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REVIEW OF MANAGEMENT INFORMATION SYSTEMS RESEARCH: A MANAGEMENT SUPPORT EMPHASIS

Related Papers

Journal of Information Engineering and Applications

PIUS VINCENT OKOYE

Saiful Islam

Alexander Decker

Dinasti International Journal of Education Management And Social Science

Ali M Zebua

Management Information System (MIS) is one of the most important achievements in the field of work administration, which aims to provide reliable, accurate, relevant and complete information to managers to improve organizational performance in organizations. This research reviews other research in the field of MIS adoption in organizations. Synthesizing from the previous literature with several books, articles and related studies, this paper proposes a theoretical framework. Previous research or relevant research is very important in a research or scientific article. Previous research or relevant research serves to strengthen the theory and phenomena of the relationship or influence between variables. This article reviews the factors that influence Information Systems in the academic field, namely: Software, Databases and Information Technology, a literature study on Information Systems Management. The purpose of writing this article is to build a hypothesis of the influence between...

Information Systems Journal

Tor Magnus T M L Larsen

Renée Pratt , Christopher Furner

The purpose of this paper is to classify the most cited papers in Management Information Systems (MIS) by theoretical perspective and subject area. The determination of the underlying theoretical perspective of these papers facilitates and verifies the dominance of positivist perspectives. Our analysis indicates that 74% of the most cited articles are positivist and 26% are interpretivist. The presence of a significant percentage of interpretive work suggests that differing theoretical perspectives are being considered relevant to solving the problems identified in the current research streams. Our results also indicated User Satisfaction and Instrument Development and Group Support Systems as the most cited articles subject areas, 16% and 14% respectively. The significance of these subject areas promotes and supports that systems is the foundation of MIS.

Relatively speaking, the field of information systems is still young, developing into a coherent field. This introduction to the minitrack is organized into the following four sections. The first section discusses three prerequisite conditions for MIS to become a coherent field of a study, as suggested by Keen (1980). 1.1 Clarifying reference disciplines 1.2 Building a cumulative research tradition 1.3 Defining the dependent variables The second section is concerned with the process by which an academic discipline becomes establishment. Once the prerequisite conditions for becoming a classic field of study have been met, a review of the major works of Kuhn (1970), Kaplan (1964), and Cushing (1990) describes the process by which an academic discipline becomes establishment in terms of the following steps: 2.1 Consensus building 2.2 Empirical studies 2.3 Articulation of Theories 2.4 Paradigm Building The third section overviews the current state of MIS research in terms of the prerequ...

JUSTIN GABRIEL

Abstract : Information has become an essential resource for managing modern organizations. This is so because today’s business environment is volatile, dynamic, turbulent and necessitates the burgeoning demand for accurate, relevant, complete, timely and economical i nformation needed to drive the decision - making process in order to accentuate organizational abilities to manage opportunities and threats . This paper is a reflection of amassed discourse available in literature concerning the nexus between management inf ormation systems – MIS and corporate decision - making. The paper suggests that a painstaking development and management of MIS in organizations is capable of triggering decisions that would not only be fast and accurate but would be in line with industry best practices and ultimately result in organizational efficiency and effectiveness.

Mahmoud Moussa, PhD

Employers at all levels, in all settings, are continually in search of information to develop decisions that can be supportive when facing complex, and unpredictable scenarios in the global market. Hence, information and information systems have become strategic tools in the hands of decision makers in today " s businesses. This paper is a presentation of the contemporary reality of information systems, and their influence in enhancing organizational performance. Further, the author identifies the types and levels of information systems available, and their fundamental purposes and roles, alongside the challenges and risks involved. Ultimately, practical implications for business leaders, and recommendations for further studies are provided.

Journal of Management Information Systems Volumes and Issues

Volume 40 number 4 2023, volume 40 number 3 2023.

Special Section: Digital Strategies for Business Readiness Guest Editors: Kauffman, Robert J and Lahiri, Atanu

Volume 40 Number 2 2023

Volume 40 number 1 2023.

Special Issue: Information Systems, Artificial Intelligence, and Analytics to Support Value Creation in Communities and Organizations Guest Editors: de Vreede, Gert-Jan and Nunamaker, Jay F

Volume 39 Number 4 2022

Volume 39 number 3 2022.

Special Section: Reevaluating Markets for Information Guest Editors: Kauffman, Robert J and Weber, Thomas A

Volume 39 Number 2 2022

Volume 39 number 1 2022, volume 38 number 4 2021.

Special Issue: Fake News on the Internet Guest Editors: Dennis, Alan R , Galletta, Dennis F , and Webster, Jane

Volume 38 Number 3 2021

Special Section: Improving New Digital Market Mechanisms Guest Editors: Kauffman, Robert J and Weber, Thomas A

Volume 38 Number 2 2021

Special Section: Strategic Integration of Blockchain Technology into Organizations Guest Editors: Kohli, Rajiv and Liang, Ting-Peng

Volume 38 Number 1 2021

Volume 37 number 4 2020, volume 37 number 3 2020.

Special Section: The Economics of Sharing and Information Security Guest Editors: Kauffman, Robert J and Weber, Thomas A

Volume 37 Number 2 2020

Special Section: The Growing Complexity of Enterprise Software Guest Editors: Briggs, Robert O and Nunamaker, Jay F

Volume 37 Number 1 2020

Volume 36 number 4 2019.

Special Section: Social Influence and Networked Business Interaction Guest Editors: Kauffman, Robert J and Weber, Thomas A

Volume 36 Number 3 2019

Special Issue: Immersive Systems Guest Editors: Cavusoglu, Huseyin , Dennis, Alan R , and Parsons, Jeffrey

Volume 36 Number 2 2019

Volume 36 number 1 2019.

Special Section: Engineering Artifacts and Processes of Information Systems Guest Editors: Giboney, Justin S , Briggs, Robert , and Nunamaker, Jr., Jay

Volume 35 Number 4 2018

Volume 35 number 3 2018.

Special Section: The Digital Transformation of Vertical Organizational Relationships Guest Editors: Kauffman, Robert J and Weber, Thomas A

Special Section: The Transformative Value of Cloud Computing: A Decoupling, Platformization, and Recombination Theoretical Framework Guest Editors: Benlian, Alexander , Kettinger, William J , Sunyaev, Ali , and Winkler, Till J

Volume 35 Number 2 2018

Special Issue: Strategic Value of Big Data and Business Analytics Guest Editors: Chiang, Roger HL , Grover, Varun , Liang, Ting-Peng , and Zhang, Dongsong

Volume 35 Number 1 2018

Special Issue: Financial Information Systems and the Fintech Revolution Guest Editors: Gomber, Peter , Kauffman, Robert J , Parker, Chris , and Weber, Bruce W

Volume 34 Number 4 2017

Special Issue: Creating Social Value with Information Guest Editors: Giboney, Justin Scott , Briggs, Robert O , and Nunamaker Jr, Jay F

Volume 34 Number 3 2017

Special Issue: Action Research in Information Systems Guest Editors: Avison, David , Kock, Ned , and Malaurent, Julien

Volume 34 Number 2 2017

Special Section: Technological Innovations for Communication and Collaboration in Social Spaces Guest Editors: Clemons, Eric K , Dewan, Rajiv M , Kauffman, Robert J , and Weber, Thomas A

Volume 34 Number 1 2017

Volume 33 number 4 2016.

Special Issue: Designing Tools to Answer Great Information Systems Research Questions Guest Editors: Giboney, Justin Scott , Briggs, Robert O , and Nunamaker, Jay F

Volume 33 Number 3 2016

Volume 33 number 2 2016.

Special Section: When Machine Meets Society: Social Impacts of Information and Information Economics Guest Editors: Clemons, Eric K , Dewan, Rajiv M , Kauffman, Robert J , and Weber, Thomas A

Special Issue: Information Systems for Deception Detection Guest Editors: Nunamaker, Jay F , Burgoon, Judee K , and Giboney, Justin Scott

Volume 33 Number 1 2016

Volume 32 number 4 2015, volume 32 number 3 2015.

Special Issue: On the Contributions of Applied Science/Engineering Research to Information Systems Guest Editors: Briggs, Robert O , Nunamaker, Jay F , and Giboney, Justin S

Volume 32 Number 2 2015

Special Section: Online Social Connections: Efficiency Versus Regulation Guest Editors: Clemons, Eric K , Dewan, Rajiv M , Kauffman, Robert J , and Weber, Thomas A

Volume 32 Number 1 2015

Spring volume 31 number 4 2015.

Special Section: Cognitive Perspectives on Information Systems Guest Editors: Briggs, Robert O

Winter Volume 31 Number 3 2014

Special Section: IT-Enabled Social and Economic Transitions Guest Editors: Clemons, Eric K , Kauffman, Robert J , and Weber, Thomas A

Fall Volume 31 Number 2 2014

Special Issue: Economics of Electronic Commerce Guest Editors: Bapna, Ravi , Barua, Anitesh , and Whinston, Andrew B

Summer Volume 31 Number 1 2014

Special Section: IT Project Management Guest Editors: Jiang, James J and Klein, Gary

Special Section: Information Systems Support for Shared Understanding Guest Editors: Briggs, Robert O

Spring Volume 30 Number 4 2014

Special Issue: Neuroscience in Information Systems Research Guest Editors: Liang, Ting-Peng and vom Brocke, Jan

Winter Volume 30 Number 3 2013

Special Issue: Information Technology and Organizational Governance: The IT Governance Cube Guest Editors: Tiwana, Amrit , Konsynski, Benn , and Venkatraman, N

Fall Volume 30 Number 2 2013

Special Issue: Information Economics and Competitive Strategy Guest Editors: Clemons, Eric K , Goh, Kim Huat , Kauffman, Robert J , and Weber, Thomas A

Summer Volume 30 Number 1 2013

Spring volume 29 number 4 2013.

Special Issue: Multiple Dimensions of Value in Information Systems Guest Editors: Briggs, Robert O and Nunamaker Jr, Jay F

Winter Volume 29 Number 3 2012

Fall volume 29 number 2 2012.

Special Section: Information and Competitive Strategy in a Networked Economy Guest Editors: Kauffman, Robert J , Weber, Thomas A , and Wu, D J

Summer Volume 29 Number 1 2012

Spring volume 28 number 4 2012.

Special Section: Creating Value with Information Guest Editors: Briggs, Robert O and Nunamaker Jr, Jay F

Winter Volume 28 Number 3 2011

Fall volume 28 number 2 2011.

