Publications by authors named "Najeeb Al-Shorbaji"

18 Publications

  • Page 1 of 1

Evidence-Based Health Informatics as the Foundation for the COVID-19 Response: A Joint Call for Action.

Methods Inf Med 2021 May 11. Epub 2021 May 11.

Center for Biomedical Data Science, Yale University, New Haven, Connecticut, United States.

Background:  As a major public health crisis, the novel coronavirus disease 2019 (COVID-19) pandemic demonstrates the urgent need for safe, effective, and evidence-based implementations of digital health. The urgency stems from the frequent tendency to focus attention on seemingly high promising digital health interventions despite being poorly validated in times of crisis.

Aim:  In this paper, we describe a joint call for action to use and leverage evidence-based health informatics as the foundation for the COVID-19 response and public health interventions. Tangible examples are provided for how the working groups and special interest groups of the International Medical Informatics Association (IMIA) are helping to build an evidence-based response to this crisis.

Methods:  Leaders of working and special interest groups of the IMIA, a total of 26 groups, were contacted via e-mail to provide a summary of the scientific-based efforts taken to combat COVID-19 pandemic and participate in the discussion toward the creation of this manuscript. A total of 13 groups participated in this manuscript.

Results:  Various efforts were exerted by members of IMIA including (1) developing evidence-based guidelines for the design and deployment of digital health solutions during COVID-19; (2) surveying clinical informaticians internationally about key digital solutions deployed to combat COVID-19 and the challenges faced when implementing and using them; and (3) offering necessary resources for clinicians about the use of digital tools in clinical practice, education, and research during COVID-19.

Discussion:  Rigor and evidence need to be taken into consideration when designing, implementing, and using digital tools to combat COVID-19 to avoid delays and unforeseen negative consequences. It is paramount to employ a multidisciplinary approach for the development and implementation of digital health tools that have been rapidly deployed in response to the pandemic bearing in mind human factors, ethics, data privacy, and the diversity of context at the local, national, and international levels. The training and capacity building of front-line workers is crucial and must be linked to a clear strategy for evaluation of ongoing experiences.
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http://dx.doi.org/10.1055/s-0041-1726414DOI Listing
May 2021

Telehealth and the COVID-19 Pandemic: International Perspectives and a Health Systems Framework for Telehealth Implementation to Support Critical Response.

Yearb Med Inform 2021 Apr 21. Epub 2021 Apr 21.

Sri Sathya Sai Central Trust, Puttaparthi, India.

Objectives: Telehealth implementation is a complex systems-based endeavour. This paper compares telehealth responses to (COrona VIrus Disease 2019) COVID-19 across ten countries to identify lessons learned about the complexity of telehealth during critical response such as in response to a global pandemic. Our overall objective is to develop a health systems-based framework for telehealth implementation to support critical response.

Methods: We sought responses from the members of the International Medical Informatics Association (IMIA) Telehealth Working Group (WG) on their practices and perception of telehealth practices during the times of COVID-19 pandemic in their respective countries. We then analysed their responses to identify six emerging themes that we mapped to the World Health Organization (WHO) model of health systems.

Results: Our analysis identified six emergent themes. (1) Government, legal or regulatory aspects of telehealth; (2) Increase in telehealth capacity and delivery; (3) Regulated and unregulated telehealth; (4) Changes in the uptake and perception of telemedicine; (5) Public engagement in telehealth responses to COVID-19; and (6) Implications for training and education. We discuss these themes and then use them to develop a systems framework for telehealth support in critical response.

Conclusion: COVID-19 has introduced new challenges for telehealth support in times of critical response. Our themes and systems framework extend the WHO systems model and highlight that telemedicine usage in response to the COVID-19 pandemic is complex and multidimensional. Our systems-based framework provides guidance for telehealth implementation as part of health systems response to a global pandemic such as COVID-19.
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http://dx.doi.org/10.1055/s-0041-1726484DOI Listing
April 2021

Digital Health during COVID-19: Informatics Dialogue with the World Health Organization.

Yearb Med Inform 2021 Apr 21. Epub 2021 Apr 21.

eHealth Development Association, Amman, Jordan.

Background: On December 16, 2020 representatives of the International Medical Informatics Association (IMIA), a Non-Governmental Organization in official relations with the World Health Organization (WHO), along with its International Academy for Health Sciences Informatics (IAHSI), held an open dialogue with WHO Director General (WHO DG) Tedros Adhanom Ghebreyesus about the opportunities and challenges of digital health during the COVID-19 global pandemic.

