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Mozhgan Farazmand, Mandana Asgari, Hamid Bouraghi, Taleb Khodaveisi, Ali Mohammadpour, Soheila Saeedi,
Volume 19, Issue 3 (9-2025)
Abstract

Background and Aim: Cardiovascular diseases have a very high prevalence globally and are recognized as one of the main causes of mortality worldwide. Artificial intelligence, as a novel technology, has garnered attention in recent years in Iran and other parts of the world for the management of a wide variety of diseases. The present study aimed to systematically review research studies conducted in the field of applying artificial intelligence in cardiovascular diseases.
Materials and Methods: To investigate research studies conducted in the field of cardiovascular diseases utilizing artificial intelligence, the Persian language databases SID, Google Scholar, and Magiran were searched. This search was conducted without time limitations on April 3, 2024 and included all research studies that, up to this date, had used various artificial intelligence methods in the field of cardiovascular diseases in the present systematic review.
Results: The results of the search in the aforementioned three databases led to the retrieval of 17,819 research studies, of which 46 research studies met the inclusion and exclusion criteria of the study. These research studies had used artificial intelligence in three areas: prediction, treatment, and diagnosis. Neural networks (n=22), support vector machines (n=20), and decision trees (n=16) were the algorithms that were used more than other techniques. The data sources of the included research studies were mainly patient medical records and the UCI database. Additionally, MATLAB software was used more than other software. The most frequently mentioned limitations in the research studies included not considering all factors, limited access to data, insufficient data, the presence of noise in signals or images, and the presence of outliers, missing values, and non-normality of data.
Conclusion: The systematic review of research studies conducted in the field of cardiovascular diseases utilizing artificial intelligence showed that this technology has been used in a wide range of cardiovascular diseases, and most of the conducted research studies confirmed its effectiveness and successful performance.

Mahnaz Moghadari Koosha, Iraj Salehi, Elaheh Mousavi, Mohammad Reza Safari, Nasim Alipour, Hossein Vakili Mofrad,
Volume 19, Issue 4 (11-2025)
Abstract

Background and Aim: The hidden curriculum is considered the most powerful means of transmitting professional values. Given the critical importance of managing the hidden curriculum to institutionalize professional ethics and professionalism within health higher education institutions, the present study was conducted to explore the perceptions of operating room and anesthesia students and instructors regarding the impact of the hidden curriculum on the promotion of professional ethics.
Materials and Methods: This study was conducted using a qualitative approach based on conventional content analysis. The study population included final-year students and instructors from the operating room and anesthesia disciplines at Hamadan University of Medical Sciences. Participants were selected through purposive and theoretical sampling methods. Data were collected via in-depth, semi-structured interviews. Data saturation was achieved after conducting 24 interviews. The data analysis followed the qualitative content analysis approach proposed by Graneheim and Lundman (2004), and was carried out in seven steps: 1. familiarization with the data, 2. identification of meaning units, 3. initial coding, 4. formation of subcategories, 5. development of categories, 6. extraction of themes, and 7. final review.
Results: The content analysis of the interviews resulted in the identification of 456 initial codes. Following refinement and consolidation, these codes were organized into four overarching categories and ten subcategories. The main categories comprised: ‘Components of the hidden curriculum in professional ethics education’, ‘Mechanisms through which the hidden curriculum exerts influence’, ‘Consequences of the hidden curriculum’, and ‘Strategies for enhancing professional ethics’. The findings indicated that the hidden curriculum, manifested through the behavioral patterns of faculty members and instructors, organizational culture, and interpersonal interactions, plays a pivotal role in shaping students’ ethical attitudes and behaviors. Furthermore, the hidden curriculum, through processes of unconscious learning, reinforcement or erosion of formal values, and the manner in which rules are implemented, can yield both positive outcomes—such as the development of ethical decision-making skills—and negative outcomes, including diminished ethical sensitivity.
Conclusion: This study revealed that the hidden curriculum in operating room and anesthesia education functions as a dual-force phenomenon. On one hand, it fosters the development of professional ethics through constructive role modeling and authentic clinical experiences. On the other hand, it can contribute to ethical erosion by conveying contradictory messages and unhealthy norms. Achieving sustainable ethical learning requires active management of the hidden curriculum through three key strategies: aligning the formal and hidden curricula, empowering instructors as agents of ethical value transmission, and shifting the organizational culture paradigm toward learning from error.

