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The Enhanced EHR-facilitated Cancer Symptom Control (E2C2) Trial is a pragmatic trial testing a collaborative care approach for managing common cancer symptoms. There were challenges in identifying cancer site and metastatic status.This study compares three different approaches to determine cancer site and six strategies for identifying the presence of metastasis using EHR and cancer registry data.The E2C2 cohort included 50,559 patients seen in the medical oncology clinics of a large [...]

Human immunodeficiency virus (HIV) remains a significant global health challenge, especially in Europe, including Italy, where it affects thousands. Antiretroviral therapy (ART) has turned HIV into a manageable chronic condition, improving the quality of life and life expectancy for people living with HIV (PLWH). Enhancing health-related quality of life (HRQoL) is essential, as it positively influences therapy adherence.The objective of the study was to evaluate the impact of the AURORA [...]

Adoption of electronic health record (EHR)-based clinical decision support tools in community-based health centers might increase the provision of indicated cancer screening orders. We examined: (1) if the use of the care gaps smartset (CGS), an EHR tool that expedites ordering care, is associated with colorectal/cervical cancer (CRC/CVC) screening order rates; and (2) how selected implementation strategies, barriers, and facilitators impact CGS use.Within a sequential mixed methods design, we used [...]

This study aimed to systematically evaluate the effectiveness and safety of telemedicine in improving the corresponding indicators in patients with rheumatoid arthritis (RA).Computer searches of PubMed, Embase, the Cochrane Library, and Web of Science were conducted to collect journal articles on randomized controlled trials and clinical trials of telemedicine interventions for RA. A meta-analysis was performed using the risk-of-bias assessment tool Reedman 5.4 software from the Cochrane Handbook.The systematic assessment [...]

Consumer involvement in the co-design of diabetes self-management smartphone apps is vital. This scoping review explored how consumers are involved in the co-design processes and methods and approaches guiding this research.Our review was guided by Arksey and O'Malley's five-stage framework, PRISMA-ScR guidelines, and Witteman and colleagues' 11-item user-centered design (UCD-11) framework. We searched literature across five databases and examined types of consumer involvement in co-design and frequency of methods and [...]

Interruptive alerts in clinical decision support (CDS) systems are intended to guide clinicians in making informed decisions and adhering to best practices. However, these alerts can often become a source of frustration, contributing to alert fatigue and clinician burnout. Traditionally, an alert's burden is often assessed by evaluating the total number of times it is seen by end-users, which can overlook the true impact of highly interruptive workflows. This study [...]

Patient portals bridge patient and provider communications but exacerbate physician and nursing burnout. Large language models (LLMs) can generate message responses that are viewed favorably by health care professionals/providers (HCPs); however, these studies have not included diverse message types or new prompt-engineering strategies.Our goal is to investigate and compare the quality and precision of GPT-generated message responses versus real doctor responses across the spectrum of message types within a patient [...]

Registered nurses increasingly work in remote care and digital interaction roles, offering flexibility and expansion of their scope of practice. These roles may expose nurses to digital compassion fatigue, a phenomenon proposed to be characterized by the negative psychological and emotional impact of caring for patients remotely through the use of technology.The first objective of this work is to propose the phenomenon of "digital compassion fatigue" as a potentially further [...]