Special Section: Information and Technology: Understanding New Strategies for Firms, Networks, and Markets Guest Editors: Clemons, Eric K , Kauffman, Robert J , and Weber, Thomas A

Summer Volume 28 Number 1 2011

Special Section: Applied Science Research in Information Systems: The Last Research Mile Guest Editors: Briggs, Robert O , Nunamaker Jr, Jay F , and Sprague Jr, Ralph H

Spring Volume 27 Number 4 2011

Winter volume 27 number 3 2010, fall volume 27 number 2 2010, summer volume 27 number 1 2010.

Special Section: Social Aspects of Sociotechnical Systems Guest Editors: Briggs, Robert O , Nunamaker Jr, Jay F , and Sprague Jr, Ralph H

Spring Volume 26 Number 4 2010

Special Issue: Information Systems in Services Guest Editors: Bardhan, Indranil R , Demirkan, Haluk , Kannan, P K , and Kauffman, Robert J

Winter Volume 26 Number 3 2009

Fall volume 26 number 2 2009, summer volume 26 number 1 2009.

Special Section: Structure and Complexity in Sociotechnical Systems Guest Editors: Nunamaker Jr, Jay F , Sprague Jr, Ralph H , and Briggs, Robert O

Spring Volume 25 Number 4 2009

Winter volume 25 number 3 2008, fall volume 25 number 2 2008.

Special Issue: Impact of Information Systems on Market Structure and Function: Developing and Testing Theories Guest Editors: Clemons, Eric K , Kauffman, Robert J , and Dewan, Rajiv M

Summer Volume 25 Number 1 2008

Special Section: Online Coordination and Interaction Guest Editors: Briggs, Robert O , Nunamaker Jr, Jay F , and Sprague Jr, Ralph H

Spring Volume 24 Number 4 2008

Special Issue: Trust in Online Environments Guest Editors: Benbasat, Izak , Gefen, David , and Pavlou, Paul A

Winter Volume 24 Number 3 2007

Fall volume 24 number 2 2007.

Special Section: Applying Information Economics to Corporate Strategy Guest Editors: Clemons, Eric K , Dewan, Rajiv M , and Kauffman, Robert J

Summer Volume 24 Number 1 2007

Spring volume 23 number 4 2007.

Special Section: Global Perspectives on Information, Communication, and E-Commerce Guest Editors: Briggs, Robert O , Nunamaker Jr, Jay F , and Sprague Jr, Ralph H

Winter Volume 23 Number 3 2006

Special Section: Customer-Centric Information Systems Guest Editors: Ting-Peng, Liang and Tanniru, Mohan R

Fall Volume 23 Number 2 2006

Special Section: Digital Economy and Information Technology Value Guest Editors: Clemons, Eric K , Dewan, Rajiv M , and Kauffman, Robert J

Summer Volume 23 Number 1 2006

Spring volume 22 number 4 2006.

Special Issue: Crossing Boundaries in Information Systems Research Guest Editors: Briggs, Robert O , Nunamaker Jr, Jay F , and Sprague Jr, Ralph H

Winter Volume 22 Number 3 2005

Special Section: Human-Computer Interaction Research in Management Information Systems Guest Editors: Ping, Zhang , Fui-Hoon Nah, Fiona , and Benbasat, Izak

Fall Volume 22 Number 2 2005

Special Section: Information Systems in Competitive Strategies Guest Editors: Kauffman, Robert J , Clemons, Eric K , and Dewan, Rajiv M

Summer Volume 22 Number 1 2005

Spring volume 21 number 4 2005.

Special Section: Context-Driven Information Access and Deployment Guest Editors: Briggs, Robert O , De Vreede, Gert-Jan , Nunamaker Jr, Jay F , and Sprague Jr, Ralph H

Winter Volume 21 Number 3 2004

Fall volume 21 number 2 2004.

Special Issue: Competitive Strategy, Economics, and Information Systems Guest Editors: Clemons, Eric K , Dewan, Rajiv M , and Kauffman, Robert J

Summer Volume 21 Number 1 2004

Special Section: Measuring Business Value of Information Technology in E-Business Environments Guest Editors: Mahmood, M Adam , Kohli, Rajiv , and Devaraj, Sarv

Spring Volume 20 Number 4 2004

Special Issue: Information Systems Design--Theory and Methodology Guest Editors: Briggs, Robert O , Nunamaker Jr, Jay F , and Sprague Jr, Ralph H

Winter Volume 20 Number 3 2003

Special Section: Assuring Information Quality Guest Editors: Ballou, Donald , Madnick, Stuart E , and Wang, Richard

Fall Volume 20 Number 2 2003

Special Section: Information Systems, Electronic Commerce, and Economics: The Interdisciplinary Research Frontier Guest Editors: Kauffman, Robert J and Bin, Wang

Summer Volume 20 Number 1 2003

Spring volume 19 number 4 2003.

Special Issue: Information Systems Success Guest Editors: Briggs, Robert O , De Vreede, Gert-Jan , Nunamaker Jr, Jay F , and Sprague Jr, Ralph H

Winter Volume 19 Number 3 2002

Special Section: Competitive Strategy, Economics, and the Internet Guest Editors: Chircu, Alina M and Kauffman, Robert J

Fall Volume 19 Number 2 2002

Summer volume 19 number 1 2002.

Special Section: Enterprise Resource Planning Guest Editors: Ragowsky, Arik and Somers, Toni M

Spring Volume 18 Number 4 2002

Special Issue: Decision-Making and a Hierarchy of Understanding Guest Editors: Briggs, Robert O , De Vreede, Gert-Jan , Nunamaker Jr, Jay F , and Sprague Jr, Ralph H

Winter Volume 18 Number 3 2001

Fall volume 18 number 2 2001.

Special Section: Economics, Electronic Commerce and Competitive Strategy Guest Editors: Clemons, Eric K , Dewan, Rajiv M , and Kauffman, Robert J

Summer Volume 18 Number 1 2001

Special Issue: Knowledge Management Guest Editors: Davenport, Thomas H and Grover, Varun

Spring Volume 17 Number 4 2001

Winter volume 17 number 3 2000.

Special Issue: Enhancing Organizations' Intellectual Bandwidth: The Quest for Fast and Effective Value Creation Guest Editors: Nunamaker Jr, Jay F , Briggs, Robert O , De Vreede, Gert-Jan , and Sprague Jr, Ralph H

Fall Volume 17 Number 2 2000

Special Issue: Technology Strategy for Electronic Marketplaces Guest Editors: Clemons, Eric K and Yu-Ming, Wang

Summer Volume 17 Number 1 2000

Spring volume 16 number 4 2000.

Special Issue: Impacts of Information Technology Investment on Organizational Performance Guest Editors: Mahmood, M Adam and Mann, Gary J

Winter Volume 16 Number 3 1999

Special Section: Exploring the Outlands of the MIS Discipline Guest Editors: Briggs, Robert O , Nunamaker Jr, Jay F , and Sprague Jr, Ralph H

Fall Volume 16 Number 2 1999

Special Section: Strategic and Competitven Information Systems - Fall 1999 Guest Editors: Clemons, Eric K and Weber, Bruce W

Summer Volume 16 Number 1 1999

Special Section: Data Mining Guest Editors: Chung, H Michael and Gray, Paul

Spring Volume 15 Number 4 1999

Winter volume 15 number 3 1998, fall volume 15 number 2 1998, summer volume 15 number 1 1998, spring volume 14 number 4 1998, winter volume 14 number 3 1997.

Special Issue: 1001 Unanswered Research Questions in GSS Guest Editors: Briggs, Robert O , Nunamaker Jr, Jay F , and Sprague Jr, Ralph H

Fall Volume 14 Number 2 1997

Summer volume 14 number 1 1997.

Special Section: The Impacts of Business Process Change on Organizational Performance Guest Editors: Chatfield, Akemi Takeoka and Bjorn-Andersen, Niels

Spring Volume 13 Number 4 1997

Winter volume 13 number 3 1996.

Special Issue: Information Technology and Its Organizational Impact Guest Editors: Nunamaker Jr, Jay F and Briggs, Robert O

Fall Volume 13 Number 2 1996

Special Section: Strategic and Competitive Information Systems Guest Editors: Clemons, Eric K and Weber, Bruce W

Summer Volume 13 Number 1 1996

Spring volume 12 number 4 1996, winter volume 12 number 3 1995.

Special Issue: Information Technology and IT Organizational Impact Guest Editors: Nunamaker Jr, Jay F and Sprague Jr, Ralph H

Fall Volume 12 Number 2 1995

Special Section: Strategic and Competitive Information Systems Guest Editors: Clemons, Eric K and Row, Michael C

Summer Volume 12 Number 1 1995

Special Section: Toward a Theory of Business Process Change Management Guest Editors: Kettinger, William J and Grover, Varun

Spring Volume 11 Number 4 1995

Special Section: Navigation in Information-Intensive Environments Guest Editors: Isakowitz, Tomas and Bieber, Michael

Winter Volume 11 Number 3 1994

Special Section: Information Technology and IT Organizational Impact Guest Editors: Nunamaker Jr, Jay F and Sprague Jr, Ralph H

Fall Volume 11 Number 2 1994

Summer volume 11 number 1 1994, spring volume 10 number 4 1994.

Special Section: Information Technology and Organization Design Guest Editors: Baroudi, Jack J and Lucas Jr, Henry C

Winter Volume 10 Number 3 1993

Special Issue: Organizational Impact of Group Support Systems, Expert Systems, and Executive Information Systems Guest Editors: Nunamaker Jr, Jay F and Sprague Jr, Ralph H

Fall Volume 10 Number 2 1993

Summer volume 10 number 1 1993.

Special Section: Realizing Value from Information Technology Investment Guest Editors: Kauffman, Robert J and Mukhopadhyay, Tridas

Spring Volume 9 Number 4 1993

Special Section: Computer Personnel Research Guest Editors: Lederer, Albert L

Special Section: Research in Integrating Learning Capabilities into Information Systems Guest Editors: Ting-Peng, Liang

Winter Volume 9 Number 3 1992

Special Issue: Collaboration Technology, Modeling, and End-User Computing for the 1990s Guest Editors: Nunamaker Jr, Jay F and Sprague Jr, Ralph H

Fall Volume 9 Number 2 1992

Summer volume 9 number 1 1992, spring volume 8 number 4 1992, winter volume 8 number 3 1991.

