ASCES:A Balanced Game Based Solution for Chronic Diseases

Worldwide the prevalence of obesity has increased dramatically, making it one of the biggest drivers of preventable chronic diseases and healthcare costs. The treatment of obesity is difficult, as it is a multifactorial problem. Obesity hampers treatment of many other chronic diseases like COPD and diabetes. It is known that at an early age a reset in the programming of body cells can occur, inducing a lifelong sensitivity for the development of obesity. Recent research has shown that changes in body composition can already start in children as young as 4 years old. Obesity is not just a matter of too much food and too little exercise. It should be handled from many different perspectives, not at least from a psychological and family-based perspective. In this project, we focus on the prevention of obesity in children using an e-health obesity prevention program: ASCeS (Anima Sana, Corporus Sana). This presentation shows the first prototype of this game based application. It will also show the development process with the Game of Games (a game to build games). The game is based upon the balanced scorecard principle, on four critical obesity factors objectives are formulated and (automatically) measured. A Tamagotchi will show if you perform well on these critical areas. The game will combine Augmented Reality, Virtual Reality but ultimately Reality. It can be tweaked to the real circumstances (demographics and professional healthcare)

Inter Organizational Evaluation of SISP; What New Criteria Are Needed?

During the three decades of research and practice, the image of Strategic Information Systems Planning has changed considerably. Flexibility, creativity, strategic thinking, and sharing of knowledge are seen as the new ways to both formulate and realize strategy. IT governance has provided a more flexible concept to discuss managerial efforts to align IT with business. But maybe the most important change has been left unattended, that is the introduction of information strategy in networks. Still, many organizations continue to use planning as a way to support their decisionmaking internally without co-operating with their business partners. Also the view of evaluating SISP effectiveness has matured. A recent research concluded six dimensions for evaluating the planning process and four criteria for evaluating its effectiveness. These studies are mainly quantitative and this paper qualitatively validates the same dimensions in a case study. Two inter organizational studies from literature add five new factors: competitive pressure, trading partner readiness, contractual level, financial agreements and certainty of implementation. This study used the internal dimensions and criteria as basis for conducting a qualitative evaluation of SISP in two case studies, one single organization case and one inter organizational case. The results of the first case confirm that these criteria provide a good basis for overall evaluation of SISP internally. In addition to the internal theory based evaluation, also an interorganizational exploration was done to explore the differences and the new evaluation criteria needed. The result is a conceptual interview framework to be tested in practice

EXPLORING STRATEGIC IS PLANNING IN A NETWORK

For three decades of research and practice, Strategic Information Systems Planning and Business Network Strategy Planning live apart together. The view of evaluating SISP effectiveness has matured and the evaluation models are validated and well studied. Networks have been increasing and every large organization is involved in several alliances. But still an important change has been left unattended, that is the introduction of information strategy in networks. Still, many organizations continue to use planning as a way to support their decision-making internally without co-operating with their business partners. The evaluation studies of SISP are mainly quantitative and qualitative studies are rare. This study used the internal dimensions and criteria as basis for conducting a qualitative evaluation of SISP in two case studies in professional organizations, one single organization case and one inter organizational case. The results of the first case confirm that the validated criteria provide a good basis for overall evaluation of SISP internally. In addition to the internal theory based evaluation, also an inter-organizational exploration was done to explore the differences and the new evaluation criteria needed. The result is a conceptual interview framework to be tested in practice. An earlier full version of this paper was accepted and presented at ECIS 2007 in Sankt Gallen, Switzerland

Making it work for me: beliefs about making a personal health record relevant and useable.

BACKGROUND: A Personal Health Record (PHR) is an electronic record that individuals use to manage and share their health information, e.g. data from their medical records and data collected by apps. However, engagement with their record can be low if people do not find it beneficial to their health, wellbeing or interactions with health and other services. We have explored the beliefs potential users have about a PHR, how it could be made personally relevant, and barriers to its use. METHODS: A qualitative design comprising eight focus groups, each with 6-8 participants. Groups included adults with long-term health conditions, young people, physically active adults, data experts, and members of the voluntary sector. Each group lasted 60-90 min, was audio recorded and transcribed verbatim. We analysed the data using thematic analysis to address the question "What are people's beliefs about making a Personal Health Record have relevance and impact?" RESULTS: We found four themes. Making it work for me is about how to encourage individuals to actively engage with their PHR. I control my information is about individuals deciding what to share and who to share it with. My concerns is about individuals' concerns about information security and if and how their information will be acted upon. Potential impact shows the potential benefits of a PHR such as increasing self-efficacy, uptake of health-protective behaviours, and professionals taking a more holistic approach to providing care and facilitating behaviour change. CONCLUSIONS: Our research shows the functionality that a PHR requires in order for people to engage with it. Interactive functions and integration with lifestyle and health apps are particularly important. A PHR could increase the effectiveness of behaviour change apps by specifying evidence-based behaviour change techniques that apps should incorporate. A PHR has the potential to increase health-protective behaviours and facilitate a more person-driven health and social care system. It could support patients to take responsibility for self-managing their health and treatment regimens, as well as helping patients to play a more active role when care transfers across boundaries of responsibility

Classification of patients with knee osteoarthritis in clinical phenotypes: data from the osteoarthritis initiative

