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  1. Article ; Online: A call for error management in academic clinical research.

    McLennan, Stuart / Briel, Matthias

    Journal of clinical epidemiology

    2022  Volume 154, Page(s) 208–211

    Language English
    Publishing date 2022-12-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639306-8
    ISSN 1878-5921 ; 0895-4356
    ISSN (online) 1878-5921
    ISSN 0895-4356
    DOI 10.1016/j.jclinepi.2022.11.023
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  2. Article ; Online: Building a house without foundations? A 24-country qualitative interview study on artificial intelligence in intensive care medicine.

    McLennan, Stuart / Fiske, Amelia / Celi, Leo Anthony

    BMJ health & care informatics

    2024  Volume 31, Issue 1

    Abstract: Objectives: To explore the views of intensive care professionals in high-income countries (HICs) and lower-to-middle-income countries (LMICs) regarding the use and implementation of artificial intelligence (AI) technologies in intensive care units (ICUs) ...

    Abstract Objectives: To explore the views of intensive care professionals in high-income countries (HICs) and lower-to-middle-income countries (LMICs) regarding the use and implementation of artificial intelligence (AI) technologies in intensive care units (ICUs).
    Methods: Individual semi-structured qualitative interviews were conducted between December 2021 and August 2022 with 59 intensive care professionals from 24 countries. Transcripts were analysed using conventional content analysis.
    Results: Participants had generally positive views about the potential use of AI in ICUs but also reported some well-known concerns about the use of AI in clinical practice and important technical and non-technical barriers to the implementation of AI. Important differences existed between ICUs regarding their current readiness to implement AI. However, these differences were not primarily between HICs and LMICs, but between a small number of ICUs in large tertiary hospitals in HICs, which were reported to have the necessary digital infrastructure for AI, and nearly all other ICUs in both HICs and LMICs, which were reported to neither have the technical capability to capture the necessary data or use AI, nor the staff with the right knowledge and skills to use the technology.
    Conclusion: Pouring massive amounts of resources into developing AI without first building the necessary digital infrastructure foundation needed for AI is unethical. Real-world implementation and routine use of AI in the vast majority of ICUs in both HICs and LMICs included in our study is unlikely to occur any time soon. ICUs should not be using AI until certain preconditions are met.
    MeSH term(s) Humans ; Artificial Intelligence ; Critical Care ; Intensive Care Units ; Knowledge ; Qualitative Research
    Language English
    Publishing date 2024-04-19
    Publishing country England
    Document type Journal Article
    ISSN 2632-1009
    ISSN (online) 2632-1009
    DOI 10.1136/bmjhci-2024-101052
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  3. Article: Diversity in German-speaking medical ethics and humanities.

    Fiske, Amelia / McLennan, Stuart

    Journal of bioethical inquiry

    2022  Volume 19, Issue 4, Page(s) 643–653

    Abstract: Background: Bioethics can play an important role in addressing diversity both in and outside of academia, setting precedents for meaningful contributions to public discourse, research, teaching, training, and policy development. However, in order to do ... ...

    Abstract Background: Bioethics can play an important role in addressing diversity both in and outside of academia, setting precedents for meaningful contributions to public discourse, research, teaching, training, and policy development. However, in order to do so, these conversations also need to reflect on the issue of diversity within the field of bioethics across the globe. This study aims to examine current gender representation and diversity at medical ethics and humanities institutes in Germany, the German-speaking areas of Switzerland, and Austria.
    Methods: A total of forty-nine medical ethics and humanities institutes from Germany (n=42), the German-speaking areas of Switzerland (n=5), and Austria (n=2) were included in the study. Institutes websites were reviewed in the first week of March 2021 and the details of each staff member listed on the website recorded.
    Results: Overall, a total of 964 staff members were identified at the forty-nine German-speaking medical ethics and humanities institutes. Just over half (530/964; 55%) of all staff were female. There were significant differences between gender in some staff positions: 64.6 per cent (31/48) of directors were male (χ
    Conclusions: There has been a significant push to address gender diversity in German-speaking academia, and this study finds overall good gender parity in medical ethics and humanities institutes. However, there has not been a similar openness to discussing issues of systemic racism or how other forms of inequality affect academic diversity. Taking diversity seriously requires opening up conversations around intersectionality, including difficult conversations around race and cultural background that have long been taboo in German-speaking countries.
    MeSH term(s) Humans ; Male ; Female ; Education, Medical ; Humanities ; Ethics, Medical ; Curriculum ; Bioethics ; Switzerland
    Language English
    Publishing date 2022-11-07
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2253038-1
    ISSN 1872-4353 ; 1176-7529
    ISSN (online) 1872-4353
    ISSN 1176-7529
    DOI 10.1007/s11673-022-10215-6
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  4. Article: Newspaper coverage on solidarity and personal responsibility in the COVID-19 pandemic: A content analysis from Germany and German-speaking Switzerland.