Ebrahim Jaafaripooyan, Seyed Farshad Allameh, Neda Alizadeh, Tahereh Sharifi,
Volume 19, Issue 4 (11-2025)
Abstract

Background and Aim: Retention of faculty members is one of the fundamental challenges of the country’s health system. Therefore, this study aimed was conducted with the aim of providing strategies for retaining faculty members in the health field.
Materials and Methods: This study was conducted in a combined manner in three stages in 2024. In a field review, related articles were reviewed from the Magiran, SID, PubMed databases and using the Google scholar search engine. Out of 18,977 identified studies, 37 articles were selected and reviewed after several stages of screening. In the second stage, 12 semi-structured interviews were conducted with relevant experts and managers using an inductive approach based on the rules of directional content analysis to identify the factors of retention of faculty members in the health field. Accordingly, the human resource management framework, which includes 5 stages of familiarization with the data, identification of the thematic framework, indexing, display with a diagram, and interpretation of the results, was used for data analysis in this study. MAXQDA-2020 software was used to analyze the research data. Finally, in the third stage, using a prioritization matrix, the solutions were scored and prioritized by 17 experts.
Results: Strategies were identified and classified into 10 areas based on the human resources management cycle, including recruitment, selection and hiring, growth and development, performance evaluation, compensation, organizational culture, improving working conditions, motivation, termination of employment, and external factors. Then, those in each area were prioritized based on their level of efficacy, with the highest priority solutions including improvement of the country’s financial and economic conditions (mean score=4.92 out of 5), an increase in faculty members’ salaries (4.90), removal of the salary cap (4.88), establishment of housing cooperatives (4.82), respect for the dignity and social status of retired professors (4.80), provision of recreational facilities for faculty members (4.79), enhancement of transparency, accountability, and adherence to the rule of law in the country (4.79), and increased faculty participation in decision-making processes (4.47).
Conclusion: Given the results, strategies such as focusing on improving the financial situation, promoting transparency, and increasing the well-being of faculty members can be effective in increasing the motivation and retention of faculty members in the health sector. Therefore, the implementation of these strategies by policymakers and education administrators is expected to improve the retention of faculty members in this sector.

Abbas Sheikhtaheri, Elaheh Jamshidi, Ali Mohammadi, Vahid Feyzollahi,
Volume 19, Issue 5 (12-2025)
Abstract

Background and Aim: Knee ligament rupture is a common knee injury, especially among athletes. Considering the importance of treatment quality in the affected population, there is a crucial need for the collection of high-quality, standardized national-level data. This can be achieved by establishing a Minimum Data Set (MDS). The present study aimed to design a Minimum Data Set for the Knee Ligament Rupture Reconstruction Registry System in Athletes.
Materials and Methods: This applied research was conducted in 2024 using a quantitative method (descriptive-comparative and Delphi technique) across three phases. In the first phase, using a descriptive-comparative approach, the required data elements from the national registry systems of selected countries (Norway, Sweden, Denmark, UK) were extracted and analyzed in comparative tables. In the second phase, the data elements currently recorded for patients undergoing knee ligament rupture reconstruction surgery in Iran were identified using a descriptive data collection form. In the third phase, based on the findings from the first two phases, a preliminary MDS was designed as a questionnaire. Its validity was then assessed over two rounds using the Delphi method by a panel of experts (24 in the first round, 18 in the second). Finally, items that achieved a consensus of 75% or higher were included in the final MDS.
Results: In the review conducted on the registry systems of selected countries, including Norway, Sweden, Denmark, and England, the data elements recorded in these systems were first extracted. Subsequently, in the first phase of the study, the extracted data elements were categorized into two main categories: Administrative and clinical. The findings of this phase were obtained through their comparison in comparative tables. The findings of the second phase of the study consisted of data elements extracted from the medical records of patients who had undergone knee ligament rupture reconstruction surgery in Iran. In the third phase of the study, the final minimum data set for patients undergoing knee ligament rupture reconstruction surgery was developed based on the findings of the first and second phases of the study as well as expert opinions. This data set comprised 78 data elements organized into two sections: administrative (9 data elements) and clinical (69 data elements). In the administrative section, data classes were categorized into demographic, socioeconomic, and visit-related groups. In the clinical section, data classes were categorized into diagnostic, anthropometric, surgical, follow-up, and outcome groups.
Conclusion: The Minimum Data Set for knee ligament rupture reconstruction surgery can play a significant role in collecting high-quality data, evaluating and managing treatment quality and outcomes, and informing planning and policymaking in this field by ensuring the collection of integrated and high-quality data.

