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Tran S, Smith L, Carter S. Understanding Patient Perspectives on the Use of Gamification and Incentives in mHealth Apps to Improve Medication Adherence: Qualitative Study. JMIR Mhealth Uhealth 2024; 12:e50851. [PMID: 38743461 PMCID: PMC11134245 DOI: 10.2196/50851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/20/2023] [Accepted: 03/27/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Medication nonadherence remains a significant health and economic burden in many high-income countries. Emerging smartphone interventions have started to use features such as gamification and financial incentives with varying degrees of effectiveness on medication adherence and health outcomes. A more consistent approach to applying these features, informed by patient perspectives, may result in more predictable and beneficial results from this type of intervention. OBJECTIVE This qualitative study aims to identify patient perspectives on the use of gamification and financial incentives in mobile health (mHealth) apps for medication adherence in Australian patients taking medication for chronic conditions. METHODS A total of 19 participants were included in iterative semistructured web-based focus groups conducted between May and December 2022. The facilitator used exploratory prompts relating to mHealth apps, gamification, and financial incentives, along with concepts raised from previous focus groups. Transcriptions were independently coded to develop a set of themes. RESULTS Three themes were identified: purpose-driven design, trust-based standards, and personal choice. All participants acknowledged gamification and financial incentives as potentially effective features in mHealth apps for medication adherence. However, they also indicated that the effectiveness heavily depended on implementation and execution. Major concerns relating to gamification and financial incentives were perceived trivialization and potential for medication abuse, respectively. CONCLUSIONS The study's findings provide a foundation for developers seeking to apply these novel features in an app intervention for a general cohort of patients. However, the study highlights the need for standards for mHealth apps for medication adherence, with particular attention to the use of gamification and financial incentives. Future research with patients and stakeholders across the mHealth app ecosystem should be explored to formalize and validate a set of standards or framework.
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Affiliation(s)
- Steven Tran
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Lorraine Smith
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Stephen Carter
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
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Opie JE, Vuong A, Welsh ET, Esler TB, Khan UR, Khalil H. Outcomes of Best-Practice Guided Digital Mental Health Interventions for Youth and Young Adults with Emerging Symptoms: Part II. A Systematic Review of User Experience Outcomes. Clin Child Fam Psychol Rev 2024:10.1007/s10567-024-00468-5. [PMID: 38634939 DOI: 10.1007/s10567-024-00468-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 04/19/2024]
Abstract
Although many young people demonstrate resilience and strength, research and clinical evidence highlight an upward trend in mental health concerns among those aged 12 to 25 years. Youth-specific digital mental health interventions (DMHIs) aim to address this trend by providing timely access to mental health support for young people (12-25 years). However, there is a considerable gap in understanding young people user experiences with digital interventions. This review, co-designed with Australia's leading mental health organization Beyond Blue, utilizes a systematic methodology to synthesize evidence on user experience in youth-oriented digital mental health interventions that are fully or partially guided. Five relevant online databases were searched for articles published from 2018 to 2023, yielding 22,482 articles for screening and 22 studies were included in the present analysis. User experience outcomes relating to satisfaction and engagement were assessed for each included intervention, with experience indicators relating to usefulness, usability, value, credibility, and desirability being examined. Elements associated with positive/negative outcomes were extracted. Elements shown to positively influence user experience included peer engagement, modern app-based delivery, asynchronous support, and personalized content. In contrast, users disliked static content, homework/log-keeping, the requirement for multiple devices, and social media integration. Asynchronous interventions showed high satisfaction but faced engagement issues, with combined asynchronous/synchronous interventions reporting better completion rates. DMHIs offer a promising platform for youth mental health support and has the potential to dramatically increase the reach of interventions through the adoption of technological and user experience best practices. While young people respond positively to many aspects of intervention modernization, such as interactive, app-based design, other concepts, such as social media integration, they need to be adopted by the field more cautiously to ensure trust and engagement.Trial Registration CRD42023405812.
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Affiliation(s)
- Jessica E Opie
- The Bouverie Centre, La Trobe University, Melbourne, 3056, Australia.
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, 3000, Australia.
| | - An Vuong
- The Bouverie Centre, La Trobe University, Melbourne, 3056, Australia
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, 3000, Australia
| | - Ellen T Welsh
- The Bouverie Centre, La Trobe University, Melbourne, 3056, Australia
| | - Timothy B Esler
- The Bouverie Centre, La Trobe University, Melbourne, 3056, Australia
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, 3000, Australia
| | - Urooj Raza Khan
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, 3000, Australia
| | - Hanan Khalil
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, 3000, Australia
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Aboye GT, Simegn GL, Aerts JM. Assessment of the Barriers and Enablers of the Use of mHealth Systems in Sub-Saharan Africa According to the Perceptions of Patients, Physicians, and Health Care Executives in Ethiopia: Qualitative Study. J Med Internet Res 2024; 26:e50337. [PMID: 38536231 PMCID: PMC11007608 DOI: 10.2196/50337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/01/2023] [Accepted: 02/13/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Digital technologies are increasingly being used to deliver health care services and promote public health. Mobile wireless technologies or mobile health (mHealth) technologies are particularly relevant owing to their ease of use, broad reach, and wide acceptance. Unlike developed countries, Sub-Saharan Africa experiences more challenges and obstacles when it comes to deploying, using, and expanding mHealth systems. In addition to barriers, there are enabling factors that could be exploited for the design, implementation, and scaling up of mHealth systems. Sub-Saharan Africa may require tailored solutions that address the specific challenges facing the region. OBJECTIVE The overall aim of this study was to identify the barriers and enablers for using mHealth systems in Sub-Saharan Africa from the perspectives of patients, physicians, and health care executives. METHODS Multi-level and multi-actor in-depth semistructured interviews were employed to qualitatively explore the barriers and enablers of the use of mHealth systems. Data were collected from patients, physicians, and health care executives. The interviews were audio recorded, transcribed verbatim, translated, and coded. Thematic analysis methodology was adopted, and NVivo software was used for the data analysis. RESULTS Through this rigorous study, a total of 137 determinants were identified. Of these determinants, 68 were identified as barriers and 69 were identified as enablers. Perceived barriers in patients included lack of awareness about mHealth systems and language barriers. Perceived enablers in patients included need for automated tools for health monitoring and an increasing literacy level of the society. According to physicians, barriers included lack of available digital health systems in the local context and concern about patients' mHealth capabilities, while enablers included the perceived usefulness in reducing workload and improving health care service quality, as well as the availability of mobile devices and the internet. As perceived by health care executives, barriers included competing priorities alongside digitalization in the health sector and lack of interoperability and complete digitalization of implemented digital health systems, while enablers included the perceived usefulness of digitalization for the survival of the highly overloaded health care system and the abundance of educated manpower specializing in technology. CONCLUSIONS mHealth systems in Sub-Saharan Africa are hindered and facilitated by various factors. Common barriers and enablers were identified by patients, physicians, and health care executives. To promote uptake, all relevant stakeholders must actively mitigate the barriers. This study identified a promising outlook for mHealth in Sub-Saharan Africa, despite the present barriers. Opportunities exist for successful integration into health care systems, and a user-centered design is crucial for maximum uptake.
