Specific Medical Information Research Articles

Principles of digital professionalism for the metaverse in healthcare

BackgroundExperts are currently investigating the potential applications of the metaverse in healthcare. The metaverse, a groundbreaking concept that arose in the early 21st century through the fusion of virtual reality and augmented reality technologies, holds promise for transforming healthcare delivery. Alongside its implementation, the issue of digital professionalism in healthcare must be addressed. Digital professionalism refers to the knowledge and skills required by healthcare specialists to navigate digital technologies effectively and ethically. This study aims to identify the core principles of digital professionalism for the use of metaverse in healthcare.MethodThis study utilized a qualitative design and collected data through semi-structured online interviews with 20 medical information and health informatics specialists from various countries (USA, UK, Sweden, Netherlands, Poland, Romania, Italy, Iran). Data analysis was conducted using the open coding method, wherein concepts (codes) related to the themes of digital professionalism for the metaverse in healthcare were assigned to the data. The analysis was performed using the MAXQDA software (VER BI GmbH, Berlin, Germany).ResultsThe study revealed ten fundamental principles of digital professionalism for the metaverse in healthcare: Privacy and Security, Informed Consent, Trust and Integrity, Accessibility and Inclusion, Professional Boundaries, Evidence-Based Practice, Continuous Education and Training, Collaboration and Interoperability, Feedback and Improvement, and Regulatory Compliance.ConclusionAs the metaverse continues to expand and integrate itself into various industries, including healthcare, it becomes vital to establish principles of digital professionalism to ensure ethical and responsible practices. Healthcare professionals can uphold these principles to maintain ethical standards, safeguard patient privacy, and deliver effective care within the metaverse.

The role of healthcare providers in expanding legal abortion: Qualitative insights from Argentina, Ireland, and South Korea.

Abortion laws are key in creating an enabling environment that facilitates the advancement of people's sexual and reproductive health and rights. Around 50 countries have liberalized their abortion laws in the last decades by adding new grounds allowing abortion. The road toward the expansion of legal abortion is a long, highly sensitive, and difficult process. The specific role of healthcare providers in influencing abortion law reforms has been scarcely studied. With the objective to better understand their (potential) roles, a qualitative study was conducted in 2021 focusing on three countries that had recently liberalized their abortion regulations: Argentina, South Korea, and Ireland. For each country, key informant interviews were conducted with actors in advocacy for legal change, the majority with healthcare providers. The study results indicate that healthcare providers can contribute to the expansion of legal abortion through their influence on public and legal debates. Healthcare providers were found to be scientifically credible and trustworthy. Their voice and argumentation counteracted anti-rights arguments and addressed information gaps, by providing specific clinical experiences and medical information. Healthcare providers amplified women's experiences through their testimonies and had entry points within governmental bodies, which facilitated their advocacy. These healthcare providers often functioned as individual operating obstetrician/gynecologists or general practitioners who were engaged in networks of health professionals or had previous advocacy experience. In a global context of social and political contention around abortion, extending the engagement of healthcare providers in law and policy deliberation on abortion appears to be useful. This requires recognizing the diversity of roles that healthcare providers can take up, creating a safe environment in which they can operate, equipping them with skills that go beyond the medical expert role and facilitating strategic partnerships that seek complementarity between multiple stakeholders, building on the uniqueness of each stakeholder's expertise.

Digital forensics in healthcare: An analysis of data associated with a CPAP machine

