and has triggered a globally recognized public health concern worldwide.ObjectiveTo better understand the prevalence of anemia and the state of nutritional health in developed countries to inform global nutritional health and better manage the disease.MethodWe employed the Healthcare Cost and Utilization Project (HCUP)-2020 National Inpatient Health Care Data (NIS), administered by The Agency for Healthcare Research and Quality. Nutritional anemia was diagnosed according to the International Classification of Diseases, 10th Revision (ICD-10). Matching analysis and multivariate regression were used to adjust for patient and hospital characteristics. Controls were obtained by stratifying and matching for age and sex.ResultsThe 2020 HCUP-NIS database encompassed a survey over 6.4 million hospitalized patients, among which 1,745,350 patients diagnosed with anemia, representing approximately 26.97% of the hospitalized population, over 310,000 were diagnosed with nutritional anemia, and 13,150 patients were hospitalized for nutritional anemia as primary diagnosis. Hospitalization rate for nutritional anemia exhibited an increased age-dependent increase nationwide, especially among females, who displayed 1.87 times higher than males. Notably, in comparison to the control group, individuals of the Black race exhibit a higher prevalence of nutritional anemia (case group: 21.7%, control group: 13.0%, p &amp;lt; 0.001). In addition, hospitalization rates were higher among low-income populations, with lower rates of private insurance (case group: 18.7%, control group: 23.5%, p &amp;lt; 0.001) and higher rates of Medicaid insurance (case group: 15.4%, control group: 13.9%, p &amp;lt; 0.001). In areas characterized by larger urban centers and advanced economic conditions within the urban–rural distribution, there was an observed increase in the frequency of patient hospitalizations. Iron deficiency anemia emerged as the predominant subtype of nutritional anemia, accounting for 12,214 (92.88%). Secondary diagnosis among patients hospitalized for nutritional anemia revealed that a significant number faced concurrent major conditions like hypertension and renal failure.ConclusionIn economically prosperous areas, greater attention should be given to the health of low-income individuals and the older adult. Our findings hold valuable insights for shaping targeted public health policies to effectively address the prevalence and consequences of nutritional anemia based on a overall population health.

I Need to See Me in It: Critical Participatory Inquiry as a Bridge Between Theory and Practice for PAR in Healthcare Organizations

Critical Participatory Inquiry (CPI) is an emergent epistemological anchoring of Participatory Action Research (PAR) that grounds its users in a spectrum of participation that considers the way that social constraints including race, politics, and power dynamics influence how researchers operationalize and practice amplification of minoritized voices in their research. This article is a scholarly and reflexive perspective piece that invites scholars, practitioners, and scholar-practitioners to explore the ontology and axiology of their own ideologies and their alignment with how they show up in the world and how they manage the implicit hierarchies within healthcare research and within healthcare organizations. The author uses her own positionality to explain how she grounds and frames her research in her lived experience and personal truths. It considers the types of knowledge and the knowledge holders that are privileged in academia and compares that to the realized hierarchies and power dynamics in the healthcare setting.

Thematic analysis informed by grounded theory (TAG) in healthcare research: foundations and applications

ABSTRACT Grounded theory (GT) and thematic analysis (TA) are commonly used in qualitative healthcare research. Published by Glaser and Strauss in 1967, GT was the first set of qualitative research strategies described. TA has since been compared with selected GT strategies. This narrative review aims to examine and illustrate how TA can be informed by GT and elucidate a TA informed by GT (TAG) methodology. Utlizing models of researching practice wisdom and reflexive inquiry, fifty author-published TAG studies (1996–2024) were examined. Analysis delineated a TAG methodology and clarifies Glaser and Strauss’s foundational roles in its development. TAG adheres to constructivism. Main GT strategies informing TAG include: comparative, predominantly inductive, and iterative analysis; and coding (data segment labels), category (code group), and thematic (category group) development. TAG can also encompass four-level thematic abstraction, and qualitative inter-rater reliability procedures enhance trustworthiness. TAG is a practical and effective methodological approach for qualitative healthcare research.