Special Issue: Decision Support Systems for Teams, Groups, and Organizations Guest Editors: Nunamaker Jr, Jay F

Fall Volume 8 Number 2 1991

Summer volume 8 number 1 1991, spring volume 7 number 4 1991, winter volume 7 number 3 1990.

Special Issue: Management Support Systems Guest Editors: Nunamaker Jr, Jay F

Fall Volume 7 Number 2 1990

Special Section: Competitive and Strategic Value of Information Technology Guest Editors: Clemons, Eric K

Summer Volume 7 Number 1 1990

Spring volume 6 number 4 1990, winter volume 6 number 3 1989, fall volume 6 number 2 1989, summer volume 6 number 1 1989, spring volume 5 number 4 1989, winter volume 5 number 3 1988, fall volume 5 number 2 1988, summer volume 5 number 1 1988, spring volume 4 number 4 1988, winter volume 4 number 3 1987, fall volume 4 number 2 1987, summer volume 4 number 1 1987, spring volume 3 number 4 1987, winter volume 3 number 3 1986, fall volume 3 number 2 1986, summer volume 3 number 1 1986, spring volume 2 number 4 1986, winter volume 2 number 3 1985, fall volume 2 number 2 1985, summer volume 2 number 1 1985, spring volume 1 number 4 1985, winter volume 1 number 3 1984.

Special Issue: Information System Design and Development Guest Editors: Weldon, Jay-Louise

Fall Volume 1 Number 2 1984

Summer volume 1 number 1 1984.

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The Oxford Handbook of Management Information Systems: Critical Perspectives and New Directions

Robert D. Galliers is Provost and Vice President for Academic Affairs at the Bentley College, USA; and Visiting Professor at the Information Systems Group, Department of Management, London School of Economics and Political Science.

Wendy L. Currie holds a PhD in Management and a BSc in Sociology. Currie is on the editorial board of ten academic journals and regularly publishes her research work. She currently serves as Hon Treasurer for the Fellowship of Postgraduate Medicine charity and is a Trustee of the Cardiovascular Research Trust. She regularly consults on the interface between business, management and technology and has recently completed assignments with Microsoft, Mouchel, 7 Layer, Deloitte, the Church of England and Barclays Capital.

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Management Information Systems (MIS) play a crucial role in an organization's operations, accounting, decision-making, project management, and competitive advantage. The Oxford Handbook of Management Information Systems takes a critical and interdisciplinary view of the increasing complexity of these systems within organizations, and the strategic, managerial, and ethical issues associated with the effective use of these technologies. The book is organized into four parts. The first part covers the background to the topic. The second part looks as theoretical and methodological perspectives in the field of MIS. Part III talks about rethinking theory in practice. Finally, the last part looks at rethinking MIS practice in a broader context. The book provides expansive coverage of the discipline and a methodological and philosophical framework for discussion of key topics, before exploring the issues associated with MIS in practice and considering the broader context and future agenda of research in light of such concerns as sustainability, ethics, and globalization.

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A Review of the Effectiveness of Management Information System in Decision Making

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Introduction
Conclusions
Article Information

WHO indicates World Health Organization.

SARS-CoV-2 enters host cells through interaction of its spike protein with angiotensin-converting enzyme 2 (ACE-2) receptors. Plausible mechanisms of injury include direct virus-mediated cytotoxic effects; dysregulation of the renin-angiotensin-aldosterone system (RAAS) resulting from downregulation of ACE-2 related to viral entry, subsequent increase in angiotensin II levels, and potential decrease in angiotensin 1-7 causing viral-induced inflammation; endothelial damage and thrombus formation; and dysregulation of the immune response with hyperinflammation caused by inhibition of interferon (INF), depletion of T lymphocytes, and production of proinflammatory cytokines. IL-6 indicates interleukin 6; RBD, receptor-binding domain; and TNF, tumor necrosis factor.

SARS-CoV-2 can trigger a range of inflammatory syndromes across the age spectrum. Compared with children, adults—particularly those with certain preexisting proinflammatory comorbidities—are more likely to develop acute COVID-19–associated hyperinflammatory syndrome within 1 to 2 weeks of exposure to SARS-CoV-2. COVID-19–associated hyperinflammatory syndrome begins with failure of the regulatory immune response to SARS-CoV-2, including abnormal interferon (INF) production that drives macrophage hyperactivation. This results in inflammatory cytokine cascades and causes significant damage to multiple organ systems. In contrast, children are more likely to have asymptomatic or mild acute SARS-CoV-2 infection without sequelae. The reason(s) why children do not commonly develop acute COVID-19–associated hyperinflammatory syndrome remains unknown. However, both children and adults can develop a multisystem inflammatory syndrome (MIS-C/A) of unclear etiology weeks after initial asymptomatic or mild SARS-CoV-2 infection. The precise cause of MIS-C/A remains unclear but may be due to development of abnormal antibody responses that drive systemic hyperinflammation. 81 ALC indicates absolute lymphocyte count; APC, antigen-presenting cell; BNP, B-type natriuretic peptide; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; GCSF, granulocyte colony-stimulating factor; IL, interleukin; IP-10, human interferon-inducible protein 10; LDH, lactate dehydrogenase; MCP, monocyte chemotactic protein; MIP, macrophage inflammatory protein; PMN, polymorphonuclear leukocyte; and TNF, tumor necrosis factor. Reproduced with permission from Prathit Arun Kulkarni (Weatherhead et al 83 ) on December 20, 2020.

eAppendix. US MIS-C Surveillance Case Report Form

eTable 1. Literature Review Search Strategy

eTable 2. Quality Rating Scheme for Studies (Modified From the Oxford Centre for Evidence-Based Medicine for Ratings of Individual Studies)

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Patel P , DeCuir J , Abrams J , Campbell AP , Godfred-Cato S , Belay ED. Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults : A Systematic Review . JAMA Netw Open. 2021;4(9):e2126456. doi:10.1001/jamanetworkopen.2021.26456

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Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults : A Systematic Review

1 CDC COVID-19 Response, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia
2 Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia

Question What are the clinical characteristics of multisystem inflammatory syndrome in adults (MIS-A)?

Findings This systematic review of patients with MIS-A reported in the literature and to the US Centers for Disease Control and Prevention identified 221 patients worldwide. The syndrome presented approximately 4 weeks after acute COVID-19 with hyperinflammation and extrapulmonary multiorgan involvement that may be difficult to discern from acute biphasic COVID-19 and postacute sequelae of SARS-CoV-2 infection.

Meaning These findings suggest that MIS-A occurs in the postacute COVID-19 period with a heterogeneous clinical presentation likely owing to a dysregulated immune response.

Importance Multisystem inflammatory syndrome in adults (MIS-A) has not been well described. Improved diagnosis and treatment of MIS-A might mitigate COVID-19 morbidity and mortality.

Objective To summarize the descriptive epidemiology and clinical characteristics of MIS-A.

Evidence Review This systematic review identified patients with MIS-A using 3 strategies: (1) literature review from May 1, 2020, to May 25, 2021, by searching MEDLINE, Embase, Global Health, CAB Abstracts, PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Academic Search Complete, Scopus, World Health Organization Global COVID-19 Literature Database, and Google Scholar; (2) voluntary reports of MIS-A to the Centers for Disease Control and Prevention (CDC); and (3) reports among persons aged 18 to 20 years in the CDC surveillance system for MIS in children.

Findings Of 221 patients with MIS-A, the median age was 21 (interquartile range [IQR], 19-34) years, and 154 of 219 (70%) with data available were men. Sixty of 169 patients (36%) were non-Hispanic Black individuals, and 122 of 209 (58%) had no underlying comorbidity. One hundred two of 149 patients (68%) noted a previous symptomatic COVID-19–like illness (median, 28 [IQR, 20-36] days previously). Most patients with MIS-A presented with fever (197 of 205 [96%]), hypotension (133 of 220 [60%]), cardiac dysfunction (114 of 210 [54%]), shortness of breath (102 of 198 [52%]), and/or diarrhea (102 of 197 [52%]). The median number of organ systems involved was 5 (IQR, 4-6). Median hospital stay was 8 (IQR, 5-12) days; 115 of 201 patients (57%) were admitted to the intensive care unit; 101 of 213 (47%) required respiratory support, and 15 of 220 (7%) died. Most patients (176 of 195 [90%]) had elevated markers of coagulopathy and/or inflammation and a positive SARS-CoV-2 serologic finding (139 of 194 [72%]). Ten patients with MIS-A presented with Kawasaki disease.

Conclusions and Relevance These findings suggest that MIS-A is a serious hyperinflammatory condition that presents approximately 4 weeks after onset of acute COVID-19 with extrapulmonary multiorgan dysfunction.

As SARS-CoV-2 infections persist in the US 1 and many countries worldwide, it is important for clinicians and public health officials to learn from the early days of the pandemic to reduce morbidity and mortality. This includes recognizing manifestations of COVID-19 with serious sequelae that may be poorly understood, underreported, and, worrisomely, not diagnosed in a timely manner, such as various clinical manifestations of hyperinflammation among persons with SARS-CoV-2 infection.

After multisystem inflammatory syndrome in children (MIS-C) was first identified in April 2020, many physicians noted a similar syndrome occurring in adults. 2 , 3 Recognition of MIS in adults (MIS-A) is complicated by the occurrence of other types of COVID-19–related hyperinflammation, which make MIS-A hard to distinguish from biphasic acute COVID-19 and postacute sequelae of SARS-CoV-2 infection. The temporal association of MIS-A with SARS-CoV-2 infection and antecedent acute COVID-19 is also unknown. Better characterization of MIS-A is important because the clinical manifestations, illness progression, and treatment may be distinct from those of other types of severe COVID-19, with and without hyperinflammation. We conducted a literature review and examined cases reported to the Centers for Disease Control and Prevention (CDC) to describe the clinical characteristics of MIS-A, including laboratory results and empirical treatments.

