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Suffoletto B. Deceptively Simple yet Profoundly Impactful: Text Messaging Interventions to Support Health. J Med Internet Res 2024; 26:e58726. [PMID: 39190427 PMCID: PMC11387917 DOI: 10.2196/58726] [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: 03/22/2024] [Revised: 05/30/2024] [Accepted: 07/15/2024] [Indexed: 08/28/2024] Open
Abstract
This paper examines the use of text message (SMS) interventions for health-related behavioral support. It first outlines the historical progress in SMS intervention research publications and the variety of funds from US government agencies. A narrative review follows, highlighting the effectiveness of SMS interventions in key health areas, such as physical activity, diet and weight loss, mental health, and substance use, based on published meta-analyses. It then outlines advantages of text messaging compared to other digital modalities, including the real-time capability to collect information and deliver microdoses of intervention support. Crucial design elements are proposed to optimize effectiveness and longitudinal engagement across communication strategies, psychological foundations, and behavior change tactics. We then discuss advanced functionalities, such as the potential for generative artificial intelligence to improve user interaction. Finally, major challenges to implementation are highlighted, including the absence of a dedicated commercial platform, privacy and security concerns with SMS technology, difficulties integrating SMS interventions with medical informatics systems, and concerns about user engagement. Proposed solutions aim to facilitate the broader application and effectiveness of SMS interventions. Our hope is that these insights can assist researchers and practitioners in using SMS interventions to improve health outcomes and reducing disparities.
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Affiliation(s)
- Brian Suffoletto
- Department of Emergency Medicine, Stanford University, Palo Alto, CA, United States
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2
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Miyakoshi T, Ito YM. Assessing the current utilization status of wearable devices in clinical research. Clin Trials 2024; 21:470-482. [PMID: 38486348 DOI: 10.1177/17407745241230287] [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] [Indexed: 08/09/2024]
Abstract
BACKGROUND/AIMS Information regarding the use of wearable devices in clinical research, including disease areas, intervention techniques, trends in device types, and sample size targets, remains elusive. Therefore, we conducted a comprehensive review of clinical research trends related to wristband wearable devices in research planning and examined their applications in clinical investigations. METHODS As this study identified trends in the adoption of wearable devices during the planning phase of clinical research, including specific disease areas and targeted number of intervention cases, we searched ClinicalTrials.gov-a prominent platform for registering and disseminating clinical research. Since wrist-worn devices represent a large share of the market, we focused on wrist-worn devices and selected the most representative models among them. The main analysis focused on major wearable devices to facilitate data analysis and interpretation, but other wearables were also surveyed for reference. We searched ClinicalTrials.gov with the keywords "ActiGraph,""Apple Watch,""Empatica,""Fitbit,""Garmin," and "wearable devices" to obtain studies published up to 21 August 2022. This initial search yielded 3214 studies. After excluding duplicate National Clinical Trial studies (the overlap was permissible among different device types except for wearable devices), our analysis focused on 2930 studies, including simple, time-series, and type-specific assessments of various variables. RESULTS Overall, an increasing number of clinical studies have incorporated wearable devices since 2012. While ActiGraph and Fitbit initially dominated this landscape, the use of other devices has steadily increased, constituting approximately 10% of the total after 2015. Observational studies outnumbered intervention studies, with behavioral and device-based interventions being particularly prevalent. Regarding disease types, cancer and cardiovascular diseases accounted for approximately 20% of the total. Notably, 114 studies adopted multiple devices simultaneously within the context of their clinical investigations. CONCLUSIONS Our findings revealed that the utilization of wearable devices for data collection and behavioral interventions in various disease areas has been increasing over time since 2012. The increase in the number of studies over the past 3 years has been particularly significant, suggesting that this trend will continue to accelerate in the future. Devices and their evaluation methods that have undergone thorough validation, confirmed their accuracy, and adhered to established legal regulations will likely assume a pivotal role in evaluations, allowing for remote clinical trials. Moreover, behavioral intervention therapy utilizing apps is becoming more extensive, and we expect to see more examples that will lead to their approval as programmed medical devices in the future.
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Affiliation(s)
- Takashi Miyakoshi
- Department of Health Data Science, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yoichi M Ito
- Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Japan
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Gao Z, Zhou Y, Zhang J, Foroughi J, Peng S, Baughman RH, Wang ZL, Wang CH. Advanced Energy Harvesters and Energy Storage for Powering Wearable and Implantable Medical Devices. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024:e2404492. [PMID: 38935237 DOI: 10.1002/adma.202404492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/21/2024] [Indexed: 06/28/2024]
Abstract
Wearable and implantable active medical devices (WIMDs) are transformative solutions for improving healthcare, offering continuous health monitoring, early disease detection, targeted treatments, personalized medicine, and connected health capabilities. Commercialized WIMDs use primary or rechargeable batteries to power their sensing, actuation, stimulation, and communication functions, and periodic battery replacements of implanted active medical devices pose major risks of surgical infections or inconvenience to users. Addressing the energy source challenge is critical for meeting the growing demand of the WIMD market that is reaching valuations in the tens of billions of dollars. This review critically assesses the recent advances in energy harvesting and storage technologies that can potentially eliminate the need for battery replacements. With a key focus on advanced materials that can enable energy harvesters to meet the energy needs of WIMDs, this review examines the crucial roles of advanced materials in improving the efficiencies of energy harvesters, wireless charging, and energy storage devices. This review concludes by highlighting the key challenges and opportunities in advanced materials necessary to achieve the vision of self-powered wearable and implantable active medical devices, eliminating the risks associated with surgical battery replacement and the inconvenience of frequent manual recharging.
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Affiliation(s)
- Ziyan Gao
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Yang Zhou
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Jin Zhang
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Javad Foroughi
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Shuhua Peng
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Ray H Baughman
- Alan G. MacDiarmid NanoTech Institute, The University of Texas at Dallas, Richardson, TX, 75080, USA
| | - Zhong Lin Wang
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, 101400, P. R. China
| | - Chun H Wang
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW, 2052, Australia
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Adibi S, Rajabifard A, Shojaei D, Wickramasinghe N. Enhancing Healthcare through Sensor-Enabled Digital Twins in Smart Environments: A Comprehensive Analysis. SENSORS (BASEL, SWITZERLAND) 2024; 24:2793. [PMID: 38732899 PMCID: PMC11086215 DOI: 10.3390/s24092793] [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: 02/06/2024] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 05/13/2024]
Abstract
This comprehensive review investigates the transformative potential of sensor-driven digital twin technology in enhancing healthcare delivery within smart environments. We explore the integration of smart environments with sensor technologies, digital health capabilities, and location-based services, focusing on their impacts on healthcare objectives and outcomes. This work analyzes the foundational technologies, encompassing the Internet of Things (IoT), Internet of Medical Things (IoMT), machine learning (ML), and artificial intelligence (AI), that underpin the functionalities within smart environments. We also examine the unique characteristics of smart homes and smart hospitals, highlighting their potential to revolutionize healthcare delivery through remote patient monitoring, telemedicine, and real-time data sharing. The review presents a novel solution framework leveraging sensor-driven digital twins to address both healthcare needs and user requirements. This framework incorporates wearable health devices, AI-driven health analytics, and a proof-of-concept digital twin application. Furthermore, we explore the role of location-based services (LBS) in smart environments, emphasizing their potential to enhance personalized healthcare interventions and emergency response capabilities. By analyzing the technical advancements in sensor technologies and digital twin applications, this review contributes valuable insights to the evolving landscape of smart environments for healthcare. We identify the opportunities and challenges associated with this emerging field and highlight the need for further research to fully realize its potential to improve healthcare delivery and patient well-being.
