Sri Lanka Journal of Bio-medical Informatics最新文献

{"title":"A Teleophthalmological intervention to integrate diabetic and eye clinics to deliver care for diabetic retinopathy","authors":"M. V. C. D. Silva, V. Gurusamy, R. Marasinghe","doi":"10.4038/sljbmi.v10i3.8083","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8083","url":null,"abstract":"Introduction: Diabetes and its complications add extra burden to the global disease burden. Diabetic retinopathy (DR) already accounts for 4% of blindness worldwide. Though screening of all diabetics for DR is advocated, only 60% global coverage is met. High patient volume, patient factors and system factors contribute to this limitation. Teleophthalmology is a recognized method to overcome some of these limiting factors. This study aimed to design & develop a teleophthalmology platform suited to a local setting and to evaluate the post implementation outcomes. Methods: The study adopted action-based research approach. A tertiary care hospital was selected with an established integrated care process for DR screening. Global teleophthalmology systems and their implementation strategies were reviewed. The requirements were gathered through key informant interviews i.e. clinicians. A teleophthalmology platform was developed and deployed to connect the diabetic clinic and the eye clinic for the purpose of evaluating the fundal images as a part of DR screening. The intervention was evaluated based on patient factors, comparing using the independent samples t test between the two samples screened for DR, with and without the teleophthalmology intervention. Results: 40 patients each were screened for the two samples with and without the aid of the teleophthalmology intervention. The average age of the participants were 62.6 years & 53.6 years while 76% were females and 42% males, respectively in the two samples. Patients screened for DR with the aid of the teleophthalmology platform showed reduced number of visits (p=0.001), reduced waiting time (p Conclusions: Adoption of teleophthalmology improves the patient waiting time, number of visits and satisfaction. This could be considered as an effective and feasible intervention to integrate into an established clinical setup for managing diabetic retinopathy.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123563807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teleradiological implementation as a decision support system at an accident service unit in a tertiary care hospital in Sri Lanka","authors":"D. Jayakody, R. Marasinghe","doi":"10.4038/sljbmi.v10i3.8082","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8082","url":null,"abstract":"Introduction: Recent developments in teleradiology have introduced various technologies including PACS (Picture Archiving and Communication System), DICOM (Digital Imaging and Communication in Medicine), & Oviyam, helping healthcare institutions to make a smooth transition to a digital radiology infrastructure, which is more efficient and effective compared to traditional radiology systems. However, given the potentially unique socio-political aspects, perspectives, & infrastructure, feasibility of a digital radiology system and the adaptable technologies can vary among different types of healthcare institutions in different regions around the world. This study attempted to make an optimal teleradiological implementation at the Accident Service Unit of Colombo South Teaching Hospital, a government tertiary care hospital in Sri Lanka. Methods: The information and subjective opinions gathered from different channels in two phases, in the form of a questionnaire, in order to make an assessment on the feasibility of transition to a digital teleradiology system. After a comprehensive analysis of requirements and constraints, a teleradiological system was implemented at the hospital. A post-implementation assessment was carried out using a questionnaire in the second phase of the study, which was conducted among all the medical professionals using the system. Results: Based on the post implementation assessment, more than 50% of the participants indicated that the ability to view radiology images at a distance with an acceptable interpretation quality, improves patient care and management of clinical data. More than 66.7% of participants indicated that the newly implemented teleradiology system improved the productivity and quality of patient care and enhanced the ability to coordinate and proceed with patient care. Conclusions: According to the post-implementation evaluation, the teleradiological solution implemented in this study has enabled a better, effective, and efficient delivery of radiology services at the tertiary care setting.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123990867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Note - Digital Health Sri Lanka 2019, Supplementary Issue (Volume 10); 2019","authors":"R. Hewapathirana, A. Wijekoon","doi":"10.4038/sljbmi.v10i3.8087","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8087","url":null,"abstract":"","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126564293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewers- Digital Health Sri Lanka 2019, Supplementary Issue (Volume 10); 2019","authors":"Managing Editors","doi":"10.4038/sljbmi.v10i3.8088","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8088","url":null,"abstract":"","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134033797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Panel - Digital Health Sri Lanka 2019, Supplementary Issue (Volume 10)","authors":"Managing Editors","doi":"10.4038/sljbmi.v10i3.8089","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8089","url":null,"abstract":"","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116925045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"System Usability Scale (SUS) on local language: A Sri Lankan case study","authors":"Gumindu Garuka Kulatunga, P. Ranatunga, J. J. Hariyaram, K. Kasturiaratchi","doi":"10.4038/sljbmi.v10i3.8065","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8065","url":null,"abstract":"Introduction: There are many information systems in Sri Lanka. However, there is no widely accepted tool to measure their usability. System Usability Scale (SUS) is a standardised metric or a quantitative measuring scale for measuring the usability of a website, information system or interactive system. SUS was released to the world by John Brooke in 1986. Currently, SUS has become an industry standard. In SUS, a user responds to 10 short questions on a 5-point Likert scale about the level of agreement.  