The need for digital forensic services across all sectors is not a new concept, nor is the increasing demand seen globally. However, the devices on which we perform digital forensics have changed and continue to evolve. For each device new approaches need to be developed or adapted to facilitate the secure preservation and analysis of the data it contains. The healthcare sector has seen particular adoption of a range of devices, from traditional through to cutting edge. The Covid-19 pandemic facilitated the need for a more boundary-agnostic level of care for patients, and medical devices are becoming increasingly more interconnected to facilitate remote care. This presents challenges in that devices are no longer “secured” in medical premises and will often be found in patient's homes, making them more exposed to attack, but also in a position to record significant amounts of personal data. The integration of information technology in medical environments has influenced the need for the development of a digital forensic process to perform analysis on medical devices. One such device is a continuous positive airway pressure (CPAP) machine, used by patients who suffer from Obstructive Sleep Apnea (OSA). It is estimated that 3-9% of the world's population suffer from this disorder, the normal medical treatment is the use of some form of CPAP machine. The research undertaken focuses on the ResMed AirSense 10 CPAP machine and a complete forensic postmortem analysis of the data contained and recorded by the device. The application of digital forensics to a traditional medical device, such as a CPAP machine, requires an adapted version of digital forensics, but in general the same tools and processes can be used. Through the analysis conducted, all patient data was located on a removable FAT32 formatted SD card, allowing the recovery of specific medical information about the device and personally identifiable information about the patient. The recovered data was then visualised using a variety of tools and systems. Information that can be derived from the visualisations include a sequence of events, to some extent how the device was operating, and the clinical information recorded on the device.

Equity in Information Retrieval

Medical librarians and information specialists have unique evidence retrieval skills that can help health technology assessment organizations reduce bias in the evidence they use: They identify gaps in mainstream evidence sources and seek out alternatives that provide the perspectives of underrepresented populations. They create complex and efficient database searches that encompass the wide variety of synonyms and phrases used to describe health disparities and inequities. They use sound, logical, and efficient ways to access evidence from paywalled systems while respecting rights of ownership. They critically appraise information systems to determine if they emphasize biases and inequities or create new ones.

Interoperable, Domain-Specific Extensions for the German Corona Consensus (GECCO) COVID-19 Research Data Set Using an Interdisciplinary, Consensus-Based Workflow: Data Set Development Study.

Background: The COVID-19 pandemic has spurred large-scale, interinstitutional research efforts. To enable these efforts, researchers must agree on data set definitions that not only cover all elements relevant to the respective medical specialty but also are syntactically and semantically interoperable. Therefore, the German Corona Consensus (GECCO) data set was developed as a harmonized, interoperable collection of the most relevant data elements for COVID-19-related patient research. As the GECCO data set is a compact core data set comprising data across all medical fields, the focused research within particular medical domains demands the definition of extension modules that include data elements that are the most relevant to the research performed in those individual medical specialties. Objective: We aimed to (1) specify a workflow for the development of interoperable data set definitions that involves close collaboration between medical experts and information scientists and (2) apply the workflow to develop data set definitions that include data elements that are the most relevant to COVID-19-related patient research regarding immunization, pediatrics, and cardiology. Methods: We developed a workflow to create data set definitions that were (1) content-wise as relevant as possible to a specific field of study and (2) universally usable across computer systems, institutions, and countries (ie, interoperable). We then gathered medical experts from 3 specialties-infectious diseases (with a focus on immunization), pediatrics, and cardiology-to select data elements that were the most relevant to COVID-19-related patient research in the respective specialty. We mapped the data elements to international standardized vocabularies and created data exchange specifications, using Health Level Seven International (HL7) Fast Healthcare Interoperability Resources (FHIR). All steps were performed in close interdisciplinary collaboration with medical domain experts and medical information specialists. Profiles and vocabulary mappings were syntactically and semantically validated in a 2-stage process. Results: We created GECCO extension modules for the immunization, pediatrics, and cardiology domains according to pandemic-related requests. The data elements included in each module were selected, according to the developed consensus-based workflow, by medical experts from these specialties to ensure that the contents aligned with their research needs. We defined data set specifications for 48 immunization, 150 pediatrics, and 52 cardiology data elements that complement the GECCO core data set. We created and published implementation guides, example implementations, and data set annotations for each extension module. Conclusions: The GECCO extension modules, which contain data elements that are the most relevant to COVID-19-related patient research on infectious diseases (with a focus on immunization), pediatrics, and cardiology, were defined in an interdisciplinary, iterative, consensus-based workflow that may serve as a blueprint for developing further data set definitions. The GECCO extension modules provide standardized and harmonized definitions of specialty-related data sets that can help enable interinstitutional and cross-country COVID-19 research in these specialties.