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Affiliation(s)
- Genet Tadese Aboye
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
- School of Biomedical Engineering, Jimma Institute of Technology, Jimma University, Jimma, Ethiopia
| | | | - Jean-Marie Aerts
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
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Opie JE, Vuong A, Welsh ET, Gray R, Pearce N, Marchionda S, Mutch R, Khalil H. Outcomes of Best-Practice Guided Digital Mental Health Interventions for Youth and Young Adults with Emerging Symptoms: Part I. A Systematic Review of Socioemotional Outcomes and Recommendations. Clin Child Fam Psychol Rev 2024:10.1007/s10567-024-00469-4. [PMID: 38489101 DOI: 10.1007/s10567-024-00469-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 03/17/2024]
Abstract
Youth-specific digital mental health interventions (DMHI) represent an emerging field of study, and aim to increase access, improve socioemotional outcomes, and, where required, support triage to targeted interventions. However, prior reviews have reported inconsistent findings on the clinical effectiveness of such interventions in young adults (12-25 years). Further, shortfalls remain for the impact of guided interventions based on the mode of delivery and the type of human support personnel (e.g., professional or peer) guiding the intervention. In response, this systematic review, co-designed with Australia's leading mental health organization, aims to assess the effectiveness of guided digital programs in improving youth socioemotional outcomes. Included studies involve young people experiencing mental ill-health, receiving brief (i.e., 1-12 sessions), digitally delivered (at least partially) psychological interventions that were guided or partially guided, tested in a type of experimental study, with a socioemotional outcome. Specific socioemotional outcomes examined were depression, anxiety, stress, wellbeing, mindfulness, and quality of life. A systematic search of the contemporary published and grey literature identified 22,482 records with 32 relevant records published between 2018 and 2023. A narrative synthesis guided integration of findings. Results demonstrated strong evidence for the effectiveness of guided interventions on socioemotional outcomes (i.e., depression, anxiety, stress) yet these effects were short-lived. When factoring in the use of different control groups (i.e., active vs. inactive), inconsistent effects were observed for the socioemotional outcomes of depression, anxiety, and stress. The mode of delivery (i.e., asynchronous, synchronous, combined) and the type of human support personnel did not appear to impact socioemotional outcomes. Results indicate efficacious brief digital interventions for depression and anxiety include refresher/follow-up content, goal setting content, and relapse prevention content. In contrast, poor efficacy is associated with interventions that include homework tasks, self-monitoring, and log-keeping content.PROSPERO, ID CRD42023405812.
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Affiliation(s)
- Jessica E Opie
- School of Psychology & Public Health, The Bouverie Centre, La Trobe University, 8 Gardiner Street, Brunswick, Melbourne, VA, 3056, Australia.
- La Trobe University, Melbourne, VA, 3000, Australia.
| | - An Vuong
- School of Psychology & Public Health, The Bouverie Centre, La Trobe University, 8 Gardiner Street, Brunswick, Melbourne, VA, 3056, Australia
- La Trobe University, Melbourne, VA, 3000, Australia
| | - Ellen T Welsh
- School of Psychology & Public Health, The Bouverie Centre, La Trobe University, 8 Gardiner Street, Brunswick, Melbourne, VA, 3056, Australia
- La Trobe University, Melbourne, VA, 3000, Australia
| | - Richard Gray
- La Trobe University, Melbourne, VA, 3000, Australia
| | - Natalie Pearce
- La Trobe University, Melbourne, VA, 3000, Australia
- Latrobe University, Bendigo, VIC, 3551, Australia
| | - Sonia Marchionda
- School of Psychology & Public Health, The Bouverie Centre, La Trobe University, 8 Gardiner Street, Brunswick, Melbourne, VA, 3056, Australia
- La Trobe University, Melbourne, VA, 3000, Australia
| | | | - Hanan Khalil
- La Trobe University, Melbourne, VA, 3000, Australia
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Haig M, Main C, Chávez D, Kanavos P. A Value Framework to Assess Patient-Facing Digital Health Technologies That Aim to Improve Chronic Disease Management: A Delphi Approach. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:1474-1484. [PMID: 37385445 DOI: 10.1016/j.jval.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/31/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVES Digital health technologies (DHTs) can optimise healthcare costs and improve quality and efficiency of care. However, the fast-paced rate of innovation and varying evidence standards can make it difficult for decision-makers to assess these technologies in an efficient and evidence-based manner. We sought to develop a comprehensive framework to assess the value of novel patient-facing DHTs used to manage chronic diseases by eliciting stakeholder value preferences. METHODS Literature review and primary data collection from a three-round web-Delphi exercise was utilized. 79 participants from 5 stakeholder groups (patients, physicians, industry, decision makers, and influencers) and 3 countries (United States of America, United Kingdom, and Germany) took part. Likert scale data were statistically analyzed to determine intergroup differences in both country and stakeholder groups, stability of results, and overall consensus. RESULTS The resulting co-created framework comprised 33 stable indicators with consensus from quantitative value judgments across domains: health inequalities, data rights and governance, technical and security, economic characteristics, clinical characteristics, and user preferences. Lack of stakeholder consensus was observed on the importance of value-based care models, optimizing resources for sustainable systems, and stakeholder involvement in DHT design, development, and implementation; however, this was because of high rates of neutrality and not negative judgments. Supply-side actors and academic experts were the most unstable stakeholder groups. CONCLUSION Stakeholder value judgments revealed a need for a coordinated regulatory and health technology assessment policy response that updates laws to meet technological innovations, offers a pragmatic approach to evidence standards to assess DHTs, and involves stakeholders to understand and meet their needs.
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Affiliation(s)
- Madeleine Haig
- Department of Health Policy and LSE Health - Medical Technology Research Group, London School of Economics and Political Science, London, England, UK.
| | - Caitlin Main
- Department of Health Policy and LSE Health - Medical Technology Research Group, London School of Economics and Political Science, London, England, UK
| | - Danitza Chávez
- Department of Health Policy and LSE Health - Medical Technology Research Group, London School of Economics and Political Science, London, England, UK
| | - Panos Kanavos
- Department of Health Policy and LSE Health - Medical Technology Research Group, London School of Economics and Political Science, London, England, UK
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Yeung AWK, Torkamani A, Butte AJ, Glicksberg BS, Schuller B, Rodriguez B, Ting DSW, Bates D, Schaden E, Peng H, Willschke H, van der Laak J, Car J, Rahimi K, Celi LA, Banach M, Kletecka-Pulker M, Kimberger O, Eils R, Islam SMS, Wong ST, Wong TY, Gao W, Brunak S, Atanasov AG. The promise of digital healthcare technologies. Front Public Health 2023; 11:1196596. [PMID: 37822534 PMCID: PMC10562722 DOI: 10.3389/fpubh.2023.1196596] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 09/04/2023] [Indexed: 10/13/2023] Open
Abstract
Digital health technologies have been in use for many years in a wide spectrum of healthcare scenarios. This narrative review outlines the current use and the future strategies and significance of digital health technologies in modern healthcare applications. It covers the current state of the scientific field (delineating major strengths, limitations, and applications) and envisions the future impact of relevant emerging key technologies. Furthermore, we attempt to provide recommendations for innovative approaches that would accelerate and benefit the research, translation and utilization of digital health technologies.