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Affiliation(s)
- Sasan Adibi
- School of Information Technology, Deakin University, Geelong, VIC 3220, Australia
- School of Computing, Engineering and Mathematical Sciences, La Trobe University, Melbourne, VIC 3086, Australia;
| | - Abbas Rajabifard
- Centre for Spatial Data Infrastructures and Land Administration, Department of Infrastructure Engineering, The University of Melbourne, Parkville, VIC 3052, Australia; (A.R.); (D.S.)
| | - Davood Shojaei
- Centre for Spatial Data Infrastructures and Land Administration, Department of Infrastructure Engineering, The University of Melbourne, Parkville, VIC 3052, Australia; (A.R.); (D.S.)
| | - Nilmini Wickramasinghe
- School of Computing, Engineering and Mathematical Sciences, La Trobe University, Melbourne, VIC 3086, Australia;
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Moorthy P, Weinert L, Schüttler C, Svensson L, Sedlmayr B, Müller J, Nagel T. Attributes, Methods, and Frameworks Used to Evaluate Wearables and Their Companion mHealth Apps: Scoping Review. JMIR Mhealth Uhealth 2024; 12:e52179. [PMID: 38578671 PMCID: PMC11031706 DOI: 10.2196/52179] [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: 08/25/2023] [Revised: 12/15/2023] [Accepted: 02/01/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Wearable devices, mobile technologies, and their combination have been accepted into clinical use to better assess the physical fitness and quality of life of patients and as preventive measures. Usability is pivotal for overcoming constraints and gaining users' acceptance of technology such as wearables and their companion mobile health (mHealth) apps. However, owing to limitations in design and evaluation, interactive wearables and mHealth apps have often been restricted from their full potential. OBJECTIVE This study aims to identify studies that have incorporated wearable devices and determine their frequency of use in conjunction with mHealth apps or their combination. Specifically, this study aims to understand the attributes and evaluation techniques used to evaluate usability in the health care domain for these technologies and their combinations. METHODS We conducted an extensive search across 4 electronic databases, spanning the last 30 years up to December 2021. Studies including the keywords "wearable devices," "mobile apps," "mHealth apps," "physiological data," "usability," "user experience," and "user evaluation" were considered for inclusion. A team of 5 reviewers screened the collected publications and charted the features based on the research questions. Subsequently, we categorized these characteristics following existing usability and wearable taxonomies. We applied a methodological framework for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. RESULTS A total of 382 reports were identified from the search strategy, and 68 articles were included. Most of the studies (57/68, 84%) involved the simultaneous use of wearables and connected mobile apps. Wrist-worn commercial consumer devices such as wristbands were the most prevalent, accounting for 66% (45/68) of the wearables identified in our review. Approximately half of the data from the medical domain (32/68, 47%) focused on studies involving participants with chronic illnesses or disorders. Overall, 29 usability attributes were identified, and 5 attributes were frequently used for evaluation: satisfaction (34/68, 50%), ease of use (27/68, 40%), user experience (16/68, 24%), perceived usefulness (18/68, 26%), and effectiveness (15/68, 22%). Only 10% (7/68) of the studies used a user- or human-centered design paradigm for usability evaluation. CONCLUSIONS Our scoping review identified the types and categories of wearable devices and mHealth apps, their frequency of use in studies, and their implementation in the medical context. In addition, we examined the usability evaluation of these technologies: methods, attributes, and frameworks. Within the array of available wearables and mHealth apps, health care providers encounter the challenge of selecting devices and companion apps that are effective, user-friendly, and compatible with user interactions. The current gap in usability and user experience in health care research limits our understanding of the strengths and limitations of wearable technologies and their companion apps. Additional research is necessary to overcome these limitations.
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Affiliation(s)
- Preetha Moorthy
- Department of Biomedical Informatics, Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lina Weinert
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
- Section for Oral Health, Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Christina Schüttler
- Medical Center for Information and Communication Technology, University Hospital Erlangen, Erlangen, Germany
| | - Laura Svensson
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Brita Sedlmayr
- Institute for Medical Informatics and Biometry, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Julia Müller
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Till Nagel
- Human Data Interaction Lab, Mannheim University of Applied Sciences, Mannheim, Germany
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Hindelang M, Wecker H, Biedermann T, Zink A. Continuously monitoring the human machine? - A cross-sectional study to assess the acceptance of wearables in Germany. Health Informatics J 2024; 30:14604582241260607. [PMID: 38900846 DOI: 10.1177/14604582241260607] [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] [Indexed: 06/22/2024]
Abstract
Background: Wearables have the potential to transform healthcare by enabling early detection and monitoring of chronic diseases. This study aimed to assess wearables' acceptance, usage, and reasons for non-use. Methods: Anonymous questionnaires were used to collect data in Germany on wearable ownership, usage behaviour, acceptance of health monitoring, and willingness to share data. Results: Out of 643 respondents, 550 participants provided wearable acceptance data. The average age was 36.6 years, with 51.3% female and 39.6% residing in rural areas. Overall, 33.8% reported wearing a wearable, primarily smartwatches or fitness wristbands. Men (63.3%) and women (57.8%) expressed willingness to wear a sensor for health monitoring, and 61.5% were open to sharing data with healthcare providers. Concerns included data security, privacy, and perceived lack of need. Conclusion: The study highlights the acceptance and potential of wearables, particularly for health monitoring and data sharing with healthcare providers. Addressing data security and privacy concerns could enhance the adoption of innovative wearables, such as implants, for early detection and monitoring of chronic diseases.
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Affiliation(s)
- Michael Hindelang
- TUM School of Medicine and Health, Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Munich, Germany
| | - Hannah Wecker
- TUM School of Medicine and Health, Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Tilo Biedermann
- TUM School of Medicine and Health, Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Alexander Zink
- TUM School of Medicine and Health, Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany; Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
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Robinson SA, Shimada SL, Zocchi MS, Etingen B, Smith B, McMahon N, Cutrona SL, Harmon JS, Wilck NR, Hogan TP. Factors Associated with Veteran Self-Reported Use of Digital Health Devices. J Gen Intern Med 2024; 39:79-86. [PMID: 38252248 PMCID: PMC10937849 DOI: 10.1007/s11606-023-08479-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/12/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Digital health devices (DHDs), technologies designed to gather, monitor, and sometimes share data about health-related behaviors or symptoms, can support the prevention or management of chronic conditions. DHDs range in complexity and utility, from tracking lifestyle behaviors (e.g., pedometer) to more sophisticated biometric data collection for disease self-management (e.g., glucometers). Despite these positive health benefits, supporting adoption and sustained use of DHDs remains a challenge. OBJECTIVE This analysis examined the prevalence of, and factors associated with, DHD use within the Veterans Health Administration (VHA). DESIGN National survey. PARTICIPANTS Veterans who receive VHA care and are active secure messaging users. MAIN MEASURES Demographics, access to technology, perceptions of using health technologies, and use of lifestyle monitoring and self-management DHDs. RESULTS Among respondents, 87% were current or past users of at least one DHD, and 58% were provided a DHD by VHA. Respondents 65 + years were less likely to use a lifestyle monitoring device (AOR 0.57, 95% CI [0.39, 0.81], P = .002), but more likely to use a self-management device (AOR 1.69, 95% [1.10, 2.59], P = .016). Smartphone owners were more likely to use a lifestyle monitoring device (AOR 2.60, 95% CI [1.42, 4.75], P = .002) and a self-management device (AOR 1.83, 95% CI [1.04, 3.23], P = .037). CONCLUSIONS The current analysis describes the types of DHDs that are being adopted by Veterans and factors associated with their adoption. Results suggest that various factors influence adoption, including age, access to technology, and health status, and that these relationships may differ based on the functionalities of the device. VHA provision of devices was frequent among device users. Providing Veterans with DHDs and the training needed to use them may be important factors in facilitating device adoption. Taken together, this knowledge can inform future implementation efforts, and next steps to support patient-team decision making about DHD use.
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Affiliation(s)
- Stephanie A Robinson
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, 200 Springs Rd., Bldg. 70 Room 263, Bedford, MA, 01730, USA.
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA.
- The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA.
| | - Stephanie L Shimada
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, 200 Springs Rd., Bldg. 70 Room 263, Bedford, MA, 01730, USA
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
- Department of Health Law, Policy, & Management, Boston University School of Public Health, Boston, MA, USA
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Mark S Zocchi
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, 200 Springs Rd., Bldg. 70 Room 263, Bedford, MA, 01730, USA
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Bella Etingen
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, 200 Springs Rd., Bldg. 70 Room 263, Bedford, MA, 01730, USA
- Center of Innovation for Complex Chronic Healthcare, Hines Veterans Affairs Hospital, Hines, IL, USA
| | - Bridget Smith
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, 200 Springs Rd., Bldg. 70 Room 263, Bedford, MA, 01730, USA
- Center of Innovation for Complex Chronic Healthcare, Hines Veterans Affairs Hospital, Hines, IL, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nicholas McMahon
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, 200 Springs Rd., Bldg. 70 Room 263, Bedford, MA, 01730, USA
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
| | - Sarah L Cutrona
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, 200 Springs Rd., Bldg. 70 Room 263, Bedford, MA, 01730, USA
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Julie S Harmon
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, 200 Springs Rd., Bldg. 70 Room 263, Bedford, MA, 01730, USA
- Office of Connected Care, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC, USA
| | - Nancy R Wilck
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, 200 Springs Rd., Bldg. 70 Room 263, Bedford, MA, 01730, USA
- Office of Connected Care, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC, USA
| | - Timothy P Hogan
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, 200 Springs Rd., Bldg. 70 Room 263, Bedford, MA, 01730, USA
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
- Peter O'Donnell Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
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李 丽, 梁 洪, 范 勇, 颜 伟, 晏 沐, 曹 德, 张 政. [Development of intelligent monitoring system based on Internet of Things and wearable technology and exploration of its clinical application mode]. SHENG WU YI XUE GONG CHENG XUE ZA ZHI = JOURNAL OF BIOMEDICAL ENGINEERING = SHENGWU YIXUE GONGCHENGXUE ZAZHI 2023; 40:1053-1061. [PMID: 38151927 PMCID: PMC10753304 DOI: 10.7507/1001-5515.202211047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 10/24/2023] [Indexed: 12/29/2023]
Abstract
Wearable monitoring, which has the advantages of continuous monitoring for a long time with low physiological and psychological load, represents a future development direction of monitoring technology. Based on wearable physiological monitoring technology, combined with Internet of Things (IoT) and artificial intelligence technology, this paper has developed an intelligent monitoring system, including wearable hardware, ward Internet of Things platform, continuous physiological data analysis algorithm and software. We explored the clinical value of continuous physiological data using this system through a lot of clinical practices. And four value points were given, namely, real-time monitoring, disease assessment, prediction and early warning, and rehabilitation training. Depending on the real clinical environment, we explored the mode of applying wearable technology in general ward monitoring, cardiopulmonary rehabilitation, and integrated monitoring inside and outside the hospital. The research results show that this monitoring system can be effectively used for monitoring of patients in hospital, evaluation and training of patients' cardiopulmonary function, and management of patients outside hospital.