A special methodology is used to prevent unintentional rating responses. A SUS score above 68 would be considered above average. This questionnaire is originally in English language. However, even a native English speaker has implications on reliability and validity of the SUS due to the misunderstanding and misinterpretation of terminology or conflicting language. Thus, translating to native local languages is considered to increase the reliability and validity of SUS. The aim was to develop a Sinhala/Tamil System Usability Scale (SUS) to be used in Sri Lanka for assessing the information system usability. Methods: Translation of SUS questions in English to Sinhala and Tamil Languages after brainstorming sessions. Questions were validated by multi-disciplinary specialists. Translations were aimed at keeping the content simple, clear and concise, achieving a conceptual translation rather than a literal translation and avoid technology jargon. The tool was pretested by using a group of users in Electronic Reproductive Health Information Management System (eRHMIS) of the Family Health Bureau. Results:  Sinhala/Tamil questions were finalized, and final SUS questionnaire was developed including a 5-point Likert scale. This tool was selected for measuring the usability of the eRHMIS of Family Health Bureau. Conclusions: There was immediate acceptance as well as plans for future use of translated SUS. This SUS questionnaire can be used to measure the usability of existing information systems in the country.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"65 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123187831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A knowledgebase to promote self-directed learning among postgraduate trainees of MSc in Biomedical Informatics degree program in University of Colombo, Sri Lanka","authors":"G. Kanchana, R. Marasinghe","doi":"10.4038/sljbmi.v10i3.8075","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8075","url":null,"abstract":"Introduction: Biomedical Informatics degree program was formulated by the Postgraduate Institute of Medicine, University of Colombo to develop medical professionals with digital health competencies to help the digital reforms in Sri Lankan health sector. Medical professionals are expected to have lifelong learning for professional development and for being up to date where Self-Directed Learning (SDL) is considered pivotal. Knowledgebase which includes document repository and discussion forum provides the platform for improving SDL related to biomedical informatics body of knowledge, facilitating collaborative learning and allowing long term knowledge management. Methods: Participatory action research was conducted among the postgraduate (Pg.) trainees who currently enrolled and completed the biomedical informatics degree program. Knowledgebase, a web-based SDL platform using Flask (Python) micro framework was introduced as the intervention and its development was guided by the ADDIE (Analysis, Design, Development, Implementation and Evaluation) model. Validated questionnaires were used as data collection tools. The analysis was done with the pre-implementation stage questionnaire by assessing the SDL practices and requirements for the knowledgebase. The evaluation was done on the knowledgebase users with post-implementation stage questionnaire including the Self Directed Learning Readiness Scale (SDLRS) by Fisher et al. SDLR was assessed along with the improvement of SDL and the relationship of socio-demographics with SDLRS scores. Descriptive and inferential statistics were used for data analysis. Results: Ninety per cent out of 52 participants confirmed the need for a web-based SDL platform at the pre implementation stage. Internet and peers were the main resources used for SDL. Twenty-three (response rate=82%) knowledgebase users participated in the post implementation stage. Nineteen (82%) confirmed that the knowledgebase improved their SDL. Mean SDLRS score was 153.83 with highest for self-control (58.52) and lowest for self-management (45.74) subscales. Around 65% had high SDLRS scores (above 150 out of 200). Statistically significant (p Conclusions: High level of SDLR was present among the majority of the knowledgebase users which was known to enhance web-based learning. Knowledgebase platform was perceived to improve the SDL among the Pg. trainees, therefore, web-based learning will augment SDL. Attention should be paid to improve self-management among the Pg. trainees of the biomedical degree program to further improve SDL.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126383124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel artificial neural network-based algorithm for detecting vascular occlusive diseases in retinal images","authors":"L. Jayaratne, V. H. W. Dissanayake","doi":"10.4038/sljbmi.v10i3.8084","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8084","url":null,"abstract":"Introduction: Central retinal vascular occlusions cause sudden painless complete blindness of one eye or partial visual loss, depending on the retinal vessel involved. These acute conditions may occur due to thrombosis, diabetic retinopathy, hypertensive retinopathy, glaucoma or due to other systemic conditions like connective tissue disorders. Central retinal artery occlusion (CRAO) is considered analogous to a cerebral stroke and it is an ophthalmological emergency. Central retinal vein occlusion (CRVO) is one of the most common causes of visual loss worldwide and the second most common cause of blindness due to retinal vascular disorders after diabetic retinopathy. Artificial intelligence (AI) based methodologies have been used in automated diagnosis support systems in detecting many ophthalmological conditions like diabetic retinopathy, retinal micro aneurisms, and retinal haemorrhages. Methods: The developed algorithm consists of modules for, image pre-processing, extraction of the areas of interest, feature extraction, feature presentation and image classification. A feed-forward back-propagation multilayer artificial neural network (ANN), with 27 input layer neurones, three output layer neurones and 81 first hidden layer and nine second hidden layer neurones, was used as the image classifier. This methodology was trained with 90 retinal images. Results: The percentage accuracy of the developed ANN-based ophthalmological image classification algorithm is 97.8% when it is trained to diagnose CRAO and CRVO. The sensitivity is 98.3%, and the specificity is 100%. Conclusions: This study presents the first AI-based approach in automatic detection of both CRAO and CRVO. Once this algorithm is trained to minimise false negatives, it can be used as an automated diagnosis support system in ophthalmological screening programs.