Objectives: The aim of this paper is to report the outcomes of the dialogue and discussions with more than 200 participants representing different civil society organizations (CSOs).

Methods: The dialogue was held in form of a webinar. After an initial address of the WHO DG, short presentations by the panelists, and live discussions between panelists, the WHO DG and WHO representatives took place. The audience was able to post questions in written. These written discussions were saved with participants' consent and summarized in this paper.

Results: The main themes that were brought up by the audience for discussion were: (a) opportunities and challenges in general; (b) ethics and artificial intelligence; (c) digital divide; (d) education. Proposed actions included the development of a roadmap based on the lessons learned from the COVID-19 pandemic.

Conclusions: Decision making by policy makers needs to be evidence-based and health informatics research should be used to support decisions surrounding digital health, and we further propose next steps in the collaboration between IMIA and WHO such as future engagement in the World Health Assembly.
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http://dx.doi.org/10.1055/s-0041-1726480DOI Listing
April 2021

Ethics in Telehealth: Comparison between Guidelines and Practice-based Experience -the Case for Learning Health Systems.

Yearb Med Inform 2020 Aug 17;29(1):44-50. Epub 2020 Apr 17.

School of Health Sciences, University of Canterbury, New Zealand.

Objectives: To understand ethical issues within the tele-health domain, specifically how well established macro level telehealth guidelines map with micro level practitioner perspectives.

Methods: We developed four overarching issues to use as a starting point for developing an ethical framework for telehealth. We then reviewed telemedicine ethics guidelines elaborated by the American Medical Association (AMA), the World Medical Association (WMA), and the telehealth component of the Health Professions council of South Africa (HPCSA). We then compared these guidelines with practitioner perspectives to identify the similarities and differences between them. Finally, we generated suggestions to bridge the gap between ethics guidelines and the micro level use of telehealth.

Results: Clear differences emerged between the ethics guidelines and the practitioner perspectives. The main reason for the differences were the different contexts where telehealth was used, for example, variability in international practice and variations in the complexity of patient-provider interactions. Overall, published guidelines largely focus on macro level issues related to technology and maintaining data security in patient-provider interactions while practitioner concern is focused on applying the guidelines to specific micro level contexts.

Conclusions: Ethics guidelines on telehealth have a macro level focus in contrast to the micro level needs of practitioners. Work is needed to close this gap. We recommend that both telehealth practitioners and ethics guideline developers better understand healthcare systems and adopt a learning health system approach that draws upon different contexts of clinical practice, innovative models of care delivery, emergent data and evidence-based outcomes. This would help develop a clearer set of priorities and guidelines for the ethical conduct of telehealth.
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http://dx.doi.org/10.1055/s-0040-1701976DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7442533PMC
August 2020

Development and Deployment of an e-Health System in UNRWA Healthcare Centers (HCs): The Experience and Evidence.

Stud Health Technol Inform 2017 ;245:1212

Department of Health, UNRWA, HQ.

UNRWA recognized the need to develop and introduce eHealth programme based on needs assessment. The web-based e-Health application was developed and deployed in 116 out of 143 HCs in the five fields of operation. Evaluation of the application revealed positive outcomes in terms of reporting requirements, statistics, time saving, efficiency, drug compliance and workflow in general.
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June 2018

Discussion of "Representation of People's Decisions in Health Information Systems: A Complementary Approach for Understanding Health Care Systems and Population Health".

Methods Inf Med 2017 Feb 1;56(S 01):e20-e29. Epub 2017 Feb 1.

This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Representation of People's Decisions in Health Information Systems: A Complementary Approach for Understanding Health Care Systems and Population Health" written by Fernan Gonzalez Bernaldo de Quiros, Adriana Ruth Dawidowski, and Silvana Figar. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the paper of de Quiros, Dawidowski, and Figar. In subsequent issues the discussion can continue through letters to the editor.
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http://dx.doi.org/10.3414/ME16-15-0001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5388925PMC
February 2017

Discussion of "The New Role of Biomedical Informatics in the Age of Digital Medicine".

Methods Inf Med 2016 Oct 15;55(5):403-421. Epub 2016 Aug 15.

