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Restrepo E, Ko N, Warner ET. An evaluation of readability and understandability of online education materials for breast cancer survivors. J Cancer Surviv 2024; 18:457-465. [PMID: 35913680 DOI: 10.1007/s11764-022-01240-w] [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: 03/24/2022] [Accepted: 07/22/2022] [Indexed: 10/16/2022]
Abstract
PURPOSE We aimed to determine the availability of existing web-based educational materials on breast cancer survivorship and assess their readability and understandability. METHODS We identified materials eligible for review in two ways: (1) reviews of websites of major cancer-related organizations (e.g., American Cancer Society); (2) Google searches for breast cancer survivorship, breast cancer, breast cancer follow-up care, and cancer survivorship. We measured Flesch-Kincaid and New Dale Readability of existing breast cancer and breast cancer survivorship materials. Readability grade levels 5 to 8 were considered ideal to acceptable. We used the Patient Education Materials Assessment Tool (PEMAT) to measure the understandability of 53 videos and 152 written materials, such as booklets and manuals. A resource was considered understandable and/or actionable if it scored ≥ 70% on either the understandability section or the actionability section of the PEMAT. RESULTS We identified a total of 205 existing materials including brochures, booklets, facts sheets, websites, and videos in English. The average Flesch-Kincaid grade score of written educational materials was 9.7 (range 3.5-16.4), which translates to a 9th grade reading level. According to the New Dale-Chall readability assessment, most of the materials were in the 9 to 10 grade level range. The average PEMAT score was 88.6% (range 56-100%). CONCLUSION Patient educational materials are available online as printable, written materials, and videos and they focus on a wide selection of survivorship-related topics. Most of the breast cancer educational materials that are available online were above an 8th grade reading level. The PEMAT results, however, suggest that materials are easy to understand regarding word choice and style, use of numbers, organization, layout and design, and use of visual aids. IMPLICATIONS FOR CANCER SURVIVORS Understandable patient education materials are essential for guiding breast cancer survivors towards improving their health outcomes and optimizing their quality of life.
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Affiliation(s)
- Emily Restrepo
- Department of Medicine, Mongan Institute, Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA, USA.
| | - Naomi Ko
- Belkin Breast Health Center, Boston Medical Center, Boston, MA, USA
| | - Erica T Warner
- Department of Medicine, Mongan Institute, Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA, USA
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2
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Kirsch EP, Kunte SA, Wu KA, Kaplan S, Hwang ES, Plichta JK, Lad SP. Digital Health Platforms for Breast Cancer Care: A Scoping Review. J Clin Med 2024; 13:1937. [PMID: 38610702 PMCID: PMC11012307 DOI: 10.3390/jcm13071937] [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: 02/28/2024] [Revised: 03/12/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024] Open
Abstract
Breast cancer is a significant global health concern affecting millions of women each year. Digital health platforms are an easily accessible intervention that can improve patient care, though their efficacy in breast cancer care is unknown. This scoping review aims to provide an overview of existing research on the utilization of digital health platforms for breast cancer care and identify key trends and gaps in the literature. A comprehensive literature search was conducted across electronic databases, including Ovid MEDLINE, Elsevier EMBASE, and Elsevier Scopus databases. The search strategy incorporated keywords related to "digital health platforms", "breast cancer care", and associated terminologies. After screening for eligibility, a total of 25 articles were included in this scoping review. The identified studies comprised mobile applications and web-based interventions. These platforms demonstrated various functionalities, including patient education, symptom monitoring, treatment adherence, and psychosocial support. The findings indicate the potential of digital health platforms in improving breast cancer care and patients' overall experiences. The positive impact on patient outcomes, including improved quality of life and reduced psychological distress, underscores the importance of incorporating digital health solutions into breast cancer management. Additional research is necessary to validate the effectiveness of these platforms in diverse patient populations and assess their impact on healthcare-resource utilization.
