Browsing by Subject "systematic literature review"

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  • Lindevall, Mari (Helsingin yliopisto, 2021)
    The purpose of this systematic review is to investigate the usage of artificial intelligence in the pharmaceutical industry in the fields of pharmaceutical manufacturing, product development, and quality control. Today, developing and getting a new drug on the market is time-consuming, ineffective, and expensive. Artificial intelligence is seen as one possible solution to the problems of the pharmaceutical industry. From 734 articles 77 academic study articles were included. Included articles showed artificial neural networks to be the most used artificial intelligence method between 1991 and 2021. The search was conducted from three databases with the following inclusion criteria: studies using AI in either pharmaceutical manufacturing, product development or quality control, English as the language, and Western medicine-based pharmacy as a branch of science. This systematic literature review has three main limitations: the possibility of an important search word missing from the search algorithm, the selection of articles according to one person's assessment, and the possible narrow picture of the used artificial intelligence methods in the pharmaceutical industry, as pharmaceutical companies also research the subject. The use of artificial intelligence in product development has been studied the most, while its use in quality control has been studied the least. In the studies, tablets were a popular drug form, while biological drugs were underrepresented. In total, the number of studies published increased over three decades. However, most of the articles were published in 2020. Nearly half of the articles had some connection to a pharmaceutical company, indicating the interest of both the academy and pharmaceutical companies in the use of artificial intelligence in manufacturing, product development, and quality control. In the future, the efficacy of artificial intelligence, as well as its limitations as a method, should be investigated to conclude its potential to play a key role in reforming the pharmaceutical industry. The results of the study show that a wave of artificial intelligence has arrived in the pharmaceutical industry, however, its real benefits will only be seen with future research.
  • Joensuu, Jaana (Helsingfors universitet, 2013)
    Rheumatoid arthritis (RA) is a chronic autoimmune disease with prevalence of 0.8% among Finnish adult population. Consequent medical treatment, joint replacement surgery and productivity losses lead to significant expenses for society. While biological treatments for RA are costly, they can improve patients' quality of life and work participation. Economic evaluations provide information on the benefits and costs of these expensive treatments to aid optimal utilization of limited healthcare resources. This master`s thesis comprises the description of the Finnish Current Care Guidelines for RA, the cost of biological treatments and the principles of economic evaluations and health technology assessment. A systematic literature review was performed to identify existing studies examining the cost-effectiveness of biological treatments for RA. Of the 4890 references found with the literature search, 38 original studies and 9 previous systematic reviews were included in the current systematic literature review. Details of the methods as well as information on treatments, costs, benefits and incremental cost-effectiveness were extracted. Quality of the original studies was evaluated using quality assessment tools. Ninety percent (34/38) of the original studies used cost-utility modeling approach. Quality of life estimates were derived from RA specific health assessment questionnaire in a majority of the studies. Based on the current systematic literature review, the evidence on the cost-effectiveness of biological treatments is inconsistent. The incremental cost-effectiveness of the tumor necrosis factor (TNF) blockers was 13 500-772 000 €/ quality adjusted life year (QALY) in comparison to conventional disease modifying anti rheumatic drugs (DMARD) among patients without previous treatment with DMARDs. Several studies reported incremental cost-effectiveness ratios over 100 000 €/QALY in this population. Among patients with insufficient response to DMARDs, TNF blockers provided incremental cost-effectiveness ratios between 6 700 and 317 000 €/QALY. In most studies Rituximab was found to be a cost-effective alternative in contrast to other treatments among patients with insufficient response to TNF blockers. Biological treatments are not cost-effective among patients naïve to conventional DMARDs. Meanwhile, in patients with previous DMARD failure TNF-blockers might be cost-effective. The evidence on the cost effectiveness of biological treatments supports Finnish Current Care Guidelines. The quality assessment of the included studies revealed several sources of bias, consequently reducing the validity of the studies. Only a few of the conference abstracts in current subject has been published later as an article indicating existence of reporting bias. This study has several strengths. First, a comprehensive literature search was performed. Second, the quality of included studies was carefully evaluated. Finally, the methods and reporting are transparent. Weakness of the current study is one person extracting data and assessing the quality of the studies, which may reduce the reliability of this study. This systematic literature review is a basis for future studies examining cost-effectiveness of biological treatments in Finnish healthcare system.