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Affiliation(s)
- 丽轩 李
- 中国人民解放军总医院 医学创新研究部 医学人工智能研究中心(北京 100853)Center for Artificial Intelligence in Medicine, Medical Innovation Research Department, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - 洪 梁
- 中国人民解放军总医院 医学创新研究部 医学人工智能研究中心(北京 100853)Center for Artificial Intelligence in Medicine, Medical Innovation Research Department, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - 勇 范
- 中国人民解放军总医院 医学创新研究部 医学人工智能研究中心(北京 100853)Center for Artificial Intelligence in Medicine, Medical Innovation Research Department, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - 伟 颜
- 中国人民解放军总医院 医学创新研究部 医学人工智能研究中心(北京 100853)Center for Artificial Intelligence in Medicine, Medical Innovation Research Department, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - 沐阳 晏
- 中国人民解放军总医院 医学创新研究部 医学人工智能研究中心(北京 100853)Center for Artificial Intelligence in Medicine, Medical Innovation Research Department, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - 德森 曹
- 中国人民解放军总医院 医学创新研究部 医学人工智能研究中心(北京 100853)Center for Artificial Intelligence in Medicine, Medical Innovation Research Department, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - 政波 张
- 中国人民解放军总医院 医学创新研究部 医学人工智能研究中心(北京 100853)Center for Artificial Intelligence in Medicine, Medical Innovation Research Department, Chinese PLA General Hospital, Beijing 100853, P. R. China
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9
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Kashani KB, Awdishu L, Bagshaw SM, Barreto EF, Claure-Del Granado R, Evans BJ, Forni LG, Ghosh E, Goldstein SL, Kane-Gill SL, Koola J, Koyner JL, Liu M, Murugan R, Nadkarni GN, Neyra JA, Ninan J, Ostermann M, Pannu N, Rashidi P, Ronco C, Rosner MH, Selby NM, Shickel B, Singh K, Soranno DE, Sutherland SM, Bihorac A, Mehta RL. Digital health and acute kidney injury: consensus report of the 27th Acute Disease Quality Initiative workgroup. Nat Rev Nephrol 2023; 19:807-818. [PMID: 37580570 PMCID: PMC11285755 DOI: 10.1038/s41581-023-00744-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 08/16/2023]
Abstract
Acute kidney injury (AKI), which is a common complication of acute illnesses, affects the health of individuals in community, acute care and post-acute care settings. Although the recognition, prevention and management of AKI has advanced over the past decades, its incidence and related morbidity, mortality and health care burden remain overwhelming. The rapid growth of digital technologies has provided a new platform to improve patient care, and reports show demonstrable benefits in care processes and, in some instances, in patient outcomes. However, despite great progress, the potential benefits of using digital technology to manage AKI has not yet been fully explored or implemented in clinical practice. Digital health studies in AKI have shown variable evidence of benefits, and the digital divide means that access to digital technologies is not equitable. Upstream research and development costs, limited stakeholder participation and acceptance, and poor scalability of digital health solutions have hindered their widespread implementation and use. Here, we provide recommendations from the Acute Disease Quality Initiative consensus meeting, which involved experts in adult and paediatric nephrology, critical care, pharmacy and data science, at which the use of digital health for risk prediction, prevention, identification and management of AKI and its consequences was discussed.
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Affiliation(s)
- Kianoush B Kashani
- Division of Nephrology and Hypertension, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Linda Awdishu
- Clinical Pharmacy, San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA
| | - Sean M Bagshaw
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Canada
| | | | - Rolando Claure-Del Granado
- Division of Nephrology, Hospital Obrero No 2 - CNS, Cochabamba, Bolivia
- Universidad Mayor de San Simon, School of Medicine, Cochabamba, Bolivia
| | - Barbara J Evans
- Intelligent Critical Care Center, University of Florida, Gainesville, FL, USA
| | - Lui G Forni
- Department of Critical Care, Royal Surrey Hospital NHS Foundation Trust & Department of Clinical & Experimental Medicine, University of Surrey, Guildford, UK
| | - Erina Ghosh
- Philips Research North America, Cambridge, MA, USA
| | - Stuart L Goldstein
- Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sandra L Kane-Gill
- Biomedical Informatics and Clinical Translational Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jejo Koola
- UC San Diego Health Department of Biomedical Informatics, Department of Medicine, La Jolla, CA, USA
| | - Jay L Koyner
- Section of Nephrology, Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Mei Liu
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Raghavan Murugan
- The Program for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- The Clinical Research, Investigation, and Systems Modelling of Acute Illness Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Girish N Nadkarni
- Division of Data-Driven and Digital Medicine (D3M), Department of Medicine, Icahn School of Medicine at Mount Sinai; Mount Sinai Clinical Intelligence Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Javier A Neyra
- Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jacob Ninan
- Division of Pulmonary, Critical Care and Sleep Medicine, Mayo Clinic, Rochester, MN, USA
| | - Marlies Ostermann
- Department of Critical Care, King's College London, Guy's & St Thomas' Hospital, London, UK
| | - Neesh Pannu
- Division of Nephrology, University of Alberta, Edmonton, Canada
| | - Parisa Rashidi
- Intelligent Critical Care Center, University of Florida, Gainesville, FL, USA
| | - Claudio Ronco
- Università di Padova; Scientific Director Foundation IRRIV; International Renal Research Institute; San Bortolo Hospital, Vicenza, Italy
| | - Mitchell H Rosner
- Department of Medicine, University of Virginia Health, Charlottesville, VA, USA
| | - Nicholas M Selby
- Centre for Kidney Research and Innovation, Academic Unit of Translational Medical Sciences, University of Nottingham, Nottingham, UK
- Department of Renal Medicine, Royal Derby Hospital, Derby, UK
| | - Benjamin Shickel
- Intelligent Critical Care Center, University of Florida, Gainesville, FL, USA
| | - Karandeep Singh
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Danielle E Soranno
- Section of Nephrology, Department of Pediatrics, Indiana University, Riley Hospital for Children, Indianapolis, IN, USA
| | - Scott M Sutherland
- Division of Nephrology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Azra Bihorac
- Intelligent Critical Care Center, University of Florida, Gainesville, FL, USA.
| | - Ravindra L Mehta
- Division of Nephrology-Hypertension, Department of Medicine, University of California San Diego, La Jolla, CA, USA.
