ORCID Profile
0000-0002-6715-9097
Current Organisation
Bond University
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Publisher: BMJ
Date: 10-2022
DOI: 10.1136/BMJGH-2022-008696
Abstract: Overdiagnosis and overuse of healthcare services harm in iduals, take resources that could be used to address underuse, and threaten the sustainability of health systems. These problems are attracting increasing attention in low-income and middle-income countries (LMICs). Unaware of any review of relevant evidence, we conducted a scoping review of the evidence around overdiagnosis and overuse of diagnostic and screening tests in LMICs. Scoping review. We searched PubMed, Embase, PsycINFO, Global Index Medicus for relevant studies published until 24 May 2021, with no restrictions on date or language. We categorised included studies by major focus (overdiagnosis, overuse of tests, or both) and main themes (presence or estimates of extent drivers consequences and solutions). We identified 2763 unique records and included 162 articles reporting on 154 studies across 55 countries, involving over 2.8 million participants and/or requests for tests. Almost half the studies focused on overdiagnosis (70 45.5%), one-third on overuse of tests (61 39.6%) and one-fifth on both (23 14.9%). Common overdiagnosed conditions included malaria (61 39.6%) and thyroid cancer (25 16.2%), estimated to be % in China. Overused tests included imaging (n=25 studies) such as CT and MRI laboratory investigations (n=18) such as serological tests and tumour markers and procedures (n=14) such as colonoscopy. Drivers included fear of conflict with patients and expanding disease definitions. Common consequences included unnecessary treatments such as antimalarials, and wasted resources, with costs of malaria overdiagnosis estimated at US$86 million in Sudan in 1 year alone. Only 9% of studies discussed solutions, which included addressing inappropriately lowered diagnostic thresholds and reforming test-ordering processes. Overdiagnosis and overuse of tests are widespread in LMICs and generate significant harm and waste. Better understanding of the problems and robust evaluation of solutions is needed, informed by a new global alliance of researchers and policy-makers.
Publisher: BMJ
Date: 06-2023
DOI: 10.1136/BMJOPEN-2022-067624
Abstract: To assess the effectiveness of bar graph, pictograph and line graph compared with text-only, and to each other, for communicating prognosis to the public. Two online four-arm parallel-group randomised controlled trials. Statistical significance was set at p .016 to allow for three-primary comparisons. Two Australian s les were recruited from members registered at Dynata online survey company. In trial A: 470 participants were randomised to one of the four arms, 417 were included in the analysis. In trial B: 499 were randomised and 433 were analysed. In each trial four visual presentations were tested: bar graph, pictograph, line graph and text-only. Trial A communicated prognostic information about an acute condition (acute otitis media) and trial B about a chronic condition (lateral epicondylitis). Both conditions are typically managed in primary care where ‘wait and see’ is a legitimate option. Comprehension of information (scored 0–6). Decision intention, presentation satisfaction and preferences. In both trials, the mean comprehension score was 3.7 for the text-only group. None of the visual presentations were superior to text-only. In trial A, the adjusted mean difference (MD) compared with text-only was: 0.19 (95% CI −0.16 to 0.55) for bar graph, 0.4 (0.04 to 0.76) for pictograph and 0.06 (−0.32 to 0.44) for line graph. In trial B, the adjusted MD was: 0.1 (−0.27 to 0.47) for bar graph), 0.38 (0.01 to 0.74) for pictograph and 0.1 (−0.27 to 0.48) for line graph. Pairwise comparisons between the three graphs showed all were clinically equivalent (95% CIs between −1.0 and 1.0). In both trials, bar graph was the most preferred presentation (chosen by 32.9% of trial A participants and 35.6% in trial B). Any of the four visual presentations tested may be suitable to use when discussing quantitative prognostic information. Australian New Zealand Clinical Trials Registry (ACTRN12621001305819).
Publisher: BMJ
Date: 02-2021
DOI: 10.1136/BMJOPEN-2020-043421
Abstract: Public cooperation to practise preventive health behaviours is essential to manage the transmission of infectious diseases such as COVID-19. We aimed to investigate beliefs about COVID-19 diagnosis, transmission and prevention that have the potential to impact the uptake of recommended public health strategies. An online cross-sectional survey. A national s le of 1500 Australian adults with representative quotas for age and gender provided by an online panel provider. Proportion of participants with correct/incorrect knowledge of COVID-19 preventive behaviours and reasons for misconceptions. Of the 1802 potential participants contacted, 289 did not qualify, 13 declined and 1500 participated in the survey (response rate 83%). Most participants correctly identified ‘washing your hands regularly with soap and water’ (92%) and ‘staying at least 1.5 m away from others’ (90%) could help prevent COVID-19. Over 40% (incorrectly) considered wearing gloves outside of the home would prevent them from contracting COVID-19. Views about face masks were ided. Only 66% of participants correctly identified that ‘regular use of antibiotics’ would not prevent COVID-19. Most participants (90%) identified ‘fever, fatigue and cough’ as indicators of COVID-19. However, 42% of participants thought that being unable to ‘hold your breath for 10 s without coughing’ was an indicator of having the virus. The most frequently reported sources of COVID-19 information were commercial television channels (56%), the Australian Broadcasting Corporation (43%) and the Australian Government COVID-19 information app (31%). Public messaging about hand hygiene and physical distancing to prevent transmission appears to have been effective. However, there are clear, identified barriers for many in iduals that have the potential to impede uptake or maintenance of these behaviours in the long term. We need to develop public health messages that harness these barriers to improve future cooperation. Ensuring adherence to these interventions is critical.