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Affiliation(s)
- Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Ali Torkamani
- Department of Integrative Structural and Computational Biology, Scripps Research Translational Institute, La Jolla, CA, United States
| | - Atul J. Butte
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, United States
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States
| | - Benjamin S. Glicksberg
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Björn Schuller
- Department of Computing, Imperial College London, London, United Kingdom
- Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Augsburg, Germany
| | - Blanca Rodriguez
- Department of Computer Science, University of Oxford, Oxford, United Kingdom
| | - Daniel S. W. Ting
- Singapore National Eye Center, Singapore Eye Research Institute, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - David Bates
- Department of General Internal Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Eva Schaden
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Hanchuan Peng
- Institute for Brain and Intelligence, Southeast University, Nanjing, China
| | - Harald Willschke
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Jeroen van der Laak
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Josip Car
- Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
- Centre for Population Health Sciences, LKC Medicine, Nanyang Technological University, Singapore, Singapore
| | - Kazem Rahimi
- Deep Medicine Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Leo Anthony Celi
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, United States
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Lodz, Poland
- Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Maria Kletecka-Pulker
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Institute for Ethics and Law in Medicine, University of Vienna, Vienna, Austria
| | - Oliver Kimberger
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Roland Eils
- Digital Health Center, Berlin Institute of Health (BIH), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | | | - Stephen T. Wong
- Department of Systems Medicine and Bioengineering, Houston Methodist Cancer Center, T. T. and W. F. Chao Center for BRAIN, Houston Methodist Academic Institute, Houston Methodist Hospital, Houston, TX, United States
- Departments of Radiology, Pathology and Laboratory Medicine and Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, United States
| | - Tien Yin Wong
- Singapore National Eye Center, Singapore Eye Research Institute, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Tsinghua Medicine, Tsinghua University, Beijing, China
| | - Wei Gao
- Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA, United States
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Atanas G. Atanasov
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Poland
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Jonathan J, Barakabitze AA. ML technologies for diagnosing and treatment of tuberculosis: a survey. HEALTH AND TECHNOLOGY 2023. [DOI: 10.1007/s12553-023-00727-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Dias RA, de Faria Cardoso C, Ghimouz R, Nono DA, Silva JA, Acuna J, Baltatu OC, Campos LA. Quantitative cardiac autonomic outcomes of hydrotherapy in women during the first stage of labor. Front Med (Lausanne) 2023; 9:987636. [PMID: 36660001 PMCID: PMC9844258 DOI: 10.3389/fmed.2022.987636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/05/2022] [Indexed: 01/04/2023] Open
Abstract
Introduction Most hydrotherapy studies during childbirth report findings related to pain using a widespread set of subjective measures. In this study, ECG biomarkers as quantitative cardiac autonomic outcomes were used to assess the effects of warm shower hydrotherapy on laboring women during the first stage of labor. Methods This was a prospective single-blind cohort study on stage I delivering women. Their cardiac autonomic function was assessed using heart rate variability (HRV) measures during a deep breathing test using point-of-care testing comprised of an HRV scanner system with wireless ECG enabling real-time data analysis and visualization. Labor pain and anxiety were assessed using the Visual Analog Scale for Pain (VASP) and the Beck Anxiety Inventory (BAI). A total of 105 pregnant women in the first stage of labor who received warm shower hydrotherapy, intravenous analgesia (scopolamine + sodium dipyrone), or spinal anesthetic (bupivacaine + morphine) were enrolled. Results In women during the first stage of labor, parasympathetic modulation reflected through RMSSD (root mean square of successive RR interval differences) was significantly reduced by hydrotherapy and intravenous analgesia (before vs. after mean rank diff. 35.73 and 65.93, respectively, p < 0.05). Overall HRV (SDNN, standard deviation of RR intervals) was significantly decreased only by intravenous analgesia (before vs. after mean rank diff. 65.43, p < 0.001). Mean heart rate was significantly increased by intravenous analgesia, while spinal anesthesia reduced it, and hydrotherapy did not alter it (before vs. after mean rank diff. -49.35*, 70.38*, -24.20 NS , respectively, *p < 0.05, NS not significant). Conclusion This study demonstrates that warm shower therapy may impact the sympathovagal balance via parasympathetic withdrawal in women during the initial stage of labor. The findings of this study provide quantitative support for using warm shower hydrotherapy during labor via point-of-care testing. The dependability of hydrotherapy as a non-pharmacological treatment is linked to the completion of more clinical research demonstrating quantitative evidence via outcome biomarkers to support indications on stress and birth progress.
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Affiliation(s)
- Raquel Aparecida Dias
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University—Anima Institute, São José dos Campos Technology Park, São José dos Campos, Brazil
| | - Cláudia de Faria Cardoso
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University—Anima Institute, São José dos Campos Technology Park, São José dos Campos, Brazil
| | - Rym Ghimouz
- Fatima College of Health Sciences, Abu Dhabi, United Arab Emirates
| | - Daniel Alessander Nono
- Center for Special Technologies, National Institute for Space Research (INPE), São José dos Campos, Brazil
| | | | - Juan Acuna
- Department of Public Health and Epidemiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Ovidiu Constantin Baltatu
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University—Anima Institute, São José dos Campos Technology Park, São José dos Campos, Brazil,Department of Public Health and Epidemiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates,*Correspondence: Ovidiu Constantin Baltatu,
| | - Luciana Aparecida Campos
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University—Anima Institute, São José dos Campos Technology Park, São José dos Campos, Brazil,Department of Public Health and Epidemiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates,Luciana Aparecida Campos,
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Baumann MF, Weinberger N, Maia M, Schmid K. User types, psycho-social effects and societal trends related to the use of consumer health technologies. Digit Health 2023; 9:20552076231163996. [PMID: 37034307 PMCID: PMC10074638 DOI: 10.1177/20552076231163996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 02/23/2023] [Indexed: 04/05/2023] Open
Abstract
Objective The term consumer health technologies we use in this paper refers to fitness and health apps, wearables and other self-tracking devices that collect health-related data. Our paper aims to bridge the gap between the growing literature base of sociological research and ethical reflection on the (non-intended) effects of consumer health technology use on the psycho-social level, such as stress, responsibilization or a loss of intuitive sense for signs of health or illness. Special consideration should be given to vulnerable individuals, as the positive and negative effects of consumer health technology use may be unequally distributed. This perspective may help to guide policymaking and the responsible development of consumer health technologies. Methods Using a narrative review approach, we refer to empirical and theoretical studies dealing with user types and effects related to the use of consumer health technologies. We provide an overview of consumer health technology user typologies and evidence of the unintended psycho-social effects of consumer health technology use. On this basis, we propose a user typology that may serve as a future tool for ethical reflection on negative side effects. Results Evidence of the potential negative side effects of consumer health technology use, as presented in the literature, is inconclusive due to the high diversity of consumer health technology users and the way they use consumer health technologies. Our proposed user typology aims to more comprehensively document the diversity of users by incorporating the way in which users identify with and use their self-tracked data, attitudes towards the new technology and social interactions via consumer health technologies, and the purpose and self-determinedness of consumer health technology use. Conclusions More systematic and quantitative empirical research on the effects of consumer health technology use in diverse settings and with diverse user types is necessary to inform public health policy. In addition to evidence-based certification of medical consumer health technologies, more practical and flexible ways to protect users from side effects may have to be developed and adopted, especially regarding the increasing number of non-medical consumer health technologies.
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Affiliation(s)
- Martina F Baumann
- Institute of Technology Assessment and Systems Analysis, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Nora Weinberger
- Institute of Technology Assessment and Systems Analysis, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Maria Maia
- Institute of Technology Assessment and Systems Analysis, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Karolin Schmid
- Institute of Technology Assessment and Systems Analysis, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Sun MD, Kentley J, Wilson BW, Soyer HP, Curiel-Lewandrowski CN, Rotemberg VM, Halpern AC. Digital skin imaging applications, part II: a comprehensive survey of post-acquisition image utilization features and technology standards. Skin Res Technol 2022; 28:771-779. [PMID: 36181365 PMCID: PMC9907633 DOI: 10.1111/srt.13195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 06/19/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite the increasing ubiquity and accessibility of teledermatology applications, few studies have comprehensively surveyed their features and technical standards. Importantly, features implemented after the point of capture are often intended to augment image utilization, while technical standards affect interoperability with existing healthcare systems. We aim to comprehensively survey image utilization features and technical characteristics found within publicly discoverable digital skin imaging applications. MATERIALS AND METHODS Applications were identified and categorized as described in Part I. Included applications were then further assessed by three independent reviewers for post-imaging content, tools, and functionality. Publicly available information was used to determine the presence or absence of relevant technology standards and/or data characteristics. RESULTS A total of 20 post-image acquisition features were identified across three general categories: (1) metadata attachment, (2) functional tools (i.e., those that utilized images or in-app content to perform a user-directed function), and (3) image processing. Over 80% of all applications implemented metadata features, with nearly half having metadata features only. Individual feature occurred and feature richness varied significantly by primary audience (p < 0.0001) and function (p < 0.0001). On average, each application included under three features. Less than half of all applications requested consent for user-uploaded photos and fewer than 10% provided clear data use and privacy policies. CONCLUSION Post-imaging functionality in skin imaging applications varies significantly by primary audience and intended function, though nearly all applications implemented metadata labeling. Technical standards are often not implemented or reported consistently. Gaps in the provision of clear consent, data privacy, and data use policies should be urgently addressed.
