evidence farming: implications for open architecture
DESCRIPTION
Presented by Ida Sim, Mobile Health 2011, May 5, 2011TRANSCRIPT
!"#$%&'%()*+,#&-./(0,12#'*3#4&5(64+71%&(8+'9#3%'3:+%
0$*(;#,<(=><(?9>>#+%'34+<(@%&3%+(64+(@2#&#'*2(*&$(A+*&52*3#4&*2(0&64+,*3#'5
B&#"%+5#3C(46(@*2#64+&#*(;*&()+*&'#5'4=*C(D<(EF..
.G#39(39*&H5(34(I#'9(J+*"#3K(=><(B@(>*"#5(*&$(L*#9:*(>:*&<(@42:,M#*
I%19+*5#&-(N>4%5(#3(G4+HOP
(Complexes of)Exposures Outcome
strength of association?
individual
population
IncreasedbreastfeedingText4Baby
@:++%&3(811+4*'9%5/(I@A
Q A%535(1+%51%'#R%$(#&3%+"%&3#4&5(*&$(4:3'4,%5Q A4('4&R+,(*(9C1439%5#5(*3(39%(141:2*3#4&(2%"%2Q ;3+4&-(#&3%+&*2("*2#$#3CQ ?+4M2%,5/(524S(34(5%3T:1<(%U1%&5#"%<(594+3T3%+,<(2*'H
+%2%"*&'%(34(39%(+%*2(S4+2$
ER visits at 1 year50 people population
100 people
ER visits at 1 year50 people
Asthma App
Usual Care
Exposures Outcomes?
population
@:++%&3(811+4*'9%5/(>*3*(=#&#&-
Q !U145:+%5(*&$(4:3'4,%5(6+4,('*+%(1+4'%55(5C53%,5Q A4(-%&%+*3%(9C1439%5%5(*3(39%(141:2*3#4&(2%"%2Q ?+4M2%,5/(2#,#3%$(34($*3*('422%'3%$<(S%*H(#&3%+&*2
"*2#$#3C(V$*3*(&43('4,12%3%(4+(5C53%,*3#'W
EHR
Apps
@:++%&3(811+4*'9%5/LT46T.(;3:$#%5
Q G#39#&T5:MX%'3(,:23#12%('+4554"%+Q 7&2C(64+,*2(,%394$(64+($%3%+,#&#&-(#&$#"#$:*2
3+%*3,%&3(%Y%'3#"%&%55Q ?+4M2%,5/('4,12#'*3%$(34(5%3(:1<(*&*2C5#5(#5
$#Z':23<(2#332%(H&4S&<(&43(S#$%2C(:5%$
individual
peak flowpeak flowUsual Care
Asthma app
Asthma app
Usual Care
Asthma app
Usual Care
!"#$%&'%(!U3+*'3#4&
Q !"#$%&'%(#5(54,%39#&-(34(M%(%U3+*'3%$6+4,(39%('*+%(1+4'%55[ ,#&#&-(#3(6+4,(39%($*3*[ $#+%'32C(,*:2*3#&-(39%('*+%(1+4'%55(S#39+#-#$(*&$(1+%T$%R&%$(1+434'425
!"#$%&'%(;3+#1(=#&#&-
!"#$%&'%()*+,#&-
Hay, et al. J Eval Clin Prac 14(2008):707-713.