Marzieh Latifi, Elahe Pourhossein, Amirhesam Alirezaei, Tannaz Hajialireza Tehrani, Maryam Pourhossein, Sanaz Dehghani,
Volume 19, Issue 5 (12-2025)
Abstract

Background and Aim: Sleep disorders are strongly associated with physical, mental, social health, as well as cognitive functioning. This study aimed to compare the quality of sleep between individuals on kidney transplant waiting list and kidney transplant recipients to develop an appropriate program to improve their health and quality of life.
Materials and Methods: This cross sectional descriptive-analytical study was conducted on 196 patients, including 100 patients who registered on the kidney transplant waiting list and 96 kidney transplant recipients at the Sina Hospital, Tehran University of Medical Sciences (TUMS). Convenience sampling was used. Patients completed a standardized Pittsburgh Sleep Quality Index (PSQI) questionnaire to assess sleep quality. The self-reporting method was used to complete the questionnaires. Clinical and demographic data were collected from patients’ medical files of Sina Hospital by kidney transplant coordinators. Statistical analysis was performed using SPSS, with a significance level set at less than 0.05.
Results: The mean age of the participants was 47 years, with an age range between 18 and 69 years. Sixty-eight-point Thirty-six percent of the patients were male. Based on results, no significant difference was found between patients in kidney waiting list to kidney transplanted patients in demographic variables (age, gender, marital status, number of children, job, level of education, cause of kidney disease). According to independent T- test, the mean score of sleep quality of patients on the waiting list and kidney transplant recipients was (7.75±3.55) and (4.54±3.57), respectively, indicting the significant differences between two groups (P<0.001). Also, the Pearson correlation test reveals a significant positive correlation between age and sleep quality (P=0.038, r=0.612), and a significant negative correlation between duration of dialysis and the average sleep score (P=0.040, r=-0.062). 
Conclusion: It is essential to emphasis attention to the quality of sleep in kidney patients, especially during the pre-transplant and dialysis era.
Additionally, kidney transplantation can be considered an effective solution for improving sleep quality and reducing complications related to kidney failure, although some patients continue to experience sleep problems after the transplant.

Saber Yazdani Damavandi, Tayebeh Baniasadi, Mohammad Ali Molavi, Farid Khorrami,
Volume 19, Issue 5 (12-2025)
Abstract

Background and Aim: Cancer has been recognized as the second leading cause of child mortality in recent years. Due to the increasing amount of healthcare data for cancer patients, healthcare providers need a tool to monitor patients for immediate intervention. An intelligent and dynamic information management dashboard is capable of compiling and displaying data using charts and tables. In the present study, a management dashboard was designed for the oncology department of a children’s hospital, and its usability was evaluated.
Materials and Methods: This developmental–applied research was conducted in 2024 at the Educational, Medical, and Research Center for Children in Bandar Abbas. In order to create a management dashboard for the pediatric oncology department, three stages were carried out. In the first stage, all necessary content to be displayed on the dashboard was extracted based on a review of literature and documents from the oncology department of Bandar Abbas Children’s Hospital. This content was then validated by experts using the Delphi method in two rounds. In the second stage, a prototype of dashboard for the oncology ward was designed using Power BI Desktop software. Finally, its usability was evaluated using a SUS questionnaire by 20 users. The data were analyzed using descriptive statistics with SPSS software.
Results: Following the screening of 3,435 initial records and a review of 22 articles alongside 38 patient files, a preliminary set of 104 managerial and 67 clinical indicators was extracted. These indicators were validated through a tworound Delphi process with 12 experts, resulting in the final selection of 105 managerial and 71 clinical indicators for dashboard inclusion. Based on this validated set, a tenpage managerial dashboard was developed to present key performance metrics. Usability assessment using the System Usability Scale (SUS) yielded a mean score of 75.87, which, according to the Bangor scale, is classified as “acceptable” and corresponds to a grade of “excellent.” User feedback informed subsequent refinements to the dashboard’s data visualizations and interface. In summary, the developed dashboard represents an effective and userfriendly tool for monitoring and managing information within a pediatric oncology department.
Conclusion: The pediatric oncology management dashboard facilitates the integration and summarization of essential data for healthcare providers, thereby assisting them in making timely diagnoses and interventions for children with cancer. Additionally, the present dashboard demonstrates appropriate usability, which enhances users’ understanding of health information and leads to more accurate decision-making.