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Affiliation(s)
- Mary D Sun
- Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Dermatology Service, Memorial Sloan Kettering, New York, New York, USA
| | - Jonathan Kentley
- Dermatology Service, Memorial Sloan Kettering, New York, New York, USA.,Chelsea and Westminster Hospital, London, UK
| | - Britney W Wilson
- Dermatology Service, Memorial Sloan Kettering, New York, New York, USA.,Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - H Peter Soyer
- Dermatology Research Centre, Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | | | | | - Allan C Halpern
- Dermatology Service, Memorial Sloan Kettering, New York, New York, USA
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11
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Tune T, Goh S, Williams PAH, Koczwara B. How Is Quality of mHealth Interventions for Cancer Survivors Defined and Described? An Umbrella Review. JCO Clin Cancer Inform 2022; 6:e2100203. [PMID: 35623020 DOI: 10.1200/cci.21.00203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Although there are commonly accepted criteria of what defines quality of health care including cancer care, less is known about what defines quality of mHealth interventions in health care. The aim of this review was to identify how quality of mHealth interventions for cancer survivors is described and measured. METHODS CINAHL, EmCare, JBI, Medline, SCOPUS, and ProQuest databases from January 2008 to January 2020 were searched. Review papers with search terms related to mobile devices, quality, and cancer relevant to adults with cancer were included. Interventions needed to consist of mHealth technologies, such as mobile applications or short message service, or wearable devices. Title and abstract screening, full-text screening, and data extraction were performed independently by two reviewers. Conflicts were resolved by a third reviewer. Reviews were evaluated for coverage of quality according to six metrics defined by the Institute of Medicine: patient-centeredness, equitability, safety, effectiveness, timeliness, and efficiency. Any additional quality items were recorded. A Measurement Tool to Assess systematic Reviews (AMSTAR) was used to rate the quality of the reviews included. RESULTS The initial search yielded 766 papers with seven systematic reviews meeting the eligibility criteria. Four papers were of AMSTAR moderate quality, with three of low quality. The median number of quality metrics reported in a review was two (the range was 1-4). Efficacy and safety and timeliness and efficiency were most reported (n = 4), followed by usability (n = 3), equitability and access (n = 2), privacy and security (n = 2), and patient-centeredness (n = 2). CONCLUSION There is great variability in how quality of mHealth interventions is defined with no reviews addressing all quality metrics. A comprehensive approach to measure quality of mHealth interventions is needed.
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Affiliation(s)
- Timothy Tune
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Shaun Goh
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Patricia A H Williams
- College of Science and Engineering, Flinders Digital Health Research Centre, Adelaide, Australia
| | - Bogda Koczwara
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
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12
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Online Interpersonal Relationships and Data Ownership Awareness Mediate the Relationship between Perceived Benefits and Problematic Internet Shopping. SUSTAINABILITY 2022. [DOI: 10.3390/su14063439] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Maladaptive and problematic buying/shopping has been the subject of a considerable amount of research over the last few decades. This research exploited the stimulus–organism–response (S-O-R) theory to evaluate the mediating effects of online interpersonal relationships and data ownership awareness on the relationship between consumers’ perceived benefit of online shopping and problematic internet shopping behavior. A total of 409 internet shoppers participated in this study. The authors performed all the analyses using the statistical package SPSS. The bootstrapping method used parallel and serial mediation models to assess whether OIR and DOA mediate the relationship between PBOS and PIS. The analysis results indicate that PBOS has a negative influence on PIS. In addition, OIR and DOA sequentially and partly mediate the relationship between PBOS and PIS. Pairwise comparisons amongst the three indirect effects suggest that OIR affects the PBOS-PIS relationship more than the other two effects. These results furnish substantial contributions that may advance a coherent theoretical framework on the pathways in which OIR and DOA may influence problematic internet shopping. Limitations of the current study and the implications of these findings are delineated.
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13
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Valias GR, Gomes PRL, Amaral FG, Alnuaimi S, Monteiro D, O'Sullivan S, Zangaro R, Cipolla-Neto J, Acuna J, Baltatu OC, Campos LA. Urinary Angiotensinogen-Melatonin Ratio in Gestational Diabetes and Preeclampsia. Front Mol Biosci 2022; 9:800638. [PMID: 35309508 PMCID: PMC8924406 DOI: 10.3389/fmolb.2022.800638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 02/04/2022] [Indexed: 12/25/2022] Open
Abstract
Background: A large research portfolio indicates that an activated renal renin-angiotensin system or a deficit on melatonin is associated with several cardiovascular pathologies. In this observational clinical study, we hypothesized that alterations in urinary melatonin or angiotensinogen levels may be altered in two common conditions, preeclampsia and gestational diabetes. Our study’s primary objective was to assess melatonin and angiotensinogen as novel disease biomarkers detectable and quantifiable in the urine of pregnant women with or without pregnancy complications. Methods: This was a concurrent cohort study of pregnant women with selected obstetric pathologies (gestational diabetes, preeclampsia, hypertension and obesity with hypertension). A group of healthy controls was also included. Urinary 6-sulfatoxymelatonin and angiotensinogen were measured by sensitive and specific ELISAs in first morning void urine samples. The patients were included in the cohort consecutively, and the diagnosis was blinded at the level of urine collection. Urinary 6-sulfatoxymelatonin and angiotensinogen levels were investigated in the patients included in the cohort. Results: Urinary levels of angiotensinogen were significantly higher in the gestational diabetes [angiotensinogen/creatinine ratio median (25th, 75th): 0.11 (0.07, 0.18)] and preeclampsia [0.08 (0.06, 0.18)] groups than in those with healthy pregnancy [0.05(0.04, 0.06]; 6-sulfatoxymelatonin levels were significantly lower in the gestational diabetes [ug/h: median (25th, 75th): 0.12(0.08, 0.17)] and preeclampsia [0.12 (0.09, 0.15)] groups than in those with healthy pregnancy [0.20 (0.15, 0.27]. Neither morning void protein/creatinine ratio nor 24-h urine protein estimate were significantly different between the study groups. Conclusion: These results suggest that urinary angiotensinogen levels may indicate an intrarenal RAS activation while melatonin production appears to be defective in gestational diabetes or hypertension. An angiotensinogen/melatonin ratio is suggested as an early biomarker for identification of gestational diabetes or hypertension. This report provides a basis for the potential use of melatonin for the treatment of preeclampsia. A prospective study in a larger number of patients to determine the operative characteristics of these markers as potential diagnostic tests is justified.