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Affiliation(s)
- Elayna P. Kirsch
- Department of Neurosurgery, Duke University Medical Center, Durham, NC 27710, USA
| | - Sameer A. Kunte
- Department of Neurosurgery, Duke University Medical Center, Durham, NC 27710, USA
| | - Kevin A. Wu
- Department of Neurosurgery, Duke University Medical Center, Durham, NC 27710, USA
| | - Samantha Kaplan
- Medical Center Library & Archives, Duke University School of Medicine, Durham, NC 27710, USA
| | - E. Shelley Hwang
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA (J.K.P.)
| | - Jennifer K. Plichta
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA (J.K.P.)
| | - Shivanand P. Lad
- Department of Neurosurgery, Duke University Medical Center, Durham, NC 27710, USA
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3
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Fleck JL, Hooijenga D, Phan R, Xie X, Augusto V, Heudel PE. Adjuvant therapeutic strategy decision support for an elderly population with localized breast cancer: A monocentric cohort retrospective study. PLoS One 2023; 18:e0290566. [PMID: 37616325 PMCID: PMC10449163 DOI: 10.1371/journal.pone.0290566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
Guidelines for the management of elderly patients with early breast cancer are scarce. Additional adjuvant systemic treatment to surgery for early breast cancer in elderly populations is challenged by increasing comorbidities with age. In non-metastatic settings, treatment decisions are often made under considerable uncertainty; this commonly leads to undertreatment and, consequently, poorer outcomes. This study aimed to develop a decision support tool that can help to identify candidate adjuvant post-surgery treatment schemes for elderly breast cancer patients based on tumor and patient characteristics. Our approach was to generate predictions of patient outcomes for different courses of action; these predictions can, in turn, be used to inform clinical decisions for new patients. We used a cohort of elderly patients (≥ 70 years) who underwent surgery with curative intent for early breast cancer to train the models. We tested seven classification algorithms using 5-fold cross-validation, with 80% of the data being randomly selected for training and the remaining 20% for testing. We assessed model performance using accuracy, precision, recall, F1-score, and AUC score. We used an autoencoder to perform dimensionality reduction prior to classification. We observed consistently better performance using logistic regression and linear discriminant analysis models when compared to the other models we tested. Classification performance generally improved when an autoencoder was used, except for when we predicted the need for adjuvant treatment. We obtained overall best results using a logistic regression model without autoencoding to predict the need for adjuvant treatment (F1-score = 0.869).
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Affiliation(s)
- Julia L. Fleck
- Mines Saint-Etienne, Univ Clermont Auvergne, CNRS, UMR 6158 LIMOS, Centre CIS, Saint-Etienne, France
| | - Daniëlle Hooijenga
- Mines Saint-Etienne, Univ Clermont Auvergne, CNRS, UMR 6158 LIMOS, Centre CIS, Saint-Etienne, France
| | - Raksmey Phan
- Mines Saint-Etienne, Univ Clermont Auvergne, CNRS, UMR 6158 LIMOS, Centre CIS, Saint-Etienne, France
| | - Xiaolan Xie
- Mines Saint-Etienne, Univ Clermont Auvergne, CNRS, UMR 6158 LIMOS, Centre CIS, Saint-Etienne, France
| | - Vincent Augusto
- Mines Saint-Etienne, Univ Clermont Auvergne, CNRS, UMR 6158 LIMOS, Centre CIS, Saint-Etienne, France
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Maes-Carballo M, Martín-Díaz M, García-García M, Reinoso-Hermida A, Mignini L, Teixeira-Arcaya RP, Khan KS, Bueno-Cavanillas A. Decision Aids for Decision Making about Locally Advance Breast Cancer: A Systematic Review. Cancer Invest 2023; 41:1-13. [PMID: 36591950 DOI: 10.1080/07357907.2023.2164895] [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: 10/24/2022] [Revised: 12/03/2022] [Accepted: 12/30/2022] [Indexed: 01/03/2023]
Abstract