Information Referral System in the Health System

Information Referral System in the Health System

Abstract B069: Patient perspectives on reimagining survivorship care: A “Chipotle” model to enhance personalized cancer recovery

Abstract Background: As the population in the United States grows, diversifies, and lives longer, the number of cancer survivors is expected to increase from 15.5 million (2016) to an estimated 20.3 million by 2026. Cancer survivors require surveillance for recurrent and subsequent malignancies, management of long-term and late effects of cancer treatment, consistent care to address comorbid conditions, health promotion and care coordination. Current survivorship care relies on distribution of a highly formulaic survivorship care plans. It likewise lacks mechanisms for communication between the oncology care team and patients’ primary care providers who see them for follow up care. Such service limitations hinder patient-responsive care for ethnically/racially, geographically, culturally and socioeconomically diverse cancer patients. Methods: Between 2020 and 2021, we convened a socio-demographically diverse Patient Advisory Board (PAB) to explore ways to improve survivorship care. All PAB members had breast or gynecological cancer diagnoses within the past five years. The research team developed discussion guides prior to each meeting to facilitate a wide ranging conversation. We conducted five PAB meetings via Zoom, maintained communication via email, and distributed four surveys on the web-based Snap Survey platform to discuss topics brought up during previous meetings or to introduce ideas for in-depth discussion at next meetings. We recorded conversations, transcribed them, and used thematic coding to identify key points for care transformation. Results: PAB members highlighted three key ideas to improve survivorship care. 1) It should not begin after treatment concludes, instead, it is a continuum with three distinct stages: diagnosis, treatment, and post-treatment. 2) Tailored documents should be generated for each patient at each stage containing stage specific medical information as well as guidance and resources on topics aligned with the patient’s unique goals for recovery. 3) Communication between a patient’s PCP and the oncology care team should begin at diagnosis and continue post-treatment, and include the patient. The PAB and research team envisioned a “Chipotle” model whereby patients have the opportunity to customize their care needs by choosing from a menu of options. The foundation (or “tortilla”) of this model allows for standard medical information to be included and serve as the foundational layer. At each survivorship stage, patients could add selected “toppings” as needed (i.e., mental health services, financial counseling, nutrition, sexual health and education, and exercise and well-being) to encourage cancer recovery. PAB members suggested that this model would allow them to play an active role in their survivorship care journeys. Conclusion: The PAB outlined a clear potential design to improve cancer survivorship care. Future work should pilot this new design to determine the acceptability and usefulness of such a model. Citation Format: Shoshana Adler Jaffe, Stephanie Rieder, Amy C. Gundelach, Tawny Boyce, Teresa Rutledge, Zoneddy Dayao, Andrew L. Sussman, Miria Kano. Patient perspectives on reimagining survivorship care: A “Chipotle” model to enhance personalized cancer recovery [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B069.

Commercial space tourism: An integrative review of spaceflight participant psychological assessment and training

Health issues typical of the expected commercial space tourism (CST) population are considered manageable, but less is known about the impact of psychological conditions on spaceflight participant (SFP) wellbeing and safety during spaceflight. Plans to detect and prepare SFP for potential effects of psychological conditions emerging during spaceflight are unknown and may be inadequate. The purpose of this integrative literature review was to identify CST operators’ plans for SFP psychological assessment and training. Forty-four (44) articles met inclusion criteria and were largely composed of grey and popular literature sourced online. Plans for SFP psychological assessment and training prior to CST were not found, although vague descriptions of training for specific CST opportunities and limited medical assessment information was located. An undisclosed or possibly non-existent psychological support approach will likely be insufficient to ensure SFP safety and optimal performance during emergencies. Instead, detailed and focused intentional screening of SFP should be completed by appropriate members of a transdisciplinary healthcare team at various phases of the spaceflight experience. Following assessment, collaborative decision making to develop training, interventions, and mitigation strategies in support of individual SFP psychological needs should occur before, during and after spaceflight. The strategies should align with standards of care and inform urgently-needed SFP research. Knowledge gained from future research will contribute to appropriate, effective SFP psychological assessments, intervention and training development, testing, and implementation, and overall management of SFP programs and strategy development aimed at optimizing the CST experience and goals.