Najeeb Al-Shorbaji, Vice-President for Knowledge, Research, and Ethics, e-Marefa (www.e-marefa.net), P.O. Box 2351, Amman 11953, Jordan, E-mail:

This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "The New Role of Biomedical Informatics in the Age of Digital Medicine" written by Fernando J. Martin-Sanchez and Guillermo H. Lopez-Campos [1]. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the paper of Martin-Sanchez and Lopez-Campos. In subsequent issues the discussion can continue through letters to the editor.
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http://dx.doi.org/10.3414/ME15-12-0005DOI Listing
October 2016

eHealth initiatives to transform health in the region of the Americas.

Rev Panam Salud Publica 2014 May-Jun;35(5-6):326-8, 323-5

Departamento de Gestión del Conocimiento, Bioética e Investigación, Organización Panamericana de la Salud, Washington, D.C, Estados Unidos de América.

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July 2016

Online eLearning for undergraduates in health professions: A systematic review of the impact on knowledge, skills, attitudes and satisfaction.

J Glob Health 2014 Jun;4(1):010406

Health Services and Outcomes Research, National Healthcare Group, Singapore ; Health Services and Outcomes Research Programme, Lee Kong Chian School of Medicine, Imperial College & Nanyang Technological University, Singapore.

Background: Health systems worldwide are facing shortages in health professional workforce. Several studies have demonstrated the direct correlation between the availability of health workers, coverage of health services, and population health outcomes. To address this shortage, online eLearning is increasingly being adopted in health professionals' education. To inform policy-making, in online eLearning, we need to determine its effectiveness.

Methods: We performed a systematic review of the effectiveness of online eLearning through a comprehensive search of the major databases for randomised controlled trials that compared online eLearning to traditional learning or alternative learning methods. The search period was from January 2000 to August 2013. We included articles which primarily focused on students' knowledge, skills, satisfaction and attitudes toward eLearning and cost-effectiveness and adverse effects as secondary outcomes. Two reviewers independently extracted data from the included studies. Due to significant heterogeneity among the included studies, we presented our results as a narrative synthesis.

Findings: Fifty-nine studies, including 6750 students enrolled in medicine, dentistry, nursing, physical therapy and pharmacy studies, met the inclusion criteria. Twelve of the 50 studies testing knowledge gains found significantly higher gains in the online eLearning intervention groups compared to traditional learning, whereas 27 did not detect significant differences or found mixed results. Eleven studies did not test for differences. Six studies detected significantly higher skill gains in the online eLearning intervention groups, whilst 3 other studies testing skill gains did not detect differences between groups and 1 study showed mixed results. Twelve studies tested students' attitudes, of which 8 studies showed no differences in attitudes or preferences for online eLearning. Students' satisfaction was measured in 29 studies, 4 studies showed higher satisfaction for online eLearning and 20 studies showed no difference in satisfaction between online eLearning and traditional learning. Risk of bias was high for several of the included studies.

Conclusion: The current evidence base suggests that online eLearning is equivalent, possibly superior to traditional learning. These findings present a potential incentive for policy makers to cautiously encourage its adoption, while respecting the heterogeneity among the studies.
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http://dx.doi.org/10.7189/jogh.04.010406DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4073252PMC
June 2014

Offline eLearning for undergraduates in health professions: A systematic review of the impact on knowledge, skills, attitudes and satisfaction.

J Glob Health 2014 Jun;4(1):010405

Global eHealth Unit, School of Public Health, Imperial College London, London, UK ; Health Services and Outcomes Research Programme, Lee Kong Chian School of Medicine, Imperial College & Nanyang Technological University, Singapore.

Background: The world is short of 7.2 million health-care workers and this figure is growing. The shortage of teachers is even greater, which limits traditional education modes. eLearning may help overcome this training need. Offline eLearning is useful in remote and resource-limited settings with poor internet access. To inform investments in offline eLearning, we need to establish its effectiveness in terms of gaining knowledge and skills, students' satisfaction and attitudes towards eLearning.

Methods: We conducted a systematic review of offline eLearning for students enrolled in undergraduate, health-related university degrees. We included randomised controlled trials that compared offline eLearning to traditional learning or an alternative eLearning method. We searched the major bibliographic databases in August 2013 to identify articles that focused primarily on students' knowledge, skills, satisfaction and attitudes toward eLearning, and health economic information and adverse effects as secondary outcomes. We also searched reference lists of relevant studies. Two reviewers independently extracted data from the included studies. We synthesized the findings using a thematic summary approach.