To provide a comprehensive overview of MIS-A, we identified cases of MIS-A using 3 strategies: (1) a literature review of case reports; (2) examination of cases that clinicians and health departments in the US voluntarily reported to the CDC using the MIS-C case report form; and (3) assessment of cases of MIS-C among persons aged 18 to 20 years reported to the CDC through the MIS-C surveillance system, which captures MIS cases in the US among persons younger than 21 years using the MIS-C case definition. 4 The MIS-C case definition includes the following: (1) an individual younger than 21 presenting with fever; (2) laboratory evidence of inflammation; (3) evidence of clinically severe illness requiring hospitalization with multisystem (>2) organ involvement (cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic, or neurological); (4) no plausible alternate diagnoses; and (5) positive results for current or recent SARS-CoV-2 infection by RT-PCR, serologic analysis, or antigen test or exposure to a suspected or confirmed COVID-19 case within the 4 weeks prior to the onset of symptoms. The MIS-C definition, except for the age criterion, was applied to identify patients with MIS-A from all sources, with at least 4 criteria needed for inclusion. The case report form includes information on patient demographics, including date of birth, underlying medical conditions, clinical findings, complications, laboratory test results, imaging findings, treatments, and outcomes (eAppendix in the Supplement ). We included cases among persons aged 18 to 20 years from the MIS-C surveillance system in this analysis because our definition of adults was persons 18 years or older. 3

The CDC librarian conducted our literature search for reported cases of MIS-A from May 1, 2020, to May 25, 2021, by searching the following databases: MEDLINE, Embase, Global Health, CAB Abstracts, PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Academic Search Complete, Scopus, World Health Organization Global COVID-19 Literature Database, and Google Scholar. Search terms included severe inflammation , multisystem , Kawasaki/Kawasaki-like , shock/hypotension , organ dysfunction , multisystem inflammatory syndrome , MIS-A , and adults (eTable 1 in the Supplement ). This activity was reviewed by the CDC and was conducted in a manner consistent with applicable federal law and CDC policy (eg, 45 CFR part 46.102[l][2]; 21 CFR part 56; 42 USC §241[d]; 5 USC §552a; and 44 USC §3501 et seq). The activity was determined to meet the requirements of public health surveillance as defined in 45 CFR 46.102(l)(2).

Of 2410 publications identified, all abstracts were screened using EndNote 20 (Clarivate) by 1 reviewer (P.P.) to identify cases of MIS-A based on the following inclusion criteria: patients 18 years or older who met at least 4 criteria of the MIS-C case definition, and the case was reported in English. 4 Case reports were excluded for insufficient data, if the report was not in English, and if the report could not be accessed. If an abstract was not available, the full report was reviewed. Two clinician reviewers (P.P. and J.D.) then examined the selected articles for pertinent data and their references for additional relevant reports. Authors were contacted for clarification if needed. In total, 449 relevant articles were identified, and 86 were selected for in-depth review; of these, 60 had data for patients with MIS-A. 2 , 5 - 63 Figure 1 summarizes the study selection process. We excluded 8 articles: 3 were not in English, 64 - 66 3 could not be located, 67 - 69 1 abstract did not have enough data for inclusion, 70 and 1 reported case was deemed a misdiagnosis by 2 clinicians (P.P. and J.D.). 71 Ten articles were case series and given a quality score of 4; all others were case reports and scored as 5 using the Quality Rating Scheme for Studies modified from the Oxford Centre for Evidence-Based Medicine for ratings of individual studies (eTable 2 in the Supplement ).

Descriptive statistics on demographic, clinical, and laboratory features as well as previous illness and an estimate of the time from the initial SARS-CoV-2 infection to onset of MIS-A were summarized. Race and ethnicity data were self-reported and included to further discern COVID-19–associated health inequities. Previous COVID-19 was defined as an illness that was at least 7 days before the MIS-A presentation. Kawasaki disease was defined using the CDC case definition: illness in a patient with fever of 5 or more days’ duration (or fever until the date of administration of intravenous immunoglobulin if it is given before the fifth day of fever), and the presence of at least 4 of the following 5 clinical signs: rash, cervical lymphadenopathy (≥1.5 cm in diameter), bilateral conjunctival injection, oral mucosal changes, and peripheral extremity changes. 72

We compared clinical characteristics of patients with MIS-A reported to the CDC with those of patients with MIS-C who were younger than 18 years in the MIS-C surveillance system using the χ 2 test. We used Excel, version 2102 (Microsoft Corp), and SAS, version 9.4 (SAS Institute, Inc), for all analyses. Two-sided P < .05 indicated statistical significance.

A total of 221 patients with MIS-A were identified: 102 were from the CDC’s MIS-C surveillance system, of whom 55 were described in a recent publication 3 ; 20 were from voluntary reports to the CDC, of whom 9 were included in a recent publication 2 ; and 99 were from case reports published in the literature. 2 , 5 - 63 Two clinician reviewers (P.P. and J.D.) examined cases in the literature to ensure there was no duplication with cases voluntarily reported to the CDC based on age, sex, and author of the publication. In addition to the US cases, we found 52 reported cases of MIS-A from 16 other countries, including the UK, Italy, Israel, India, Canada, Japan, Pakistan, the United Arab Emirates, Croatia, Norway, France, Spain, Belgium, Portugal, South Africa, and Uruguay.

Of the 221 patients with MIS-A, median age was 21 (interquartile range [IQR], 19-34) years; of whom, 99 patients drawn from the literature had a median age of 33 (IQR, 24-45) years. Among those with data available, 154 of 219 patients (70%) were men and 65 of 219 (30%) were women; 60 of 169 (36%) were non-Hispanic Black individuals; and 122 of 209 (58%) had no underlying comorbidity ( Table ). Of 149 patients, 102 (68%) noted a previous symptomatic COVID-19–like illness and recovered before presenting with MIS-A; other patients were assumed to have had asymptomatic acute SARS-CoV-2 infection. The median time from onset of symptoms of prior COVID-19–like illness to MIS-A was 28 (IQR, 20-36) days, with the longest reported period being 68 days in a 67-year-old man with cirrhosis and hypertension.

Most patients with MIS-A presented with fever (197 of 205 [96%]), hypotension (133 of 220 [60%]), cardiac dysfunction (114 of 210 [54%]), shortness of breath (102 of 198 [52%]), and/or diarrhea (102 of 197 [52%]). The organ systems most affected were hematologic (184 of 200 [92%]), cardiovascular (193 of 221 [87%]), gastrointestinal tract (182 of 218 [83%]), and respiratory (159 of 215 [74%]); a median of 5 (IQR, 4-6) organ systems was involved. Myocarditis was reported in 61 of 205 patients (30%); 44 of 175 (25%) had pericardial effusion ( Table ). Ten of 94 patients with MIS-A reported in the literature (11%) presented with Kawasaki disease (median age, 37 [IQR, 33-44] years). None of the patients with MIS-A reported to the CDC met the criteria for Kawasaki disease. Nine of 195 patients (5%) experienced arterial or venous thrombosis. One patient reported in the literature 16 had severe mononeuritis multiplex, affecting the right median and facial nerves and both ulnar, tibial, peroneal, and sural nerves, in addition to myocarditis and cardiogenic shock.

Most patients had an elevated D-dimer level (138 of 151 [91%]) and/or lymphopenia (94 of 109 [86%]). Most patients (176 of 195 [90%]) had elevated markers of coagulopathy and/or inflammation. Among patients with laboratory investigations, each had elevated levels of at least 1 of the following: interleukin 6 (61 of 62 [98%]), ferritin (150 of 165 [91%]), fibrinogen (93 of 102 [91%]), C-reactive protein (176 of 195 [90%]), B-type natriuretic peptide (BNP) (56 of 76 [74%]), and N-terminal proBNP (NT-proBNP) (53 of 59 [90%]) ( Table ). For the subset of case reports to the CDC with available data, the median peak values of inflammatory markers were 86 (IQR, 35-229) pg/mL for interleukin 6 (reference range, ≤1.8 pg/mL [n = 34]), 1029 (IQR, 422-3094) ng/mL for ferritin (reference range, 12-300 ng/mL for men and 12-150 ng/mL for women [n = 93]), 24 (IQR, 19-34) mg/dL for C-reactive protein (reference range, 0-10 mg/dL [n = 105]), 624 (IQR, 473-722) mg/dL for fibrinogen (reference range, 200-400 mg/dL [n = 77]), 271 (IQR, 163-900) for BNP (reference range, <100 pg/mL [n = 43]), and 2219 (IQR, 318-9491) ng/L for NT-proBNP (reference range, <125 ng/L [n = 36]).

Of 211 patients with available data, 207 (98%) had laboratory evidence of current or past SARS-CoV-2 infection; 188 of 194 (97%) had positive serologic and/or RT-PCR test results. Both RT-PCR and serologic test results were positive in 62 of 192 patients (32%) during the hospitalization. Of note, 139 of 194 patients (72%) were seropositive; 49 of 194 (25%) had positive RT-PCR results only, and 77 of 194 (40%) had positive serologic results only.

Treatment of MIS-A included anticoagulants (eg, heparin, enoxaparin) in 110 of 193 patients (57%), corticosteroids (eg, dexamethasone) in 152 of 205 (74%), intravenous immunoglobulin in 112 of 205 (55%), and immune modulators (eg, tocilizumab) in 42 of 203 (21%). The median hospital stay was 8 (IQR, 5-12) days. Patients with MIS-A were severely ill: 110 of 214 (51%) had shock/hypotension requiring vasoactive medications, 115 of 201 (57%) were admitted to the intensive care unit, 101 of 213 (47%) required respiratory support (of whom 53 [52%] needed mechanical ventilation), and 15 of 220 (7%) died.

Compared with patients with MIS-C who were younger than 18 years (n = 3639), patients with MIS-A (n = 221) were more likely to report previous COVID-19 (102 of 149 [68%] vs 826 of 2858 [29%]; P < .001) and to present with myocarditis (61 of 205 [30%] vs 543 of 3639 [15%]; P < .001), cardiac dysfunction (114 of 210 [54%] vs 975 of 3362 [29%]; P < .001), and arterial thrombosis, pulmonary embolism, and/or deep venous thrombosis (9 of 195 [5%] vs 24 of 3639 [1%]; P < .001). Patients with MIS-C were more likely to have dermatologic and mucocutaneous manifestations (2755 of 3639 [76%] vs 100 of 218 [46%]; P < .001) and to receive intravenous immunoglobulin (3121 of 3639 [86%] vs 112 of 205 [55%]; P < .001) compared with patients with MIS-A. Patients with MIS-A had longer hospital stays (median, 8 [IQR, 5-12] days [n = 180] vs 5 [IQR, 4-8] days [n = 3639]; P < .001), and higher proportions needed ventilation (53 of 213 [25%] vs 338 of 3639 [9%]; P < .001) and died (15 of 220 [7%] vs 27 of 3639 [1%]; P < .001) compared with patients with MIS-C.

