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Here is my dashboard https://tinyurl.com/2abpx3zw
It contained a total of confirmed cases, recovered cases, and deaths. This dashboard also visualizes the bubbles on the map so you can easily see roughly how the situation between countries. It also shows the daily new case and daily deaths. The table in the bottom right list the countries which had the highest reported confirmed cases.
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Here is my new dashboard link https://tinyurl.com/ykrmukva
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Here is my link https://tinyurl.com/5hcxyzfu
The first page is a summary dashboard composed of a Map, Card, Funnel, and a stacked bar chart which can adjust with the date slicer. This dashboard illustrates the overall pictured of total confirmed case of COVID-19 all over the world.
The second page is 100% stage column chart and line with stacked column chart which can adjust by the date and countries slicer. So you can see the proportion of daily confirmed case by continents with a stacked column and total confirmed and daily confirmed cases by countires with a line graph.
The third page consist of Sunburst and tree map with a date slicer. So you can see the proportion of daily confirm cases.
The fourth page is Line with forecast and Sparkline with countries slicer, so you can see the trend of daily confirmed cases and predict the amount of infected patients in the future.
The last page is Scatter Plot with date slicer which demonstrates an association between total confirmed cases and recovered cases by countries.
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Dear all,
Here is my report link https://tinyurl.com/yn7h5kppThis table report the COVID-19 situation, the variables include The name of country, Confirmed cases, total deaths, recovered cases and GDP.
And here is my screen captured showing the connected datasets https://drive.google.com/file/d/1JwCFJXXOXcPW8Njij24Ykn6RBPtkja26/view?usp=sharing
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The Global COVID-19 Tracker shows the new positive case of COVID-19
They divided into three column which is,First column on the left-hand side is the histogram demonstrating the new positive case and new death all over the world. This histogram is very useful and explicit in demonstrating the trend of cases over time. Moreover, they also provide the data that show the increase or decrease in percentage compared to the previous day.
The middle column demonstrates the area of new cases in the bubble chart, which is a good idea to show the data on the world map or geographical area. However, the volume of cases that estimate by the size of the bubble is difficult to compare, especially if the volume is not large different.
The column on the right-hand side is the bar chart that shows the new positive cases which is already arranged from the maximum to the minimum. This bar chart shows this kind of data is the best way to see what is the country that is the highest or lowest number of new cases confirmed. They also display the exact number of the new case which is very clear compared to the other country.
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The approach would be, firstly, to examine the uniqueness of the individual’s lived situation or experience. Then create the research question which is “What are the reasons that most of the respondents did not use bednets for malaria prevention”. The method for seeking of information would be interview of the respondents, it could be describe/write the reason or experience. Then the researcher identified the themes and structural explanation the reasons.
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Case-Fatality rate
Definition: Case-Fatality rate is the proportion of people who die from a specified disease among all individuals diagnosed with the disease over a certain period of time.
Calculate: The number of deaths from a specified disease over a defined period of time divided by the number of individuals diagnosed with the disease during that time
Usefulness: Used as a measure of disease severity and used for prognosis (predicting disease course or outcome), where comparatively high rates are indicative of relatively poor outcomes.
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Please find attached
https://drive.google.com/file/d/1ZYDKCbhclw6FjzDSIj9P8mUJhjqXzOd9/view?usp=sharing -
In my experience, there are some steps in initial data management that I already did such as protocol discussion, data design, data acquisition, and database access control. However, there are many important steps that I did not perform such as data management plan development, edit check programming, data entry screen test, and CRF completion training. During the study conduct, I also missed the important steps of data validation and data quality control which cause the invalid and lots of missing data for further analysis. For the project closure, I did not know about quality assurance before and data standards or coding are also neglected.
If I have a chance to go back to improve the project, I think the protocol discussion and data design should be more consolidated than the previous. The data management plan should be established and should be well written. The investigator meeting and training are also important and should be done to arrange the understanding of all investigators. The data validation and data quality control are also the cornerstone of data entry and should be revised. The data quality assurance, data standard or coding also should be used to improve my future research project.