Search like an expert: Reducing expertise disparity using a hybrid neural index for COVID-19 queries

Consumers from non-medical backgrounds often look for information regarding a specific medical information need; however, they are limited by their lack of medical knowledge and may not be able to find reputable resources. As a case study, we investigate reducing this knowledge barrier to allow consumers to achieve search effectiveness comparable to that of an expert, or a medical professional, for COVID-19 related questions. We introduce and evaluate a hybrid index model that allows a consumer to formulate queries using consumer language to find relevant answers to COVID-19 questions. Our aim is to reduce performance degradation between medical professional queries and those of a consumer. We use a universal sentence embedding model to project consumer queries into the same semantic space as professional queries. We then incorporate sentence embeddings into a search framework alongside an inverted index. Documents from this index are retrieved using a novel scoring function that considers sentence embeddings and BM25 scoring. We find that our framework alleviates the expertise disparity, which we validate using an additional set of crowdsourced—consumer—queries even in an unsupervised setting. We also propose an extension of our method, where the sentence encoder is optimised in a supervised setup. Our framework allows for a consumer to search using consumer queries to match the search performance with that of a professional.

Discovering Key Topics From Short, Real-World Medical Inquiries via Natural Language Processing

Millions of unsolicited medical inquiries are received by pharmaceutical companies every year. It has been hypothesized that these inquiries represent a treasure trove of information, potentially giving insight into matters regarding medicinal products and the associated medical treatments. However, due to the large volume and specialized nature of the inquiries, it is difficult to perform timely, recurrent, and comprehensive analyses. Here, we combine biomedical word embeddings, non-linear dimensionality reduction, and hierarchical clustering to automatically discover key topics in real-world medical inquiries from customers. This approach does not require ontologies nor annotations. The discovered topics are meaningful and medically relevant, as judged by medical information specialists, thus demonstrating that unsolicited medical inquiries are a source of valuable customer insights. Our work paves the way for the machine-learning-driven analysis of medical inquiries in the pharmaceutical industry, which ultimately aims at improving patient care.

A National Comparative Investigation of Twins With Congenital Heart Defects for Neurodevelopmental Outcomes and Quality of Life (Same Same, but Different?): Protocol for a Prospective Observational Study.

BackgroundDue to the increased survival rates of patients with congenital heart defects (CHD), associated disorders are an increasing focus of research. Existing studies figured out an association between CHD and its treatment, and neurodevelopmental outcomes including motor competence impairments. All these studies, however, compared their test results with reference values or results of healthy control groups. This comparison is influenced by socioeconomic and genetic aspects, which do have a known impact on neurodevelopmental outcomes.ObjectiveThis study protocol describes a setting that aims to find out the role of CHD and its treatments on neurodevelopmental outcomes, excluding socioeconomic and genetic aspects. Only a twin comparison provides the possibility to exclude these confounding factors.MethodsIn a German-wide prospective cohort study, 129 twin siblings registered in the National Register for Congenital Heart Defects will undergo testing on cognitive function (Wechsler Intelligence Tests age-dependent: Wechsler Adult Intelligence Scale, fourth edition; Wechsler Intelligence Scale for Children, fifth edition; and Wechsler Preschool and Primary Scale of Intelligence, fourth edition) and motor competence (Movement Assessment Battery for Children, second edition). Additionally, the self-reported health-related quality of life (KINDL-R for children, Short Form 36 for adults) and the parent-reported strength and difficulties of the children (Strength and Difficulties Questionnaire, German version) will be assessed by standardized questionnaires. CHD data on the specific diagnosis, surgeries, transcatheter procedures, and additional medical information will be received from patient records.ResultsThe approval of the Medical Ethics Committee Charité Mitte was obtained in June 2018. After getting funded in April 2019, the first enrollment was in August 2019. The study is still ongoing until June 2022. Final results are expected in 2022.ConclusionsThis study protocol provides an overview of the study design’s technical details, offering an option to exclude confounding factors on neurodevelopmental outcomes in patients with CHD. This will enable a specific analysis focusing on CHD and clinical treatments to differentiate in terms of neurodevelopmental outcomes of patients with CHD compared to twin siblings with healthy hearts. Finally, we aim to clearly define what is important to prevent patients with CHD in terms of neurodevelopmental impairments to be able to develop targeted prevention strategies for patients with CHD.Trial RegistrationGerman Clinical Trials Register DRKS00021087; https://tinyurl.com/2rdw8w67International Registered Report Identifier (IRRID)DERR1-10.2196/26404

Tailoring Tofacitinib Oral Therapy in Rheumatoid Arthritis: The TuTORApp-A Usability Study.