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Affiliation(s)
- Gabriela Ribeiro Valias
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University–Anima Institute, Sao Jose dos Campos Technology Park, Sao Jose dos Campos, Brazil
| | | | - Fernanda G. Amaral
- Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
| | - Saif Alnuaimi
- Department of Public Health and Epidemiology, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Daniela Monteiro
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University–Anima Institute, Sao Jose dos Campos Technology Park, Sao Jose dos Campos, Brazil
| | - Siobhán O'Sullivan
- Department of Molecular Biology and Genetics, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Renato Zangaro
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University–Anima Institute, Sao Jose dos Campos Technology Park, Sao Jose dos Campos, Brazil
| | - José Cipolla-Neto
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Juan Acuna
- Department of Public Health and Epidemiology, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Ovidiu Constantin Baltatu
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University–Anima Institute, Sao Jose dos Campos Technology Park, Sao Jose dos Campos, Brazil
- Department of Public Health and Epidemiology, Khalifa University, Abu Dhabi, United Arab Emirates
- *Correspondence: Ovidiu Constantin Baltatu, ; Luciana Aparecida Campos,
| | - Luciana Aparecida Campos
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University–Anima Institute, Sao Jose dos Campos Technology Park, Sao Jose dos Campos, Brazil
- Department of Public Health and Epidemiology, Khalifa University, Abu Dhabi, United Arab Emirates
- *Correspondence: Ovidiu Constantin Baltatu, ; Luciana Aparecida Campos,
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Fritz BA, Ramsey B, Taylor D, Shoup JP, Schmidt JM, Guinn M, Maddox TM. Association of Race and Neighborhood Disadvantage with Patient Engagement in a Home-Based COVID-19 Remote Monitoring Program. J Gen Intern Med 2022; 37:838-846. [PMID: 34993862 PMCID: PMC8734539 DOI: 10.1007/s11606-021-07207-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 10/08/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND COVID-positive outpatients may benefit from remote monitoring, but such a program often relies on smartphone apps. This may introduce racial and socio-economic barriers to participation. Offering multiple methods for participation may address these barriers. OBJECTIVES (1) To examine associations of race and neighborhood disadvantage with patient retention in a monitoring program offering two participation methods. (2) To measure the association of the program with emergency department visits and hospital admissions. DESIGN Retrospective propensity-matched cohort study. PARTICIPANTS COVID-positive outpatients at a single university-affiliated healthcare system and propensity-matched controls. INTERVENTIONS A home monitoring program providing daily symptom tracking via patient portal app or telephone calls. MAIN MEASURES Among program enrollees, retention (until 14 days, symptom resolution, or hospital admission) by race and neighborhood disadvantage, with stratification by program arm. In enrollees versus matched controls, emergency department utilization and hospital admission within 30 days. KEY RESULTS There were 7592 enrolled patients and 9710 matched controls. Black enrollees chose the telephone arm more frequently than White enrollees (68% versus 44%, p = 0.009), as did those from more versus less disadvantaged neighborhoods (59% versus 43%, p = 0.02). Retention was similar in Black enrollees and White enrollees (63% versus 62%, p = 0.76) and in more versus less disadvantaged neighborhoods (63% versus 62%, p = 0.44). When stratified by program arm, Black enrollees had lower retention than White enrollees in the app arm (49% versus 55%, p = 0.01), but not in the telephone arm (69% versus 71%, p = 0.12). Compared to controls, enrollees more frequently visited the emergency department (HR 1.71 [95% CI 1.56-1.87]) and were admitted to the hospital (HR 1.16 [95% CI 1.02-1.31]). CONCLUSIONS In a COVID-19 remote patient monitoring program, Black enrollees preferentially selected, and had higher retention in, telephone- over app-based monitoring. As a result, overall retention was similar between races. Remote monitoring programs with multiple modes may reduce barriers to participation.
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Affiliation(s)
- Bradley A Fritz
- Healthcare Innovation Lab, BJC HealthCare/Washington University School of Medicine, St. Louis, MO, USA. .,Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.
| | - Brett Ramsey
- Healthcare Innovation Lab, BJC HealthCare/Washington University School of Medicine, St. Louis, MO, USA
| | - Dick Taylor
- Epic1, BJC HealthCare/Washington University School of Medicine, St. Louis, MO, USA
| | | | - Jennifer M Schmidt
- Division of General Internal Medicine, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Thomas M Maddox
- Healthcare Innovation Lab, BJC HealthCare/Washington University School of Medicine, St. Louis, MO, USA.,Division of Cardiology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
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15
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Figueroa CA, Murayama H, Amorim PC, White A, Quiterio A, Luo T, Aguilera A, Smith ADR, Lyles CR, Robinson V, von Vacano C. Applying the Digital Health Social Justice Guide. Front Digit Health 2022; 4:807886. [PMID: 35295620 PMCID: PMC8918521 DOI: 10.3389/fdgth.2022.807886] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/01/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Digital health, the use of apps, text-messaging, and online interventions, can revolutionize healthcare and make care more equitable. Currently, digital health interventions are often not designed for those who could benefit most and may have unintended consequences. In this paper, we explain how privacy vulnerabilities and power imbalances, including racism and sexism, continue to influence health app design and research. We provide guidelines for researchers to design, report and evaluate digital health studies to maximize social justice in health. Methods From September 2020 to April 2021, we held five discussion and brainstorming sessions with researchers, students, and community partners to develop the guide and the key questions. We additionally conducted an informal literature review, invited experts to review our guide, and identified examples from our own digital health study and other studies. Results We identified five overarching topics with key questions and subquestions to guide researchers in designing or evaluating a digital health research study. The overarching topics are: 1. Equitable distribution; 2. Equitable design; 3. Privacy and data return; 4. Stereotype and bias; 5. Structural racism. Conclusion We provide a guide with five key topics and questions for social justice digital health research. Encouraging researchers and practitioners to ask these questions will help to spark a transformation in digital health toward more equitable and ethical research. Future work needs to determine if the quality of studies can improve when researchers use this guide.
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Affiliation(s)
- Caroline A. Figueroa
- School of Social Welfare, University of California, Berkeley, Berkeley, CA, United States
- D-Lab, University of California, Berkeley, Berkeley, CA, United States
- *Correspondence: Caroline A. Figueroa
| | - Hikari Murayama
- D-Lab, University of California, Berkeley, Berkeley, CA, United States
- Energy and Resources Group, University of California, Berkeley, Berkeley, CA, United States
| | | | - Alison White
- D-Lab, University of California, Berkeley, Berkeley, CA, United States
| | - Ashley Quiterio
- D-Lab, University of California, Berkeley, Berkeley, CA, United States
| | - Tiffany Luo
- School of Social Welfare, University of California, Berkeley, Berkeley, CA, United States
| | - Adrian Aguilera
- School of Social Welfare, University of California, Berkeley, Berkeley, CA, United States
- UCSF Center for Vulnerable Populations in the Division of General Internal Medicine San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Angela D. R. Smith
- School of Information, University of Texas at Austin, Austin, TX, United States
| | - Courtney R. Lyles
- UCSF Center for Vulnerable Populations in the Division of General Internal Medicine San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Victoria Robinson
- Ethnic Studies, University of California, Berkeley, Berkeley, CA, United States
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16
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Eichler GS, Imbert G, Branson J, Balibey R, Laramie J. Democratizing data at Novartis through clinical trial data access. Drug Discov Today 2022; 27:1533-1537. [DOI: 10.1016/j.drudis.2022.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/07/2022] [Accepted: 02/22/2022] [Indexed: 11/27/2022]
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17
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Belani S, Tiarks GC, Mookerjee N, Rajput V. "I Agree to Disagree": Comparative Ethical and Legal Analysis of Big Data and Genomics for Privacy, Consent, and Ownership. Cureus 2021; 13:e18736. [PMID: 34796049 PMCID: PMC8589338 DOI: 10.7759/cureus.18736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022] Open
Abstract
Statement of Purpose: Digital healthcare, as it relates to big data and genomics, presents a real threat to privacy and ownership rights for individuals and society. Research Question/Hypothesis: Our experience with genomics provides a lens to facilitate the way we navigate toward a future health data space. Contemporary and innovative legal and ethical models can be applied to concepts of privacy, ownership, and consent in relation to big data. Significance: Technological innovation has transformed healthcare at a faster rate than legal reform, security measures, and consent policies can adapt. The Health Information Portability and Accountability Act (HIPAA) has been recognized as a work in progress, with respect to big data as it relates to healthcare and individual wellbeing. The shortcomings of HIPAA, and its application to big data, can be paralleled with its prior limitations surrounding genomics in the last two decades. The Genetic Information and Nondiscrimination Act (2008) and Genomic Data Sharing Policy (2015) were established to overcome HIPAA’s inadequacies concerning genetic discrimination and security. These policies can serve as a basic model for our approach to legislative reform as it relates to privacy risks with big data generated in healthcare and from healthy individuals in society who are not patients. In addition to notions of privacy, concepts of ownership and consent have become increasingly vague and opaque. The technological advancements have facilitated access and transmission of information, such that big data can be sold for financial gain for commercial enterprise. This applies to genomics, with companies like 23andMe, in addition to big data, as it relates to big tech giants like Apple or Google who oversee wearable and search term data. Clarity of ownership within a digital healthcare arena needs to be defined through ethical and legal frameworks at a global level. Approach: A narrative review of the literature published between 2010 and 2021 was performed using PubMed and Google Scholar. Articles discussing privacy, security, ownership, big data, and genomics were included as relevant literature. Importance: As a society, we are at a crossroads; we must determine the extent of privacy that we are willing to give for science and society. We cannot continue with the current status quo in hope that individual will be used for the greater good of society. We need to strive for a cohesive approach to combat privacy violations by encouraging legislative reform, ethical accountability, and individual responsibility.