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10
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Lee MA, Song M, Bessette H, Roberts Davis M, Tyner TE, Reid A. Use of wearables for monitoring cardiometabolic health: A systematic review. Int J Med Inform 2023; 179:105218. [PMID: 37806179 DOI: 10.1016/j.ijmedinf.2023.105218] [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: 05/09/2023] [Revised: 08/28/2023] [Accepted: 09/15/2023] [Indexed: 10/10/2023]
Abstract
INTRODUCTION Cardiometabolic disorders (CMD) such as hyperglycemia, obesity, hypertension, and dyslipidemia are the leading causes of mortality and significant public health concerns worldwide. With the advances in wireless technology, wearables have become popular for health promotion, but its impact on cardiometabolic health is not well understood. PURPOSE A systematic literature review aimed to describe the features of wearables used for monitoring cardiometabolic health and identify the impact of using wearables on those cardiometabolic health indicators. METHODS A systematic search of PubMed, CINAHL, Academic Search Complete, and Science and Technology Collection databases was performed using keywords related to CMD risk indicators and wearables. The wearables were limited to sensors for blood pressure (BP), heart rate (HR), electrocardiogram (ECG), glucose, and cholesterol. INCLUDED STUDIES 1) were published from 2016 to March 2021 in English, 2) focused on wearables external to the body, and 3) examined wearable use by individuals in daily life (not by health care providers). Protocol, technical, and non-empirical studies were excluded. RESULTS Out of 53 studies, the types of wearables used were smartwatches (45.3%), patches (34.0%), chest straps (22.6%), wristbands (13.2%), and others (9.4%). HR (58.5%), glucose (28.3%), and ECG (26.4%) were the predominant indicators. No studies tracked BP or cholesterol. Additional features of wearables included physical activity, respiration, sleep, diet, and symptom monitoring. Twenty-two studies primarily focused on the use of wearables and reported direct impacts on cardiometabolic indicators; seven studies used wearables as part of a multi-modality approach and presented outcomes affected by a primary intervention but measured through CMD-sensor wearables; and 24 validated the precision and usability of CMD-sensor wearables. CONCLUSION The impact of wearables on cardiometabolic indicators varied across the studies, indicating the need for further research. However, this body of literature highlights the potential of wearables to promote cardiometabolic health.
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Affiliation(s)
- Mikyoung A Lee
- Texas Woman's University, College of Nursing, Dallas, TX, United States.
| | - MinKyoung Song
- Oregon Health & Science University, School of Nursing, Portland, OR, United States.
| | - Hannah Bessette
- Oregon Health & Science University, School of Nursing, Portland, OR, United States
| | - Mary Roberts Davis
- Oregon Health & Science University, School of Nursing, Portland, OR, United States
| | - Tracy E Tyner
- Texas Woman's University, College of Nursing, Dallas, TX, United States
| | - Amy Reid
- Texas Woman's University, College of Nursing, Dallas, TX, United States
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11
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Matti C, Essig S, Föhn Z, Balthasar A. The Role of Wearable Sensors in the Future Primary Healthcare - Preferences of the Adult Swiss Population: A Mixed Methods Approach. J Med Syst 2023; 47:111. [PMID: 37907653 PMCID: PMC10618354 DOI: 10.1007/s10916-023-01998-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 09/28/2023] [Indexed: 11/02/2023]
Abstract
Wearable sensors have the potential to increase continuity of care and reduce healthcare expenditure. The user concerns and preferences regarding wearable sensors are the least addressed topic in related literature. Therefore, this study aimed first, to examine the preferences of the adult Swiss population regarding the use of wearable sensors in primary healthcare. Second, the study aimed to explain and learn more about these preferences and why such wearable sensors would or would not be used. An explanatory sequential design was used to reach the two aims. In the initial quantitative phase preferences of a nationwide survey were analyzed descriptively and a multivariable ordered logistic regression was used to identify key characteristics, that influence the preferences. In the second phase, eight semi-structured interviews were conducted. The cleaned study sample of the survey included 687 participants, 46% of whom gave a positive rating regarding the use of wearable sensors. In contrast, 44% gave a negative rating and 10% were neutral. The interviews showed that sensors should be small, not flashy and be compatible with everyday activities. Individuals without a current health risk or existing chronic disease showed lower preferences for using wearable sensors, particularly because they fear losing control over their own body. In contrast, individuals with increased risk or with an existing chronic disease were more likely to use wearable sensors as they can increase the personal safety and provide real-time health information to physicians. Therefore, an important deciding factor for and against the use of wearable sensors seems to be the perceived personal susceptibility for potential health problems.
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Affiliation(s)
- Corinne Matti
- Department Health Sciences and Medicine, University Lucerne, Lucerne, 6002, Switzerland.
- Institute of Social and Preventive Medicine, University Bern, Mittelstrasse 43, Bern, 3012, Switzerland.
| | - Stefan Essig
- Department Health Sciences and Medicine, University Lucerne, Lucerne, 6002, Switzerland
- Interface Politikstudien Forschung Beratung AG, Seidenhofstrasse 12, Lucerne, 6003, Switzerland
| | - Zora Föhn
- Department Health Sciences and Medicine, University Lucerne, Lucerne, 6002, Switzerland
- Interface Politikstudien Forschung Beratung AG, Seidenhofstrasse 12, Lucerne, 6003, Switzerland
| | - Andreas Balthasar
- Department Health Sciences and Medicine, University Lucerne, Lucerne, 6002, Switzerland
- Interface Politikstudien Forschung Beratung AG, Seidenhofstrasse 12, Lucerne, 6003, Switzerland
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12
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Shenvi E, Boxwala A, Sittig D, Zott C, Lomotan E, Swiger J, Dullabh P. Visualization of Patient-Generated Health Data: A Scoping Review of Dashboard Designs. Appl Clin Inform 2023; 14:913-922. [PMID: 37704021 PMCID: PMC10665122 DOI: 10.1055/a-2174-7820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/11/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Patient-centered clinical decision support (PC CDS) aims to assist with tailoring decisions to an individual patient's needs. Patient-generated health data (PGHD), including physiologic measurements captured frequently by automated devices, provide important information for PC CDS. The volume and availability of such PGHD is increasing, but how PGHD should be presented to clinicians to best aid decision-making is unclear. OBJECTIVES Identify best practices in visualizations of physiologic PGHD, for designing a software application as a PC CDS tool. METHODS We performed a scoping review of studies of PGHD dashboards that involved clinician users in design or evaluations. We included only studies that used physiologic PGHD from single patients for usage in decision-making. RESULTS We screened 468 titles and abstracts, 63 full-text papers, and identified 15 articles to include in our review. Some research primarily sought user input on PGHD presentation; other studies garnered feedback only as a side effort for other objectives (e.g., integration with electronic health records [EHRs]). Development efforts were often in the domains of chronic diseases and collected a mix of physiologic parameters (e.g., blood pressure and heart rate) and activity data. Users' preferences were for data to be presented with statistical summaries and clinical interpretations, alongside other non-PGHD data. Recurrent themes indicated that users desire longitudinal data display, aggregation of multiple data types on the same screen, actionability, and customization. Speed, simplicity, and availability of data for other purposes (e.g., documentation) were key to dashboard adoption. Evaluations were favorable for visualizations using common graphing or table formats, although best practices for implementation have not yet been established. CONCLUSION Although the literature identified common themes on data display, measures, and usability, more research is needed as PGHD usage grows. Ensuring that care is tailored to individual needs will be important in future development of clinical decision support.
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Affiliation(s)
- Edna Shenvi
- Elimu Informatics, El Cerrito, California, United States
| | - Aziz Boxwala
- Elimu Informatics, El Cerrito, California, United States
| | - Dean Sittig
- McWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, United States
| | - Courtney Zott
- NORC at the University of Chicago, Bethesda, Maryland, United States
| | - Edwin Lomotan
- Center for Evidence and Practice Improvement, Agency for Healthcare Research and Quality, Rockville, Maryland, United States
| | - James Swiger
- Center for Evidence and Practice Improvement, Agency for Healthcare Research and Quality, Rockville, Maryland, United States
| | - Prashila Dullabh
- NORC at the University of Chicago, Bethesda, Maryland, United States
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13
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Richardson KM, Jospe MR, Saleh AA, Clarke TN, Bedoya AR, Behrens N, Marano K, Cigan L, Liao Y, Scott ER, Guo JS, Aguinaga A, Schembre SM. Use of Biological Feedback as a Health Behavior Change Technique in Adults: Scoping Review. J Med Internet Res 2023; 25:e44359. [PMID: 37747766 PMCID: PMC10562972 DOI: 10.2196/44359] [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: 11/16/2022] [Revised: 07/26/2023] [Accepted: 08/03/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Recent advancements in personal biosensing technology support the shift from standardized to personalized health interventions, whereby biological data are used to motivate health behavior change. However, the implementation of interventions using biological feedback as a behavior change technique has not been comprehensively explored. OBJECTIVE The purpose of this review was to (1) map the domains of research where biological feedback has been used as a behavior change technique and (2) describe how it is implemented in behavior change interventions for adults. METHODS A comprehensive systematic search strategy was used to query 5 electronic databases (Ovid MEDLINE, Elsevier Embase, Cochrane Central Register of Controlled Trials, EBSCOhost PsycINFO, and ProQuest Dissertations & Theses Global) in June 2021. Eligible studies were primary analyses of randomized controlled trials (RCTs) in adults that incorporated biological feedback as a behavior change technique. DistillerSR was used to manage the literature search and review. RESULTS After removing 49,500 duplicates, 50,287 articles were screened and 767 articles were included. The earliest RCT was published in 1972 with a notable increase in publications after 2000. Biological feedback was most used in RCTs aimed at preventing or managing diabetes (n=233, 30.4%), cardiovascular disease (n=175, 22.8%), and obesity (n=115, 15%). Feedback was often given on multiple biomarkers and targeted multiple health behaviors. The most common biomarkers used were anthropometric measures (n=297, 38.7%), blood pressure (n=238, 31%), and glucose (n=227, 29.6%). The most targeted behaviors were diet (n=472, 61.5%), physical activity (n=417, 54.4%), and smoking reduction (n=154, 20.1%). The frequency and type of communication by which biological feedback was provided varied by the method of biomarker measurement. Of the 493 (64.3%) studies where participants self-measured their biomarker, 476 (96.6%) received feedback multiple times over the intervention and 468 (94.9%) received feedback through a biosensing device. CONCLUSIONS Biological feedback is increasingly being used to motivate behavior change, particularly where relevant biomarkers can be readily assessed. Yet, the methods by which biological feedback is operationalized in intervention research varied, and its effectiveness remains unclear. This scoping review serves as the foundation for developing a guiding framework for effectively implementing biological feedback as a behavior change technique. TRIAL REGISTRATION Open Science Framework Registries; https://doi.org/10.17605/OSF.IO/YP5WAd. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/32579.