Objective: To create a mobile application able to help patients follow medical treatments properly. Methods: We designed and developed a custom Android/iOS App to remind patients of the pharmaceutical drugs to be taken, of the visits and exams to attend, and to detect their compliance with their personal therapeutic plan. In this paper we describe the App development, UX/UI design, Gamification. TuTOR is an Android and iOS application designed to remind patients of the drugs to be taken, giving them all the information related to their therapeutic plans in a simple and non-invasive way. Thanks to a dedicated back-office, specially designed to meet specific medical information needs, the App can also help physicians detect their patients’ compliance with their treatments and modify prescriptions in real time. The App also ensures a state-of-the-art approach to data security and privacy protection. The main feature of TuTOR is the smart therapy assistant, which features dedicated alarms to remind users of taking their prescription drugs. Thanks to the automatic synchronization with a local database, the alert system works even without connection to the Internet. Particular attention was paid during the App’s design process: we looked to create an intuitive interface to ensure absolute ease of use, with state-of-the-art visual design aimed at maximizing user experience. Other relevant features include the App’s ability to givevisual evidence of the most important drugs to be taken and its note-taking feature, which gives patients the possibility to note down indications on why a specific drug was skipped. The App also keeps track of upcoming medical exams, laboratory tests, and visits on a devoted calendar. It also helps patients by listing therapy contacts, such as physicians’ phone numbers, and indicates all medical references by showing, for example, locations of relevant clinics and pharmacies on a map. Thanks to specific visual progress indicators and an innovative gamification approach, the App encourages users to faithfully follow therapy guidelines. With TuTOR, assessing the therapy’s state of completion is quick and easy.Thanksto the privacy-by-design approach used, all data managed by the system is compliant with the European Privacy Regulation and it is not available to third parties. Expected results: A mobile App for medication adherence might increase objectively and subjectively measured adherence.

The Medical Library Association’s Role in Disseminating Information Related to the COVID-19 Pandemic

The Medical Library Association (MLA) has been part of the library and information science field since 1898 (The Medical Library Association, 2020). According to the website, the mission of the organization is to promote library and information science knowledge and make it available and accessible to medical information specialists and the general public. This content analysis examines the Medical Library Association’s (MLA) role in the 2019/2020 COVID-19 public health crisis, specifically the ways in which the MLA has provided resources about the pandemic to libraries and librarians as well as the public.

Meeting Abstracts - Academy of Managed Care Pharmacy Nexus 2019.

AMCP Nexus 2019: The Intersection of Value and Care, in National Harbor, MD, is expected to attract more than 2,400 managed care pharmacists and other health care professionals who manage and evaluate drug therapies, develop and manage networks, and work with medical managers and information specialists to improve the care of all individuals enrolled in managed care programs. The AMCP Abstracts program provides a forum through which authors can share their insights and outcomes of advanced managed care practice. Poster presentations are scheduled for Thursday, October 31, from 12:30 pm to 2:00 pm. For each poster, at least 1 author will be available during the poster presentations to discuss findings. Posters will also be displayed on Wednesday, October 30, from 4:30 pm to 6:30 pm, during the opening night reception in the Exchange. Podium presentations for the Platinum award-winning abstracts are Thursday, October 31, from 10:00 am to 11:30 am. Professional abstracts that have been reviewed are published in the Journal of Managed Care & Specialty Pharmacy's (JMCP) Meeting Abstracts supplement.

Health Information Technologies in the Support Systems of Pregnant Women and Their Caregivers: Mixed-Methods Study.