Shohreh Seyyed-Hosseini, Marzieh Shahbazi, Alireza Davarpanah, Fatemeh Kalteh, Reza Basirian-Jahromi,
Volume 19, Issue 5 (12-2025)
Abstract

Background and Aim: The monitoring of users’ real-time and continuous web searches, in conjunction with the identification of research conducted by experts in a specific field, constitutes the domain of infodemiology. The present study sought to examine the correlation between the demand for health information among users and the scientific output of researchers in elderly health from 2015 to 2024.
Materials and Methods: The present data mining research is of a descriptive-analytical nature, conducted using web mining and scientometrics approaches, employing infodemiology indicators. The web mining section of the study population comprised global user search keywords in the field of elderly health, as examined using Google Trends. In the scientometrics section, the research conducted by researchers in the field of elderly health was analyzed. This research was indexed in the PubMed database from 2015 to 2024. To examine the alignment between users’ information-seeking behavior and researchers’ scientific output, correlation tests were performed using SPSS software.
Results: A rise was observed in the volume of scientific output from researchers and the user search volume index in the field of elderly health on the Google search engine from 2015 to 2024. The monthly mean growth of scientific output from researchers over the ten years was 1439.70. In the user behavior of health information seeking (health information demand), the highest relative search volume index belonged to Ireland, Jamaica, and the United States of America, respectively. The highest number of scientific articles by researchers in the field of elderly health, with 20,480 articles, was related to the year 2021. Also, the average monthly growth of scientific output by researchers in the field of elderly health in this ten-year period (from January 2015 to December 2024) was 1439.70. The investigation revealed a direct and significant relationship (P-value<0.005) between users’ information-seeking behavior and researchers’ scientific output in this field, as determined by applying the Google search engine.
Conclusion: A multitude of factors have the capacity to influence the level of scientific output from researchers in the field of elderly health. In view of the positive relationship that has been observed and the reciprocal relation between the variables of users’ information-seeking behavior and researchers’ scientific output, it can be concluded that the factor of information demand, or users’ internet information-seeking behavior in the web environment, in this area, can be one of the most significant factors. This factor must be given due consideration through rigorous research.

Ahmad Negahban, Azam Salehzadeh, Razieh Farrahi, Alireza Nourozi, Sina Tavakoli,
Volume 19, Issue 6 (3-2026)
Abstract

Background and Aim: With the digitalization of healthcare, hospital information systems handle vast amounts of sensitive data, making their protection crucial. This study aimed to assess the compliance of these systems in hospitals affiliated with Birjand University of Medical Sciences with the physical and technical safeguard standards of Health Insurance Portability and Accountability Act (HIPAA) in 2024.
Materials and Methods: This cross-sectional descriptive study was conducted in 15 hospitals affiliated with Birjand University of Medical Sciences. The study population consisted of Information Technology (IT) unit managers, who were selected using a census method (15 individuals). The research instrument was a researcher-developed checklist consisting of 56 items based on the physical and technical standards of HIPAA. The face validity of the checklist was confirmed by five experts in Health Information Management, Medical Informatics, and Health Policy, and its reliability was verified with a Cronbach’s alpha coefficient of 0.84. Data were analyzed using SPSS software and descriptive statistics, including frequency, percentage, mean, and standard deviation.
Results: A total of 15 information technology managers (14 men and 1 woman) from 15 hospitals, including 8 teaching and 7 non-teaching hospitals, participated in the study. The findings showed that the hospital information systems of Birjand University of Medical Sciences complied with the HIPAA physical and technical safeguard standards at rates of 81.7% and 86.7%, respectively. In the domain of physical safeguards, the workstation security standard demonstrated the highest level of compliance, with a mean score of 89.3%. Full compliance (100%) was observed for certain indicators, including emergency access procedures for facilities and physical access control procedures. In contrast, the lowest compliance in this domain was related to the device and media controls standard, with a mean score of 74.9%, particularly in the identification and tracking of hardware and electronic media. In the domain of technical safeguards, the overall mean compliance rate was 86.7%. Among these standards, person or entity authentication achieved the highest level of compliance, with all hospitals demonstrating full compliance (100%). In addition, access control (93.3%), audit controls (86.7%), and transmission security (85.3%) were all at desirable levels. However, the lowest compliance was observed for the integrity standard (50%), highlighting the need to strengthen technical infrastructure and implement more advanced electronic mechanisms to ensure data accuracy and integrity.
Conclusion: Although the overall level of compliance in the hospitals under study is satisfactory, significant gaps remain, particularly in device and media control and data integrity. These deficiencies may lead to breaches of patient privacy and undermine public trust in the healthcare system. It is recommended that senior hospital managers and health policymakers address these deficiencies by developing and implementing clear internal guidelines, investing in appropriate supportive technologies, and conducting continuous, targeted training programs for all personnel. In addition, periodic compliance monitoring is essential to ensure continuous improvement.