2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines.

The "2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy" provides recommendations to guide clinicians in the management of patients with hypertrophic cardiomyopathy. A comprehensive literature search was conducted from September 14, 2022, to November 22, 2022, encompassing studies, reviews, and other evidence on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. Additional relevant studies, published through May 23, 2023, during the guideline writing process, were also considered by the writing committee and added to the evidence tables, where appropriate. Hypertrophic cardiomyopathy remains a common genetic heart disease reported in populations globally. Recommendations from the "2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy" have been updated with new evidence to guide clinicians.

Computer vision digitization of smartphone images of anesthesia paper health records from low-middle income countries

BackgroundIn low-middle income countries, healthcare providers primarily use paper health records for capturing data. Paper health records are utilized predominately due to the prohibitive cost of acquisition and maintenance of automated data capture devices and electronic medical records. Data recorded on paper health records is not easily accessible in a digital format to healthcare providers. The lack of real time accessible digital data limits healthcare providers, researchers, and quality improvement champions to leverage data to improve patient outcomes. In this project, we demonstrate the novel use of computer vision software to digitize handwritten intraoperative data elements from smartphone photographs of paper anesthesia charts from the University Teaching Hospital of Kigali. We specifically report our approach to digitize checkbox data, symbol-denoted systolic and diastolic blood pressure, and physiological data.MethodsWe implemented approaches for removing perspective distortions from smartphone photographs, removing shadows, and improving image readability through morphological operations. YOLOv8 models were used to deconstruct the anesthesia paper chart into specific data sections. Handwritten blood pressure symbols and physiological data were identified, and values were assigned using deep neural networks. Our work builds upon the contributions of previous research by improving upon their methods, updating the deep learning models to newer architectures, as well as consolidating them into a single piece of software.ResultsThe model for extracting the sections of the anesthesia paper chart achieved an average box precision of 0.99, an average box recall of 0.99, and an mAP0.5-95 of 0.97. Our software digitizes checkbox data with greater than 99% accuracy and digitizes blood pressure data with a mean average error of 1.0 and 1.36 mmHg for systolic and diastolic blood pressure respectively. Overall accuracy for physiological data which includes oxygen saturation, inspired oxygen concentration and end tidal carbon dioxide concentration was 85.2%.ConclusionsWe demonstrate that under normal photography conditions we can digitize checkbox, blood pressure and physiological data to within human accuracy when provided legible handwriting. Our contributions provide improved access to digital data to healthcare practitioners in low-middle income countries.

Long COVID in Children, Adults, and Vulnerable Populations: A Comprehensive Overview for an Integrated Approach

Long COVID affects both children and adults, including subjects who experienced severe, mild, or even asymptomatic SARS-CoV-2 infection. We have provided a comprehensive overview of the incidence, clinical characteristics, risk factors, and outcomes of persistent COVID-19 symptoms in both children and adults, encompassing vulnerable populations, such as pregnant women and oncological patients. Our objective is to emphasize the critical significance of adopting an integrated approach for the early detection and appropriate management of long COVID. The incidence and severity of long COVID symptoms can have a significant impact on the quality of life of patients and the course of disease in the case of pre-existing pathologies. Particularly, in fragile and vulnerable patients, the presence of PASC is related to significantly worse survival, independent from pre-existing vulnerabilities and treatment. It is important try to achieve an early recognition and management. Various mechanisms are implicated, resulting in a wide range of clinical presentations. Understanding the specific mechanisms and risk factors involved in long COVID is crucial for tailoring effective interventions and support strategies. Management approaches involve comprehensive biopsychosocial assessments and treatment of symptoms and comorbidities, such as autonomic dysfunction, as well as multidisciplinary rehabilitation. The overall course of long COVID is one of gradual improvement, with recovery observed in the majority, though not all, of patients. As the research on long-COVID continues to evolve, ongoing studies are likely to shed more light on the intricate relationship between chronic diseases, such as oncological status, cardiovascular diseases, psychiatric disorders, and the persistent effects of SARS-CoV-2 infection. This information could guide healthcare providers, researchers, and policymakers in developing targeted interventions.