BackgroundThe quality and quantity of families’ support systems during pregnancy can affect maternal and fetal outcomes. The support systems of expecting families can include many elements, such as family members, friends, and work or community groups. Emerging health information technologies (eg, social media, internet websites, and mobile apps) provide new resources for pregnant families to augment their support systems and to fill information gaps.ObjectiveThis study sought to determine the number and nature of the components of the support systems of pregnant women and their caregivers (eg, family members) and the role of health information technologies in these support systems. We examined the differences between pregnant women’s support systems and those of their caregivers and the associations between support system composition and stress levels.MethodsWe enrolled pregnant women and caregivers from advanced maternal-fetal and group prenatal care clinics. Participants completed surveys assessing sociodemographic characteristics, health literacy, numeracy, and stress levels and were asked to draw a picture of their support system. Support system elements were extracted from drawings, categorized by type (ie, individual persons, groups, technologies, and other) and summarized for pregnant women and caregivers. Participant characteristics and support system elements were compared using the Pearson chi-square test for categorical variables and Wilcoxon ranked sum test for continuous variables. Associations between support system characteristics and stress levels were measured with Spearman correlation coefficient.ResultsThe study enrolled 100 participants: 71 pregnant women and 29 caregivers. The support systems of pregnant women were significantly larger than those of caregivers—an average of 7.4 components for pregnant women and 5.4 components for caregivers (P=.003). For all participants, the most commonly reported support system elements were individual persons (408/680, 60.0%), followed by people groups (132/680, 19.4%), technologies (112/680, 16.5%), and other resources (28/680, 4.1%). Pregnant women’s and caregivers’ technology preferences within their support systems differed—pregnant women more often identified informational websites, apps, and social media as parts of their support systems, whereas caregivers more frequently reported general internet search engines. The size and components of these support systems were not associated with levels of stress.ConclusionsThis study is one of the first demonstrating that technologies comprise a substantial portion of the support systems of pregnant women and their caregivers. Pregnant women more frequently reported specific medical information websites as part of their support system, whereas caregivers more often reported general internet search engines. Although social support is important for maternal and fetal health outcomes, no associations among stress, support system size, and support system components were found in this study. As health information technologies continue to evolve and their adoption increases, their role in patient and caregiver support systems and their effects should be further explored.

Meeting Abstracts - AMCP Managed Care & Specialty Pharmacy Annual Meeting 2019.

The AMCP Managed Care & Specialty Pharmacy Annual Meeting 2019 in San Diego, California, is expected to attract more than 4,000 managed care pharmacists and other health care professionals who manage and evaluate drug therapies, develop and manage networks, and work with medical managers and information specialists to improve the care of all individuals enrolled in managed care programs. The AMCP Abstracts program provides a forum through which authors can share their insights and outcomes of advanced managed care practice. Poster presentations are scheduled for Wednesday, March 27, from 11:30 am to 1:00 pm. Posters will also be displayed on Tuesday, March 26, from 5:30 pm to 7:00 pm, during the opening night reception in the Expo, and on Thursday, March 28, from 9:30 am to 11:00 am. Podium presentations for the Platinum award-winning abstracts are Tuesday, March 26, from 2:30 pm to 3:45 pm. Professional abstracts that have been reviewed are published in the Journal of Managed Care & Specialty Pharmacy's Meeting Abstracts supplement. Abstracts were submitted in the following categories.

Effectiveness of stop smoking interventions among adults: protocol for an overview of systematic reviews and an updated systematic review

BackgroundTobacco smoking is the leading cause of cancer, preventable death, and disability. Smoking cessation can increase life expectancy by nearly a decade if achieved in the third or fourth decades of life. Various stop smoking interventions are available including pharmacotherapies, electronic cigarettes, behavioural support, and alternative therapies. This protocol outlines an evidence review which will evaluate the benefits and harms of stop smoking interventions in adults.MethodsThe evidence review will consist of two stages. First, an overview of systematic reviews evaluating the benefits and harms of various stop smoking interventions delivered in or referred from the primary care setting will be conducted. The second stage will involve updating a systematic review on electronic cigarettes identified in the overview; randomized controlled trials will be considered for outcomes relating to benefits while randomized controlled trials, non-randomized controlled trials, and comparative observational studies will be considered for evaluating harms. Search strategies will be developed and peer-reviewed by medical information specialists. The search strategy for the updated review on e-cigarettes will be developed using that of the candidate systematic review. The MEDLINE®, PsycINFO, Embase, and the Cochrane Library electronic databases will be searched as of 2008 for the overview of reviews and from the last search date of the selected review for the updated review. Organizational websites and trial registries will be searched for unpublished or ongoing reviews/studies. Two reviewers will independently screen the title and abstracts of citations using the liberal accelerated method. Full-text screening will be performed independently by two reviewers. Extracted data will be verified by a second reviewer. Disagreements regarding full-text screening and data extraction will be resolved by consensus or third-party adjudication. The methodological quality of systematic reviews, risk of bias of randomized and non-randomized trials, and methodological quality of cohort studies will be evaluated using AMSTAR 2, the Cochrane risk of bias tool, and a modified version of the Scottish Intercollegiate Guidelines Network critical appraisal tool, respectively. The GRADE framework will be used to assess the quality of the evidence for outcomes.DiscussionThe evidence review will evaluate the benefits and harms of various stop smoking interventions for adults. Findings will be used to inform a national tobacco cessation guideline by the Canadian Task Force on Preventive Health Care.Systematic review registrationPROSPERO (CRD42018099691, CRD42018099692)