I443#&-(64+(!"#$%&'%
0&$:53+#*2(!"#$%&'%()*+,#&-
ER visits at 1 year50 people population
100 people
ER visits at 1 year50 people
Asthma App
Usual Care
?%+54&*2(!"#$%&'%(\*+$%&5
individual
peak flowpeak flowUsual Care
Asthma app
Asthma app
Usual Care
Asthma app
Usual Care
?%+54&*2(!"#$%&'%(\*+$%&5
individual
dancingFlovent PRN
Flovent
Flovent
Flovent PRN
Flovent
Flovent PRN
dancing
@+4S$54:+'#&-(G9*3(=*33%+5
Q V@4,12%U%5(46W(!U145:+%5[ $4%5('94'42*3%(3+#--%+(V,CW(*539,*O[ 3%53#&-('4,,4&(+%-#,%&5(V8@!0<(53*3#&<(MTM24'H%+W<
'4,12%,%&3*+C(,%$#'#&%5
Q V@4,12%U%5(46W(7:3'4,%5[ S9*3(4:3'4,%5($4(1*3#%&35('*+%(*M4:3O
!"#$%&'%(=*'+45C53%,Rooting forEvidence
Industrial EvidenceFarming
Personal EvidenceGardens
]4S('*&(S%(5'*2%(%"*2:*3#4&O
;34"%1#1%$,]%*239
Q ]%*239(*115(M:#23#&$%1%&$%&32C[ 2#332%($*3*(59*+#&-(*&$
#&3%+41%+*M#2#3C
Q ^#,#35(%Z'#%&'C(*&$#,1*'3(46(_:*2#3C,]%*239
0&3%+&%3(]4:+-2*55(=4$%2
Q ;3*&$*+$#K%(*&$,*H%(41%&(39%N&*++4S(S*#53P
Q I%$:'%5($:12#'*3#4&<51:+5('4,,:C#&&4"*3#4&<(5:114+35'4,,%+'#*2(*&$(&4&T1+4R3(:5%5
71%&,]%*239`4+-
Estrin DE, Sim I. Science; 330: 759-60. 2010.
Q A9%(S*#53(594:2$(5:114+339%(%"#$%&'%(,*'+45C53%,
71%&,]%*239`4+-
71%&(8+'9#3%'3:+%(64+(*&!"#$%&'%(=*'+45C53%,
Q =4$:2%5(64+(:5*-%(*&*2C3#'5[ a(46(3%U3(,%55*-%5<(a(46(5%55#4&5<(%3'`
Q I443#&-(64+(V-24'*2W(%"#$%&'%[ $*3*(59*+#&-(S#39(59*+%$(5C&3*U(*&$(5%,*&3#'5
Q 0&$:53+#*2(6*+,#&-<(%`-`<(S#39(I@A5[ ,4$:2%5(64+(#&64+,%$('4&5%&3<(+*&$4,#K*3#4&<(*$*13#"%
3+%*3,%&3(53+*3%-C<(,#U%$(,%394$5<(%3'`
Q ?%+54&*2(%"#$%&'%(-*+$%&#&-<(%`-`<(LT46T.[ ,4$:2%5(64+(5'+#13#&-(*&$(*&*2CK#&-(#&$#"#$:*2#K%$(LT46T
.(1+434'425<(%3'`
71%&(8+'9#3%'3:+%(64+(*&!"#$%&'%(=*'+45C53%,
Q ;4'#*2(,%$#*(64+($#5'4"%+C(46(%U145:+%5(*&$4:3'4,%5(39*3(,*33%+
Q ;9*+%$(2#M+*+#%5(46("*2#$*3%$(,%*5:+%5(*&$#&53+:,%&35(V%`-`<(?I7=0;W[ ,%*5:+%5(39*3(-%3(*3(R&%+T-+*#&%$(,%'9*,5(M*5%$
4&(39%4+%3#'*2(,4$%25(46('9*&-%<(%3'`
\4*2(64+(,]%*239(!"#$%&'%
Q 8(2%*+&#&-('4,,:C('4:12%$(S#39(*&41%&(*+'9#3%'3:+%(64+(M+4*$<(+*1#$<(*&$#3%+*3#"%($#55%,#&*3#4&(46(%"*2:*3#4&,%394$5(*&$(R&$#&-5(39*3(,*33%+
Q 0$*(;#,(#$*`5#,b:'56`%$:Q >%M4+*9(!53+#&($%53+#&b'5`:'2*`%$:Q 9331/cc41%&,9%*239`4+-c