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1. My experience with data collection is mainly about the research and data registry project. It had been 2 years since my department try to establish the data registry for specific disease, chronic limb-threatening ischemia.
2. The process of collecting data is from primary and secondary data sources because I have to collect data in the past and also collect data from the new patient as well.
3. For the methods used for data collection, I use mainly paper-based. Recently I try to create an electronic database that is still in the development process.
4. There are some problems during the process of data collection. First, the protocol is still not consolidated, many investigators had different opinions about what is the important data to collect. Secondly, the completion of collected data because we didn’t have the assigned data manager so the data will be collected by the investigator individually. Lastly, the problems of the data collecting method because we are making the change from paper-based to electronic data records which is still the problem.
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Please find attatched.
https://drive.google.com/file/d/1HLdqpGXjq4i029pbFrJAPxqna6lk3pJf/view?usp=sharing -
Please find attached link
https://drive.google.com/file/d/1425vYsYiQciFssTo8w0Y6ARtDjlSGzaQ/view?usp=sharing -
Please find attached
https://drive.google.com/file/d/1Nqn-YP4KoghIJY1_B1SmXx-nyePD8iNV/view?usp=sharing -
From what I have learned in the past, I think I am a frequentist. I have some experience in clinical research and I use frequentist inference. Bayesian statistics is another type of statistical method that uses Bayes’ theorem. The difference between these two methods would be Frequentists use likelihood to calculate probabilities while Bayesian has to use the previous knowledge of the conditions that associated with the event to calculate the probabilities. The Bayesian seems to be more accurate in the statistic for diagnosis of the disease, however, there are some limitations to using it such as how to determine the prior knowledge and the calculation is far more complex than frequentist. Interestingly, the other utility of using Bayesian statistics is for machine learning algorithms which might be an important thing to learn in the near future.
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Hi my name Tossapol Prapassaro. Currently, I work as a vascular surgeon at the faculty of medicine Siriraj Hospital. Statistics had been involved in my work since I was training as a resident and fellowship program of vascular surgery. I have learned some basic short courses of clinical epidemiology and medical statistic because I have to conduct research in the future to expand my knowledge, facilitate the learning, and to my future career. And I hope that after finishing this course it would fulfill my knowledge and I can apply it to my current work.
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I agree with Auswin and other about the UHC scheme in Thailand. Furthermore, I would like to share some advantages for the patient who has universal health coverage.
In my point of view, as a surgeon, I notice that UHC will ensure that everyone has health insurance and can access to medical services equally, especially the operation that the cost of surgical instruments is very high so the low-income population has low potential to afford it. However, with the UHC they can receive equal treatment with a little money spent on it. UHC make healthier and longer life for the patient and reduce societal inequality. For the government level, universal health care reduces health care costs for the national finance, because the government can control prices for medications and services. Additionally, UHC also equalizes service which implies that everyone gets the same level of care.
Although there are many strengths as mentioned above, UHC also has a drawback, especially the burden of the budget that the hospital had to spend for the treatment of the patient. For the improvement in this aspect, I suggest that the government or hospital should analyze the cost-effectiveness of instruments that had been used and give information to practitioners to reduce that burden. -
As a surgeon. I had a chance to be a group member to develop the workflow for a surgical patient during the pandemic, especially the suspicious case or confirmed case of COVID-19.
For developing the operating theatre protocol, we must consider the patient’s disease condition and emergency of disease for ensuring that patient will receive treatment in the timely manner, not delay and taking patient at risk. The other issue that we have to consider is the safety of the healthcare personnel, including surgeon team members, scrubs nurse, anesthesiologist team, etc. We have to rehearse the plan to make sure that everyone in the multidisciplinary team has the same agreement and ask for feedback to develop the protocol and make it more practical and more safety. -
In my point of view, the informatician in Thailand is still lacking as everyone said. The challenge regarding this issue might be. The recognition from the organization, most health care organizations did not recognize the importance of informaticians as it should be, because organizations had both healthcare professionals and IT professionals and they assumed that this should be enough for developing the system, but it isn’t, the informatician is the key to communicating between these two professionals. Another issue is the implementation of the electronic system instead of the previous system is very challenging and really needs high effort. Many organizations do not adopt the new system, so the development of the health informatics workforce is lacking.