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Affiliation(s)
- Kelli M Richardson
- School of Nutritional Sciences and Wellness, College of Agriculture, Life and Environmental Sciences, University of Arizona, Tucson, AZ, United States
| | - Michelle R Jospe
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
| | - Ahlam A Saleh
- Arizona Health Sciences Library, University of Arizona, Tucson, AZ, United States
| | - Thanatcha Nadia Clarke
- Department of Physiology, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Arianna R Bedoya
- Department of Internal Medicine, College of Medicine - Phoenix, University of Arizona, Tucson, AZ, United States
| | - Nick Behrens
- Department of Ecology and Evolutionary Biology, College of Science, University of Arizona, Tucson, AZ, United States
| | - Kari Marano
- College of Nursing, University of Arizona, Tucson, AZ, United States
| | - Lacey Cigan
- School of Nutritional Sciences and Wellness, College of Agriculture, Life and Environmental Sciences, University of Arizona, Tucson, AZ, United States
| | - Yue Liao
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
| | - Eric R Scott
- Communications & Cyber Technologies, Arizona Experiment Station, University of Arizona, Tucson, AZ, United States
| | - Jessica S Guo
- Communications & Cyber Technologies, Arizona Experiment Station, University of Arizona, Tucson, AZ, United States
| | - April Aguinaga
- Arizona Health Sciences Library, University of Arizona, Tucson, AZ, United States
| | - Susan M Schembre
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
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14
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Cudejko T, Button K, Al-Amri M. Wireless pressure insoles for measuring ground reaction forces and trajectories of the centre of pressure during functional activities. Sci Rep 2023; 13:14946. [PMID: 37696840 PMCID: PMC10495386 DOI: 10.1038/s41598-023-41622-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/29/2023] [Indexed: 09/13/2023] Open
Abstract
Wireless pressure insoles may enable the assessment of movement biomechanics in a real-world setting, and thus play an important role in the recommendation of clinical management, but they are not yet a gold standard due to the unknown accuracy and reliability with respect to different functional activities. Here, we compare novel wireless pressure insoles with force plates and examine the test-retest reliability of the insoles for measuring vertical ground reaction forces (vGRFs) and trajectories of the center of pressure (COP). In this observational study, healthy adults underwent two data collection sessions during one day. The Bland-Altman analysis was used to compare the outcomes measured with the two instruments during squats, jumps, and the sit-to-stand test. Test-retest reliability was assessed by the interclass correlation coefficient and the standard error of measurement for the outcomes during squats, jumps, walking, and stair ambulation. Trajectories of the COP in the anterior-posterior direction were comparable between the two systems during all activities. The insoles consistently measured shorter trajectories of the COP in the medial-lateral direction (except jumps) and lower vGRFs than the force plates. Test-retest reliability of the insoles was fair to high or excellent for all outcomes during all activities. In conclusion, the insoles provide reliable measures of vGRFs and trajectories of the COP during multiple functional activities in healthy adults. Although the insoles do not produce identical results to the force plate, the qualitative similarity and consistency between the two systems confirm the insoles can be used to measure these outcomes, based on the purpose and accuracy required.
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Affiliation(s)
- T Cudejko
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
| | - K Button
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, CF14 4EP, UK
| | - M Al-Amri
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, CF14 4EP, UK.
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15
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Jiang P, Li Q, Luo Y, Luo F, Che Q, Lu Z, Yang S, Yang Y, Chen X, Cai Y. Current status and progress in research on dressing management for diabetic foot ulcer. Front Endocrinol (Lausanne) 2023; 14:1221705. [PMID: 37664860 PMCID: PMC10470649 DOI: 10.3389/fendo.2023.1221705] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Diabetic foot ulcer (DFU) is a major complication of diabetes and is associated with a high risk of lower limb amputation and mortality. During their lifetime, 19%-34% of patients with diabetes can develop DFU. It is estimated that 61% of DFU become infected and 15% of those with DFU require amputation. Furthermore, developing a DFU increases the risk of mortality by 50%-68% at 5 years, higher than some cancers. Current standard management of DFU includes surgical debridement, the use of topical dressings and wound decompression, vascular assessment, and glycemic control. Among these methods, local treatment with dressings builds a protective physical barrier, maintains a moist environment, and drains the exudate from DFU wounds. This review summarizes the development, pathophysiology, and healing mechanisms of DFU. The latest research progress and the main application of dressings in laboratory and clinical stage are also summarized. The dressings discussed in this review include traditional dressings (gauze, oil yarn, traditional Chinese medicine, and others), basic dressings (hydrogel, hydrocolloid, sponge, foam, film agents, and others), bacteriostatic dressings, composite dressings (collagen, nanomaterials, chitosan dressings, and others), bioactive dressings (scaffold dressings with stem cells, decellularized wound matrix, autologous platelet enrichment plasma, and others), and dressings that use modern technology (3D bioprinting, photothermal effects, bioelectric dressings, microneedle dressings, smart bandages, orthopedic prosthetics and regenerative medicine). The dressing management challenges and limitations are also summarized. The purpose of this review is to help readers understand the pathogenesis and healing mechanism of DFU, help physicians select dressings correctly, provide an updated overview of the potential of biomaterials and devices and their application in DFU management, and provide ideas for further exploration and development of dressings. Proper use of dressings can promote DFU healing, reduce the cost of treating DFU, and reduce patient pain.
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Affiliation(s)
- Pingnan Jiang
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Qianhang Li
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yanhong Luo
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Feng Luo
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Qingya Che
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Zhaoyu Lu
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Shuxiang Yang
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yan Yang
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Endocrinology and Metabolism, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Xia Chen
- Department of Endocrinology, Kweichow Moutai Hospital, Renhuai, Guizhou, China
| | - Yulan Cai
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Endocrinology and Metabolism, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Department of Endocrinology, Kweichow Moutai Hospital, Renhuai, Guizhou, China
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16
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Shiwani MA, Chico TJA, Ciravegna F, Mihaylova L. Continuous Monitoring of Health and Mobility Indicators in Patients with Cardiovascular Disease: A Review of Recent Technologies. SENSORS (BASEL, SWITZERLAND) 2023; 23:5752. [PMID: 37420916 PMCID: PMC10300851 DOI: 10.3390/s23125752] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/01/2023] [Accepted: 06/12/2023] [Indexed: 07/09/2023]
Abstract
Cardiovascular diseases kill 18 million people each year. Currently, a patient's health is assessed only during clinical visits, which are often infrequent and provide little information on the person's health during daily life. Advances in mobile health technologies have allowed for the continuous monitoring of indicators of health and mobility during daily life by wearable and other devices. The ability to obtain such longitudinal, clinically relevant measurements could enhance the prevention, detection and treatment of cardiovascular diseases. This review discusses the advantages and disadvantages of various methods for monitoring patients with cardiovascular disease during daily life using wearable devices. We specifically discuss three distinct monitoring domains: physical activity monitoring, indoor home monitoring and physiological parameter monitoring.