    Zimmermann, Bettina M / Buyx, Alena / McLennan, Stuart

    SSM - population health

    2023  Volume 22, Page(s) 101388

    Abstract: Solidarity and personal responsibility have been repeatedly called upon during the COVID-19 pandemic. This study quantifies and contextualizes the use of these terms in newspaper coverage in Germany and German-speaking Switzerland based on n = 640 ... ...

    Abstract Solidarity and personal responsibility have been repeatedly called upon during the COVID-19 pandemic. This study quantifies and contextualizes the use of these terms in newspaper coverage in Germany and German-speaking Switzerland based on n = 640 articles from six functionally equivalent newspapers. The term solidarity in the context of the COVID-19 pandemic was mentioned in 541/640 articles (84.5%) and was primarily used during phases with high death rates and comparatively stringent policies in place, supporting the idea that solidarity was used to explain restrictive measures to the population and motivate people to comply with these measures. German newspapers published more articles on solidarity than Swiss-German newspapers, consistent with more stringent COVID-19 policies in Germany. Personal responsibility was mentioned in 133/640 articles (20.8%), meaning that the term was less frequently discussed than solidarity. Articles covering personal responsibility included more negative evaluations during phases of high infection rates as compared to phases of low infection rates. Findings indicate that the two terms were, at least to some extent, used in newspaper reporting to contextualize and justify COVID-19 policy during phases of high infection rates. Moreover, the term solidarity was used in a high variety of different contexts and the inherent limits of solidarity were rarely mentioned. Policymakers and journalists need to take this into account for future crises to not jeopardize the positive effects of solidarity.
    Language English
    Publishing date 2023-03-27
    Publishing country England
    Document type Journal Article
    ISSN 2352-8273
    ISSN 2352-8273
    DOI 10.1016/j.ssmph.2023.101388
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  5. Article ; Online: Rejected Online Feedback From a Swiss Physician Rating Website Between 2008 and 2017: Analysis of 2352 Ratings.

    McLennan, Stuart

    Journal of medical Internet research

    2020  Volume 22, Issue 8, Page(s) e18374

    Abstract: Background: Previous research internationally has only analyzed publicly available feedback on physician rating websites (PRWs). However, it appears that many PRWs are not publishing all the feedback they receive. Analysis of this rejected feedback ... ...

    Abstract Background: Previous research internationally has only analyzed publicly available feedback on physician rating websites (PRWs). However, it appears that many PRWs are not publishing all the feedback they receive. Analysis of this rejected feedback could provide a better understanding of the types of feedback that are currently not published and whether this is appropriate.
    Objective: The aim of this study was to examine (1) the number of patient feedback rejected from the Swiss PRW Medicosearch, (2) the evaluation tendencies of the rejected patient feedback, and (3) the types of issues raised in the rejected narrative comments.
    Methods: The Swiss PRW Medicosearch provided all the feedback that had been rejected between September 16, 2008, and September 22, 2017. The feedback were analyzed and classified according to a theoretical categorization framework of physician-, staff-, and practice-related issues.
    Results: Between September 16, 2008, and September 22, 2017, Medicosearch rejected a total of 2352 patient feedback. The majority of feedback rejected (1754/2352, 74.6%) had narrative comments in the German language. However, 11.9% (279/2352) of the rejected feedback only provided a quantitative rating with no narrative comment. Overall, 25% (588/2352) of the rejected feedback were positive, 18.7% (440/2352) were neutral, and 56% (1316/2352) were negative. The average rating of the rejected feedback was 2.8 (SD 1.4). In total, 44 subcategories addressing the physician (n=20), staff (n=9), and practice (n=15) were identified. In total, 3804 distinct issues were identified within the 44 subcategories of the categorization framework; 75% (2854/3804) of the issues were related to the physician, 6.4% (242/3804) were related to the staff, and 18.6% (708/3804) were related to the practice. Frequently mentioned issues identified from the rejected feedback included (1) satisfaction with treatment (533/1903, 28%); (2) the overall assessment of the physician (392/1903, 20.6%); (3) recommending the physician (345/1903, 18.1%); (4) the physician's communication (261/1903, 13.7%); (5) the physician's caring attitude (220/1903, 11.6%); and (6) the physician's friendliness (203/1903, 10.6%).
    Conclusions: It is unclear why the majority of the feedback were rejected. This is problematic and raises concerns that online patient feedback are being inappropriately manipulated. If online patient feedback is going to be collected, there needs to be clear policies and practices about how this is handled. It cannot be left to the whims of PRWs, who may have financial incentives to suppress negative feedback, to decide which feedback is or is not published online. Further research is needed to examine how many PRWs are using criteria for determining which feedback is published or not, what those criteria are, and what measures PRWs are using to address the manipulation of online patient feedback.
    MeSH term(s) Feedback ; Female ; History, 21st Century ; Humans ; Internet ; Male ; Patient Satisfaction/statistics & numerical data ; Physicians/standards ; Switzerland
    Language English
    Publishing date 2020-08-03
    Publishing country Canada
    Document type Historical Article ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2028830-X
    ISSN 1438-8871 ; 1439-4456
    ISSN (online) 1438-8871
    ISSN 1439-4456
    DOI 10.2196/18374
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Qualitative Evidence for Concern: Digital Health Technologies and the COVID-19 Pandemic.