Locally advanced breast cancer (LABC) is a subset of breast cancer with locoregional progression without distant metastasis. The multimodality treatment (surgery, chemotherapy, radiotherapy, hormonal and targeted therapy if required) could significantly improve results in this specific group of patients. The complex and multiple options of treatment with similar mortality rates but different outcomes depending on the patient's desires, preferences and social environment require aid to facilitate the individual patient's decisions (e.g. Decision Aids (DAs) targeting patients considering primary or adjuvant treatment in LABC). In this context, DAs have been proven fundamental to help patients and clinicians share and agree on the best value option. The current systematic review aimed to evaluate the existing DAs related to these patients with LABC and identify current status and possible improvement areas (possible scarcity and heterogeneity of instruments, the status of their development, explanation of their purpose,…). No previous systematic reviews have been published on this topic. Following Prospero registration no: CRD42021286173, studies about LABC DAs were identified, without data or language restrictions, through a systematic search of bibliographic databases in December 2021. Quality was assessed using Qualsyst criteria (range 0.0-1.0). The quality of the 17 selected studies ranged from 0.46 to 0.95. Of them, 14/17 (82%) were DAs about treatment, only one (6%) about diagnosis, and 2/17 (12%) about the employment of DAs. No screening or follow-up DAs were retrieved. Twelve (70.6%) DAs were online tools. They varied broadly regarding their characteristics and purposes. Most of the studies focused on developing and testing different DAs (5/17; 29.4%) and their impact (7/17; 41.2%). Only 4/17 (23.5%) analysed their implementation and cost. These instruments have proven to improve patient's knowledge and decision-making, decrease patient anxiety, and patients tend to undergo treatment. However, nowadays, there is still a need for further research and consensus on methodology to develop practical DAs.
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Affiliation(s)
- Marta Maes-Carballo
- Department of General Surgery, Breast Cancer Unit, Complexo Hospitalario de Ourense, Ourense, Spain
- Department of General Surgery, Hospital Público de Verín, Ourense, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Manuel Martín-Díaz
- Department of General Surgery, Hospital Santa Ana de Motril, Granada, Spain
| | - Manuel García-García
- Department of General Surgery, Breast Cancer Unit, Complexo Hospitalario de Ourense, Ourense, Spain
- Departmento de Cirugía General, Unidad de Mastología de Grupo Oroño, Rosario, Argentina
| | - Ayla Reinoso-Hermida
- Department of General Surgery, Breast Cancer Unit, Complexo Hospitalario de Ourense, Ourense, Spain
| | - Luciano Mignini
- Departmento de Cirugía General, Unidad de Mastología de Grupo Oroño, Rosario, Argentina
| | | | - Khalid Saeed Khan
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria IBS, Granada, Spain
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Roumen C, Hasannejadasl H, Swart R, Raphael D, Wee L, Sloep M, van den Bongard DHJG, Verkooijen H, Thijssen S, Velting M, Schuurman M, Russell NS, Fijten R, Boersma LJ. Breast cancer patients’ most important quality of life themes for a radiotherapy decision aid. Breast 2022; 65:8-14. [PMID: 35728438 PMCID: PMC9218231 DOI: 10.1016/j.breast.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/23/2022] [Accepted: 06/05/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Cheryl Roumen
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET, Maastricht, the Netherlands.
| | - Hajar Hasannejadasl
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET, Maastricht, the Netherlands.
| | - Rachelle Swart
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET, Maastricht, the Netherlands.
| | - Daniela Raphael
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET, Maastricht, the Netherlands.
| | - Leonard Wee
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET, Maastricht, the Netherlands.
| | - Matthijs Sloep
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET, Maastricht, the Netherlands.
| | - Desiree H J G van den Bongard
- Department of Radiation Oncology, Amsterdam University Medical Centers, De Boelelaan 1117 and 1118, 1081 HV, Amsterdam, Amsterdam, the Netherlands.
| | - Helena Verkooijen
- Division of Imaging and Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands.
| | - Salina Thijssen
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET, Maastricht, the Netherlands.
| | | | | | - Nicola S Russell
- Department of Radiotherapy, The Netherlands Cancer Institute- Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
| | - Rianne Fijten
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET, Maastricht, the Netherlands.
| | - Liesbeth J Boersma
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET, Maastricht, the Netherlands.