Publisher: Elsevier BV
Date: 2024
Publisher: JMIR Publications Inc.
Date: 02-08-2020
Abstract: imely and effective contact tracing is an essential public health measure for curbing the transmission of COVID-19. App-based contact tracing has the potential to optimize the resources of overstretched public health departments. However, its efficiency is dependent on widespread adoption. his study aimed to investigate the uptake of the Australian Government’s COVIDSafe app among Australians and examine the reasons why some Australians have not downloaded the app. n online national survey, with representative quotas for age and gender, was conducted between May 8 and May 11, 2020. Participants were excluded if they were a health care professional or had been tested for COVID-19. f the 1802 potential participants contacted, 289 (16.0%) were excluded prior to completing the survey, 13 (0.7%) declined, and 1500 (83.2%) participated in the survey. Of the 1500 survey participants, 37.3% (n=560) had downloaded the COVIDSafe app, 18.7% (n=280) intended to do so, 27.7% (n=416) refused to do so, and 16.3% (n=244) were undecided. Equally proportioned reasons for not downloading the app included privacy (165/660, 25.0%) and technical concerns (159/660, 24.1%). Other reasons included the belief that social distancing was sufficient and the app was unnecessary (111/660, 16.8%), distrust in the government (73/660, 11.1%), and other miscellaneous responses (eg, apathy and following the decisions of others) (73/660, 11.1%). In addition, knowledge about COVIDSafe varied among participants, as some were confused about its purpose and capabilities. or the COVIDSafe app to be accepted by the public and used correctly, public health messages need to address the concerns of citizens, specifically privacy, data storage, and technical capabilities. Understanding the specific barriers preventing the uptake of contact tracing apps provides the opportunity to design targeted communication strategies aimed at strengthening public health initiatives, such as downloading and correctly using contact tracing apps.
Publisher: JMIR Publications Inc.
Date: 04-11-2020
DOI: 10.2196/23081
Abstract: Timely and effective contact tracing is an essential public health measure for curbing the transmission of COVID-19. App-based contact tracing has the potential to optimize the resources of overstretched public health departments. However, its efficiency is dependent on widespread adoption. This study aimed to investigate the uptake of the Australian Government’s COVIDSafe app among Australians and examine the reasons why some Australians have not downloaded the app. An online national survey, with representative quotas for age and gender, was conducted between May 8 and May 11, 2020. Participants were excluded if they were a health care professional or had been tested for COVID-19. Of the 1802 potential participants contacted, 289 (16.0%) were excluded prior to completing the survey, 13 (0.7%) declined, and 1500 (83.2%) participated in the survey. Of the 1500 survey participants, 37.3% (n=560) had downloaded the COVIDSafe app, 18.7% (n=280) intended to do so, 27.7% (n=416) refused to do so, and 16.3% (n=244) were undecided. Equally proportioned reasons for not downloading the app included privacy (165/660, 25.0%) and technical concerns (159/660, 24.1%). Other reasons included the belief that social distancing was sufficient and the app was unnecessary (111/660, 16.8%), distrust in the government (73/660, 11.1%), and other miscellaneous responses (eg, apathy and following the decisions of others) (73/660, 11.1%). In addition, knowledge about COVIDSafe varied among participants, as some were confused about its purpose and capabilities. For the COVIDSafe app to be accepted by the public and used correctly, public health messages need to address the concerns of citizens, specifically privacy, data storage, and technical capabilities. Understanding the specific barriers preventing the uptake of contact tracing apps provides the opportunity to design targeted communication strategies aimed at strengthening public health initiatives, such as downloading and correctly using contact tracing apps.
Publisher: Elsevier BV
Date: 07-2021
Publisher: Springer Science and Business Media LLC
Date: 25-08-2021
DOI: 10.1186/S12911-021-01612-9
Abstract: Understanding prognostic information can help patients know what may happen to their health over time and make informed decisions. However, communicating prognostic information well can be challenging. To conduct a systematic review to identify and synthesize research that has evaluated visual presentations that communicate quantitative prognostic information to patients or the public. MEDLINE, EMBASE, CINAHL, PsycINFO , ERIC and the Cochrane Central Register of Controlled Trials (CENTRAL) (from inception to December 2020), and forward and backward citation search. Two authors independently screened search results and assessed eligibility. To be eligible, studies required a quantitative design and comparison of at least one visual presentation with another presentation of quantitative prognostic information. The primary outcome was comprehension of the presented information. Secondary outcomes were preferences for or satisfaction with the presentations viewed, and behavioral intentions. Two authors independently assessed risk of bias and extracted data. Eleven studies (all randomized trials) were identified. We grouped studies according to the presentation type evaluated. Bar graph versus pictograph (3 studies): no difference in comprehension between the groups. Survival vs mortality curves (2 studies): no difference in one study higher comprehension in survival curve group in another study. Tabular format versus pictograph (4 studies): 2 studies reported similar comprehension between groups 2 found higher comprehension in pictograph groups. Tabular versus free text (3 studies): 2 studies found no difference between groups 1 found higher comprehension in a tabular group. Heterogeneity in the visual presentations and outcome measures, precluding meta-analysis. No visual presentation appears to be consistently superior to communicate quantitative prognostic information.
No related grants have been discovered for Eman Abukmail.