Clinical informatics, decision support for health professionals, electronic health records, and ehealth infrastructures.

To understand the influence of demographics and education levels on awareness levels, and on the prevalence of hesitancy to receive the influenza vaccine among adult patients at King Saud University Medical City (KSUMC). A crosssectional study in the outpatient pharmacy area at KSUMC was conducted. Data was collected from January 1 to January 31, 2020. A total of 318 random adult patients were encountered and a predesigned survey was administered. After capturing demographic information, respondents were categorized into 3 groups: group A consisted of respondents who had never heard of the influenza vaccine; group B was comprised of respondents who answered that they had never received the influenza vaccine; and group C included respondents who answered that they had received at least one influenza vaccine. Out of the 317 survey respondents, 36 (11%) had never heard of the influenza vaccine (Group A). Of the remaining 281 (89%), 122 (39%) had not received the vaccine (Group B), whereas 159 (50%) had received it (Group C). Chi-square test results indicated a significant association between age group and awareness of the vaccine (p = .023). Moreover, there was a significant association between education level and awareness of the vaccine (p = .002). The prevalence of vaccination hesitancy was 42%. Chi-square test results indicated a significant association between gender and vaccination hesitancy (p < .001), and between education level and vaccination hesitancy (p = .011). Influenza vaccination hesitancy is prevalent among the study's population. Further efforts by health care providers and public health services may be necessary to educate the community regarding the influenza vaccine's safety and efficacy.

To assess the efficacy and safety of topical application of clotrimazole versus others in the treatment of oropharyngeal candidiasis (OPC). Four electronic databases, registries of ongoing trials, and manual search were used to identify randomized controlled trials (RCTs) that compared the efficacy of clotrimazole to other antifungal agents in patients who were clinically diagnosed with oral candidiasis up to November 1st, 2019. Primary outcomes were clinical response and mycological cure rates. Secondary outcomes include relapse rate, incidence of systemic infections, and compliance. Adverse effects were also evaluated. Sixteen RCTs with a total of 1685 patients were included. Half of the eligible studies were considered at high risk of performance bias and more than a third, at high risk of reporting bias. Our analysis showed no significant difference in clinical response between clotrimazole and all other antifungal agents. However, clotrimazole was less effective in terms of mycologic cure and relapse rate. Sensitivity analysis comparing clotrimazole to other topical antifungal agents only showed no differences in clinical response, microbiologic cure or relapse. Further sensitivity analysis showed significant efficacy of fluconazole over clotrimazole. This meta-analysis indicated that clotrimazole is less effective than fluconazole but as effective as other topical therapies in treating OPC. Well-designed high-quality RCT is needed to validate these findings.

Background As opioid prescriptions have risen, there has also been a rise in opioid overdose deaths and substance use disorders. Public health systems have tried to improve their ability to detect and intervene in opioid use disorders to prevent death due to overdose. The objective of this study is to compare two approaches to identify opioid use problems (OUP) using electronic health record data- text mining versus diagnostic codes.Methods Our sample consisted of adults on long-term opioid therapy (LTOT), defined as at least ≥ 70 days of supply within 90 days, and who visited a large multi-hospital network within a two-year period, between 1 January 2013 and 31 December 2014. We excluded patients with active cancer or schizophrenia. Text mining results were validated by a semi-assisted human review process and positive predictive value and level of agreement was reported. Each algorithm sought to identify patients who visited a health care facility due to an opioid poisoning event, opioid abuse, or opioid dependence. Population characteristics for positive OUP identified by text mining and ICD cohorts were compared. Chi-square and Fishers exact test were used for categorical data analysis and independent t-test was used to compare means for continuous variables. We further compared the demographics of the cohorts identified by the two methods.Results We identified 14,298 eligible LTOT patients. Text mining of relevant electronic clinical notes yielded 127 positive OUP cases compared to 45 cases using International Classification of Disease (ICD)-9 codes for the same population. Just eight OUP patients were identified using both methods. The two cohorts differed significantly with respect to age, gender, and other characteristics.Conclusions Compared to diagnostic codes, text mining identified more OUP cases with distinct characteristics. Incorporating text-mining techniques into OUP surveillance methods may support better detection of OUP and more accurate estimates of prevalence.

During the COVID-19 pandemic, Saudi Arabia witnessed hesitancy from a proportion of the population toward taking the vaccine; thus, it was necessary to nudge them to uptake it. This study was conducted to assess the impact of using different types of messages to nudge the public to increase the proportion of vaccinated individuals. This study is a multi-arm randomized controlled trial aiming to assess the efficacy of using differently framed messages that appear as pop-notifications in Sehatty application. Of those who preregistered to receive a COVID-19 vaccine but didn’t take it according to the Saudi national vaccine registry (n = 1,291,686), 12,000 individuals were randomly recruited and randomly assigned to one of five intervention groups (commitment, loss aversion, salience, social norms, and ego) or a control group. To ensure the exposure occurred in the intervention groups, we included only those who received the notification, which was confirmed by checking the information technology system. We used the Chi-square test to compare each intervention group against the control group separately. Also, we used the same test to investigate whether sex and age influenced the percentage of booked appointments in the intervention groups. Social norms, ego, salience and loss aversion groups had higher percentages of booked appointments when compared to the control group (21.0%, p = 0.001; 19.1%, p = 0.011; 19.0%, p = 0.013; 18.4%, p = 0.034, respectively). Moreover, when combining the intervention groups, the percentage was higher than the control group (p < 0.001). The percentages of booked appointments made by Young adults (18–35 years old) were higher than that of adults over 35 years old in the social norms (22.6%, p = 0.016) and ego groups (21.0%, p = 0.010). At the same time, sex didn’t affect the percentages of booked appointments in any group. Using different framings of messages to nudge the public to take vaccines can help increase the percentage of immunized individuals in a community. Nudges can boost the public health of a population during an unusual spread of vaccine-preventable diseases. Findings might also inspire governmental responses to other public health situations.