Saudi Cultural Missions Theses & Dissertations
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Item Restricted DESIGNING A CLINICAL TRIALS FRAMEWORK FOR WEARABLE TECHNOLOGIES AT SEHA VIRTUAL HOSPITAL IN SAUDI ARABIA(UCL, 2024) Madkhali, Marwan; Expert, PaulThe purpose of this research is to design a clinical trials framework for wearable technologies at Seha Virtual Hospital (SVH) in Saudi Arabia. The framework aims to evaluate the usability, effectiveness, and impact of wearable technologies on patient outcomes in a virtual care setting, aligning with the national strategy for digital health transformation. The research also seeks to establish benchmarks and generate high-quality evidence on the efficacy of these technologies for digital health in Saudi Arabia. The SVH, as a pioneering digital health centre, recognises the potential of wearable technologies to revolutionise healthcare by enabling remote monitoring and real-time data collection. The proposed framework will facilitate the integration of these technologies into clinical trials, contributing to evidence-based practices and improved patient care. The research methodology involved a systematic literature review to identify key themes and challenges in integrating wearable technologies into clinical trials. The review adhered to the PRISMA guidelines and included studies published between 2014 and 2024 that examined the use of wearable technologies in clinical trials for virtual healthcare delivery. Thematic analysis was employed to identify key themes and challenges. The findings highlighted the importance of usability and positive user experience, seamless data integration and high data quality, patient-centric design to promote adherence, the value of real-world evidence and feasibility studies, addressing regulatory and ethical considerations, and ensuring successful technology integration. The research also identified key benchmarks from existing clinical trials in different countries, including usability and patient-centred design, real-world data integration, methodological rigour and validation, ethical and regulatory compliance, personalised treatment plans and data accuracy, and hybrid models and flexibility. Results the comprehensive clinical trials framework was proposed. The framework incorporates needs assessment, technical performance evaluation, usability testing, feasibility assessment, and outcome measurement. It also emphasises ethical considerations, regulatory compliance, and data security. The implementation of this framework at SVH will enable the effective evaluation of wearable technologies, leading to improved patient monitoring, enhanced virtual care delivery, and ultimately, better patient outcomes. Keywords: clinical trials, wearable technologies, virtual healthcare, usability, and framework.10 0Item Restricted CLINICAL CARE STRATEGIES FOR THE DIAGNOSIS AND MANAGEMENT OF ADULT PATIENTS WITH RESPIRATORY SLEEP DISORDERS(Imperial College London, 2024-05-01) Alsaif, Sulaiman S; Kelly, Julia L; Morrell, Mary JMany patients with obstructive sleep apnoea (OSA) in the UK remain undiagnosed, and untreated. Conventional clinical care for OSA diagnosis and management is insufficient to meet the increasing demand, which has been exponentially rising post-pandemic. This Thesis investigated new clinical care strategies for the diagnosis and management of OSA and evaluated patient experiences with, and preferences for, these strategies. Quantitative and qualitative investigations in adult patients with suspected or existing OSA diagnosis were conducted. In a randomised controlled pilot study, patients referred for suspected OSA were investigated using novel mandibular movement (MM) monitoring with automated machine-learning analysis. Reduced time to treatment decision and saved healthcare professionals’ time, were found compared to conventional home respiratory polygraphy. In a qualitative evaluation, nested study, within the randomised controlled study, patients described their journeys to OSA diagnosis. They expressed their preference for home OSA testing with the “unobtrusive” MM monitor, compared to the more “cumbersome and restrictive” respiratory polygraphy. In a systematic review and meta-analysis, virtual care via telephone or video consultations was found to be as effective as in-person consultations for improving subjective sleepiness in patients treated with continuous positive airway pressure (CPAP). Virtual care also appeared to be less costly than in-person care strategies. In a UK survey of patients with self-reported OSA treated with CPAP, most patients reported being satisfied with their CPAP initiation experience. Most patients also expressed their preference for in-person CPAP initiation and follow-up care, compared to remote care strategies. These findings show that digitally-enabled clinical care can be considered for OSA diagnosis and management. However, remote care pathways for OSA may not accommodate the preferences and needs of all patients, specifically those at higher risk of being digitally excluded. Thus, future investigations should address potential health inequalities associated with widespread implementation of remote care pathways for OSA.31 0