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6
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Win H, Russell S, Wertheim BC, Maizes V, Crocker R, Brooks AJ, Mesa R, Huberty J, Geyer H, Eckert R, Larsen A, Gowin K. Mobile App Intervention on Reducing the Myeloproliferative Neoplasm Symptom Burden: Pilot Feasibility and Acceptability Study. JMIR Form Res 2022; 6:e33581. [PMID: 35357315 PMCID: PMC9015738 DOI: 10.2196/33581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/21/2021] [Accepted: 01/12/2022] [Indexed: 12/12/2022] Open
Abstract
Background Myeloproliferative neoplasms (MPNs) are a group of myeloid malignancies associated with significant symptom burden. Despite pharmacological advances in therapies, inadequate management of MPN symptoms results in reduced quality of life. Objective This study aims to determine the feasibility of a 12-week global wellness mobile app intervention in decreasing MPN symptom burden. The University of Arizona Andrew Weil Center for Integrative Medicine’s global wellness mobile app, My Wellness Coach (MWC), guides patients to improve their health and well-being through facilitating behavior changes. Methods Of the 30 patients enrolled in a 12-week intervention, 16 (53%) were retained through the final assessment. Feasibility was assessed by the ease of recruitment, participant adherence, and mobile app acceptability. App acceptability was measured using the user version of the Mobile Application Rating Scale. MPN symptom burden was measured at baseline and 12 weeks after the intervention. Results Recruitment was efficient, with the participant goal reached within a 60-day period, suggestive of a demand for such an intervention. Adherence was less than the target within study design (75%), although similar to mobile device app use in other studies (53%). The app was deemed acceptable based on the mean user version of the Mobile Application Rating Scale 3-star rating by participants. Finally, there were statistically significant improvements in several MPN symptoms, quality of life, and total score on the Myeloproliferative Neoplasm Symptom Assessment Form surveys. Conclusions Our 12-week intervention with the MWC app was feasible and was associated with a decrease in MPN symptom burden. Further investigation of the MWC app for use as a self-management strategy to reduce the symptom burden in patients with MPN is warranted.
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Affiliation(s)
- Hninyee Win
- Department of Medicine, University of Arizona, Tucson, AZ, United States
| | - Samantha Russell
- Department of Medicine, University of Arizona, Tucson, AZ, United States
| | | | - Victoria Maizes
- Andrew Weil Center for Integrative Medicine, University of Arizona, Tucson, AZ, United States
| | - Robert Crocker
- Andrew Weil Center for Integrative Medicine, University of Arizona, Tucson, AZ, United States
| | - Audrey J Brooks
- Andrew Weil Center for Integrative Medicine, University of Arizona, Tucson, AZ, United States
| | - Ruben Mesa
- Mays Cancer Center, University of Texas, San Antonio, TX, United States
| | - Jennifer Huberty
- Department of Hematology, University of Arizona, Tucson, AZ, United States
| | - Holly Geyer
- Mays Cancer Center, University of Texas, San Antonio, TX, United States
| | - Ryan Eckert
- Mays Cancer Center, University of Texas, San Antonio, TX, United States
| | - Ashley Larsen
- Department of Medicine, University of Arizona, Tucson, AZ, United States
| | - Krisstina Gowin
- Department of Hematology, University of Arizona, Tucson, AZ, United States
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7
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Burnett JL, Dale R, Hou CY, Palomo-Munoz G, Whitney KS, Aulenbach S, Bristol RS, Valle D, Wellman TP. Ten simple rules for creating a scientific web application. PLoS Comput Biol 2021; 17:e1009574. [PMID: 34882674 PMCID: PMC8659688 DOI: 10.1371/journal.pcbi.1009574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The use of scientific web applications (SWApps) across biological and environmental sciences has grown exponentially over the past decade or so. Although quantitative evidence for such increased use in practice is scant, collectively, we have observed that these tools become more commonplace in teaching, outreach, and in science coproduction (e.g., as decision support tools). Despite the increased popularity of SWApps, researchers often receive little or no training in creating such tools. Although rolling out SWApps can be a relatively simple and quick process using modern, popular platforms like R shiny apps or Tableau dashboards, making them useful, usable, and sustainable is not. These 10 simple rules for creating a SWApp provide a foundation upon which researchers with little to no experience in web application design and development can consider, plan, and carry out SWApp projects.