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I would say sharing as everyone did. In modern health care, data are invaluable for research and knowledge. Data creates a lot of information that could use for the development of healthcare practice such as a big registration or trial that need a large number of participants sharing data could help them develop the protocol and we could use those protocol for our patient as well. The other example is the COVID-19 pandemic data, we could see that sharing data is very important to the other country to handle the outbreak or create a vaccine or treatment guideline. However, we should de-identify the personal data and keep it private for our individual patients.
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From my experience, I had a bad experience with the EMR, even though I know its usefulness. It occurs when my department tries to adopt the EMR system in the IPD setting. Firstly, I found that the provided notebook was not enough for many users and did not work properly. Secondly, the interface of the EMR is not user-friendly, so you have to spend more time to complete individual patients, but you have to complete all ward rounds within a specific time limit. However, they provide an intensive course to prepare you and a hotline for helping you; it is still challenging to understand and not practical during the service ward round. Lastly, many complex orders, procedures, or drugs still need paper-based input, so the adoption of EMR in my department failed due to many reasons mentioned above.
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As mentioned in the article, there are many distinctly different challenges.
The challenge of disease definition, data quality, and missing data. I suggest that we create a working group that gathers all cardiovascular disease specialized people to give the standardized disease definition, create only variables essential for further analysis, and create a user-friendly platform for EHR. After that, this working group should possess generalized knowledge to frontline workers (such as physicians, nurses, operators, or managers of the project), emphasizing the importance and benefit of those collected data to all members. The Working group should assign the project manager to verify the completeness of the data and feedback to the collector.
For unstructured data, we might have to reconsider its importance; if it is still essential, we have to structure it or make a score or tier it. For source availability challenges, we should start with the center or area willing to do so.
For data sharing, linkage, inconsistency, and security, we should create a database system that can provide or share the data with another researcher under the security circumstance. The database system should have the ability to collect data from a different source or input and match data if there were stored in various formats.
To interpret results, data analysis, and selection bias that might occur using the extensive data set, we should emphasize the correction of methodology and good clinical practice on the researcher to reduce the risk of bias if the data are collected very well. -
I agree with the article about four recommended points against corruption because they provide all perspectives of anti-corruption efforts. Like others in discuss room already mentioned about patronage system that had been used in Thailand for a long time, which led to a problematic change in the system. Therefore, in my opinion, I would suggest that we should create an anti-fraud culture that should begin with a clear commitment to tackling corruption led by the government and leaders. Secondly, building a fraud awareness culture for everyone that has been involved in the health sector and creating a professional anti-corruption team to scan the potential gap of strategies or policy that may lead to fraud easily. In addition, the anti-fraud procedure should have a guideline on what to do next when your suspicions of fraud arise, a response plan, and a whistleblowing protection plan. Lastly, sharing and reporting the outcome on a successful anti-fraud measurement, money saved, creditability, and qualified anti-fraud system to an internal and external organization.
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An example of health system improvement was the development of a surgical safety checklist which was the service part of the health system. The surgical safety checklist has three steps: sign in, time out, and sign out. These steps are designed to improve communication and teamwork for surgeons, anesthesia, and nurses involved to ensure that critical safety measures are performed before, during, and after an operation. The possible barriers could be the attention and cohesion of team members to apply the surgical safety checklist to all patients.
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Thank you for sharing. This is an exciting surveillance system in a particular situation. I also agree with Auswin that we could combine some diseases related to flooding. So this surveillance system could be an example of the other disease surveillance system connected to disasters or different situations.
