Background Complaints made online by patients about their health care experiences are becoming prevalent because of widespread worldwide internet connectivity. An a priori framework, based on patient centeredness, may be useful in identifying the types of issues patients complain about online across multiple settings. It may also assist in examining whether the determinants of patient-centered care (PCC) mirror the determinants of patient experiences. Objective The objective of our study was to develop a taxonomy framework for patient complaints online based on patient centeredness and to examine whether the determinants of PCC mirror the determinants of patient experiences. Methods First, the best fit framework synthesis technique was applied to develop the proposed a priori framework. Second, electronic databases, including Web of Science, Scopus, and PubMed, were searched for articles published between 2000 and June 2018. Studies were only included if they collected primary quantitative data on patients’ online complaints. Third, a deductive and inductive thematic analysis approach was adopted to code the themes of recognized complaints into the framework. Results In total, 17 studies from 5 countries were included in this study. Patient complaint online taxonomies and theme terms varied. According to our framework, patients expressed most dissatisfaction with patient-centered processes (101,586/204,363, 49.71%), followed by prerequisites (appropriate skills and knowledge of physicians; 50,563, 24.74%) and the care environment (48,563/204,363, 23.76%). The least dissatisfied theme was expected outcomes (3651/204,363, 1.79%). People expressed little dissatisfaction with expanded PCC dimensions, such as involvement of family and friends (591/204,363, 0.29%). Variation in the concerns across different countries’ patients were also observed. Conclusions Online complaints made by patients are of major value to health care providers, regulatory bodies, and patients themselves. Our PCC framework can be applied to analyze them under a wide range of conditions, treatments, and countries. This review has shown significant heterogeneity of patients’ online complaints across different countries.

Background:One of the main aims of the updated Prostate Imaging Reporting and Data System Version 2 (PI-RADS v2) is to diminish variation in the interpretation and reporting of prostate imaging, especially among readers with varied experience levels. This study aimed to retrospectively analyze diagnostic consistency and accuracy for prostate disease among six radiologists with different experience levels from a single center and to evaluate the diagnostic performance of PI-RADS v2 scores in the detection of clinically significant prostate cancer (PCa).Methods:From December 2014 to March 2016, 84 PCa patients and 99 benign prostatic shyperplasia patients who underwent 3.0T multiparametric magnetic resonance imaging before biopsy were included in our study. All patients received evaluation according to the PI-RADS v2 scale (1–5 scores) from six blinded readers (with 6 months and 2, 3, 4, 5, or 17 years of experience, respectively, the last reader was a reviewer/contributor for the PI-RADS v2). The correlation among the readers' scores and the Gleason score (GS) was determined with the Kendall test. Intra-/inter-observer agreement was evaluated using κ statistics, while receiver operating characteristic curve and area under the curve analyses were performed to evaluate the diagnostic performance of the scores.Results:Based on the PI-RADS v2, the median κ score and standard error among all possible pairs of readers were 0.506 and 0.043, respectively; the average correlation between the six readers' scores and the GS was positive, exhibiting weak-to-moderate strength (r = 0.391, P = 0.006). The AUC values of the six radiologists were 0.883, 0.924, 0.927, 0.932, 0.929, and 0.947, respectively.Conclusion:The inter-reader agreement for the PI-RADS v2 among the six readers with different experience is weak to moderate. Different experience levels affect the interpretation of MRI images.

Background Although patient accessible electronic health records (PAEHRs) offer great potential in enhancing the provision of patient-centered care and improving satisfaction, the adoption rate is still low. Currently, few studies are there for researchers and health organization leaders to understand patients’ thoughts and related factors of PAEHRs adoption in developing countries. China adopted more limited practices of PAEHRs, among which we selected Yuebei People's Hospital as an example. Objective The study aimed to research patient attitudes toward PAEHRs use and the associated factors of patients’ adoption of PAEHRs in China, which is achieved by both qualitative and quantitative studies. Methods This study employed sequential mixed-methods. The DeLone & McLean information systems (D&M IS) success model, Unified Theory of Acceptance and Use of Technology (UTAUT) and task-technology fit (TTF) model were used to guide the research. Finally, we collected 28 valid in-depth interview responses, 51 valid semi-structured interview responses and 235 valid questionnaire responses. The research model was tested and validated using data collected. Results The findings of the qualitative study reveal that patients’ rate perceived task productivity and customer satisfaction as benefits, and poor-quality information as flaws. Results of the quantitative study show that the drivers of behavioral intention are performance expectance, effort expectancy and social influence; the predictors of use behavior are TTF and behavioral intention. Conclusion It is necessary to consider PAEHRs’ task-tool role in patients’ adoption behavior. Hospitalized patients value PAEHRs’ practical attributes and attach much importance to the information content and application design.