  • Karlsson, Linda C.; Antfolk, Jan; Putkonen, Hanna; Amon, Sabine; da Silva Guerreiro, Joao; de Vogel, Vivienne; Flynn, Sandra; Weizmann-Henelius, Ghitta (2021)
    Familicides have received relatively little attention and are mostly discussed in studies with broader aims. Here, we reviewed 67 studies from 18 countries on familicides, in which an offender killed or attempted to kill their current or former spouse/intimate partner and one or more of their biological or stepchildren. We conducted a systematic literature search in PubMed, PsycINFO, and Google Scholar. Eight studies investigated familicide specifically, while the remaining reported on familicide cases as a subsample. We retrieved data on offenders' gender, age, and background as well as on victims and their relationship to the offender. We also retrieved data on contextual factors and offense characteristics (i.e., modus operandi, offense location, premeditation, and whether or not the offender had committed suicide). We also coded methodological aspects of the studies. Familicides were almost exclusively committed by men and about half of the familicide cases led to the suicide of the offender. Mental health problems, relationship problems, and financial difficulties were prevalent. Because few studies reported population base rates of the investigated characteristics, it is difficult to draw conclusions about specific risk factors. Future research should further investigate typologies of familicide and examine risk factors for different types of familicides.
  • Laukka, Elina; Huhtakangas, Moona; Heponiemi, Tarja; Kujala, Sari; Kaihlanen, Anu-Marja; Gluschkoff, Kia; Kanste, Outi (2020)
    Background: The popularity of web-based patient-professional communication over patient portals is constantly increasing. Good patient-professional communication is a prerequisite for high-quality care and patient centeredness. Understanding health care professionals' experiences of web-based patient-professional communication is important as they play a key role in engaging patients to use portals. More information is needed on how patient-professional communication could be supported by patient portals in health care. Objective: This systematic review of qualitative studies aims to identify how health care professionals experience web-based patient-professional communication over the patient portals. Methods: Abstract and full-text reviews were conducted by 2 reviewers independently. A total of 4 databases were used for the study: CINAHL (EBSCO), ProQuest (ABI/INFORM), Scopus, and PubMed. The inclusion criteria for the reviewed studies were as follows: the examination of health care professionals' experiences, reciprocal communication between patients and health care professionals, peer-reviewed scientific articles, and studies published between 2010 and 2019. The Joanna Briggs Institute's quality assessment criteria were used in the review process. A total of 13 included studies were analyzed using a thematic synthesis, which was conducted by 3 reviewers. Results: A total of 6 analytical themes concerning health care professionals' experiences of web-based patient-professional communication were identified. The themes were related to health care professionals' work, change in communication over patient portals, patients' use of patient portals, the suitability of patient portals for communication, the convenience of patient portals for communication, and change in roles. Conclusions: Health care professionals' experiences contain both positive and negative insights into web-based patient-professional communication over patient portals. Most commonly, the positive experiences seem to be related to the patients and patient outcomes, such as having better patient engagement. Health care professionals also have negative experiences, for example, web-based patient-professional communication sometimes has deficiencies and has a negative impact on their workload. These negative experiences may be explained by the poor functionality of the patient portals and insufficient training and resources. To reduce health care professionals' negative experiences of web-based patient-professional communication, their experiences should be taken into account by policy makers, health care organizations, and information technology enterprises when developing patient portals. In addition, more training regarding web-based patient-professional communication and patient portals should be provided to health care professionals.
  • Akesson, Agneta; Andersen, Lene F.; Kristjansdottir, Asa G.; Roos, Eva; Trolle, Ellen; Voutilainen, Eeva; Wirfalt, Elisabet (2013)
  • Sneck, Antti (Helsingin yliopisto, 2019)
    Objectives. Attachment theory is a theory of social development and personality, known around the world. According to the theory, children have an innate tendency to develop a biologically based and central nervous system-regulated attachment bond to their primary caregivers in order to ensure safety, care, and survival. Early attachment experiences contribute to the way one sees oneself and others and lead to secure, insecure, or disorganized attachment styles, which affect rest of one’s life. Previous research has confirmed the universal nature of attachment, different attachment categories and styles, and early attachment’s links with future relationships and various internal and external problems. Attachment research has traditionally concentrated on early childhood and early childhood environments, whereas middle childhood, adolescence, and school context have been studied less. The objectives of the present study were to find out what kinds of links there are between attachment and the lives of school-aged children and youngsters, what kinds of attachment-related challenges teachers encounter at school, and how teachers could support their students with those attachment-related challenges. The aim is to explore attachment in the lives of school-aged children and youngsters, including at school, to gain a better understanding and to create a valuable foundation for future research. Methodology. The present study was conducted as a systematic literature review, which allowed the gathering of diverse and comprehensive, yet relevant research material, while also supporting objectivity and reproducibility aspects of the study. The material, available through electronic databases, was comprised of research articles from around the world, published in peer-reviewed international research journals. The material was analyzed thematically by research questions and topics, which were then used as a framework in the Results section. Results and conclusions. Early attachment and attachment styles were directly and indirectly linked to the lives of school-aged children and youngsters, including teacher-student relationships, peer relationships, family relationships, and academic achievement, as well as internal and external problems. Various attachment-related challenges and problems were visible at school, but teachers had many ways to buffer them. Current attachment research has not affected or changed school environments enough. Much more attention should be given to attachment within schools, teacher education, and in-service training programs in order to give students better support for their attachment-related problems and challenges.