    Fiske, Amelia / McLennan, Stuart / Buyx, Alena

    AJOB neuroscience

    2022  Volume 13, Issue 3, Page(s) 204–206

    MeSH term(s) COVID-19/epidemiology ; Digital Technology ; Humans ; Mental Health ; Mobile Applications ; Pandemics
    Language English
    Publishing date 2022-08-26
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2576262-X
    ISSN 2150-7759 ; 2150-7740
    ISSN (online) 2150-7759
    ISSN 2150-7740
    DOI 10.1080/21507740.2022.2082587
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    In stock of ZB MED Cologne/Königswinter

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  7. Article ; Online: One Decade of Online Patient Feedback: Longitudinal Analysis of Data From a German Physician Rating Website.

    Emmert, Martin / McLennan, Stuart

    Journal of medical Internet research

    2021  Volume 23, Issue 7, Page(s) e24229

    Abstract: Background: Feedback from patients is an essential element of a patient-oriented health care system. Physician rating websites (PRWs) are a key way patients can provide feedback online. This study analyzes an entire decade of online ratings for all ... ...

    Abstract Background: Feedback from patients is an essential element of a patient-oriented health care system. Physician rating websites (PRWs) are a key way patients can provide feedback online. This study analyzes an entire decade of online ratings for all medical specialties on a German PRW.
    Objective: The aim of this study was to examine how ratings posted on a German PRW have developed over the past decade. In particular, it aimed to explore (1) the distribution of ratings according to time-related aspects (year, month, day of the week, and hour of the day) between 2010 and 2019, (2) the number of physicians with ratings, (3) the average number of ratings per physician, (4) the average rating, (5) whether differences exist between medical specialties, and (6) the characteristics of the patients rating physicians.
    Methods: All scaled-survey online ratings that were posted on the German PRW jameda between 2010 and 2019 were obtained.
    Results: In total, 1,906,146 ratings were posted on jameda between 2010 and 2019 for 127,921 physicians. The number of rated physicians increased constantly from 19,305 in 2010 to 82,511 in 2018. The average number of ratings per rated physicians increased from 1.65 (SD 1.56) in 2010 to 3.19 (SD 4.69) in 2019. Overall, 75.2% (1,432,624/1,906,146) of all ratings were in the best rating category of "very good," and 5.7% (107,912/1,906,146) of the ratings were in the lowest category of "insufficient." However, the mean of all ratings was 1.76 (SD 1.53) on the German school grade 6-point rating scale (1 being the best) with a relatively constant distribution over time. General practitioners, internists, and gynecologists received the highest number of ratings (343,242, 266,899, and 232,914, respectively). Male patients, those of higher age, and those covered by private health insurance gave significantly (P<.001) more favorable evaluations compared to their counterparts. Physicians with a lower number of ratings tended to receive ratings across the rating scale, while physicians with a higher number of ratings tended to have better ratings. Physicians with between 21 and 50 online ratings received the lowest ratings (mean 1.95, SD 0.84), while physicians with >100 ratings received the best ratings (mean 1.34, SD 0.47).
    Conclusions: This study is one of the most comprehensive analyses of PRW ratings to date. More than half of all German physicians have been rated on jameda each year since 2016, and the overall average number of ratings per rated physicians nearly doubled over the decade. Nevertheless, we could also observe a decline in the number of ratings over the last 2 years. Future studies should investigate the most recent development in the number of ratings on both other German and international PRWs as well as reasons for the heterogeneity in online ratings by medical specialty.
    MeSH term(s) Feedback ; Female ; Germany ; Humans ; Internet ; Longitudinal Studies ; Male ; Patient Satisfaction/statistics & numerical data ; Physicians ; Surveys and Questionnaires
    Language English
    Publishing date 2021-07-26
    Publishing country Canada
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2028830-X
    ISSN 1438-8871 ; 1439-4456
    ISSN (online) 1438-8871
    ISSN 1439-4456
    DOI 10.2196/24229
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  8. Article ; Online: Newspaper coverage on solidarity and personal responsibility in the COVID-19 pandemic