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Affiliation(s)
- Muhammad Ali Shiwani
- Department of Automatic Control and Systems Engineering, The University of Sheffield, Sheffield S1 3JD, UK
| | - Timothy J. A. Chico
- Department of Infection, Immunity and Cardiovascular Disease, The Medical School, The University of Sheffield, Sheffield S10 2RX, UK
| | - Fabio Ciravegna
- Dipartimento di Informatica, Università di Torino, 10124 Turin, Italy
| | - Lyudmila Mihaylova
- Department of Automatic Control and Systems Engineering, The University of Sheffield, Sheffield S1 3JD, UK
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17
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Gabriel CL, Pires IM, Coelho PJ, Zdravevski E, Lameski P, Mewada H, Madeira F, Garcia NM, Carreto C. Mobile and wearable technologies for the analysis of Ten Meter Walk Test: A concise systematic review. Heliyon 2023; 9:e16599. [PMID: 37274667 PMCID: PMC10238910 DOI: 10.1016/j.heliyon.2023.e16599] [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] [Received: 01/03/2023] [Revised: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 06/06/2023] Open
Abstract
Physical issues started to receive more attention due to the sedentary lifestyle prevalent in modern culture. The Ten Meter Walk Test allows measuring the person's capacity to walk along 10 m and analyzing the advancement of various medical procedures for ailments, including stroke. This systematic review is related to the use of mobile or wearable devices to measure physical parameters while administering the Ten Meter Walk Test for the analysis of the performance of the test. We applied the PRISMA methodology for searching the papers related to the Ten Meter Walk Test. Natural Language Processing (NLP) algorithms were used to automate the screening process. Various papers published in two decades from multiple scientific databases, including IEEE Xplore, Elsevier, Springer, EMBASE, SCOPUS, Multidisciplinary Digital Publishing Institute (MDPI), and PubMed Central were analyzed, focusing on various diseases, devices, features, and methods. The study reveals that chronometer and accelerometer sensors measuring spatiotemporal features are the most pertinent in the Gait characterization of most diseases. Likewise, all studies emphasized the close relation between the quality of the sensor's data obtained and the system's ultimate accuracy. In other words, calibration procedures are needed because of the body part where the sensor is worn and the type of sensor. In addition, using ambient sensors providing kinematic and kinetic features in conjunction with wearable sensors and consistently acquiring walking signals can enhance the system's performance. The most common weaknesses in the analyzed studies are the sample size and the unavailability of continuous monitoring devices for measuring the Ten Meter Walk Test.
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Affiliation(s)
| | - Ivan Miguel Pires
- Instituto de Telecomunicações, 6201-001 Covilhã, Portugal
- Department of Informatics and Quantitative Methods, Research Centre for Arts and Communication (CIAC)/Pole of Digital Literacy and Social Inclusion, Polytechnic Institute of Santarém, 2001-904 , Santarém, Portugal
| | - Paulo Jorge Coelho
- Polytechnic of Leiria, Leiria, Portugal
- INESC Coimbra, University of Coimbra, Department of Electrical and Computer Engineering, Pólo 2, 3030-290, Coimbra, Portugal
| | - Eftim Zdravevski
- Faculty of Computer Science and Engineering, University Ss Cyril and Methodius, 1000, Skopje, Macedonia
| | - Petre Lameski
- Faculty of Computer Science and Engineering, University Ss Cyril and Methodius, 1000, Skopje, Macedonia
| | - Hiren Mewada
- Department of Electrical Engineering, Prince Mohammad Bin Fahd University, Al Khobar, 31952, Kingdom of Saudi Arabia
| | - Filipe Madeira
- Department of Informatics and Quantitative Methods, Research Centre for Arts and Communication (CIAC)/Pole of Digital Literacy and Social Inclusion, Polytechnic Institute of Santarém, 2001-904 , Santarém, Portugal
| | - Nuno M. Garcia
- Instituto de Telecomunicações, 6201-001 Covilhã, Portugal
- Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisbon, Portugal
| | - Carlos Carreto
- Research Unit for Inland Development, Polytechnic of Guarda, Guarda, Portugal
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18
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Etienne S, Oliveras R, Schiboni G, Durrer L, Rochat F, Eib P, Zahner M, Osthoff M, Bassetti S, Eckstein J. Free-living core body temperature monitoring using a wrist-worn sensor after COVID-19 booster vaccination: a pilot study. Biomed Eng Online 2023; 22:25. [PMID: 36915134 PMCID: PMC10010220 DOI: 10.1186/s12938-023-01081-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/13/2023] [Indexed: 03/14/2023] Open
Abstract
Core body temperature (CBT) is a key vital sign and fever is an important indicator of disease. In the past decade, there has been growing interest for vital sign monitoring technology that may be embedded in wearable devices, and the COVID-19 pandemic has highlighted the need for remote patient monitoring systems. While wrist-worn sensors allow continuous assessment of heart rate and oxygen saturation, reliable measurement of CBT at the wrist remains challenging. In this study, CBT was measured continuously in a free-living setting using a novel technology worn at the wrist and compared to reference core body temperature measurements, i.e., CBT values acquired with an ingestible temperature-sensing pill. Fifty individuals who received the COVID-19 booster vaccination were included. The datasets of 33 individuals were used to develop the CBT prediction algorithm, and the algorithm was then validated on the datasets of 17 participants. Mean observation time was 26.4 h and CBT > 38.0 °C occurred in 66% of the participants. CBT predicted by the wrist-worn sensor showed good correlation to the reference CBT (r = 0.72). Bland-Altman statistics showed an average bias of 0.11 °C of CBT predicted by the wrist-worn device compared to reference CBT, and limits of agreement were - 0.67 to + 0.93 °C, which is comparable to the bias and limits of agreement of commonly used tympanic membrane thermometers. The small size of the components needed for this technology would allow its integration into a variety of wearable monitoring systems assessing other vital signs and at the same time allowing maximal freedom of movement to the user.
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Affiliation(s)
- Samuel Etienne
- Division of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
| | | | | | | | | | | | | | - Michael Osthoff
- Division of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Stefano Bassetti
- Division of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Jens Eckstein
- Division of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland. .,Department Digitalization and ICT, University Hospital Basel, Basel, Switzerland.
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Mavragani A, Wu Y, Meng Z, Li J, Xu L, Sun X, Zang S. Willingness to Use Mobile Health Devices in the Post-COVID-19 Era: Nationwide Cross-sectional Study in China. J Med Internet Res 2023; 25:e44225. [PMID: 36719823 PMCID: PMC9942786 DOI: 10.2196/44225] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Despite the increased development and use of mobile health (mHealth) devices during the COVID-19 pandemic, there is little knowledge of willingness of the Chinese people to use mHealth devices and the key factors associated with their use in the post-COVID-19 era. Therefore, a more comprehensive and multiangle investigation is required. OBJECTIVE We aimed to probe Chinese attitudes regarding the use of mHealth and analyze possible associations between the attitude of willingness to use mHealth devices and some factors based on the socioecological model. METHODS A survey was conducted using quota sampling to recruit participants from 148 cities in China between June 20 and August 31, 2022. Data from the survey were analyzed using multiple stepwise regression to examine the factors associated with willingness to use mHealth devices. Standardized regression coefficients (β) and 95% CIs were calculated using multiple stepwise regression. RESULTS The survey contained a collection of 21,916 questionnaires and 21,897 were valid questionnaires, with a 99.91% effective response rate. The median score of willingness to use mHealth in the post-COVID-19 era was 70 points on a scale from 0 to 100. Multiple stepwise regression results showed that the female gender (β=.03, 95% CI 1.04-2.35), openness personality trait (β=.05, 95% CI 0.53-0.96), higher household per capita monthly income (β=.03, 95% CI 0.77-2.24), and commercial and multiple insurance (β=.04, 95% CI 1.77-3.47) were factors associated with the willingness to use mHealth devices. In addition, people with high scores of health literacy (β=.13, 95% CI 0.53-0.68), self-reported health rating (β=.22, 95% CI 0.24-0.27), social support (β=.08, 95% CI 0.40-0.61), family health (β=.03, 95% CI 0.03-0.16), neighbor relations (β=.12, 95% CI 2.09-2.63), and family social status (β=.07, 95% CI 1.19-1.69) were more likely to use mHealth devices. CONCLUSIONS On the basis of the theoretical framework of socioecological model, this study identified factors specifically associated with willingness of the Chinese people to use mHealth devices in the post-COVID-19 era. These findings provide reference information for the research, development, promotion, and application of future mHealth devices.