The true incidence of MIS-A is unknown, but it appears to be rare. In our review, most patients with MIS-A were young (aged 19-34 years), male, and either non-Hispanic Black or Hispanic persons. Clinicians should consider a diagnosis of MIS-A among persons with hyperinflammatory illness and severe extrapulmonary multiorgan dysfunction, particularly cardiovascular, occurring within 2 to 5 weeks of antecedent COVID-19 or exposure to a person with diagnosed COVID-19. Because data on known SARS-CoV-2 infection or exposure are not always available at the time of hospital admission, clinicians should maintain a high index of suspicion for MIS-A among patients in whom a history of illness is not known. These patients should undergo evaluation for current or previous SARS-CoV-2 infection (by RT-PCR, rapid antigen tests, or serologic tests for antibodies, including measuring titers) and for severe inflammation and/or coagulopathy (eg, elevated C-reactive protein, ferritin, interleukin 6, or D-dimer levels). Interim recommendations for MIS-C treatment include corticosteroids, intravenous immunoglobulin, or possibly other immunomodulators. 73 In this systematic review, clinicians reported using these treatments for MIS-A as well. However, further investigation of MIS-A is needed to strengthen diagnostic criteria and understand its association with postacute sequelae of SARS-CoV-2 infection and to identify effective treatments.

Multisystem inflammatory syndrome seems to have different phenotypes across the age spectrum, and persons older than 18 years are more likely to report previous COVID-19. 3 Given that more than 50% of patients with MIS-A came from the MIS-C surveillance system, there is an inherent bias toward reporting among younger age groups. However, the other patients drawn from the literature were quite young as well (median age, 33 [IQR, 24-45] years); it is unclear whether this observation is a result of detection bias or whether MIS-A occurs mainly in younger adults. In addition, some cases may represent acute biphasic COVID-19, particularly among persons with delayed severe pulmonary manifestations. Large data registries and clinical cohorts are needed to further define and distinguish between these clinical entities as well as mitigate the selection bias.

Although extrapulmonary manifestations and elevated laboratory markers of coagulopathy and inflammation are also seen in severe COVID-19, 74 MIS-A appears to be distinct in that it presents as a postacute, postinfectious illness, often after a period of recovery, and is heralded by the onset of new symptoms. However, efforts are needed to distinguish it from biphasic acute COVID-19. Using both RT-PCR and serologic testing for antibodies may aid in the diagnosis of MIS-A, especially among persons who had asymptomatic acute COVID-19, because IgG antibodies become detectable 3 to 4 weeks after SARS-CoV-2 infection, 75 at the time when MIS-A commonly presents (median, 28 [IQR, 20-36] days). In addition, owing to comorbidities, some individuals may be delayed in mounting an antibody response and have persistently positive SARS-CoV-2 RNA. As SARS-CoV-2 vaccination programs are implemented, antibody assays that distinguish between antibody response to natural infection, which produces antibodies to the nucleocapsid protein, and vaccination, which produces antibodies to the spike protein of SARS-CoV-2, have been authorized for use in the US. 76

The apparent increased occurrence of MIS-A among men and some minority populations requires further study. Sex differences in COVID-19 severe outcomes and cardiovascular disease have been reported, suggesting the possibility that biological and/or behavioral differences predispose men to both illnesses. 77 In the US, it is widely recognized that minority populations are at higher risk of COVID-19, which is thought to be largely owing to long-standing health and social inequities. 78 , 79 In the UK, compared with persons of White ethnicities, persons of Bangladeshi, Pakistani, Indian, and mixed ethnicities also have a significantly increased risk of COVID-19–related death. 80 Further investigation is warranted to better understand and address both socioeconomic factors and potential biological factors that predispose minority populations to severe outcomes and consequences of COVID-19 globally.

COVID-19 causes both significant respiratory and extrapulmonary pathology. Because the SARS-CoV-2 spike protein has an affinity for angiotensin-converting enzyme 2 receptors, which facilitate entry of the virus into cells, extrapulmonary manifestations are often noted in tissues that express angiotensin-converting enzyme 2 receptors. 74 Plausible mechanisms of injury include direct virus-mediated cytotoxic effects; dysregulation of the renin-angiotensin-aldosterone system resulting from downregulation of angiotensin-converting enzyme 2 and causing viral-induced inflammation; endothelial damage and thromboinflammation; and dysregulation of the immune response with hyperinflammation caused by inhibition of interferon, depletion of T lymphocytes, and production of proinflammatory cytokines ( Figure 2 ). 75 , 81 The hyperinflammatory syndrome of COVID-19 shares similarities with cytokine release syndromes. 82 Criteria to identify COVID-19–associated hyperinflammatory syndrome have been proposed and are being validated. 82 The relationship between MIS-A and COVID-19–associated hyperinflammatory syndrome is not yet clear. For example, lymphopenia is an early indicator for severe COVID-19 with COVID-19–associated hyperinflammatory syndrome, but it is unclear whether the same is true for MIS-A, because this has not yet been studied.

Multisystem inflammatory syndrome among adults is proposed to result from a delayed, dysregulated immune response ( Figure 3 ). 83 Multisystem inflammatory syndrome among children has been postulated to involve a dysregulated immune response with reduced neutralizing antibody levels and diminished functional capacity leading to low-level persistent infection in extrapulmonary tissues. 84 In addition, among children with MIS, autoreactive antibodies have been recently identified that may promote anomalous immune responses promoting inflammation. 84 The same processes may occur in adults with MIS 82 ; however, in adults, the balance between antiviral and proinflammatory responses may be negatively influenced by age, leading to hyperinflammation. 85 Immunosenescence (aging of the immune cells) and inflammation due to aging, as well as immunosuppression due to comorbidities and medications, may be factors that complicate or obscure the presentation of MIS-A. 85 This may explain why the patients in our systematic review were mostly young and middle-aged adults with few comorbidities. It is likely that MIS-A occurs in older adults but that the presentation may be more complex and challenging to diagnose. It is also possible that MIS-A may be a late sequela of acute COVID-19. Further research is needed to understand the immunopathogenesis of MIS-A; immunotyping and testing specimens for a variety of immune markers such as interleukins and tumor necrosis factors may identify pathognomonic markers. Studies of immunopathology should help to understand the pathophysiology of MIS-A and whether endotheliitis or autoimmune and/or other mechanisms are responsible, in association with other hyperinflammatory phenotypes and other consequences of COVID-19.

Some limitations of this study should be noted. This study is primarily descriptive and combines data from multiple sources, which might result in an inherent reporting bias. We note above that using data from the MIS-C surveillance system may have contributed to selection bias and thus a propensity toward reporting cases in the younger group. However, selection bias might also affect the distribution of other characteristics such as (1) the time from COVID-19 diagnosis to MIS-A, because younger individuals are less likely to report acute COVID-19 or symptomatic SARS-CoV-2 infection, and bias may arise, for example, if shorter times would be considered biphasic acute COVID-19; (2) intensive care unit admission, which may reflect severe COVID-19; and (3) comorbidities, which may influence whether MIS-A is considered or reported given the unusual presentation similar to that of patients with cancer. 60 Another limitation is our inability to report specifics of SARS-CoV-2 antibody testing (eg, brand of test performed, IgM vs IgG, and titers), given the limited availability and lack of consistent use during 2020, as well as other laboratory parameters that may be important to the diagnosis of MIS-A.

It is important for the clinical and public health community to suspect and identify MIS-A, a delayed immunologic response to SARS-CoV-2 infection in adults with hyperinflammation, by exercising clinical acumen and considering empirical treatment to reduce related morbidity and mortality. We have summarized the current evidence and knowledge about MIS-A. Moving forward, improvements in our understanding of MIS-A will require engagement across public health, translational research, and health care systems. In particular, prospective research should systematically screen for MIS-A to reveal a more accurate representation of this clinical entity. Currently, the best way to prevent COVID-19 and its dire outcomes, including hyperinflammatory syndromes such as MIS-A, is to prevent SARS-CoV-2 infection and transmission.

Accepted for Publication: July 6, 2021.

Published: September 22, 2021. doi:10.1001/jamanetworkopen.2021.26456

Corresponding Author: Pragna Patel, MD, MPH, CDC COVID-19 Response, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333 ( [email protected] ).

Author Contributions: Drs Patel and Abrams had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Patel.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Patel.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Patel, DeCuir, Abrams.

Supervision: Patel, Godfred-Cato, Belay.

Conflict of Interest Disclosures: None reported.

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC).

Additional Contributions: We recognize all our state and local jurisdiction partners who submit cases to the US CDC through the surveillance system for multisystem inflammatory syndrome (MIS) in children, as well as those who work tirelessly to maintain the system, especially the CDC MIS data team.

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Mis- and disinformation studies are too big to fail: Six suggestions for the field’s future

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Who are mis-/disinformation studies for? What agenda does the field serve? How can it be improved? While the increase in the attention towards the topic in the last years is healthy, it has also led to an explosion of papers in all directions, and the field has been subject to various criticisms and attacks. In this commentary, we discuss the status and wider impact of the field, raise current challenges, and propose ways ahead for the development of a more critical, interdisciplinary, and rigorous scholarly discipline of mis- and disinformation studies.

Department of Computer Science, University of Exeter, UK

Oxford Internet Institute, University of Oxford, UK

Introduction

The field of mis- and disinformation studies is here to stay. 1 We define mis- and disinformation studies loosely as a multi-disciplinary and developing field of study that focuses on studying multimodal forms of communication, which unintentionally (misinformation) or intentionally (disinformation) misinform audiences. This includes the study of motivations (e.g., political, ideological, or financial), actors, and the mechanisms by which false or misleading information is created, distributed, and received, and the ways it may affect audiences in their beliefs and behaviors. It is firmly entrenched in various academic disciplines, with work coming from areas such as sociology, communication, medicine and pharmacology, as well as computer science (Righetti et al., 2022). A broad range of funding bodies and governments have devoted significant financial resources to the study of mis-/disinformation, and journalists and policymakers continue to display a keen interest in the topic. Altogether, this has resulted in renewed efforts to understand how our information environment works and how it can, and should, be improved. The field has long been in the crosshairs, with critics finding fault—among other things—with its normative underpinnings and agenda, methodological rigor and quality of output, as well as with its impact in shaping public opinion and policymaking (Adler-Bell, 2022; Bernstein, 2021; Farkas & Schou, 2018; Hwang, 2020). Mis-/disinformation studies has been accused of lacking clear definitions, having a simplified understanding of what it studies, a too great emphasis on media effects, a neglect of intersectional factors, an outsized influence of funding bodies and policymakers on the research agenda of the field, and an outsized impact of the field on policy and policymaking.