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Thank you for sharing. This surveillance is a very interesting project. As a vascular surgeon, I usually face an ESRD patient who had to start hemodialysis with a catheter-based approach, which is not the appropriate strategy. This surveillance system could change the strategic plan to a fistula-first policy by early detection and proper management in CKD patients.
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I believe that the replication technology may suit my organization more than a backup system because health data has been recorded throughout the day, and data are matter, so we need a system that can reduce the recovery point objective (RPO). Furthermore, replication technology provides a shortage of time to recovery (less recovery time objective, RTO), which is very important for the mission-critical application that must always be running to take care of a patient.
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There are many benefits to adopting the high availability technology into the hospital information system. Patient’s safety reason because the availability of data and information (laboratory report, imaging report, previous illness, or history of health condition) is essential for life-saving, especially during the critical period. Furthermore, availability is crucial for the seamless flow management of hospital services.
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In my opinion, I realized that some program in my computer workplace has a common password that everyone knows. This would be the confidentiality issue (access control) according to the CIA triad. This common password makes everyone easy to access, but it is not secure for the patient data. If we want to prevent it, 1) The administer should give us the user name/password individually, 2) Not allow access by using the previous common password, and 3) Ask or request us to change the personal password periodically.
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According to the STEEP analysis that related to healthcare resources during the pandemic.
Social:
– Decisions for seeing the doctor may be deferred until the disease is worsening
– Patient might look for telehealth or other platforms of disease consultation rather than physical visiting
– Remote working, Virtual meeting, Lack of communication among healthcare teamTechnological:
– Telehealth and telecommunication have increased significantly
– Robotic assist may have an important role in the future to reduce close contactEconomic:
– The unemployment rate has increased which may impact the self-pay service of patient
– The hospital budget may spend on the facilities that support the treatment of COVID-19 rather than other specific diseases.Environmental:
– Work environment has changed to more safety to prevent airborne transmission (distancing, more space)Political:
– Regulation about disease control and prevention might be change -
I would like to share my Gantt chart about the research project timeline in LIFE project
https://drive.google.com/file/d/1GmStSoRxdK5wzrpXPvijyoabp0bFnigb/view?usp=sharing
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According to PM Lee Hsien Loong and President Donald Trump address on the COVID-19 situation
1. Be first
PM Lee Hsien Loong: He gives a formal speech to the public quite early after outbreak (2 weeks).
President Donald Trump: He gives a formal speech to the public quite late after the outbreak (March 11), which is the day WHO officially states the global pandemic.2. Be Right
PM Lee Hsien Loong: He gives the correct information directly to the public, stating where they are and what may lie ahead. He mentions that the new virus is more infectious than SARS, which makes them harder to stop from spreading, and he also said that the new virus is much less dangerous than SARS (0.2 % death rate from the new virus compared to 10% death rate from SARS)
President Donald Trump: He gives the correct information about the situation of the COVID-19 outbreak that already hit the United States; however, he underestimates the potential of disease spreading and the threat of the disease by using the phrase “The vast majority of Americans: The risk is very, very low….”. He also blamed European Union for failing to restrict the outbreak, which may not be the right thing to address.3. Be credible
PM Lee Hsien Loong: He honestly gives the information that they have some case that cannot be traced to the source of infection, which mean that the virus is probably circulating in the population. However, he also mentions the measurements to contain those spread.
President Donald Trump: The way he spoke was overconfident “Our team is the best anywhere in the world…” or “No nation is more prepared or more resilient than the United States.”, which I think makes his speech untrustworthy.4. Express Empathy
PM Lee Hsien Loong: He shows empathy by mentioning that he knows everyone might feel fear and anxiety, which is a typical human reaction, and everyone wants to protect themselves and their family. Furthermore, the content of his speech, tone, and gesture also expresses his empathy to the audience.
