Saudi Cultural Missions Theses & Dissertations
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Item Restricted Mortality and Prolonged ICU Stay Analysis in the MIMIC-III Database: A Dual Analytical(Saudi Digital Library, 2025) Aldawsari, Fayez; Concha, Oscar; Welberry, HeidiAbstract Background: Understanding mortality patterns across ICU types and identifying patients at risk for prolonged stays is crucial for resource allocation and clinical decision-making. Objectives: This study examined (1) differences in in-hospital mortality across ICU types after risk adjustment, and (2) developed a predictive model for prolonged ICU stays using early clinical data. Methods: Using MIMIC-III database, we analyzed 61,533 ICU admissions. Propensity score matching with logistic regression compared mortality across five ICU types against MICU. XGBoost classification predicted ICU stays ≥7 days using first 24-hour clinical features. Results: Overall mortality was 4.6%, with 16.1% prolonged stays. After propensity adjustment, CSRU demonstrated significantly lower mortality versus MICU (OR: 0.22, 95% CI: 0.16-0.29), while SICU, CCU, and TSICU showed no significant differences. The XGBoost model achieved excellent discrimination (AUC-ROC: 0.862, sensitivity: 0.264, specificity: 0.978). Glasgow Coma Scale mean score was the most important predictor, followed by vasopressor use and mechanical ventilation. Conclusions: Substantial mortality differences exist across ICU types after risk adjustment, with cardiac surgery patients showing superior outcomes. Early clinical data accurately identifies patients at risk for prolonged stays, enabling proactive resource planning.24 0Item Restricted What are the barriers to User Acceptance and Use of EHRs in the Gulf Regions? Systematic Review of Qualitative Studies(Saudi Digital Library, 2025) Huntul, Ahmed; JENKINS, JUDYBackground: The global shift towards Electronic Health Records (EHRs) has been fuelled by the constraints of paper-based patient records, which have long been the norm in the healthcare industry. These drawbacks include limited accessibility, missing data, and legibility concerns. One of the main areas of healthcare reform in the Gulf Cooperation Council (GCC) is the implementation of EHRs. But there are still a lot of obstacles to adoption and utilisation, particularly for frontline healthcare workers. Objective: Through a systematic review of qualitative studies, this study aims to investigate the obstacles to user acceptance and usage of EHRs in the Gulf area, offering thematic insights into adoption-affecting issues. Methods: For studies published between 2015 and June 2025, a systematic review using the SPIDER methodology was carried out across five databases (Scopus, Cinhal, Embase, Medline, and Google Scholar). Qualitative or mixed-methods research involving medical professionals in GCC countries were the focus of the inclusion criteria. The CASP checklist was used to evaluate quality. Four major themes, fourteen subthemes, and 141 codes were produced by thematically synthesising data from nine qualifying studies. Results: Technical and system-related problems, such as unstable infrastructure, poor interoperability, and usability issues; human and behavioural barriers, such as resistance to change, lack of training, and workload burden; organisational and administrative weaknesses, such as unstable leadership, poor governance, and staffing shortages; and data and security issues, such as privacy, confidentiality, and data integrity risks, were the four categories of barriers that were identified. Conclusion: EHR adoption in the Gulf is not only a technical problem, but also a cultural, organisational, and policy issue. For the region's digital health transition to be sustainable, it is essential that governance be strengthened, leadership be stable, user training be improved, and strong data governance frameworks be developed.10 0Item Restricted Exploring Digital Transformation Strategies in Healthcare: Integration of Telemedicine and Electronic Health Records (EHR) Systems(University of Warwick, 2024-07-29) Aljamaan, Rayan; Beck, SusanneTelemedicine and Electronic Health Records (EHR) are a combination that significantly drove digital transformation in the healthcare sector. This study addresses the question: How does the integration of telemedicine and Electronic Health Records (EHR) systems affect the efficiency, accessibility, and quality of healthcare services? The importance of this study is best understood in the background of the increasing need for practical, affordable, and patient-centered solutions, particularly in the post-COVID-19 world and the progression of digital health solutions. Methodologically, the study uses a literature review conducted using research retrieved from peer-reviewed scientific journals. Databases used for search include Google Scholar, Scopus, ResearchGate, and ScienceDirect. The collected information was thematically organized into themes and sub-themes to present the results systematically. Generally, the review looks at the literature on telemedicine and EHR systems separately to determine their joint influence on the overall delivery of healthcare services and patients’ satisfaction. The Technology Acceptance Model (TAM) and Diffusion of Innovations (DOI) concepts are used to assess the influencing factors related to the adoption and impacts of these technologies. The main findings show that the successful implementation of telemedicine and EHR provides a better opportunity to increase the access of patients and, at the same time, reduce healthcare workers' workload and increase patient revisit. However, challenges like technical integration, security of information, and training and follow-up still need to be solved. These results imply that it is necessary to deal with these challenges using phased approaches of implementing innovations, involving all relevant stakeholders, and providing ongoing education. Thus, this study contributed to the growing body of knowledge and helped identify possible approaches to improving integration perspectives of digital business models in the healthcare industry.44 0Item Restricted A systematic Review of Codes Used to Determine the Presence of Hypertension in Routinely Collected Electronic Healthcare Record (EHRs) Data.(Saudi Digital Library, 2023-08-22) Ghazwani, Faisal Abdullah; Quint, JenniferAbstract Background: Hypertension, or high blood pressure, is a global health concern that plays a significant role in various serious conditions, including kidney disease, heart disease, and stroke. Electronic healthcare records (EHRs) have become an indispensable tool in researching hypertension, but the inconsistency in defining hypertension across different EHRs can affect the reliability and reproducibility of research findings. Objectives: This systematic review aims to identify and analyse the coding systems and code lists used in defining hypertension within EHRs in various research studies. By investigating most frequent codes and coding systems utilised across multiple databases, the review aims to promote more accurate, reliable, and comparable study outcomes. Design: The study encompasses research conducted from January 2010 to January 2023, specifically focusing on the utilisation of electronic medical records for hypertension investigation. To ensure accuracy in identifying hypertension cases, codes were extracted and analysed from various clinical coding systems. These codes are integral in defining hypertension within the studies included in the research. Results: The findings reveal a diverse array of coding systems employed across different studies. The ICD-10 system emerged as the most prevalent, encompassing approximately 44% of the total codes in use, followed by ICD-9, accounting for about 32%. Other systems, such as Read Version 2 and ICD-11, were rarely used, while UK Biobank self-diagnosis, SNOMED CT, ICPC, CTV3, and Medcode were utilised at varying frequencies. The ICD-11 system, launched in Jan 2022, has only been implemented in two distinct research studies. Conclusion: The varying utilisation of coding systems in hypertension research underscores the complexity of standardising this critical health metric across studies. This review highlights the dominant use of the ICD-10 system, the substantial use of the ICD-9 system, and the growing but still limited adoption of newer coding systems like ICD-11. It emphasises the need for consistent adoption of standardised codes to improve the coherence and comparability of hypertension research and to provide a more unified understanding of this global health issue.7 0