  • Lipsanen, Tuomas (Helsingfors universitet, 2010)
    Medication review is relatively new intervention in Finland that potentially promotes safe and rational use of medicines. During the recent years, the effectiveness of different kind of medication review procedures has been evaluated in many countries. The results considering the cost-effectiveness have varied and conclusions have been difficult to make. Because of the limited resources, the funders and decisionmakers need evidence-based effectiveness data to get the best possible value for the money spent in health care. The aim of the study was to gather, analyze and summarize the published data of costeffectiveness of the medication review by means of a systematic review. The aim was also to represent the medication review as a concept, procedure and study objective. This study was conducted as an analysis of study methods applied in published studies on cost-effectiveness of medication review procedures. In total, 947 references were found using a systematic literature search covering three electronic databases (Medline, CRD and IPA). Most of the references were excluded based on titles and abstracts, and 85 full-text articles were evaluated. After the duplicates were removed, 11 articles met the requested inclusion criteria and were entered to the study. There was a lot of variation between selected articles. In five articles the description of the medication review was not detailed or the intervention was not equal to the expected content level. Also the outcomes measures used in the studies varied. Most studies measured the use of medicines or the number of drug-related problems in different ways. Quality of life was applied as an outcome measure only in five studies and none of the studies were able to show statistically significant differences between intervention and control groups. Mortality was measured in four studies. In most studies the definition and calculation of the costs was limited and inadequate for proper economic evaluation. It was also common that only the direct drug costs from patient's perspective were calculated. The cost of pharmacist's working hours was taken into account in five studies. The incremental analysis was performed only in one study which also got high quality scores compared to all other studies. On the whole the economic evaluations in the selected studies were of low quality and performed in simple a way.
  • Huttu, Martta (Helsingfors universitet, 2016)
    In the United States pharmacists have prescribed medicines and managed patient's drug therapy since the 1970s, and in the United Kingdom pharmacists have been authorization to prescribe medications since 2003. The discussion about the right of Masters of Science in Pharmacy will be renewed prescriptions during the last decade in Finland but few Finnish studies have been published from the subject. In the document Medicines Policy 2020 published by Ministry of Social Affairs and Health states that by prescribing should be used cost-effective modes of operation. The knowledge about pharmacist prescribing benefits and costs, and also prescribing practice in Finland, is needed to evaluate the cost-effectiveness of pharmacists' authorization to prescribe and to support the decision-making concerning pharmacist prescribing. The aim of this master's thesis is to gather all existing knowledge about the economic and other effects of pharmacist prescribing using a systematic literature review method. The aim of theoretical part of this master's thesis is to explain the Finnish prescribing, the participation of pharmacists in drug therapy management in Finland and internationally pharmacist prescribing. The empirical part of this master's thesis is also to assess the quality of the studies of pharmacist prescribing benefits and costs using quality assessment checklists. In addition, this thesis describes the principles of the cost and benefit analyses, economic evaluations and systematic literature reviews. As a result of the literature search were found 1825 references. Based on the inclusion and exclusion criteria, 17 studies were selected to include in the systematic review. Of these studies three were economic assessments, 8 randomized controlled trials and 6 observational studies. The quality of these studies was assessed using four quality assessment checklists. On the basis of a systematic literature review pharmacist prescribing has been studied in the treatment of type 2 diabetes, hypertension, dyslipidemia, anticoagulation, chronic pain, emergency contraception and minor ailments and renewal of long-term medicines. Pharmacists reduced blood pressure by providing follow-up care with prescribing compared with the usual care, but not compared with the case management, which does not include prescribing. In addition, the follow-up care was to improve the treatment results of type II diabetes. The results obtained in the care of dyslipidemia were partly unclear. In the clinic follow-up care with prescribing could be reduced LDL-cholesterol, but not the risk of cardiovascular disease compared with the control group. In the pharmacy follow-up care had no effect on the treatment of patients with LDL-cholesterol compared with the control group. In addition, pharmacist prescribing improved how well patients stayed within INR target range. Pharmacist medication review with pharmacist prescribing achieved in the care of chronic pain patients differed few from the results of pharmacist medication review with feedback for a general practitioner. Pharmacist prescribing could reduce errors in inpatient medication compared with usual care. Much uncertainty is connected to the results of the study. The limited amount of studies, heterogeneity of the studies and methodological quality make the evaluation of real effects more difficult. The included studies of pharmacist prescribing were so heterogeneous. In addition treated disease, assessed benefits and scope of working environment were varied in included studies. Pharmacist prescribing was often studied as part of other care or pharmaceutical service, such as chronic disease management or medication review. The quality assessment of the included studies revealed several sources of bias. The available research information is the insufficient reliable evaluation of economic and other effects of pharmacist prescribing and the need for the further research is big.