Saeideh Ayoubi, Saman Salemi, Mohammad Ali Sahraian, Termeh Tarjoman, Sharareh Eskandarieh,
Volume 19, Issue 6 (3-2026)
Abstract

Background and Aim: Noncommunicable diseases are one of the most important public health challenges in the 21st century. Neuromyelitis optica (NMO) is a rare autoimmune disease that affects the central nervous system and can lead to permanent disability in young people. This disease is important due to its economic impact and reduced quality of life, and it is essential to understand its economic and social factors on these subjects.
Materials and Methods: This study is a cross-sectional study based on the population of Iranian NMO patients. The instrument of this study was a researcher-made questionnaire in English from Harvard University, USA, which was translated into Persian and re-translated into English (translate- retranslate technique). The samples included NMO patients registered in the Iranian National NMO Registry System at Sina Hospital in Tehran, who completed information about their employment, income, and socioeconomic status via telephone interviews. The data were analyzed by SPSS software.
Results: The total number of samples was 70, with a mean age of 41.40 years with a standard deviation of 10.91 years. The majority of patients were women, with 71.4% (50 of 70) of patients being female and 28.6% (20 of 70) being male. Sixty-one-point four percent of patients (43 of 70) had lost their jobs due to NMO and 70% (49 of 70) had reduced their working hours. Also, 47.1% of patients (33 of 70) reported a decrease in their annual income. Thirty-two-point eight percent (23 of 70) had lost between 51% and 100% of their annual income due to this disease and 10% (7 of 70) of patients had no annual income. Eighteen point five percent (13 of 70) of patients no longer work outside home due to the occurrence of NMO disease. Overall, the effects of NMO on the reduction of employment, working hours and income of patients were significantly high.
Conclusion: The results showed that NMO has serious effects on the employment and income status of these patients in Iran and they need more economic and social support. Considering the physical disabilities caused by this disease and the reduced ability to work, NMO patients should receive special social and economic support from government.

Hojjat Rahmani, Payam Bahadori, Hossein Dargahi, Mohammad Arab, Nasrin Abolhasanbeigi Gallehzan, Mohsen Mardali,
Volume 19, Issue 6 (3-2026)
Abstract

Background and Aim: The occurrence of conflict of interest in the Iranian health system has a negative impact on the provision of efficient and effective health care and services to patients, the training and education of students in medical sciences. Despite the efforts made in the country’s health system to manage conflict of interest, this phenomenon is currently observed through various factors, including the inefficiency of the financial structure, lack of transparency, and the lack of an integrated health information system in Iran.
Materials and Methods: The present scoping review study that aimed to identify and determine conflict of interest management strategies in the Iranian health system in comparison with selected countries and to select appropriate strategies in 2024-2025 using the Arksey and O’Malley guidelines. All relevant articles and resources from 2007 to 2024 were extracted from national and international databases by observing the entry and exit criteria and by selecting Persian and English keywords. After screening steps using Prisma flowchart, 23 studies in English and Persian language from international and national databases, were analyzed.
Results: Findings from 17 international studies—most of which were conducted in the United States—along with 6 domestic articles, showed main strategies of Iranian conflict of interest which included participation, transparency, legal oversight, processes reform, restructuring and reorganization. Although, using collective campaigns for correction of process behaviors and decisions, definition of ethical ethic codes, and standardization may help implementation of these strategies. Also, the most common cause of conflict of interest in the health system is individual rather than organizational, which requires regulation, the use of legislative levers, and the transparency of financial relations in the health system.
Conclusion: Accurate identification of potential examples of conflict of interests among the agents of health care system by implementing information clarification, and using modern procedures may decrease the challenges in formulating and implementing strategies of conflict of interests among Iranian health care system. Although benchmarking from successful countries will be helpful in these countries. The implementation of these recommendations may face challenges within Iranian society, including resistance from certain professional groups, a lack of financial and technical resources, and the complexity and specific conditions of the health system. Therefore, a step-by-step approach to implementing policy recommendations for managing conflicts of interest in the health system should be considered.


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