This presents a challenge. With mis-/disinformation studies in our view being “too big [and important] to fail,” the question is then what to do with this state of affairs: how should we address the real shortcomings of the field to ensure its positive long-term impact? We deem a complete overhaul of mis-/disinformation studies unlikely—nor is it necessarily needed. Instead, in this commentary we draw on the most salient criticism the field has received and propose a number of ways to address it so as to further develop mis-/disinformation studies as a rigorous and robust field of research, thus safeguarding its positive contributions to society.

Taking stock: The strengths and weaknesses of mis- and disinformation studies

A first step is to clearly acknowledge the positive and negative effects of the rise of mis-/disinformation studies as a field. The most evident positive effect has been the mobilization of wider society around the real dangers arising from dis- and misinformation, for example, around elections, pandemics, or political conflicts. We side with Guess (2021)who has argued that various “research strands have succeeded in providing descriptive and causal evidence on the scope of the misinformation problem” (p. 2) as well as possible interventions. The flurry of activity since 2016 after Brexit and the election of Donald Trump—arguably catalysts for the emergence of the field—have also helped shine a spotlight on the general quality and structure of our information and media environments, their interdependency with functioning democracies, and how they have been reshaped through digital media (Jungherr & Schroeder, 2021b). This, in turn, has spurred greater awareness and investment on these issues, for example, in journalistic reporting that has held platforms and purveyors of mis-/disinformation accountable, as well as various initiatives which seek to improve the quality of information available to audiences, such as fact checkers. Meanwhile, terms such as disinformation studies and infodemiology have also become effective trading zones (Bensaude Vincent, 2014, p. 250)which allow for different stakeholders—in this case, academics, journalists, funders, policymakers, and the wider public—to communicate with each other and investigate a topic which clearly calls for multidisciplinary perspectives (Simon & Camargo, 2021).

Unfortunately, there have also been undesirable consequences and various critiques have been made against the field in this regard. Some recent criticisms include:

The persistence of a “fuzzy ontology,” with terms that have conflicting and ambiguous meanings “often thrown around with little justification” (Hwang, 2020, p. 1; Pabst, 2022, p.1). While various disciplines grapple with the problem of finding good working definitions in response to questions and phenomena that have no single right answer or definition, the failure to reach commonly agreed-upon understandings of what we mean when we talk about mis- or disinformation makes it more difficult to research and address them (Adler-Bell, 2022; Bernstein, 2021; Farkas & Schou, 2018; Hwang, 2020).
A sometimes simplistic understanding of the effects of media, media technologies, and journalistic processes (Jungherr et al., 2020; Mercier, 2020).
A neglect of issues and conflicts of race and ethnicity, class, gender, and sexuality, as well as status, inequality, social structure, and power and a reduction of these issues to epistemological and perceptual issues (Kreiss, 2021; Kuo & Marwick, 2021). Relatedly, critics have accused the field of being often too U.S.-focused and Anglocentric, generalizing from a very peculiar set of cases, limited by its strong focus on social and digital media in general, and selected platforms in particular.
The risk of a dilution of scientific quality as the topic grows in popularity (Simon & Camargo, 2021), encouraged by incentive structures that can favor rapid and attention-grabbing results over those deriving from more time-consuming and rigorous approaches (West & Bergstrom, 2021). This includes an outsizedinfluence of funding bodies and policymakers in shaping research directions (Abhishek, 2021). In this context, critics have also highlighted that studies in the field are at times unclear about the boundaries and limitations of their findings, thus fanning moral panics and “contributing to an overall sense of democratic crisis” (Jungherr & Schroeder, 2021a, p. 10).
An outsized impact of mis-/disinformation studies on policy and policymaking (Adler-Bell, 2022; Bernstein, 2021) with work based on sometimes questionable premises and methods shaping policies and political decisions, which have often turned out to be problematic from a human rights perspective (“Inconvenient Truths,” 2021; Novak, 2020; Radu, 2020). The close connection to the world of policy also sits uneasily with the fact that “misinformation often comes from the top” (Nielsen, 2019; see also Brennen et al., 2020) and that “government officials are [often] professional liars” (Adler-Bell, 2022, p. 1), which may lead to an inability to challenge structures of power fundamental to mis- and disinformation’s proliferation.

Facing the critics: Six suggestions for mis- and disinformation studies

While we do not necessarily agree with all the points listed previously, we think that they cannot be easily ignored either. Consequently, we have the following suggestions that might contribute to pushing mis-/disinformation studies as a whole onto firmer ground:

1) Critically reflect on mis-/disinformation studies’ audience and agenda

In other words, who are mis-/disinformation studies for? Whose agenda does the field serve? The heightened attention around its subject matter places the field of mis- and disinformation studies in a unique position: whatever counts as mis-/disinformation will likely be regulated as such. This extra pressure means that it is fundamentally important for scholars to be mindful not just of whether their research is useful for scholarship and theory, but also for whom it is useful—beyond the realm of academic inquiry—and for what purpose. This is not to say these studies should not be done, but rather that they should be done with the multitude of other “end-users” in mind. This point is also intimately connected to our next point.

2) Interrogate the wider impact of mis-/disinformation studies

Despite the positive effects of a rallying cry for countering mis- and disinformation, terms that evoke crisis and emergency discourse—such as misinformation crisis , information war s, and infodemic— not only obfuscate the complexity of the situation but also create an atmosphere of “moral panic” 2 Here understood as an instance of public anxiety or alarm in response to a problem regarded as threatening the (moral) standards and fabric of society. (Hwang, 2020; Jungherr & Schroeder, 2021a), which can itself contribute to a delegitimisation of democratic processes and institutions and potentially provide cover for political leaders keen to curb human rights. As mentioned above, various international leaders and governments have used the pandemic and the alleged flood of misinformation or “fake news” as an excuse to pass laws that effectively curtail fundamental human rights, such as freedom of speech or press freedom (Ong, 2021; Radu, 2020; Simon & Camargo, 2021). While it would be a stretch to argue that this is the field’s fault, there still needs to be a reckoning with the impact mis- /disinformation studies has, especially in light of the varying quality standards of some work in this area.

3) Investigate the main actors and incentives, as well as their relationships with funders, policymakers, journalists, and affected communities

Studies assessing the potentially negative impact of the increased attention towards mis- and disinformation (e.g., Jungherr & Schroeder, 2021a; Radu, 2020) are still rare, but necessary. As critics have highlighted, the field is subject to some of the same dynamics that have plagued its predecessors—such as the fields of mass communication, propaganda studies, political science, and behavioural science—in their early decades, where genuine academic inquiry was often intertwined with the hunt for personal fame, influence, and commercial opportunities (Lepore, 2021). These dynamics are exacerbated by a modern academic landscape that increasingly encourages researchers to become rapid-response experts and orient their work towards topics and questions that carry the promise of attracting funding and media attention (Falkenberg, 2020; Fochler, 2016; Simon, 2020). These dynamics are not unique to mis-/disinformation studies, but they ought to be taken seriously.

While mis-/disinformation studies’ deep enmeshment in the spheres of academia, media, and policy is one issue, its relationship to the communities it studies—especially those affected by mis- and disinformation—is another. Consequently, a thorough self-assessment is needed, aiming to identify the central groups of actors and their incentives, along with the core tenets of the field, while also shining a light on the flows of influence, values, and priorities between philanthropists, funders, academics, policymakers, and the media. A transparent self-assessment is especially important considering the point above about the wider impact of mis-/disinformation studies—and is what ultimately makes the field “too big to fail.”

4) Challenge the ahistoricism of the field and clarify its normative positions

One of the key problems of mis-/disinformation studies is its lack of historical grounding. We agree with Anderson (2021), who argues that “the field needs to be more conscious of its own history, particularly its historical conceptual predecessors” (p. 5), namely mass communication and persuasion, propaganda studies, and behavioral science. Founded and flourishing in the U.S. Cold War environment of the 1950s, these fields’ concerns with the manipulation of supposedly gullible populations (Mercier, 2020) and their implicit emphasis of technocratic control continue to shape the field of mis-/disinformation to this day (Abhishek, 2021; Anderson, 2021; Lepore, 2021). This reckoning with the field’s origins should include, as Anderson (2021) goes on to state, “taking a normative position on what a good information environment would look like from the point of view of political theory” (p. 5). The problem here is clear: if one operates without awareness of one’s priors (in terms of theories or normative positions), one inevitably relies on implicit versions of both. It is better to foreground these priors than to be subliminally guided and perhaps misled by them (Schroeder, 2018). Mis-/disinformation studies should strive to do the same.

5) Broaden mis-/disinformation studies’ scope

Mis- and disinformation, propaganda, and any other form of information and communication are inherently contextual and situated within deep-rooted national, political, social, cultural, racial, and ethnical contexts (Kreiss, 2021; Kuo & Marwick, 2021; Phillips & Milner, 2021). The field should reflect on this and take it into account. By this , we mean that, for one, mis-/disinformation studies should look beyond “the usual suspects” such as the United States, English-speaking countries, and the Global North more broadly, and consider in more detail the role of race, gender, and class, as well as the other factors mentioned above (e.g., Freelon & Wells, 2020; Nguyễn et al., 2022; Shabbir et al., 2022).

This need for a broader demographic scope also applies to the social media platforms being studied. While focusing on specific platforms such as Twitter is understandable from a data availability perspective, this narrow scope becomes an issue considering how much of our information and communication happens outside of these platforms. It is not just that certain demographic sectors are over- or under-represented on Twitter, or that different countries might use VKontakte or Weibo instead; audiences still consume news and information via traditional—but often less studied—means such as TV, or increasingly through social messaging apps such as WhatsApp or Telegram (Allen et al., 2020; Newman et al., 2022). It is, therefore, important to broaden our focus to the larger media ecosystem (Benkler et al., 2018; Kuo & Marwick, 2021; Phillips & Milner, 2021).

While there has been progress in this regard, we believe that current efforts do not go far enough. Widening perspectives, case studies, and sources of scholarship are needed not only to achieve equity but also for producing methodologically stronger papers.