  • Laakso, Senja; Aro, Riikka; Heiskanen, Eva; Kaljonen, Minna (Taylor & Francis Online, 2020)
    Sustainability: Science, Practice and Policy 17 1 (2020)
    Two streams of literature have become especially prominent in understanding social change toward sustainability within the past decades: the research on socio-technical transitions and applications of social practice theory. The aim of this article is to contribute to efforts to create dialogue between these two approaches. We do this by focusing on the concept of reconfiguration, which has become a much-used, but poorly defined notion in the discussion on sustainability transitions. To understand what is defined as reconfiguration in systems and practices, and how the understanding of reconfiguration in regimes could benefit from insights about reconfiguration in practices, we conducted a systematic and critical literature review of 43 journal articles. The findings showed a trend toward a focus on whole-system reconfiguration and interlinked dynamics between practices of production and consumption. However, our study suggests that a less hierarchical understanding of transitions utilizing insights from practice theory might be fruitful. Future research on sustainability transitions could benefit from addressing the tensions between and within niche and regime practices; the dynamics maintaining and challenging social and cultural norms; the efforts in creating new normalities and in recruiting actors in practices; and investigating the different roles the various actors play in these practices.
  • Niskanen, Ville-Pekka; Rask, Mikko; Raisio, Harri (2021)
    The theory of wicked problems, originating from Western academic discussion, has evolved since the 2000s toward a universal diagnostic of societal challenges. In this article, we employ a systematic literature review to investigate the application of the concept of wicked problems in studies focusing on the African context. Our aim is to understand the additional value and limitations of using the concept in a non-Western frame of reference. We conclude that the concept remains underutilized in studies concentrating on Africa; moreover, when it is used, it is mainly by academics of Western or Anglophone origin. Overall, the concept of wicked problems is mainly applied descriptively rather than theoretically. Based on the analysis of the themes and issues characterized as wicked, we elaborate toward a typology that takes account of the concrete "manifestations" (e.g., health issues such as AIDS/HIV and its treatment history) and "mechanisms" (e.g., historical path dependency) that condition the presence of wicked problems in the African context. The article contributes to the theory of wicked problems by developing a typology that distinguishes between interlinked and contextual problems (often characterized through the concept of "dual wickedness"), and proposes that problems can become exacerbated when the two dimensions are simultaneously present.
  • Niskanen, Ville-Pekka (Helsingin yliopisto, 2021)
    This Master’s thesis is two-part. The first part is the Methodological Introduction, which introduces the background of this research, the research process, methods and ethical considerations. The second part is a manuscript of a scientific article, sent for review in the scientific journal Sage Open, with the title Wicked problems in Africa – A systematic literature review. The article is a systematic literature review of the usage of Horst W. J. Rittel and Melvin M. Webber’s wicked problems concept in peer-reviewed scientific literature focusing on Africa. The reviewed 45 scientific articles were chosen using a systematic methdolology, basing on a set of inclusion criteria. Based on the reviewed literature, three research questions were answered by utilizing the tabulation of key information from the articles, and with content analysis. The research questions are: 1) What are the main themes and concrete manifestations of issues descri-bed as wicked in the African context? 2) What are the geographic foci of articles that use the concept of wicked problems in the African context? 3) Is the concept of wicked problems utilized and therefore seen as applicable by authors affiliated with African cultures? Based on the reviewed articles, a typology is formed. According to this typology, wicked problems in the African context can be interlinked, exacerbated, or contextual. Especially important is the contextuality, which the concept of dual wickedness reminds us of. In addition, the research states that the lack of usage of the wicked problems concept in scientific literature on Africa may be because of the English-language or Western background of the concept. Based on the results, we suggest, that future characterizations of the wicked problems concept should include context-sensitivity.