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Affiliation(s)
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
| | - Zhiyu Meng
- Department of the First Clinical Medical College, Jinzhou Medical University, Jinzhou, China
| | - Jiayuan Li
- Department of the First Clinical Medical College, Jinzhou Medical University, Jinzhou, China
| | - Li Xu
- Department of Community Nursing, China Medical University, Shenyang, China
| | - Xinying Sun
- School of Public Health, Peking University, Beijing, China
| | - Shuang Zang
- Department of Community Nursing, China Medical University, Shenyang, China
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Nair P, Antoniou PE, Pino EJ, Fico G. Editorial: Highlights in connected health 2021/22. Front Digit Health 2022; 4:1066860. [PMID: 36506846 PMCID: PMC9727374 DOI: 10.3389/fdgth.2022.1066860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 10/28/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Pradeep Nair
- Department of New Media, Central University of Himachal Pradesh, Dharamshala, India,Correspondence: Pradeep Nair
| | | | - Esteban J. Pino
- Electrical Engineering Department, Universidad de Concepcion, Concepcion, Chile
| | - Giuseppe Fico
- Department of Biomedical Engineering, Polytechnic University of Madrid, Madrid, Spain
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Souza J, Escadas S, Baxevani I, Rodrigues D, Freitas A. Smart Wearable Systems for the Remote Monitoring of Selected Vascular Disorders of the Lower Extremity: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15231. [PMID: 36429951 PMCID: PMC9690814 DOI: 10.3390/ijerph192215231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/03/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
This systematic review aims at providing an overview of the state of the art regarding smart wearable systems (SWS) applications to monitor the status of patients suffering from vascular disorders of the lower extremity. Peer-reviewed literature has been analyzed to identify employed data collection methods, system characteristics, and functionalities, and research challenges and limitations to be addressed. The Medline (PubMed) and SCOPUS databases were considered to search for publications describing SWS for remote or continuous monitoring of patients suffering from intermittent claudication, venous ulcers, and diabetic foot ulcers. Publications were first screened based on whether they describe an SWS applicable to the three selected vascular disorders of the lower extremity, including data processing and output to users. Information extracted from publications included targeted disease, clinical parameters to be measured and wearable devices used; system outputs to the user; system characteristics, including capabilities of remote or continuous monitoring or functionalities resulting from advanced data analyses, such as coaching, recommendations, or alerts; challenges and limitations reported; and research outputs. A total of 128 publications were considered in the full-text analysis, and 54 were finally included after eligibility criteria assessment by four independent reviewers. Our results were structured and discussed according to three main topics consisting of data collection, system functionalities, and limitations and challenges.
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Affiliation(s)
- Julio Souza
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, 4200-450 Porto, Portugal
| | - Sara Escadas
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, 4200-450 Porto, Portugal
| | - Isidora Baxevani
- Department of Materials Science and Technology, University of Crete, 700 13 Iraklio, Greece
| | - Daniel Rodrigues
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, 4200-450 Porto, Portugal
| | - Alberto Freitas
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, 4200-450 Porto, Portugal
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22
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Choi JY, Jeon S, Kim H, Ha J, Jeon GS, Lee J, Cho SI. Health-Related Indicators Measured Using Earable Devices: Systematic Review. JMIR Mhealth Uhealth 2022; 10:e36696. [PMID: 36239201 PMCID: PMC9709679 DOI: 10.2196/36696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 09/23/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Earable devices are novel, wearable Internet of Things devices that are user-friendly and have potential applications in mobile health care. The position of the ear is advantageous for assessing vital status and detecting diseases through reliable and comfortable sensing devices. OBJECTIVE Our study aimed to review the utility of health-related indicators derived from earable devices and propose an improved definition of disease prevention. We also proposed future directions for research on the health care applications of earable devices. METHODS A systematic review was conducted of the PubMed, Embase, and Web of Science databases. Keywords were used to identify studies on earable devices published between 2015 and 2020. The earable devices were described in terms of target health outcomes, biomarkers, sensor types and positions, and their utility for disease prevention. RESULTS A total of 51 articles met the inclusion criteria and were reviewed, and the frequency of 5 health-related characteristics of earable devices was described. The most frequent target health outcomes were diet-related outcomes (9/51, 18%), brain status (7/51, 14%), and cardiovascular disease (CVD) and central nervous system disease (5/51, 10% each). The most frequent biomarkers were electroencephalography (11/51, 22%), body movements (6/51, 12%), and body temperature (5/51, 10%). As for sensor types and sensor positions, electrical sensors (19/51, 37%) and the ear canal (26/51, 51%) were the most common, respectively. Moreover, the most frequent prevention stages were secondary prevention (35/51, 69%), primary prevention (12/51, 24%), and tertiary prevention (4/51, 8%). Combinations of ≥2 target health outcomes were the most frequent in secondary prevention (8/35, 23%) followed by brain status and CVD (5/35, 14% each) and by central nervous system disease and head injury (4/35, 11% each). CONCLUSIONS Earable devices can provide biomarkers for various health outcomes. Brain status, healthy diet status, and CVDs were the most frequently targeted outcomes among the studies. Earable devices were mostly used for secondary prevention via monitoring of health or disease status. The potential utility of earable devices for primary and tertiary prevention needs to be investigated further. Earable devices connected to smartphones or tablets through cloud servers will guarantee user access to personal health information and facilitate comfortable wearing.
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Affiliation(s)
- Jin-Young Choi
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Seonghee Jeon
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Hana Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jaeyoung Ha
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Gyeong-Suk Jeon
- Department of Nursing, College of Natural Science, Mokpo National University, Mokpo, Republic of Korea
| | - Jeong Lee
- Department of Nursing, College of Health and Medical Science, Chodang University, Muan, Republic of Korea
| | - Sung-Il Cho
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
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23
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de-la-Fuente-Robles YM, Ricoy-Cano AJ, Albín-Rodríguez AP, López-Ruiz JL, Espinilla-Estévez M. Past, Present and Future of Research on Wearable Technologies for Healthcare: A Bibliometric Analysis Using Scopus. SENSORS (BASEL, SWITZERLAND) 2022; 22:8599. [PMID: 36433195 PMCID: PMC9696945 DOI: 10.3390/s22228599] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/30/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
Currently, wearable technology is present in different fields that aim to satisfy our needs in daily life, including the improvement of our health in general, the monitoring of patient health, ensuring the safety of people in the workplace or supporting athlete training. The objective of this bibliometric analysis is to examine and map the scientific advances in wearable technologies in healthcare, as well as to identify future challenges within this field and put forward some proposals to address them. In order to achieve this objective, a search of the most recent related literature was carried out in the Scopus database. Our results show that the research can be divided into two periods: before 2013, it focused on design and development of sensors and wearable systems from an engineering perspective and, since 2013, it has focused on the application of this technology to monitoring health and well-being in general, and in alignment with the Sustainable Development Goals wherever feasible. Our results reveal that the United States has been the country with the highest publication rates, with 208 articles (34.7%). The University of California, Los Angeles, is the institution with the most studies on this topic, 19 (3.1%). Sensors journal (Switzerland) is the platform with the most studies on the subject, 51 (8.5%), and has one of the highest citation rates, 1461. We put forward an analysis of keywords and, more specifically, a pennant chart to illustrate the trends in this field of research, prioritizing the area of data collection through wearable sensors, smart clothing and other forms of discrete collection of physiological data.
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Roesler A, Lange B. The engagement of nursing and healthcare researchers with digital technologies: lessons learnt in an Australian university. J Res Nurs 2022; 27:592-603. [PMID: 36405805 PMCID: PMC9669936 DOI: 10.1177/17449871221086830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Abstract
Background The use of digital technologies has expanded rapidly in recent years, particularly with the onset of COVID-19. Digital technologies have been implemented in nursing and healthcare to support necessary care. Aims This research explored how nursing and healthcare researchers engage with digital technologies, including the types of technologies, facilitators, barriers and suggested improvements to enable engagement. Methods Semi-structured interviews were conducted with 36 nursing and healthcare researchers from an Australian University. Interviews were recorded, transcribed, coded and thematically analysed using the COREQ checklist. Results Four major types of digital technologies were engaged by nursing and healthcare researchers. These included monitoring, intervention, communication and data collection and analysis technologies. The research setting provided the overarching systems and policies that could delay actions or provide necessary supports. Access to experts, good communication, sharing digital technology information, and time and funding were identified as important. Conclusion This research highlights that nursing and healthcare researchers are engaging with digital technologies but there are areas for improvement that are underpinned by the research setting and need to be considered to ensure effective use of digital technologies in nursing and healthcare research.
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Affiliation(s)
- Anna Roesler
- Research Officer, Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
| | - Belinda Lange
- Research Lead, Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
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Koch M, Matzke I, Huhn S, Gunga HC, Maggioni MA, Munga S, Obor D, Sié A, Boudo V, Bunker A, Dambach P, Bärnighausen T, Barteit S. Wearables for Measuring Health Effects of Climate Change–Induced Weather Extremes: Scoping Review. JMIR Mhealth Uhealth 2022; 10:e39532. [PMID: 36083624 PMCID: PMC9508665 DOI: 10.2196/39532] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Although climate change is one of the biggest global health threats, individual-level and short-term data on direct exposure and health impacts are still scarce. Wearable electronic devices (wearables) present a potential solution to this research gap. Wearables have become widely accepted in various areas of health research for ecological momentary assessment, and some studies have used wearables in the field of climate change and health. However, these studies vary in study design, demographics, and outcome variables, and existing research has not been mapped.