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Affiliation(s)
- Seema Belani
- College of Allopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
| | - Georgina C Tiarks
- College of Allopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Davie, USA
| | - Neil Mookerjee
- Medical Education, Cooper Medical School of Rowan University, Camden, USA
| | - Vijay Rajput
- Medical Education, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
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Raepsaet C, Serraes B, Verhaeghe S, Beeckman D. Integrating Sensor Technology in Disposable Body-Worn Absorbent Products: A Qualitative Study to Define User Profile, (Technical) Criteria, Conditions, and Potential Benefits. J Wound Ostomy Continence Nurs 2021; 48:560-567. [PMID: 34781313 DOI: 10.1097/won.0000000000000812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to define the user profile, (technical) criteria, conditions, and potential benefits of the integration of sensor technology in disposable body-worn incontinence materials. DESIGN Qualitative study using a framework method. SUBJECT AND SETTING The sample included residents with incontinence, nurses, and decision-makers in a selection of Flemish nursing homes (Belgium). METHODS Semistructured interviews were performed between June and August 2020. The interviews with nurses included open-ended questions focusing on the user profile, (technical) criteria, conditions, and potential benefits of the integration of sensor technology in disposable body-worn incontinence materials. The interviews with decision-makers were supplemented with questions about purchase cost and other economic criteria (such as reimbursement). Interviews with residents included questions about wearing comfort. Interviews were tape-recorded and transcribed verbatim. Data were analyzed using a framework method. RESULTS The user profile was defined as (1) residents with cognitive impairment and (2) residents who are bedridden or are severely limited in mobility. The following (technical) criteria emerged from the analyses: a small, thin, and oval/circular sensor, an adaptable or in front attachment of the sensor on the absorbent product, a real-time indication of the absorbent product's saturation, leakage detection, liquid stool detection, the automatic recording of incontinence-related data, a durable sensor easy to disinfect, and receiving notifications on a wearable device. Conditions included a stable connection between the wearable device and the sensor, accurate measurements, user-friendly system, comprehensible training, affordability, and data protection. Potential benefits included workload reduction, increased comfort for residents and staff, more person-centered care, increased quality of care, less skin damage and economic (eg, less costs due to less excessive absorbent product changes), and/or environmental (e.g. less waste) gains. CONCLUSION Study findings identified the user profile, (technical) criteria, conditions, and potential benefits of the integration of sensor technology in disposable body-worn incontinence materials. Respondents reported problems with changing routines and skepticism about the sensor's accuracy. Based on findings from this study, we recommend involving representatives of all relevant stakeholders in the design of sensor technology to ensure users' needs and increase the use of sensor technology. Comprehensive education is recommended to inform nurses, residents, and their family members on the importance and benefits of the technology and to aid overcoming barriers to use (skepticism, resistance to new technologies, and changing care routines). Study findings also indicate that the sensor technology cannot replace the existing voiding programs; rather it should be an addition to routine continence care.
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Affiliation(s)
- Charlotte Raepsaet
- Charlotte Raepsaet, Skin Integrity Research Group, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Brecht Serraes, Skin Integrity Research Group, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Sofie Verhaeghe, Professor, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, West Flanders, Belgium; Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Dimitri Beeckman, Professor Skin Integrity Research Group, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Swedish Centre for Skin and Wound Research, School of Health Sciences, Örebro University, Örebro, Sweden; Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, Odense, Denmark
| | - Brecht Serraes
- Charlotte Raepsaet, Skin Integrity Research Group, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Brecht Serraes, Skin Integrity Research Group, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Sofie Verhaeghe, Professor, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, West Flanders, Belgium; Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Dimitri Beeckman, Professor Skin Integrity Research Group, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Swedish Centre for Skin and Wound Research, School of Health Sciences, Örebro University, Örebro, Sweden; Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, Odense, Denmark
| | - Sofie Verhaeghe
- Charlotte Raepsaet, Skin Integrity Research Group, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Brecht Serraes, Skin Integrity Research Group, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Sofie Verhaeghe, Professor, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, West Flanders, Belgium; Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Dimitri Beeckman, Professor Skin Integrity Research Group, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Swedish Centre for Skin and Wound Research, School of Health Sciences, Örebro University, Örebro, Sweden; Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, Odense, Denmark
| | - Dimitri Beeckman
- Charlotte Raepsaet, Skin Integrity Research Group, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Brecht Serraes, Skin Integrity Research Group, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Sofie Verhaeghe, Professor, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, West Flanders, Belgium; Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Dimitri Beeckman, Professor Skin Integrity Research Group, University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Swedish Centre for Skin and Wound Research, School of Health Sciences, Örebro University, Örebro, Sweden; Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, Odense, Denmark
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Ash GI, Stults-Kolehmainen M, Busa MA, Gaffey AE, Angeloudis K, Muniz-Pardos B, Gregory R, Huggins RA, Redeker NS, Weinzimer SA, Grieco LA, Lyden K, Megally E, Vogiatzis I, Scher L, Zhu X, Baker JS, Brandt C, Businelle MS, Fucito LM, Griggs S, Jarrin R, Mortazavi BJ, Prioleau T, Roberts W, Spanakis EK, Nally LM, Debruyne A, Bachl N, Pigozzi F, Halabchi F, Ramagole DA, Janse van Rensburg DC, Wolfarth B, Fossati C, Rozenstoka S, Tanisawa K, Börjesson M, Casajus JA, Gonzalez-Aguero A, Zelenkova I, Swart J, Gursoy G, Meyerson W, Liu J, Greenbaum D, Pitsiladis YP, Gerstein MB. Establishing a Global Standard for Wearable Devices in Sport and Exercise Medicine: Perspectives from Academic and Industry Stakeholders. Sports Med 2021; 51:2237-2250. [PMID: 34468950 PMCID: PMC8666971 DOI: 10.1007/s40279-021-01543-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 10/20/2022]
Abstract
Millions of consumer sport and fitness wearables (CSFWs) are used worldwide, and millions of datapoints are generated by each device. Moreover, these numbers are rapidly growing, and they contain a heterogeneity of devices, data types, and contexts for data collection. Companies and consumers would benefit from guiding standards on device quality and data formats. To address this growing need, we convened a virtual panel of industry and academic stakeholders, and this manuscript summarizes the outcomes of the discussion. Our objectives were to identify (1) key facilitators of and barriers to participation by CSFW manufacturers in guiding standards and (2) stakeholder priorities. The venues were the Yale Center for Biomedical Data Science Digital Health Monthly Seminar Series (62 participants) and the New England Chapter of the American College of Sports Medicine Annual Meeting (59 participants). In the discussion, stakeholders outlined both facilitators of (e.g., commercial return on investment in device quality, lucrative research partnerships, and transparent and multilevel evaluation of device quality) and barriers (e.g., competitive advantage conflict, lack of flexibility in previously developed devices) to participation in guiding standards. There was general agreement to adopt Keadle et al.'s standard pathway for testing devices (i.e., benchtop, laboratory, field-based, implementation) without consensus on the prioritization of these steps. Overall, there was enthusiasm not to add prescriptive or regulatory steps, but instead create a networking hub that connects companies to consumers and researchers for flexible guidance navigating the heterogeneity, multi-tiered development, dynamicity, and nebulousness of the CSFW field.