6) Improve methodological rigor

While rigor can take (and should take) many different forms, we see a commitment to methods-agnostic approaches as one of the most pressing issues. The question and the topic under investigation should drive the selection of methods, not vice-versa. This includes a greater appreciation for and support of qualitative and mixed-methods research alongside computational methods. This argument works in both directions: it is important for qualitative work in mis-/disinformation to become more accepting of, for example, Bayesian statistics, RCTs, and computational modelling, but also for computational approaches to become more demanding when it comes to the theory and operationalization of what is being measured. Mis-/disinformation research is often interdisciplinary, and as experts in the field such as Joe Bak-Coleman and Rachel Moran have argued (Radzvilavicius, 2022), outlets that publish such type of work at a quick turnaround are sorely needed to ensure the timely provision of methodologically sound information to policymakers and the public.

Another promising avenue for improving methodological rigor in mis-/disinformation studies could be adversarial collaborations (e.g., the Adversarial Collaboration Project ; 3 See: https://web.sas.upenn.edu/adcollabproject/about/ Rakow et al., 2015) both in empirical and theoretical work. As things stand, the field is composed of actors with sometimes widely differing viewpoints, something well encapsulated for example by the debates around the effects of mis-/disinformation. Such good-faith collaborations between antagonistic camps might lead to better outcomes than the current gridlock often marked by ad hominem attacks and the somewhat credulous belief in the self-correcting nature of the scientific enterprise (which might be the case in the longue durée but often seems to fail in the short term).

Conclusions

The future of mis- and disinformation studies does not have to look like the present. We do not want to suggest that the present state of the field is dismal. It isn’t. But to simply dismiss the critiques lobbied against it out of hand would not be responsible either. Mis-/disinformation studies has made important—and much-needed—contributions, which allow us to gain a deeper understanding of our information environments and hopefully improve and reshape them, and by extension our societies, for the better. As such, the field is too big to fail—and cannot be allowed to. Therefore, it is vital that the community active in this space engages with the shortcomings of the field and tries to find ways to address them. We hope that our commentary can provide some guidance on the matter.

Ultimately, the recommendations we make here are applicable to any field in the social sciences and humanities. Critically reflecting on a field’s actors, history, and impact is important to understand its past and present while clarifying its epistemic priors, normative positions, incentives, and agendas, and is necessary when deciding its future directions. In this context, however, these are more than healthy scholarly habits. We believe the changes we suggest here (or equivalent ones) will be essential to the development of mis-/disinformation studies as a rigorous and impactful discipline—one which is wide in scope, robust in its methodological approaches, and whose benefits extend across our whole information ecosystem.

Undoubtedly, the main problem with building solid foundations for a field from the inside is that any such undertaking requires sometimes uncomfortable choices by the involved actors, which go against very strong incentives to keep things the same. Yet, looking at other fields’ capacity for self-reform (albeit slowly and in piecemeal fashion)—as evidenced, for instance, by the “replication crisis” in psychology—makes us hopeful that mis- and disinformation studies can ultimately achieve the same.

Cite this Essay

Camargo, C. Q., & Simon, F. M. (2022). Mis- and disinformation studies are too big to fail: Six suggestions for the field’s future. Harvard Kennedy School (HKS) Misinformation Review . https://doi.org/10.37016/mr-2020-106

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No financial support was received for this study. Felix M. Simon gratefully acknowledges the support of the Leverhulme Trust for his doctoral studies.

Competing Interests

The authors declare no competing interests.

This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided that the original authors and source are properly credited.

Acknowledgments

The authors would like to thank the participants and organizers of the ICA pre-conference “What comes after disinformation Studies?” hosted at the Médialab at Science Po, Paris, France, in May 2022, for their insightful discussions on the topic. The authors would further like to thank Natascha Chtena, the HKS Misinformation Review Editorial Board, and their colleagues at the Oxford Internet Institute, the Reuters Institute, and the University of Exeter.

Both authors contributed equally to this work.

Open access
Published: 18 May 2024

Role of surgical simulation on self-reported confidence level on cardiothoracic surgical trainees

Len En Yean ORCID: orcid.org/0000-0002-1025-0308 1 &
Shahrul Amry bin Hashim ORCID: orcid.org/0000-0001-5164-4832 1

Journal of Cardiothoracic Surgery volume 19 , Article number: 293 ( 2024 ) Cite this article

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Metrics details

Simulated self-practice using simulation models could improve fine motor skills and self confidence in surgical trainees.

The purpose of this study is to evaluate on self-reported confidence level in cardiothoracic surgical trainees by using surgical simulation models.

We conducted a cross-sectional study on all surgeons ( n =10) involved in MIS simulation training. All surgeons are required to perform on three minimally invasive surgery (MIS) procedures (Mitral Valve Repair, Mitral Valve Replacement and Aortic Valve Replacement). A questionnaire was designed based on two existing scales related to self-confidence, the surgical self-efficacy scale [SSES] and the perceived competency scale [PCS]. We assessed their self-confidence (before and after training) in the use of simulation in MIS procedures using rating scales 1-5. The mean score was calculated for each domain and used as the predictor variable. We also developed six questions (PCS) using Objective Structured Assessment of Technical Skills (OSAT) related to each domain and asked participants how confident they were after performing each MICS procedure.

The mean score was 4.7 for all assessed domains, except "knowledge" (3.8). Surgeons who had performed one or more MIS procedures had higher scores ( P <0.05). There was no correlation between the number of MIS procedures performed and self-confidence scores.

Conclusions

The results indicate that the cardiac surgery training based on MIS simulation improves trainees and consultants in terms of the level of self-confidence. Although surgeons generally have high levels of self-confidence after simulation training in MIS cardiac procedures, there is still room for improvement with respect to technical skills related to the procedure itself and its results.

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Introduction

Self-confidence is a state of mind marked by an individual's belief in his or her ability to succeed at a task or tasks. It is generally seen as a positive trait, although too much self-confidence can lead to carelessness and arrogance, while too little can lead to insecurity and self-doubt. A lack of self-confidence may be due to an individual's poor personal performance relative to others, such as in sports or work situations.

Self-confidence is an important attribute for surgeons and healthcare professionals. It is an essential aspect of surgical performance and a reliable and valid self-confidence scale can help improve training and assessment [ 1 ]. A cross-sectional study was conducted among residents of general surgery in the United States, revealing that 27.5% were not confident when performing procedures independently [ 2 ]. To be successful in clinical practise, it is crucial to possess critical thinking skills and self-confidence [ 3 ].

Minimally invasive surgical (MIS) techniques have become the standard of surgical care in the 21 st century and are highly suitable for simulation-based training due to their inherent nature compared to open surgery [ 4 ]. A simulator allows trainees to improve their skills and performance with a particular technique or new instrument during training [ 5 ].

Objective Structured Assessment of Technical Skills (OSATS) has been used to assess surgeon technical skills in laparoscopic surgery [ 6 ]. OSATS has been used locally as a standard for evaluating surgical training programmes and as an assessment tool for individual surgeons seeking certification. It provides data on how well surgeons use technical skills in patient management, but does not provide information on how confident they are about performing these skills or how often they use them in their daily practise. In this study, we sought to evaluate a self-confidence scale by using OSATS for participants.

In this study, we aimed to evaluate a self-confidence scale for surgical trainees and consultants using a self-designed simulation tools in minimally invasive cardiac surgery (MIS). Participants consist of five final year surgical trainees and five consultants which had at least three years of working experience at a consultant level. They all were from different institution and had comparable training and skills levels. We use a simulation tools (as shown in Figs. 1 & 2 ) in minimally invasive surgery (MIS) for cardiac surgery. All surgeons are required to perform on three MIS procedures (Mitral Valve Repair, Mitral Valve Replacement and Aortic Valve Replacement). We hypothesised that the instrument would be able to distinguish between the two groups of surgeons (trainees and consultants) and that the level of confidence would be higher between consultants than among trainees. Data were collected using survey questionnaires and analysed using descriptive statistics, t tests, and ANOVA.

Surgical simulation tools on minimally invasive cardiac surgery training

A questionnaire was designed based on two existing scales related to the surgical self-efficacy scale [SSES] of self-confidence and the perceived competence scale [PCS]). We developed six questions related to each domain in PCS and asked participants how satisfied and confident they were after performing each MICS procedure (as shown in Figs. 3 and 4 ).

Training in the simulator

Aortic valve replacement model

Surgical Self-Efficacy Scale (SSES) Questionnaire for Confidence Level

To evaluate the effect of a hands-on workshop on the level of self-confidence of surgical trainees and consultants in the use of simulation tools in minimally invasive cardiac surgery, we designed a prospective observational study with two groups: group A ( n = 5) consisting of surgical trainees and group B ( n = 5) consisting of consultants. All participants completed the SSES questionnaire before and after a hands-on workshop on MIS. The study population included all surgical trainees and consultants working in the cardiothoracic surgical field.

The SSES questionnaire is designed to assess their self-confidence (before and after training) in the use of simulation tools in MIS cardiac procedures through rating scales 1-5. From 1 not being confident at all to 5 being completely confident. Each procedure is divided into suture placement, ring/valve implantation, and suture knotting using a knot pusher (as shown in Fig. 5 ). Data were assessed by comparing mean scores obtained by the two groups (trainees vs consultants), depending on whether the data was normally distributed.

The PCS questionnaire includes six items on surgeons' confidence in MIS simulator training, which include time and motion, knowledge of instruments, instrument handling using dominant and nondominant hand, synchronisation between hands, and respect for tissue. Each item had 5 possible responses, from the rating scales 1-5, based on their satisfaction and confidence (as shown in Fig. 6 ). Three separate questionnaires for 3 different MIS procedures training (Mitral valve repair, Mitral Valve replacement and Aortic valve replacement) were filled in by the participants after their training, The data was assessed by comparing mean scores for all domains.

Objective Structured Assessment of Technical Skills (OSAT) form for perceived competency scale (PCS) assessment

For the surgical self-efficacy scale [SSES], the results showed that there was a significant difference between the two groups in terms of their level of confidence after MIS training ( p < 0.05) in training for the three procedures (mitral valve repair, mitral valve replacement, aortic valve replacement). Two groups had a significant increase in confidence level in terms of suture placement, ring / valve implantation, and suture knotting using a knot pusher. For all the three procedures, the mean score was 2.6 before the training and ranging from 4.3-4.5 after the training.