    Bettina M. Zimmermann / Alena Buyx / Stuart McLennan

    SSM: Population Health, Vol 22, Iss , Pp 101388- (2023)

    A content analysis from Germany and German-speaking Switzerland

    2023  

    Abstract: Solidarity and personal responsibility have been repeatedly called upon during the COVID-19 pandemic. This study quantifies and contextualizes the use of these terms in newspaper coverage in Germany and German-speaking Switzerland based on n = 640 ... ...

    Abstract Solidarity and personal responsibility have been repeatedly called upon during the COVID-19 pandemic. This study quantifies and contextualizes the use of these terms in newspaper coverage in Germany and German-speaking Switzerland based on n = 640 articles from six functionally equivalent newspapers. The term solidarity in the context of the COVID-19 pandemic was mentioned in 541/640 articles (84.5%) and was primarily used during phases with high death rates and comparatively stringent policies in place, supporting the idea that solidarity was used to explain restrictive measures to the population and motivate people to comply with these measures. German newspapers published more articles on solidarity than Swiss-German newspapers, consistent with more stringent COVID-19 policies in Germany. Personal responsibility was mentioned in 133/640 articles (20.8%), meaning that the term was less frequently discussed than solidarity. Articles covering personal responsibility included more negative evaluations during phases of high infection rates as compared to phases of low infection rates. Findings indicate that the two terms were, at least to some extent, used in newspaper reporting to contextualize and justify COVID-19 policy during phases of high infection rates. Moreover, the term solidarity was used in a high variety of different contexts and the inherent limits of solidarity were rarely mentioned. Policymakers and journalists need to take this into account for future crises to not jeopardize the positive effects of solidarity.
    Keywords Public health ethics ; Health policy ; SARS-CoV-2 ; Public debates ; Media reporting ; Public aspects of medicine ; RA1-1270 ; Social sciences (General) ; H1-99
    Subject code 070
    Language English
    Publishing date 2023-06-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: The ethical oversight of learning health care activities in Switzerland: a qualitative study.

    McLennan, Stuart

    International journal for quality in health care : journal of the International Society for Quality in Health Care

    2019  Volume 31, Issue 8, Page(s) G81–G86

    Abstract: Objective: This study aims to identify the key issues regarding the ethical oversight of health care improvement activities in Switzerland.: Design: Individual semi-structured qualitative interviews, analysed using conventional content analysis.: ... ...