<div><p>Objectives</p><p>The existence of phenotypes has been hypothesized to explain the large heterogeneity characterizing the knee osteoarthritis. In a previous systematic review of the literature, six main phenotypes were identified: Minimal Joint Disease (MJD), Malaligned Biomechanical (MB), Chronic Pain (CP), Inflammatory (I), Metabolic Syndrome (MS) and Bone and Cartilage Metabolism (BCM). The purpose of this study was to classify a sample of individuals with knee osteoarthritis (KOA) into pre-defined groups characterized by specific variables that can be linked to different disease mechanisms, and compare these phenotypes for demographic and health outcomes.</p><p>Methods</p><p>599 patients were selected from the OAI database FNIH at 24 months’ time to conduct the study. For each phenotype, cut offs of key variables were identified matching the results from previous studies in the field and the data available for the sample. The selection process consisted of 3 steps. At the end of each step, the subjects classified were excluded from the further classification stages. Patients meeting the criteria for more than one phenotype were classified separately into a ‘complex KOA’ group.</p><p>Results</p><p>Phenotype allocation (including complex KOA) was successful for 84% of cases with an overlap of 20%. Disease duration was shorter in the MJD while the CP phenotype included a larger number of Women (81%). A significant effect of phenotypes on WOMAC pain (F = 16.736 p <0.001) and WOMAC physical function (F = 14.676, p < 0.001) was identified after controlling for disease duration.</p><p>Conclusion</p><p>This study signifies the feasibility of a classification of KOA subjects in distinct phenotypes based on subgroup-specific characteristics.</p></div

A consensus-based framework for conducting and reporting osteoarthritis phenotype research

Background The concept of osteoarthritis (OA) heterogeneity is evolving and gaining renewed interest. According to this concept, distinct subtypes of OA need to be defined that will likely require recognition in research design and different approaches to clinical management. Although seemingly plausible, a wide range of views exist on how best to operationalize this concept. The current project aimed to provide consensus-based definitions and recommendations that together create a framework for conducting and reporting OA phenotype research. Methods A panel of 25 members with expertise in OA phenotype research was composed. First, panel members participated in an online Delphi exercise to provide a number of basic definitions and statements relating to OA phenotypes and OA phenotype research. Second, panel members provided input on a set of recommendations for reporting on OA phenotype studies. Results Four Delphi rounds were required to achieve sufficient agreement on 11 definitions and statements. OA phenotypes were defined as subtypes of OA that share distinct underlying pathobiological and pain mechanisms and their structural and functional consequences. Reporting recommendations pertaining to the study characteristics, study population, data collection, statistical analysis, and appraisal of OA phenotype studies were provided. Conclusions This study provides a number of consensus-based definitions and recommendations relating to OA phenotypes. The resulting framework is intended to facilitate research on OA phenotypes and increase combined efforts to develop effective OA phenotype classification. Success in this endeavor will hopefully translate into more effective, differentiated OA management that will benefit a multitude of OA patients

An automated workflow based on hip shape improves personalized risk prediction for hip osteoarthritis in the CHECK study

Objective: To design an automated workflow for hip radiographs focused on joint shape and tests its prognostic value for future hip osteoarthritis. Design: We used baseline and 8-year follow-up data from 1,002 participants of the CHECK-study. The primary outcome was definite radiographic hip osteoarthritis (rHOA) (Kellgren–Lawrence grade ≥2 or joint replacement) at 8-year follow-up. We designed a method to automatically segment the hip joint from radiographs. Subsequently, we applied machine learning algorithms (elastic net with automated parameter optimization) to provide the Shape-Score, a single value describing the risk for future rHOA based solely on joint shape. We built and internally validated prediction models using baseline demographics, physical examination, and radiologists scores and tested the added prognostic value of the Shape-Score using Area-Under-the-Curve (AUC). Missing data was imputed by multiple imputation by chained equations. Only hips with pain in the corresponding leg were included. Results: 84% were female, mean age was 56 (±5.1) years, mean BMI 26.3 (±4.2). Of 1,044 hips with pain at baseline and complete follow-up, 143 showed radiographic osteoarthritis and 42 were replaced. 91.5% of the hips had follow-up data available. The Shape-Score was a significant predictor of rHOA (odds ratio per decimal increase 5.21, 95%-CI (3.74–7.24)). The prediction model using demographics, physical examination, and radiologists scores demonstrated an AUC of 0.795, 95%-CI (0.757–0.834). After addition of the Shape-Score the AUC rose to 0.864, 95%-CI (0.833–0.895). Conclusions: Our Shape-Score, automatically derived from radiographs using a novel machine learning workflow, may strongly improve risk prediction in hip osteoarthritis

Efficacy of bisphosphonates in specific knee osteoarthritis subpopulations: protocol for an OA Trial Bank systematic review and individual patient data meta-analysis

INTRODUCTION: Randomised clinical trials to date investigating the efficacy of bisphosphonates in knee osteoarthritis (OA) have found divergent results, with a recent meta-analysis finding no superiority of these drugs over placebo. Whether particular patient subgroups are more likely to benefit from this therapy than others is still unclear. We aim to investigate the effects of bisphosphonates compared with a control group (placebo, no treatment, another active treatment) on clinical and structural outcomes in specific knee OA subpopulations with possible distinct rates of subchondral bone turnover. METHODS AND ANALYSIS: Medline, Embase, Scopus, Web of Sciences and Cochrane Central Register of Controlled Trials will be searched from inception to February 2018. Randomised clinical trials will be eligible if they reported at least one potential treatment effect modifier at baseline: gender, menopausal status, age, body mass index, radiographic stage, knee pain severity, presence of bone marrow lesions, levels of biochemical markers of bone turnover (serum and/or urinary) and systemic bone mineral density status. Authors of original trials will be contacted to obtain individual patient data from each study. Risk of bias will be assessed using the Cochrane Collaboration's tool. The primary o