Tinnitus in Children.

This perspective reviews the current state of the art and literature on tinnitus in children, prevalence and risk factors, clinical management, and future priorities for healthcare provision and research. Most research in the field to date appears to be prevalence studies, which have reached dramatically different estimates; this reflects the lack of a standard language when asking about the presence of tinnitus, or how bothersome, distressing, or negatively impacting it is for the child. Estimates are also likely affected by a lack of awareness of tinnitus amongst children and parents. Children are less likely to spontaneously report tinnitus than adults, and parents are often unaware their child could even develop tinnitus, considering it a disease of older age for example. It is critical that children are asked and learn about tinnitus. In hearing clinics, clinicians should routinely ask about all children about tinnitus and offer tinnitus care and settings that are child- and family-friendly. As well as asking directly, clinicians should be alert to soft signs of tinnitus such as unexplained listening, speech perception, concentration difficulties, worry or anxiety, or difficulties completing hearing tests or using hearing aids. The recently developed impact of Tinnitus in Children Questionnaire (iTICQ) can then be used to assess problems that are most commonly core to children's experience of tinnitus. Clinical guidelines for tinnitus in children are few but provide recommendations for additional paediatric questionnaires and alternative assessments and for a range of treatment options. Of note, however, is the lack of clinical trials and, therefore, evidence of the effectiveness of any treatment for tinnitus in children. Significant and concerted work is therefore needed to raise awareness of tinnitus in children, understand the scale of clinical need, and standardise and evaluate clinical management options.

Guidelines for chronic pain in adult spinal cord injury population: Scoping review

Background: Chronic pain among survivors of spinal cord injury (SCI) hurts physical and mental health. Persons with SCI have demonstrated dissatisfaction with the management of their chronic pain.Objectives: This study aimed to identify existing clinical practice guidelines for chronic pain in the SCI population.Method: A scoping review was conducted across various databases available at the University of the Western Cape, in addition to guideline clearing houses (BioMedCentral, Cambridge Journals Online, CINAHL, Cochrane Library, Medline [EbscoHost], Medline [Pubmed], Sabinet Reference, SAGE Journals Online, ScienceDirect, SCOPUS, Wiley Online Library, Springerlink, PubMed, Guideline Central, and Agency for Healthcare Research and Quality). The population consisted of adults with SCI, and the interventions that were included were pharmacological and nonpharmacological management of chronic pain. Guidelines that met the inclusion criteria were critically appraised by two reviewers from this study using the AGREE II instrument. Inter-rater reliability was calculated using SPSS 27, and Cohen’s kappa coefficients were established.Results: Five articles were included in the data extraction, analysis and appraisal. Two guidelines were rated as high quality, according to the AGREE II tool. In addition, most guidelines focused on neuropathic pain (NeuP) and only one guideline included nociceptive pain and NeuP.Conclusion: One guideline met the objectives of this scoping review.Clinical implications: Guidelines developed in the future should include a screening tool to identify the specific type of pain and distinguish peripheral NeuP from central NeuP.

Association between non-alcoholic fatty liver disease and risk of sarcopenia: a systematic review and meta-analysis

ObjectivesTo determine the association of non-alcoholic fatty liver disease (NAFLD) with the incidence of sarcopenia.DesignSystematic review and meta-analysis of observational clinical studies.Setting and participantsAdults with NAFLD.MethodsDatabases such as PubMed, Embase,...