    Abstract Objective: This study aims to identify the key issues regarding the ethical oversight of health care improvement activities in Switzerland.
    Design: Individual semi-structured qualitative interviews, analysed using conventional content analysis.
    Setting: Interviews were conducted in Switzerland between July 2017 and February 2018.
    Participants: A purposive sample of 38 key stakeholders from four different groups: health care improvement researchers and practitioners (n = 19), representatives of clinical trial units (n = 3), clinical ethicists (n = 5), quality heads of university hospitals (n = 5), and cantonal ethics committee members (n = 6).
    Results: There appears to be widespread uncertainty regarding when certain learning health care activities require ethical review by a research ethics committee in Switzerland. This situation is exacerbated by legislative ambiguity and limited guidance. It was reported that the lack of other oversight mechanisms for activities outside of the Human Research Act is also leading many investigators to submit projects to research ethics committees to avoid barriers to publication.
    Conclusions: The continuous, integrated, and dynamic nature of learning health care poses significant challenges to the current regulatory framework. It will be important that more clarification and guidance is provided regarding which activities require ethical review, and that it is considered how the ethical oversight of activities falling outside human research legislation can be strengthened. However, the traditional model of ethical oversight is poorly suited to learning health care and may need to be replaced with new systemic oversight approaches.
    MeSH term(s) Ethics Committees, Research ; Health Services Research/ethics ; Humans ; Qualitative Research ; Quality Improvement/ethics ; Quality of Health Care/ethics ; Switzerland
    Language English
    Publishing date 2019-05-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 1194150-9
    ISSN 1464-3677 ; 1353-4505
    ISSN (online) 1464-3677
    ISSN 1353-4505
    DOI 10.1093/intqhc/mzz045
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3052: Show issues Location:
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  10. Article ; Online: Quantitative Ratings and Narrative Comments on Swiss Physician Rating Websites: Frequency Analysis.

    McLennan, Stuart

    Journal of medical Internet research

    2019  Volume 21, Issue 7, Page(s) e13816

    Abstract: Background: Physician rating websites (PRWs) have been developed as part of a wider move toward transparency around health care quality, and these allow patients to anonymously rate, comment, and discuss physicians' quality on the Web. The first Swiss ... ...

    Abstract Background: Physician rating websites (PRWs) have been developed as part of a wider move toward transparency around health care quality, and these allow patients to anonymously rate, comment, and discuss physicians' quality on the Web. The first Swiss PRWs were established in 2008, at the same time as many international PRWs. However, there has been limited research conducted on PRWs in Switzerland to date. International research has indicated that a key shortcoming of PRWs is that they have an insufficient number of ratings.
    Objective: The aim of this study was to examine the frequency of quantitative ratings and narrative comments on the Swiss PRWs.
    Methods: In November 2017, a random stratified sample of 966 physicians was generated from the regions of Zürich and Geneva. Every selected physician was searched for on 4 rating websites (OkDoc, DocApp, Medicosearch, and Google) between November 2017 and July 2018. It was recorded whether the physician could be identified, what the physician's quantitative rating was, and whether the physician had received narrative comments. In addition, Alexa Internet was used to examine the number of visitors to the PRWs, compared with other websites.
    Results: Overall, the portion of physicians able to be identified on the PRWs ranged from 42.4% (410/966) on OkDoc to 87.3% (843/966) on DocApp. Of the identifiable physicians, only a few of the selected physicians had been rated quantitatively (4.5% [38/843] on DocApp to 49.8% [273/548] on Google) or received narrative comments (4.5% [38/843] on DocApp to 31.2% [171/548] on Google) at least once. Rated physicians also had, on average, a low number of quantitative ratings (1.47 ratings on OkDoc to 3.74 rating on Google) and narrative comments (1.23 comment on OkDoc to 3.03 comments on Google). All 3 websites allowing ratings used the same rating scale (1-5 stars) and had a very positive average rating: DocApp (4.71), Medicosearch (4.69), and Google (4.41). There were significant differences among the PRWs (with the majority of ratings being posted on Google in past 2 years) and regions (with physicians in Zurich more likely to have been rated and have more ratings on average). Only Google (position 1) and Medicosearch (position 8358) are placed among the top 10,000 visited websites in Switzerland.
    Conclusions: It appears that this is the first time Google has been included in a study examining physician ratings internationally and it is noticeable how Google has had substantially more ratings than the 3 dedicated PRWs in Switzerland over the past 2 and a half years. Overall, this study indicates that Swiss PRWs are not yet a reliable source of unbiased information regarding patient experiences and satisfaction with Swiss physicians; many selected physicians were unable to be identified, only a few physicians had been rated, and the ratings posted were overwhelmingly positive.
    MeSH term(s) Adult ; Data Collection/methods ; Female ; Humans ; Male ; Narration ; Patient Satisfaction/statistics & numerical data ; Physicians/standards ; Quality of Health Care/standards ; Research Design ; Switzerland ; Young Adult
    Language English
    Publishing date 2019-07-26
    Publishing country Canada
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2028830-X
    ISSN 1438-8871 ; 1439-4456
    ISSN (online) 1438-8871
    ISSN 1439-4456
    DOI 10.2196/13816
    Database MEDical Literature Analysis and Retrieval System OnLINE

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