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132996171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital health needs assessment at a national-subnational level in Sri Lanka","authors":"Y. A. K. E. Samaranayake, N. P. Liyanarachchi, C. Weerabaddana, K. Sylva, M. de Silva, R. Ranwala, M. Manoj, M. Perera, W. M. A. Wijekoon, P. V. A. I. Gunawardena, A. Amarathunga, C. M. Manawadu, S. D. Siriwardane","doi":"10.4038/sljbmi.v10i3.8077","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8077","url":null,"abstract":"Introduction: Healthcare stakeholders hold diverse opinions and needs. Different Inputs, opinions and concerns of the stakeholders are essential to build a sustainable and successful digital health strategy. Successful digital initiatives are based on the understanding of the user characteristics, needs and challenges. Collaborating with stakeholders, sharing information and insights, sharing strategies and resources across projects/organizations leads to increased efficiency and impact. The aim was to assess the national to subnational level digital health needs of the government health sector stakeholders as a preliminary step of the national digital health strategy development. Methods: A consultative process was carried out for stakeholders at the national and subnational level to capture high level digital health needs of the government health sector in Sri Lanka. Stakeholders were gathered for a consultative workshop and divided according to their institutional level and influential capacity. Stakeholder needs were captured through structured discussions. The needs were analysed according to the eHealth building blocks of WHO National eHealth strategy toolkit. Results: Majority of the national level administrator and policy maker needs were the processes and solutions addressing legislation, policy and compliance (40%). Requirements of PDHS/RDHS were primarily concentrated on digital health services and applications (69%) which are essential for their institutions. Hospital sector was predominantly concerned about services and applications (71%). Programmes and campaigns were concerned mainly about the overarching digital health standards and interoperability (33%) and service-related applications (33%). Professional bodies required systems and applications on human resource management (53%). Conclusions: The digital health needs of the policy makers were more focused in the direction of legislation, policy and compliance while provincial, preventive and curative institutions were focusing on services and applications. Even though there are multiple vertical solutions running independently, suboptimal interoperability between the systems was highlighted. Hence, there is a necessity of a national digital health strategy to align services, solutions, guidelines and standards addressing the national to sub-national digital health needs.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134072558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A web-based survey on academic fields of interest among the Biomedical Informatics trainees and health informaticians in Sri Lanka","authors":"S. Irfaan, C. M. Manawadu, S. Pathirana, F. Mubarak, M. Ikram, P. Siribaddana","doi":"10.4038/sljbmi.v10i3.8079","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8079","url":null,"abstract":"Introduction: Biomedical Informatics is a rapidly growing discipline, which intersects the fields of Information Communication Technology, Medicine and Biology. Given the multidisciplinary and rapidly evolving nature of this field of study, trainees and graduates may possess a variety of academic and research interests, complicating the task of training and curriculum development. The aim of this study is to identify the key interest areas among the trainees of existing post graduate programmes in Biomedical and Health Informatics, conducted by the Post Graduate Institute of Medicine (PGIM), Sri Lanka in view of identifying their key learning needs. Methods: A web-based survey was conducted among current MSc trainees of Biomedical Informatics and MD trainees of Health Informatics attached to Post Graduate Institute of Medicine, University of Colombo, Sri Lanka. Participants were asked to rate academic interest for given fields and to rate interest for the tools/areas in which they want to build their competency. The rating was done using a Likert scale. Gathered data was analysed using descriptive statistics.  Results: There were 40 responders (Response rate – 47.1%). Forty five percent had MBBS as their highest educational qualification and the rest had MSc, MD or BDS. Out of the 17 Academic areas checked for, Clinical Informatics (median = 4.4), followed by the Decision Support Systems and Artificial Intelligence (median = 4.2) are the areas which had drawn the highest level of academic interest. The lowest level of academic interest was identified in Bioinformatics (median = 3.1). Electronic Health Record systems (median = 4.375) is the area in which most of the participants want to build their competency and least preference was given to BLAST (Basic Local Alignment Search Tool) (median = 2.75) out of the 22 tools/areas checked for. Conclusions: The interests and needs of the trainees of these courses are diverse, which warrants constant curriculum reviews. The areas highlighted in this study could be given priority when revising curriculums and allocating resources for the MSc and MD courses.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117105668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}