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Affiliation(s)
- Garrett I Ash
- Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
- Center for Medical Informatics, Yale University, New Haven, CT, USA
| | - Matthew Stults-Kolehmainen
- Digestive Health Multispecialty Clinic, Yale-New Haven Hospital, New Haven, CT, USA
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Michael A Busa
- Center for Human Health and Performance, Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA
- Department of Kinesiology, University of Massachusetts, Amherst, MA, USA
| | - Allison E Gaffey
- Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
- Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine, New Haven, CT, USA
| | | | - Borja Muniz-Pardos
- GENUD Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
| | - Robert Gregory
- Department of Health and Movement Sciences, Southern Connecticut State University, New Haven, CT, USA
| | - Robert A Huggins
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, CT, USA
| | | | | | | | | | | | - Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, School Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
- European Respiratory Society (ERS), Digital Health Working Group, Lausanne, Switzerland
| | - LaurieAnn Scher
- Consumer Technology Association Working Groups for Health Technology Standards, Washington, DC, USA
- Fitscript LLC, New Haven, CT, USA
| | - Xinxin Zhu
- Center for Biomedical Data Science, Yale School of Medicine, New Haven, CT, USA
| | - Julien S Baker
- Faculty of Sports Science, Ningbo University, Ningbo, China
- School of Health and Life Sciences, Institute for Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, Scotland, UK
- Department of Sport, Physical Education and Health, Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Cynthia Brandt
- Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
- Center for Medical Informatics, Yale University, New Haven, CT, USA
- Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Michael S Businelle
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Tobacco Settlement Endowment Trust Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
| | - Lisa M Fucito
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
- Smilow Cancer Hospital, Yale-New Haven Hospital, New Haven, CT, USA
| | - Stephanie Griggs
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Robert Jarrin
- Department of Emergency Medicine, George Washington University, Washington, DC, USA
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Washington, DC, USA
| | - Bobak J Mortazavi
- Department of Computer Science and Engineering, Texas A&M University, College Station, TX, USA
| | | | - Walter Roberts
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Elias K Spanakis
- University of Maryland School of Medicine, Baltimore, MD, USA
- Division of Endocrinology, Baltimore Veterans Affairs Medical Center, Maryland, USA
| | - Laura M Nally
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - Andre Debruyne
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
| | - Norbert Bachl
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
- Institute of Sports Science, University of Vienna, Vienna, Austria
- Austrian Institute of Sports Medicine, Vienna, Austria
| | - Fabio Pigozzi
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
- Villa Stuart Sport Clinic, FIFA Medical Center of Excellence, Rome, Italy
| | - Farzin Halabchi
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Dimakatso A Ramagole
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Dina C Janse van Rensburg
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Bernd Wolfarth
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Department of Sports Medicine, Humboldt University and Charité University School of Medicine, Berlin, Germany
| | - Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Sandra Rozenstoka
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
- FIMS Collaboration Centre of Sports Medicine, Sports Laboratory, Riga, Latvia
| | - Kumpei Tanisawa
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Mats Börjesson
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Department of Molecular and Clinical Medicine, Center for Health and Performance, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
- Department of MGA, Region of Western Sweden, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - José Antonio Casajus
- GENUD Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
| | - Alex Gonzalez-Aguero
- GENUD Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
| | - Irina Zelenkova
- GENUD Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
- I.M. Sechenov First Moscow State Medical University (Sechenov University, Ministry of Health of Russia, Moscow, Russia
| | - Jeroen Swart
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Division of Physiological Sciences and HPALS Research Centre, FIMS Collaboration Centre of Sports Medicine, University of Cape Town, Cape Town, South Africa
| | - Gamze Gursoy
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA
| | - William Meyerson
- Duke Psychiatry and Behavioral Sciences, Duke Medicine, Durham, NC, USA
- Department of Molecular Biophysics and Biochemistry, Yale University, New Haven, CT, USA
| | - Jason Liu
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA
| | - Dov Greenbaum
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA
- Zvi Meitar Institute for Legal Implications of Emerging Technologies, Interdisciplinary Center Herzliya, Herzliya, Israel
- Harry Radyzner Law School, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - Yannis P Pitsiladis
- Centre for Stress and Age-related Disease, University of Brighton, Brighton, UK.
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland.
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland.
| | - Mark B Gerstein
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA
- Department of Molecular Biophysics and Biochemistry, Yale University, New Haven, CT, USA
- Department of Computer Science, Yale University, New Haven, CT, USA
- Department of Statistics and Data Science, Yale University, New Haven, CT, USA
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20
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Dirzu N, Hotea I, Jitaru C, Brinza M, Urian L, Peters MC, Gal K, Popescu L, Blag C, Marian M, Pal E, Stanescu M, Cenariu D, Tarniceriu C, Serban M, Dima D, Coriu D, Tomuleasa C. Mobile Health Technology for the Personalized Therapy of Hemophilia. Front Med (Lausanne) 2021; 8:711973. [PMID: 34447770 PMCID: PMC8382969 DOI: 10.3389/fmed.2021.711973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/12/2021] [Indexed: 01/19/2023] Open
Abstract
The management of patients with hemophilia has evolved significantly since the first treatment attempts were made in the late 1930s. Since then, each new step in the treatment of patients with hemophilia has brought important advancements, as well as its unique set of challenges. Today, a patient-centered, individualized comprehensive approach is the new paradigm, moving away from the traditional "one size-fits-all" approach, to provide the best possible care for each patient with a bleeding disorder. As part of this complex task, mobile health applications might have the capacity to play an important role in reaching that goal. However, the use of new electronic technologies as part of a comprehensive treatment approach for patients with hemophilia simultaneously presents a new set of challenges that needs consideration. In the first section, currently available treatment of hemophilia patients will be revised, while in the second part the role of IT software in the treatment monitoring of hemophilia patients will be discussed.