President Donald Trump: His speech and his tone did not acknowledge the suffering of people as much as they should. He did not share his feeling about the situation sincerely.5. Promote action
PM Lee Hsien Loong: He shows how the government is prepared, including adequate supplies of masks and PPE, expanded and upgraded medical facilities, advanced research capabilities, and well-trained doctors and nurses. He also mentions strategies to control imported cases by discovering the cases, isolating the patients, contacting tracing and quarantine measurement to contain the spread.
President Donald Trump: He already mentions the measures, including financial aspects, supporting CDC, supporting vaccines, treatments, and distributing medical supplies.6. Show respect
PM Lee Hsien Loong: He shows respect to a group of people that work for the public, including volunteers that distribute masks to households, university students delivering food daily to school mate, health care workers treating the patients, business federation, union, and public transport workers that maintain their service to keep Singapore running.
President Donald Trump: His speech did not show respect or acknowledgment to his volunteer or co-worker as much as it should be.To be summarized, PM Lee Hsien Loong gave a very excellent speech that included all aspects of the principles of CERC, which is a superb example of what a leader should do during a crisis. Contrast to President Trump that quite arrogant, blaming and underestimating the situation.
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In my opinion, teleconsultation technology still has room for development, as you can see in the period of high contracted cases, which overwhelm the public health system. The home isolation strategies had been used; however, this strategy had a problem because some patients’ symptoms were rapidly progressing, and the patient could not promptly reach the proper consultation and treatment. So, if we could build the fundamental technology that facilitates teleconsultation and provide the channel for the patient to receive treatment earlier, it would leverage the home isolation treatment in the future.
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There are six events of PHEIC that are a formal declaration by WHO, which everybody already mentions ( H1N1 swine flu, polio, Ebola, Zika, Kivu Ebola, COVID-19 ).
These outbreaks had raised concerns because of their impact not only on public health locally but also the public health worldwide, so that it may need immediate international action.
I believe that the disease that might be potentially lead to PHEIC in the future would be the condition that very contagious, especially air-borne transmitted disease like a new strain of influenza virus or coronavirus.
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To be an early morning person is worthy. Two years ago, I listened to the podcast “mission to the moon” about how good that early morning person can be, which fascinates me. In the past, I usually get up around 6.30 am, and I rushed to work every day. So I decided to change my routine morning by waking up earlier, around 5.30 am. As a result, I have time to list and set priorities for my tasks on that day. I do treadmill exercise run and find some good coffee and breakfast. After I wake up earlier, I focus more on jobs, and my task is more complete and effective. However, to be an early morning person is not that easy, especially when I have nighttime jobs.
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The inaccurate data report will affect many aspects of the disease surveillance system, such as lack of exact incidence and prevalence of disease, misinterpretation of the burden of illness, outbreak pattern/magnitude/time trend/outlies/exposure, or incubation period the disease, etc. Therefore the inaccurate data report will lead to inappropriate measures to prevent and control the disease.
Data overestimate will affect two levels of public health resources. The first level is the individual case that the public health practitioner might have unnecessarily investigated or given prophylaxis treatment. The other level is the epidemic study which false-positive cases will lead to inappropriate trigger outbreak investigation.
Data underestimate will affect the individual health directly, which come from under-recognized this condition and might lead to delayed treatment. Moreover, data underestimate will reduce the chance of disease control, which usually needs control measures in a timely manner. -
Information technology can implement into the process of an outbreak investigation in many aspects. Firstly, an information system promotes systematically collected data and records information. In addition, data integration and system interoperability facilitate field investigators and central office staff to access the data on time, which is a vital part of an outbreak investigation. Secondly, information technology enables the pattern of spread, magnitude, time trend, outliers, exposure, and disease incubation period from Epi curve analysis. Moreover, implementation of control measures and follow-up also need information technology. Lastly, communicating and reporting to the public using many social media platforms is the other advantage of information technology.