Findings: Forty-nine studies, including 4955 students enrolled in undergraduate medical, dentistry, nursing, psychology, or physical therapy studies, met the inclusion criteria. Eleven of the 33 studies testing knowledge gains found significantly higher gains in the eLearning intervention groups compared to traditional learning, whereas 21 did not detect significant differences or found mixed results. One study did not test for differences. Eight studies detected significantly higher skill gains in the eLearning intervention groups, whilst the other 5 testing skill gains did not detect differences between groups. No study found offline eLearning as inferior. Generally no differences in attitudes or preference of eLearning over traditional learning were observed. No clear trends were found in the comparison of different modes of eLearning. Most of the studies were small and subject to several biases.

Conclusions: Our results suggest that offline eLearning is equivalent and possibly superior to traditional learning regarding knowledge, skills, attitudes and satisfaction. Although a robust conclusion cannot be drawn due to variable quality of the evidence, these results justify further investment into offline eLearning to address the global health care workforce shortage.
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http://dx.doi.org/10.7189/jogh.04.010405DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4073241PMC
June 2014

On the Internet of Things, smart cities and the WHO Healthy Cities.

Int J Health Geogr 2014 Mar 27;13:10. Epub 2014 Mar 27.

Plymouth University, Devon, United Kingdom.

This article gives a brief overview of the Internet of Things (IoT) for cities, offering examples of IoT-powered 21st century smart cities, including the experience of the Spanish city of Barcelona in implementing its own IoT-driven services to improve the quality of life of its people through measures that promote an eco-friendly, sustainable environment. The potential benefits as well as the challenges associated with IoT for cities are discussed. Much of the 'big data' that are continuously generated by IoT sensors, devices, systems and services are geo-tagged or geo-located. The importance of having robust, intelligent geospatial analytics systems in place to process and make sense of such data in real time cannot therefore be overestimated. The authors argue that IoT-powered smart cities stand better chances of becoming healthier cities. The World Health Organization (WHO) Healthy Cities Network and associated national networks have hundreds of member cities around the world that could benefit from, and harness the power of, IoT to improve the health and well-being of their local populations.
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http://dx.doi.org/10.1186/1476-072X-13-10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987056PMC
March 2014

Empowering people and organizations through information.

J Health Commun 2012 ;17 Suppl 2:1-4

Knowledge Management and Sharing, World Health Organization, Geneva, Switzerland.

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http://dx.doi.org/10.1080/10810730.2012.670553DOI Listing
October 2012

E-health in the Eastern Mediterranean Region: a decade of challenges and achievements.

East Mediterr Health J 2008 ;14 Suppl:S157-73

Knowledge Management and Sharing, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt.

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March 2009

BabelMeSH and PICO Linguist in Arabic.

AMIA Annu Symp Proc 2008 Nov 6:944. Epub 2008 Nov 6.

Weill Cornell Medical College-Qatar, Doha, Qatar.

BabelMeSH is a multilanguage search for MEDLINE/PubMed. We created a database of Arabic translations of MeSH terms and other medical terms using MySQL and developed a Web interface for searching MEDLINE/PubMed in Arabic. We evaluated the accuracy of BabelMeSH using a list of medical terms from BMJ Clinical Evidence. The accuracy was 58% (machine scoring) and 65% human review.) The result obtained may be explained by variations in expressing medical terms in Arabic.
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November 2008

Index Medicus for the Eastern Mediterranean region.

Emerg Themes Epidemiol 2008 Sep 30;5:14. Epub 2008 Sep 30.

Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt.

The study provides the rationale, history and current status of the Index Medicus for the World Health Organization Eastern Mediterranean Region. The Index is unique in combining the geographic coverage of peer-reviewed health and biomedical journals (408 titles) from the 22 countries of the Region. Compiling and publishing the Index coupled with a document delivery service is an integral part of the WHO Regional Office's knowledge management and sharing programme. In this paper, bibliometric indicators are presented to demonstrate the distribution of journals, articles, languages, subjects and authors as well as availability in printed and electronic formats. Two countries in the Region (Egypt and Pakistan) contribute over 50% of the articles in the Index. About 90% of the articles are published in English. Epidemiology articles represent 8% of the entire Index. 15% of the journals in the Index are also indexed in MEDLINE, while 7% are indexed in EMBASE. Future developments of the Index will include covering more journals and adding other types of health and biomedical literature, including reports, theses, books and current research. The challenges and lessons learnt are discussed.
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http://dx.doi.org/10.1186/1742-7622-5-14DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565659PMC
September 2008