2018 Korean Association for the Study of the Liver (KASL) Clinical Practice Guidelines of Chronic Hepatitis B: What's Different?

The clinical practice guideline for the management of chronic hepatitis B (CHB) was originally enacted in 2004 by the Korean Association for the Study of the Liver in order to provide medical practitioners with specific medical information regarding CHB to help them facilitate their understanding of the disease and treatment of the infected patients. Other than an update on the treatment of antiviral resistance in 2014, which is a partial revision, the guidelines for the treatment of chronic hepatitis B have been revised entirely three times in 2007, 2011, and 2015. Although several major international liver association have established and revised clinical practice guidelines, since the medical environment in each country is somewhat different depending on race, region, institution, and economic conditions, it is necessary to revise the Korean guidelines to that reflect our medical environment and own research results. In this review, major change and its background will be summarized about 2018 updated clinical practice guidelines for the management of CHB.

Meeting Abstracts - Academy of Managed Care Pharmacy Nexus 2018.

AMCP Nexus 2018: Preparing for the Next Generation of Care in Orlando, Florida, is expected to attract more than 2,400 managed care pharmacists and other health care professionals who manage and evaluate drug therapies, develop and manage networks, and work with medical managers and information specialists to improve the care of all individuals enrolled in managed care programs. The AMCP Abstracts program provides a forum through which authors can share their insights and outcomes of advanced managed care practice. Poster author presentations for AMCP Nexus 2018 are scheduled for Wednesday, October 24, from 12:30 pm to 2:30 pm. For each poster, at least one author will be available during the poster presentations to discuss findings. Posters will also be displayed on Tuesday, October 23, from 4:15 pm to 6:10 pm, during the opening night reception in the Exchange, and on Wednesday, October 24, from 11:30 am to 2:45 pm. Podium presentations for the Platinum award-winning abstracts are Tuesday, October 23, from 12:45 pm to 2:15 pm. Professional abstracts that have been reviewed are published in the Journal of Managed Care & Specialty Pharmacy's Meeting Abstracts supplement.

The Experiences of Young Liver Patients Transferring From Children's to Adult Services and Their Support Needs for a Successful Transition.

The period of transition from pediatric to adult services represents a time when young people need support, information, and appropriate care in order to successfully move. It is a period that is associated with nonadherence and disengagement with care. To explore the experiences of young liver transplant recipients transitioning to adult services and determine what they require in order to achieve a successful move. The research also explored the possibility of using a mobile phone application (app) as a tool to support transition. Qualitative approach using novel arts-based focus groups and one-to-one interviews. Twenty-one young people aged 16 to 25 years, 16 health-care professionals involved in their care, and 7 young people as follow-up. Participants used services provided by the 3 liver centers in England (Leeds, Birmingham, and London). Data highlighted the variability of transition pathways in England for young people moving from child to adult health services. The results showed that they required clear information regarding transition processes including specific medical information and that there was a shortfall in such information. Support was required in the form of a designated transition coordinator or similar specialist who could act as a point of reference and guidance throughout the process. Transitions needed to be individualized and based upon transition readiness rather than age, although the research showed that age cut-offs were still used. Young people welcomed apps to provide information, reminders, contacts, and connections. Future research should explore the efficacy of such apps.