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In my opinion, digital contact tracing for COVID-19 is the most exciting technology. This technology would facilitate identification and isolation to prevent the spreading of the outbreak by using the Bluetooth-enabled smartphone. In brief, the proximity detection apps will emit the signal to a nearby device to record contact events, and all this information will keep in the central server. When one user reports testing positive for COIVD-19, the other user who had contacted the confirmed case will receive a notification alert and be advised to further management. The importance of this technology is the control of the disease outbreak, especially the COVID-19 and other droplet or airborne transmission outbreaks. However, this technology still has some limitations, such as the distance of contact and the period that had been contacted, which is the critical factor of disease spreading.
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– How can surveillance help to detect and control the disease?
Surveillance can detect and control disease, especially COVID-19, in many ways. Firstly, surveillance (passive) identifies new severe acute respiratory syndrome cases that are admitted to the hospital. After that, they realized this could be the new disease outbreak by epidemiologic investigation, so they immediately responded to this situation by warning the public for proper measurement of disease control such as isolate contracted disease, self-protection, etc. Early detection of new virus pathogen also plays an important role in disease control; analytic report of the virus genome sequencing is essential for the prompt of vaccine manufacturing. Finally, surveillance also helps monitor, control, and eradicate the disease by allocating resources to the hotspot outbreak area to control the disease and distribution of vaccines to specific locations first.– Should we conduct active or passive surveillance or both for the disease, why?
For the COVID-19 outbreak, we should conduct both active and passive surveillance because the outbreak is very contagious, so active surveillance will facilitate finding out asymptomatic or mild symptomatic contracted diseases and isolate them before they spread to others. Passive surveillance is also essential for identifying the burden of disease and monitoring and controlling the outbreak.– Which method should be best to identify cases, why?
Cases in medical facilities VS community
Identifying cases in the hospital and community both are important. Although seeking the contracted cases in the hospital is more likely to find the positive case, however; the COVID-19 is an outbreak that is needed to find out asymptomatic patients in the community and control the spreading of disease.Sentinel VS population-based surveillance
In my opinion, population-based surveillance might be more effective than sentinel surveillance in this situation because this outbreak is widespread, and we need immediate response to the contracted case, which sentinel surveillance might not provide the massive surveillance. However, to adopt population-based surveillance, we need more qualified laboratory or reliable rapid tests to implementation of population-based surveillance.Case-based VS aggregated surveillance
At the initial stage of outbreaks, case-based surveillance, which includes detailed information of person, place, and time, will facilitate the detection of the patient under investigation. However, when the positive case increases significantly, the case-based surveillance might not be appropriate because it can cause a lot of workload for healthcare investigators, so the aggregated surveillance, which includes the number of confirmed or suspected cases but lack of detailed information, might work effectively.Syndromic VS laboratory-confirmed surveillance
Both syndromic and laboratory-confirmed surveillance are important. For syndromic, we use some certain criteria for rapid identification that might warrant further investigation so we can separate the suspicious case, and this is useful in disease control. For laboratory-confirmed surveillance is important to identify the real burden of outbreak and provide strains of virus which is essential for health public policy and vaccination program– What dissemination tools will you choose to disseminate COVID-19 surveillance information? Why do you choose this/these tools?
I will use the ongoing, real-time dissemination tools for surveillance because of the real time information is essential for strategic plan to control and eradicate the outbreak. -
I would not provide the data to those research team because they actually require the individual data, which will violate personal privacy according to privacy rights. If the research team is willing to do the research, they must clarify the research proposal for the institutional review board committee (IRB). If I have to provide the data to the research team, I will give only the anonymous and relevant data need
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According to this scenario, this situation is a dilemma. You are in the condition of dual loyalty; you do not want to break the patient’s confidentiality, however; this risk might be harmful to your friend.
From my point of view, if I were a health information professional, I would not tell my friend and would not interfere with other family issues. According to fundamental ethic principles, all principles are important and equal; the contradict will occur when you must prioritize which rule is important than the others (like in this situation, autonomy vs. beneficence or non-maleficence). However, I would not tell my friend because I think that your friend’s husband can manage his own life and protect his health information. In addition, your friend’s husband must had been informed and signed consent by counselors or doctors about partner notification and disclosed his HIV status.
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