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Affiliation(s)
- Noemi Dirzu
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, Cluj Napoca, Romania
| | - Ionut Hotea
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, Cluj Napoca, Romania.,Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, Cluj Napoca, Romania.,Department of Hematology, Ion Chiricuta Clinical Cancer Center, Cluj Napoca, Romania
| | - Ciprian Jitaru
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, Cluj Napoca, Romania.,Department of Hematology, Ion Chiricuta Clinical Cancer Center, Cluj Napoca, Romania
| | - Melen Brinza
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania.,Department of Hematology, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | - Laura Urian
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, Cluj Napoca, Romania.,Department of Hematology, Ion Chiricuta Clinical Cancer Center, Cluj Napoca, Romania
| | - Mareike-Catrina Peters
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, Cluj Napoca, Romania
| | - Krisztina Gal
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, Cluj Napoca, Romania
| | - Louis Popescu
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, Cluj Napoca, Romania
| | - Cristina Blag
- Department of Pediatrics, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, Cluj Napoca, Romania.,Department of Hematology, Emergency Clinical Children's Hospital, Cluj Napoca, Romania
| | - Mirela Marian
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, Cluj Napoca, Romania
| | - Eva Pal
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, Cluj Napoca, Romania
| | | | - Diana Cenariu
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, Cluj Napoca, Romania
| | - Cristina Tarniceriu
- Department of Anatomy, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.,Department of Hematology, St. Spiridon County Clinical Emergency Hospital, Iasi, Romania
| | - Margit Serban
- Department of Hematology, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania.,European Haemophilia Treatment Center, Timisoara, Romania
| | - Delia Dima
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, Cluj Napoca, Romania
| | - Daniel Coriu
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania.,Department of Hematology, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | - Ciprian Tomuleasa
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, Cluj Napoca, Romania.,Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, Cluj Napoca, Romania.,Department of Hematology, Ion Chiricuta Clinical Cancer Center, Cluj Napoca, Romania
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21
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Anýž J, Bakštein E, Dally A, Kolenič M, Hlinka J, Hartmannová T, Urbanová K, Correll CU, Novák D, Španiel F. Validity of the Aktibipo Self-rating Questionnaire for the Digital Self-assessment of Mood and Relapse Detection in Patients With Bipolar Disorder: Instrument Validation Study. JMIR Ment Health 2021; 8:e26348. [PMID: 34383689 PMCID: PMC8386400 DOI: 10.2196/26348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/23/2021] [Accepted: 05/10/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Self-reported mood is a valuable clinical data source regarding disease state and course in patients with mood disorders. However, validated, quick, and scalable digital self-report measures that can also detect relapse are still not available for clinical care. OBJECTIVE In this study, we aim to validate the newly developed ASERT (Aktibipo Self-rating) questionnaire-a 10-item, mobile app-based, self-report mood questionnaire consisting of 4 depression, 4 mania, and 2 nonspecific symptom items, each with 5 possible answers. The validation data set is a subset of the ongoing observational longitudinal AKTIBIPO400 study for the long-term monitoring of mood and activity (via actigraphy) in patients with bipolar disorder (BD). Patients with confirmed BD are included and monitored with weekly ASERT questionnaires and monthly clinical scales (Montgomery-Åsberg Depression Rating Scale [MADRS] and Young Mania Rating Scale [YMRS]). METHODS The content validity of the ASERT questionnaire was assessed using principal component analysis, and the Cronbach α was used to assess the internal consistency of each factor. The convergent validity of the depressive or manic items of the ASERT questionnaire with the MADRS and YMRS, respectively, was assessed using a linear mixed-effects model and linear correlation analyses. In addition, we investigated the capability of the ASERT questionnaire to distinguish relapse (YMRS≥15 and MADRS≥15) from a nonrelapse (interepisode) state (YMRS<15 and MADRS<15) using a logistic mixed-effects model. RESULTS A total of 99 patients with BD were included in this study (follow-up: mean 754 days, SD 266) and completed an average of 78.1% (SD 18.3%) of the requested ASERT assessments (completion time for the 10 ASERT questions: median 24.0 seconds) across all patients in this study. The ASERT depression items were highly associated with MADRS total scores (P<.001; bootstrap). Similarly, ASERT mania items were highly associated with YMRS total scores (P<.001; bootstrap). Furthermore, the logistic mixed-effects regression model for scale-based relapse detection showed high detection accuracy in a repeated holdout validation for both depression (accuracy=85%; sensitivity=69.9%; specificity=88.4%; area under the receiver operating characteristic curve=0.880) and mania (accuracy=87.5%; sensitivity=64.9%; specificity=89.9%; area under the receiver operating characteristic curve=0.844). CONCLUSIONS The ASERT questionnaire is a quick and acceptable mood monitoring tool that is administered via a smartphone app. The questionnaire has a good capability to detect the worsening of clinical symptoms in a long-term monitoring scenario.
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Affiliation(s)
- Jiří Anýž
- National Insitute of Mental Health, Klecany, Czech Republic
| | | | | | - Marián Kolenič
- National Insitute of Mental Health, Klecany, Czech Republic
| | | | - Tereza Hartmannová
- National Insitute of Mental Health, Klecany, Czech Republic.,Mindpax s.r.o, Prague, Czech Republic
| | - Kateřina Urbanová
- National Insitute of Mental Health, Klecany, Czech Republic.,Mindpax s.r.o, Prague, Czech Republic
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY, United States.,Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.,Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel Novák
- Department of Cybernetics, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Filip Španiel
- National Insitute of Mental Health, Klecany, Czech Republic
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22
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Gruson D. Controlling Reliability, Interoperability and Security of Mobile Health Solutions. EJIFCC 2021; 32:118-123. [PMID: 34421479 PMCID: PMC8343048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Mobile health (mHealth), including mobile devices and digital services, is a component of the transforming health ecosystem. The validation of the scientific validity, analytical performance, clinical performance and security of mHealth solutions is critical to guarantee patient care and safety. To this end, laboratory experts, scientific societies and notified bodies should define and recommend validation framework addressing multiple dimensions.
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Affiliation(s)
- Damien Gruson
- Department of Clinical Biochemistry, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium
- Pole de recherche en Endocrinologie, Diabète et Nutrition, Institut de Recherche Expérimental et Clinique, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium
- Emerging Technologies Division, International Federation of Clinical Chemistry and Laboratory Medicine
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23
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Prospective Intention-Based Lifestyle Contracts: mHealth Technology and Responsibility in Healthcare. HEALTH CARE ANALYSIS 2021; 29:189-212. [PMID: 33428016 PMCID: PMC8321967 DOI: 10.1007/s10728-020-00424-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2020] [Indexed: 10/25/2022]
Abstract
As the rising costs of lifestyle-related diseases place increasing strain on public healthcare systems, the individual's role in disease may be proposed as a healthcare rationing criterion. Literature thus far has largely focused on retrospective responsibility in healthcare. The concept of prospective responsibility, in the form of a lifestyle contract, warrants further investigation. The responsibilisation in healthcare debate also needs to take into account innovative developments in mobile health technology, such as wearable biometric devices and mobile apps, which may change how we hold others accountable for their lifestyles. Little is known about public attitudes towards lifestyle contracts and the use of mobile health technology to hold people responsible in the context of healthcare. This paper has two components. Firstly, it details empirical findings from a survey of 81 members of the United Kingdom general public on public attitudes towards individual responsibility and rationing healthcare, prospective and retrospective responsibility, and the acceptability of lifestyle contracts in the context of mobile health technology. Secondly, we draw on the empirical findings and propose a model of prospective intention-based lifestyle contracts, which is both more aligned with public intuitions and less ethically objectionable than more traditional, retrospective models of responsibility in healthcare.
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24
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Zhang M, Chow A, Smith H. COVID-19 Contact-Tracing Apps: Analysis of the Readability of Privacy Policies. J Med Internet Res 2020; 22:e21572. [PMID: 33170798 PMCID: PMC7717894 DOI: 10.2196/21572] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/25/2020] [Accepted: 10/08/2020] [Indexed: 12/30/2022] Open
Abstract
Apps that enable contact-tracing are instrumental in mitigating the transmission of COVID-19, but there have been concerns among users about the data collected by these apps and their management. Contact tracing is of paramount importance when dealing with a pandemic, as it allows for rapid identification of cases based on the information collected from infected individuals about other individuals they may have had recent contact with. Advances in digital technology have enabled devices such as mobile phones to be used in the contract-tracing process. However, there is a potential risk of users’ personal information and sensitive data being stolen should hackers be in the near vicinity of these devices. Thus, there is a need to develop privacy-preserving apps. Meanwhile, privacy policies that outline the risk associated with the use of contact-tracing apps are needed, in formats that are easily readable and comprehensible by the public. To our knowledge, no previous study has examined the readability of privacy policies of contact-tracings apps. Therefore, we performed a readability analysis to evaluate the comprehensibility of privacy policies of 7 contact-tracing apps currently in use. The contents of the privacy policies of these apps were assessed for readability using Readability Test Tool, a free web-based reliability calculator, which computes scores based on a number of statistics (ie, word count and the number of complex words) and indices (ie, Flesch Reading Ease, Flesch-Kincaid Reading Grade Level, Gunning Fog Index, and Simplified Measure of Gobbledygook index). Our analysis revealed that explanations used in the privacy policies of these apps require a reading grade between 7 and 14, which is considerably higher than the reading ability of the average individual. We believe that improving the readability of privacy policies of apps could be potentially reassuring for users and may help facilitate the increased use of such apps.
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Affiliation(s)
- Melvyn Zhang
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Aloysius Chow
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Helen Smith
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
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