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Affiliation(s)
- Jessica L. Burnett
- U.S. Geological Survey, Core Science Systems Science Analytics and Synthesis, Lakewood, Colorado, United States of America
- * E-mail:
| | - Renee Dale
- Donald Danforth Plant Science Center, Olivette, Missouri, United States of America
| | - Chung-Yi Hou
- Apogee Engineering, Colorado Springs, Colorado, United States of America
| | - Gabriela Palomo-Munoz
- School of Natural Resources, University of Nebraska-Lincoln, Nebraska, United States of America
| | | | - Steve Aulenbach
- U.S. Geological Survey, Core Science Systems Science Analytics and Synthesis, Lakewood, Colorado, United States of America
| | - Robert Sky Bristol
- U.S. Geological Survey, Core Science Systems Science Analytics and Synthesis, Lakewood, Colorado, United States of America
| | - Denis Valle
- School of Forest Resources and Conservation, University of Florida, Gainesville, Florida, United States of America
| | - Tristan P. Wellman
- U.S. Geological Survey, Core Science Systems Science Analytics and Synthesis, Lakewood, Colorado, United States of America
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Yung A, Kay J, Beale P, Gibson KA, Shaw T. Computer-Based Decision Tools for Shared Therapeutic Decision-making in Oncology: Systematic Review. JMIR Cancer 2021; 7:e31616. [PMID: 34544680 PMCID: PMC8579220 DOI: 10.2196/31616] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Therapeutic decision-making in oncology is a complex process because physicians must consider many forms of medical data and protocols. Another challenge for physicians is to clearly communicate their decision-making process to patients to ensure informed consent. Computer-based decision tools have the potential to play a valuable role in supporting this process. OBJECTIVE This systematic review aims to investigate the extent to which computer-based decision tools have been successfully adopted in oncology consultations to improve patient-physician joint therapeutic decision-making. METHODS This review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist and guidelines. A literature search was conducted on February 4, 2021, across the Cochrane Database of Systematic Reviews (from 2005 to January 28, 2021), the Cochrane Central Register of Controlled Trials (December 2020), MEDLINE (from 1946 to February 4, 2021), Embase (from 1947 to February 4, 2021), Web of Science (from 1900 to 2021), Scopus (from 1969 to 2021), and PubMed (from 1991 to 2021). We used a snowball approach to identify additional studies by searching the reference lists of the studies included for full-text review. Additional supplementary searches of relevant journals and gray literature websites were conducted. The reviewers screened the articles eligible for review for quality and inclusion before data extraction. RESULTS There are relatively few studies looking at the use of computer-based decision tools in oncology consultations. Of the 4431 unique articles obtained from the searches, only 10 (0.22%) satisfied the selection criteria. From the 10 selected studies, 8 computer-based decision tools were identified. Of the 10 studies, 6 (60%) were conducted in the United States. Communication and information-sharing were improved between physicians and patients. However, physicians did not change their habits to take advantage of computer-assisted decision-making tools or the information they provide. On average, the use of these computer-based decision tools added approximately 5 minutes to the total length of consultations. In addition, some physicians felt that the technology increased patients' anxiety. CONCLUSIONS Of the 10 selected studies, 6 (60%) demonstrated positive outcomes, 1 (10%) showed negative results, and 3 (30%) were neutral. Adoption of computer-based decision tools during oncology consultations continues to be low. This review shows that information-sharing and communication between physicians and patients can be improved with the assistance of technology. However, the lack of integration with electronic health records is a barrier. This review provides key requirements for enhancing the chance of success of future computer-based decision tools. However, it does not show the effects of health care policies, regulations, or business administration on physicians' propensity to adopt the technology. Nevertheless, it is important that future research address the influence of these higher-level factors as well. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42021226087; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021226087.