Towards sharing tools and artefacts for reusable simulations in healthcare

ABSTRACT Discrete-event simulation (DES) is a widely used computational method in health services and health economic studies. Despite increasing recognition of the advantages of open, reusable DES models for both healthcare practitioners and simulation researchers, in practice very few authors share their model code alongside a published paper. In the context of Free and Open Source Software (FOSS), this paper presents a pilot framework called STARS: Sharing Tools and Artefacts for Reusable Simulations to begin to address the challenges and leverage the opportunities of sharing DES models in healthcare. STARS aligns with existing guidelines and documentation, including reproducibility initiatives, and enables computer models to be shared with users of differing technical abilities. We demonstrate the feasibility and applicability of STARS with three applied DES examples using Python. Our framework supports the development of open, reusable DES models which can enable partner healthcare organisations to preview, validate, and use models. Academic research teams can benefit from knowledge exchange, enhanced recognition and scrutiny of their work, and long-term archiving of models.

Managing gastrointestinal challenges: Diarrhea in sickle cell anemia.

Sickle cell anemia (SCA), a hereditary hemoglobinopathy, is characterized by the presence of abnormal hemoglobin and has long been associated with a wide range of complications. While much attention has been given to the condition hematological aspects, gastrointestinal complications, particularly diarrhea, have been relatively understudied and often overlooked. This publication delves into the management of gastrointestinal challenges, with a focus on diarrhea, in individuals living with SCA. The pathophysiology of SCA is intrinsically linked to gastrointestinal complications, and diarrhea is a common manifestation of this condition. This abstract publication outlines the key elements discussed in the full-length work, which includes the clinical presentation of diarrhea in these patients, the diagnostic tools used to evaluate the condition, and various management strategies to alleviate symptoms and enhance the overall quality of life for affected individuals. The paper emphasizes the importance of patient education, offering healthcare professionals valuable insights into how to inform and support patients in managing their conditions effectively. It also highlights the need for continued research to further our understanding of gastrointestinal challenges in SCA and to identify potential areas for future therapeutic interventions. Ultimately, the comprehensive management of diarrhea in individuals with SCA is vital for their overall well-being. This publication serves as a valuable resource for healthcare providers, researchers, and caregivers in addressing the gastrointestinal challenges that accompany SCA, ultimately working toward a better quality of life for those affected by this condition.

Influence of job satisfaction components on staff performance in the emergency department

Background/Aims The relationship between job satisfaction and job performance has been well-established in healthcare research. This study aimed to measure job satisfaction and performance among staff working in emergency departments in Jordan, and to explore the association between these two variables, focusing on the different components of job satisfaction. Methods A cross-sectional design with a convenience sampling approach was used, recruiting 286 staff working across 11 emergency departments in Jordan. Participants completed a questionnaire comprising validated scales to measure job satisfaction and job performance. Descriptive statistics, Pearson correlation, Cronbach's alpha and multiple regression analysis were used, via the SPSS version 25, to explore the relationship between job performance and different components of job satisfaction. Results Mean scores on the job satisfaction and job performance scales indicated that participants were neither satisfied nor dissatisfied with their jobs, but had high perceived job performance levels. Multiple regression showed a significant positive relationship between three job satisfaction dimensions (colleagues' communication and relationship: B=0.16; physical environment and workplace safety: B=0.28; supervisor support: B=0.17) and perceived job performance (P&lt;0.001). There was a small but insignificant association between job performance and the compensation and promotion dimension of job satisfaction (B=−0.05, P=0.192). Conclusions This study supports previous evidence indicating that job satisfaction is positively linked with job performance, although compensation and promotion may not be a strong predictor of job performance in an emergency department context. Overall, these findings highlight the importance of strategies to improve job satisfaction among healthcare professionals.

Performance of health care service area definitions for capturing variation in inpatient care and social determinants of health.