The results showed that the before and after training scores were significantly higher in both groups (surgical trainees and consultants) after the hands-on workshop than before ( p <0.05). There were no significant differences between groups A and B ( p >0.05)

In terms of the perceived competence scale [PCS] using Objective Structured Assessment of Technical Skills (OSATS), the mean score for the 3 MIS procedures was lower than 4 (scale range 0–5) for all evaluated domains (time and motion, handling of instruments using the dominant and non-dominant hand, synchronisation between hands, respect for tissue) except for "knowledge of instruments" (> 4). The mean scores of all domains except knowledge ranged from 3.5-3.9.

The use of simulation in minimally invasive cardiac surgery (MICS) has been rising over the last decade. In view of increasing patient demand for less invasive surgery, it is important that cardiovascular surgeons remain familiar with the most widely used approaches to surgery [ 7 ]. Training in cardiac surgery using simulation has demonstrated a substantial influence on the clinical knowledge, surgical skills (including accuracy, timing, and dexterity), and confidence of trainees in addressing cardiac surgical scenarios, in regardless both junior and senior levels [ 8 ].

Studies have shown that surgeons who have undergone additional simulation training improve significantly in terms of surgical skill [ 9 ]. However, there are still many concerns regarding effectiveness and cost-effectiveness; Simulators have proven to be effective in cost-effectively teaching complex laparoscopic skills with the current surgical training, as discussed in the paper [ 10 ].

Simulation based training program has been proven to improve not only performance skills but also self confidence among trainees [ 11 ]. The self-confidence scale can be used to identify trainees who may benefit from additional training and support and to assess the effectiveness of training programmes [ 1 ].

In this study, we developed a self-confidence scale for surgeons to evaluate their confidence in using simulation and compared surgical trainees and consultants. The results showed that both groups had moderate self-confidence in using simulation to develop minimally invasive cardiac surgery skills, but this was significantly higher among consultants compared to trainees. However, there were no differences between the two groups in their perception of the importance of using simulation in teaching surgical skills. This is consistent with previous studies that have found that surgeons believe that the use of technology can improve skill acquisition and lead to better outcomes [ 12 ].

Although this study was conducted in a single institution, similar findings may be obtained in other institutions, as many hospitals use simulators to teach skills related to minimally invasive cardiac surgery.

However, this study is only conducted in a small sample size. Therefore, it is recommended that further studies with larger samples be conducted to establish if there are differences between these two groups with respect to their level of confidence in the training of MIS simulation tools for cardiac surgery.

To date, there has been no published work exploring whether surgeons’ perceptions about the importance of using simulators differ according to speciality or experience levels.

This study provides a new way to evaluate surgical self-confidence using an easy questionnaire with good psychometric properties. The self-designed MIS simulation tools also can be used as an evaluation tool during training courses or when evaluating surgical trainees or consultants before starting a procedure to assess their self-confidence before starting the procedure. Our study has shown that this scale can be used effectively to evaluate surgical trainees and consultants in the use of simulation for minimally invasive cardiac surgery. The results indicate that a single adjective rating can help measure tools for training and self-improvement in surgical skills.

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SA provides the simulation tools for minimally invasive cardiac valve surgery and was the primary supervisor of the project. LEY primarily drafted the manuscript and contributed to collect the data and feedback from cardiothoracic surgeons regarding the simulation tools, and also contributed to the writing of the manuscript.

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Correspondence to Shahrul Amry bin Hashim .

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Yean, L.E., Hashim, S.A.b. Role of surgical simulation on self-reported confidence level on cardiothoracic surgical trainees. J Cardiothorac Surg 19 , 293 (2024). https://doi.org/10.1186/s13019-024-02647-5

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Kerry Brian Walsh. Thakur Prasad Bhattarai. A farm management information system (MIS) entails record keeping based on a database management system, typically using a client-server architecture, i ...
Review of management information systems research: A management support
This article organizes, describes, and evaluates MIS research from 1981 through 1985 in order to provide an understanding of what constitutes MIS research and to indicate potentially rich areas for future research. The review emphasizes information systems research in support of management decision making as opposed, for example, to research ...
Journal of Management Information Systems
The journal accepts for double anonymized review, full-scale research submissions that make a significant contribution to the field of information systems. Such contributions may present: Impactful and methodologically sound research work leading to the progress of the knowledge field; Paradigmatic and generalizable designs and applications
(Pdf) Review of Management Information Systems Research: a Management
As a result, many MIS articles will be missed by this review. It is hoped, however, that the major MIS research streams will be adequately represented in the 5 journals selected, and thus reported in this article. 2. SUMMARY OF MIS RESEARCH UP TO 1980 In December of 1980 the First International Conference on Information Systems was held in ...
Journal of Management Information Systems
Bureaucratizing the Clan: Impact of Technology Affordances on Control. Abdul Sesay et al. Article | Published online: 19 Feb 2024. Explore the current issue of Journal of Management Information Systems, Volume 41, Issue 1, 2024.
JMIS
JMIS - Journal of Management Information Systems. Message from the Editor in Chief: Vladimir Zwass. Web Site Editors: Yang Gao and Sagar Samtani. Past Web Site Editor: David Eargle. Journal Profile Board of Editors. Journal Rankings, FT50 Listing, H-Index, and Impact Factor. Referees.
The Oxford Handbook of Management Information Systems: Critical
The book is organized into four parts. The first part covers the background to the topic. The second part looks as theoretical and methodological perspectives in the field of MIS. Part III talks about rethinking theory in practice. Finally, the last part looks at rethinking MIS practice in a broader context.
A Review of MIS Research and Disciplinary Development
Management Information Systems, Management Science, MIS Quarterly, and Sloan Management Review. The MIS articles published in these journals between 1968 and 1988 were collected and analyzed. For an article to be included in the study, it had to address an aspect of research, management, design, implementation, operation, use, or impact of MIS or
A Review of the Effectiveness of Management Information System in
The rapid advancement of technology has revolutionized the way organizations operate, resulting in the widespread adoption of Management Information Systems (MIS) as a crucial tool in decision-making processes. This research paper presents a comprehensive review of the effectiveness of Management Information Systems in facilitating decision-making within various organizational contexts. The ...
PDF Management information systems and business decision making: review
good management information system. As a notable general observation, a good MIS ensures good decision making just in the same way bad MIS propel the making of bad decisions. UStudy.in (2010) supports the above observation by saying that "The quality of managerial decision-making depends directly on the quality of available information" and the
Impact of Management Information Systems (MIS) on ...
Overall review of literature highlighted positive impact of MIS on school administration and management including better accessibility to information, more efficient administration, higher utilization of school resources, reduction in workload, better time management, and improvement in the quality of reports. ... Telem (1999) defines MIS as â ...
Clinical Characteristics of Multisystem Inflammatory ...
Key Points. Question What are the clinical characteristics of multisystem inflammatory syndrome in adults (MIS-A)?. Findings This systematic review of patients with MIS-A reported in the literature and to the US Centers for Disease Control and Prevention identified 221 patients worldwide. The syndrome presented approximately 4 weeks after acute COVID-19 with hyperinflammation and ...
Review of management information systems research: A management support
Abstract. This article organizes, describes, and evaluates MIS research from 1981 through 1985 in order to provide an understanding of what constitutes MIS research and to indicate potentially rich areas for future research. The review emphasizes information systems research in support of management decision making as opposed, for example, to ...
PDF Review on Management Information Systems (MIS) and its Role in ...
Review on Management Information Systems (MIS) and its Role in Decision Making. 2) data. 3) inferences and predictions drawn from data. 4) value and choices. 5) action which involves course of action.[5] Management information system has a purpose to meet the general information needs of all the managers in an organization or in some subunits ...
The Role of Management Information System: Review on the ...
The literature review shows the big importance of industries and organizations to maximize the utilization of the unit. It is recommended that all institutions should revisit and include the Management Information System unit as a priority unit for improvement for organizational effectiveness and innovation.
Management Information Systems: Articles & Journals
A peer-reviewed (or refereed) journal:. uses experts from the same subject field or profession as the author to evaluate a manuscript prior to acceptance for publication; has articles that report on research studies or provide scholarly analysis of topics; may include book reviews, editorials, or other brief items that are not considered scholarly articles
Management Information Systems Quarterly
A peer reviewed scholarly journal, the editorial objective of the MIS Quarterly is the enhancement and communication of knowledge concerning the development of IT-based services, the management of IT resources, and the use, impact, and economics of IT with managerial, organizational, and societal implications.
Mis-Dis Information in COVID-19 Health Crisis: A Narrative Review
Background: In this narrative review, we address the COVID-19 pandemic mis-dis information crisis in which healthcare systems have been pushed to their limits, with collapses occurring worldwide. The context of uncertainty has resulted in skepticism, confusion, and general malaise among the population. Informing the public has been one of the major challenges during this pandemic.
Give They an Inch and It Takes a Mile: The ...
Bryan A. Garner is the author of The Chicago Guide to Grammar, Usage, and Punctuation, Garner's Modern English Usage, and The HBR Guide to Better Business Writing.
Mis- and disinformation studies are too big to fail: Six suggestions
Introduction. The field of mis- and disinformation studies is here to stay. 1 We define mis- and disinformation studies loosely as a multi-disciplinary and developing field of study that focuses on studying multimodal forms of communication, which unintentionally (misinformation) or intentionally (disinformation) misinform audiences. This includes the study of motivations (e.g., political ...
(PDF) Information Systems Success: A Literature Review
The review examined up to 250 articles published between 2015 - 2020 on database indexing within topics related to the 'Information System Success Model,' 'Delone and McLean are Model,' and ...
Multi-Exposure Image Fusion Techniques: A Comprehensive Review
Multi-exposure image fusion (MEF) is emerging as a research hotspot in the fields of image processing and computer vision, which can integrate images with multiple exposure levels into a full exposure image of high quality. It is an economical and effective way to improve the dynamic range of the imaging system and has broad application prospects. In recent years, with the further development ...
Role of surgical simulation on self-reported confidence level on
For the surgical self-efficacy scale [SSES], the results showed that there was a significant difference between the two groups in terms of their level of confidence after MIS training (p < 0.05) in training for the three procedures (mitral valve repair, mitral valve replacement, aortic valve replacement).Two groups had a significant increase in confidence level in terms of suture placement ...

REVIEW OF MANAGEMENT INFORMATION SYSTEMS RESEARCH: A MANAGEMENT SUPPORT EMPHASIS

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