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Affiliation(s)
- Alan Yung
- Research in Implementation Science and eHealth, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Judy Kay
- Human Centred Technology Cluster, School of Computer Science, The University of Sydney, Sydney, Australia
| | - Philip Beale
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, Australia
| | - Kathryn A Gibson
- Department of Rheumatology, Liverpool Hospital, Ingham Research Institute, University of New South Wales, Sydney, Australia
| | - Tim Shaw
- Research in Implementation Science and eHealth, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Sydney Catalyst Translational Cancer Research Centre, The University of Sydney, Sydney, Australia
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9
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Wu D, Lowry PB, Zhang D, Parks RF. Patients' compliance behavior in a personalized mobile patient education system (PMPES) setting: Rational, social, or personal choices? Int J Med Inform 2020; 145:104295. [PMID: 33129124 DOI: 10.1016/j.ijmedinf.2020.104295] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 09/19/2020] [Accepted: 10/02/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE With the advancement of mobile technologies, patients can access medical and patient educational information anytime and anywhere. Computer-aided patient education has been advocated as a key means of interventions for improving patient knowledge and compliance (i.e., adherence). However, evidence of the efficacy of computer-aided patient education remains relatively limited. For example, little is known about how the latest mobile technologies influence patients' compliance intention and their actual compliance behavior. The objective of this study is to investigate patients' compliance intention and behavior using a personalized mobile patient education system (PMPES) as a novel technological intervention for patients based on rational choice theory (RCT) and the theory of planned behavior (TPB). MATERIALS AND METHODS We conducted a field survey with 125 actual patients in U.S. who obtained their patient education through PMPES while seeking medical treatment advice from their doctors. We used partial least squares (PLS) regression path modeling to test our model. RESULTS We found that, based on RCT, the benefits of compliance and cost/threat of noncompliance positively influenced intention toward treatment compliance; in contrast, costs of compliance negatively influenced intention toward treatment compliance. However, the benefits of noncompliance had no effect on intention toward treatment compliance. The results also indicated that intention toward treatment compliance, response efficacy, and self-efficacy related to TPB jointly influenced the degree of actual compliance behaviors. Social influence factors including subjective norms and descriptive norms had no influence on patients' actual treatment compliance behavior. CONCLUSION Overall, the research model explains 69.2 % of the variance in patients' actual compliance behavior. We find our model robust in using RCT as a key theoretical lens for the assessment of patients' compliance intention to follow medical recommendations enabled by the PMPES and delivered to mobile devices. The factors associated with RCT and TPB jointly influence patients' actual compliance behavior. Future mobile patient education programs should consider patients' age groups, mixed-gender groups, different medical settings, and cross-cultural contexts.
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Affiliation(s)
- Dezhi Wu
- University of South Carolina, 550 Assembly Street, Columbia, SC 29298, USA.
| | | | - Dongsong Zhang
- University of North Carolina, 9201 University City Blvd., Charlotte, NC 28223, USA.
| | - Rachida F Parks
- Quinnipiac University, 275 Mt Carmel Ave, Hamden, CT 06518, USA.
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