To quantify the degree to which health care service area (HCSA) definitions captured hospitalizations and heterogeneity in social determinants of health (SDOH). Geospatial data from the Centers for Medicare and Medicaid Services, the Census Bureau, and the Dartmouth Institute. Drive-time isochrones from MapBox. Area Deprivation Index (ADI) data. 2017 inpatient discharge data from Arizona, Florida, Iowa, Maryland, Nebraska, New Jersey, New York, and Wisconsin, State Emergency Department Databases and State Inpatient Databases, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality; and Fee-For-Service Medicare data in 48 states. Cross-sectional, descriptive analysis. The capture rate was the percentage of inpatient discharges occurring in the same HCSA as the hospital. We compared capture rates for each HCSA definition for different populations and by hospital type. We measured SDOH heterogeneity using the coefficient of variation of the ADI among ZIP codes within each HCSA. HCSA definitions captured a wide range of inpatient discharges, ranging from 20% to 50% for Public Use Microdata Areas (PUMAs) to 93%-97% for Metropolitan Statistical Areas (MSAs). Three-quarters of inpatient discharges were from facilities within the same county as the patient's residential ZIP code, while nearly two-thirds were within the same Hospital Service Area. From the hospital perspective, 74.7% of inpatient discharges originated from within a 30-min drive and 90.1% within a 60-min drive. Capture rates were the lowest for teaching hospitals. PUMAs and drive-time-based HCSAs encompassed more homogenous populations while MSAs, Commuting Zones, and Hospital Referral Regions captured the most variation. The proportion of hospital discharges captured by each HCSA varied, with MSAs capturing the highest proportion of discharges and PUMAs capturing the lowest. Additionally, researchers face a trade-off between capture rate and population homogeneity when deciding which HCSA to use.

Experiences of participant and public involvement in an international randomized controlled trial for people living with dementia and their informal caregivers

BackgroundThis study was initiated and co-designed by a Participant and Public Involvement (PPI) group attached to HOMESIDE, a randomized controlled trial that investigated music and reading interventions for people living with dementia and their family caregivers across five countries: Australia, Germany, Norway, Poland, and the UK. The aim was to capture experiences of PPI across the five countries, explore the benefits and challenges of PPI in dementia research, and identify contributions made to the study.MethodsWe surveyed PPI members and academic researchers who collaborated on the HOMESIDE study. The survey was co-designed through consultation with PPI members and academics, alongside a small scoping literature review. Survey questions covered four topics: (1) expectations for PPI, (2) perceived contributions of PPI to the research study, (3) benefits and challenges of PPI, and (4) recommendations for future PPI in dementia research.ResultsThere were 23 responses, representing 50% of the PPI members (n = 16) and 29% of academics (n = 7). PPI was found to be beneficial to the research and individuals involved. Contributions to the research included supporting recruitment and publicity, advising on the design of participant-facing materials, guiding the design and delivery of the interventions, and identifying cultural differences affecting research delivery. PPI members benefited from building connections, sharing experiences and receiving support, learning about dementia and research, and gaining new unexpected experiences. Academics learned about the realities of living with dementia, which they felt informed and grounded their work. Several challenges were identified, including the need for clear expectations and objectives, inconsistency of PPI members across research stages, limitations of meeting online versus in-person, scheduling difficulties, and language barriers.ConclusionsThis study identifies important considerations for implementing PPI within dementia studies and international healthcare research more broadly. Our findings guided the development of five recommendations: (1) involve PPI members as early as possible and throughout the research process; (2) create a space for constructive criticism and feedback; (3) have clear tasks, roles, and expectations for PPI members; (4) involve PPI members with a diverse range of experiences and backgrounds; and (5) embed infrastructure and planning to support PPI.

Artificial Intelligence and ChatGPT: Physician Friend or Foe?

ChatGPT is a language model trained on massive volumes of Internet data. It attempts to imitate human text and can perform various roles in healthcare and health research. The program enables users to tap into vast amounts of information and understand words in context. ChatGPT can access large amounts of data and computing techniques to make predictions and string words together meaningfully. This article discusses the history of artificial intelligence, provides an example of using artificial intelligence to obtain prior authorization, and discusses the ethical considerations of this exciting new technology.