Objective
In this review, we aimed to map existing research on wearables used to detect direct health impacts and individual exposure during climate change–induced weather extremes, such as heat waves or wildfires.
Methods
We conducted a scoping review according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) framework and systematically searched 6 databases (PubMed [MEDLINE], IEEE Xplore, CINAHL [EBSCOhost], WoS, Scopus, Ovid [MEDLINE], and Google Scholar). The search yielded 1871 results. Abstracts and full texts were screened by 2 reviewers (MK and IM) independently using the inclusion and exclusion criteria. The inclusion criteria comprised studies published since 2010 that used off-the-shelf wearables that were neither invasive nor obtrusive to the user in the setting of climate change–related weather extremes. Data were charted using a structured form, and the study outcomes were narratively synthesized.
Results
The review included 55,284 study participants using wearables in 53 studies. Most studies were conducted in upper–middle-income and high-income countries (50/53, 94%) in urban environments (25/53, 47%) or in a climatic chamber (19/53, 36%) and assessed the health effects of heat exposure (52/53, 98%). The majority reported adverse health effects of heat exposure on sleep, physical activity, and heart rate. The remaining studies assessed occupational heat stress or compared individual- and area-level heat exposure. In total, 26% (14/53) of studies determined that all examined wearables were valid and reliable for measuring health parameters during heat exposure when compared with standard methods.
Conclusions
Wearables have been used successfully in large-scale research to measure the health implications of climate change–related weather extremes. More research is needed in low-income countries and vulnerable populations with pre-existing conditions. In addition, further research could focus on the health impacts of other climate change–related conditions and the effectiveness of adaptation measures at the individual level to such weather extremes.
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Affiliation(s)
- Mara Koch
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Ina Matzke
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Sophie Huhn
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Hanns-Christian Gunga
- Charité - Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environment Berlin, Berlin, Germany
| | - Martina Anna Maggioni
- Charité - Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environment Berlin, Berlin, Germany
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | | | - David Obor
- Kenya Medical Research Institute, Kisumu, Kenya
| | - Ali Sié
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Centre de Recherche en Santé, Nouna, Burkina Faso
| | | | - Aditi Bunker
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Center for Climate, Health, and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Peter Dambach
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Sandra Barteit
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
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Bube B, Zanón BB, Lara Palma AM, Klocke H. Wearable Devices in Diving: Scoping Review. JMIR Mhealth Uhealth 2022; 10:e35727. [PMID: 36066926 PMCID: PMC9490542 DOI: 10.2196/35727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/20/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background Wearables and their benefits for the safety and well-being of users have been widely studied and have had an enormous impact on the general development of these kinds of devices. Yet, the extent of research into the use and impact of wearable devices in the underwater environment is comparatively low. In the past 15 years, there has been an increased interest in research into wearables that are used underwater, as the use of such wearables has steadily grown over time. However, there has so far been no clear indication in the literature about the direction in which efforts for the design and construction of underwater wearable devices are developing. Therefore, the analysis presented in this scoping review establishes a good and powerful basis for the further development and orientation of current underwater wearables within the field. Objective In this scoping review, we targeted wearable devices for underwater use to make a comprehensive map of their capabilities and features and discuss the general direction of the development of underwater wearables and the orientation of research into novel prototypes of these kinds of devices. Methods In September 2021, we conducted an extensive search for existing literature on 4 databases and for grey literature to identify developed prototypes and early-stage products that were described and tested in water, could be worn and interacted with (eg, displays, buttons, etc), and were fully functional without external equipment. The studies were written in English, came from peer-reviewed academic sources, and were published between 2005 and 2021. We reviewed each title and abstract. The data extraction process was carried out by one author and verified by another author. Results In total, 36 relevant studies were included. Among these, 4 different categories were identified; 18 studies dealt primarily with safety devices, 9 dealt with underwater communication devices, 7 dealt with head-up displays, and 2 dealt with underwater human-computer interaction approaches. Although the safety devices seemed to have gained the most interest at the time of this study, a clear trend toward underwater communication wearables was identified. Conclusions This review sought to provide a first insight into the possibilities and challenges of the technologies that have been used in and for wearable devices that are meant for use in the underwater environment. Among these, underwater communication technologies have had the most significant influence on future developments. Moreover, a topic that has not received enough attention but should be further addressed is human-computer interaction. By developing underwater wearables that cover 2 or more of the technology categories that we identified, the extent of the benefits of such devices can be significantly increased in the future.
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Affiliation(s)
- Benjamin Bube
- Faculty of Computer Science and Engineering Science, University of Applied Sciences Cologne, Gummersbach, Germany
- Departamento de Ingeniera Informática, Escuela Politecnica Superior, Universidad de Burgos, Burgos, Spain
| | - Bruno Baruque Zanón
- Departamento de Ingeniera Informática, Escuela Politecnica Superior, Universidad de Burgos, Burgos, Spain
| | - Ana María Lara Palma
- Departamento de Ingeniería de Organización Industrial, Escuela Politecnica Superior, Universidad de Burgos, Burgos, Spain
| | - Heinrich Klocke
- Faculty of Computer Science and Engineering Science, University of Applied Sciences Cologne, Gummersbach, Germany
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Abstract
Digital health and telehealth connectivity have become important aspects of clinical care. Connected devices, including continuous glucose monitors and automated insulin delivery systems for diabetes, are being used increasingly to support personalized clinical decisions based on automatically collected data. Furthermore, the development, demand, and coverage for telehealth have all recently expanded, as a result of the COVID-19 pandemic. Medical care, and especially diabetes care, are therefore becoming more digital through the use of both connected digital health devices and telehealth communication. It has therefore become necessary to integrate digital data into the electronic health record and maintain personal data confidentiality, integrity, and availability. Connected digital monitoring combined with telehealth communication is known as virtual health. For this virtual care paradigm to be successful, patients must have proper skills, training, and equipment. We propose that along with the five current vital signs of blood pressure, pulse, respiratory rate, temperature, and pain, at this time, digital connectivity should be considered as the sixth vital sign. In this article, we present a scale to assess digital connectivity.
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Affiliation(s)
| | - Trisha Shang
- Diabetes Technology Society, Burlingame, CA, USA
| | | | - Eda Cengiz
- Yale School of Medicine, New Haven, CT, USA
| | - Chhavi Mehta
- Palo Alto Medical Foundation, Burlingame, CA, USA
| | - David Kerr
- Sansum Diabetes Research Institute, Santa Barbara, CA, USA
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Bläsing D, Hinrichsen S, Wurm S, Bornewasser M. Information assistance systems as preventive mediators between increasing customization and mental workload. Work 2022; 72:1535-1548. [DOI: 10.3233/wor-211283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: The future of work in Germany is shaped by megatrends like globalization, automatization, digitization, and the demographic change. Furthermore, mass customization and the increasing usage of AI even in manual assembly offers new opportunities as well as it creates new challenges. OBJECTIVE: The trend towards mass customization in turn leads to increased complexity in production, which results in additional mental workload. This effect will continue in the foreseeable future. METHOD: Especially for small and medium sized companies, the backbone of Germany’s economy, automatization and Human-Robot-Collaboration will take time to develop. Information assistance systems are and will be a bridging technology to help organizations to manage increasing complexity and the mental workload of their employees to not only boost productivity but also keep their workforce healthy. The ongoing demographic change further underlines the need to use information assistance systems to compensate possible age-associated deficits, but also keep older employees committed to their work and avoid effects of disengagement or disenfranchisement through participatory ergonomics. RESULTS: Information assistance systems can only develop their inherent potential if they are designed to support employees of varying age, competence levels, and affinity for technology. Participatory development and early engagement are key factors for an increased acceptance and usage of the systems as well as the individualization to make it suitable for each individual employee. CONCLUSION: Expanding the functionalities to an adaptive assistance system, using physiological correlates of mental workload as an input, is conceivable in the future.
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Affiliation(s)
- Dominic Bläsing
- Institute for Community Medicine, Prevention Research and Social Medicine University Medicine Greifswald, Greifswald, Germany
| | - Sven Hinrichsen
- Industrial Engineering Laboratory, Ostwestfalen-Lippe University of Applied Sciences and Arts, Lemgo, Germany
| | - Susanne Wurm
- Institute for Community Medicine, Prevention Research and Social Medicine University Medicine Greifswald, Greifswald, Germany
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Ahmed A, Aziz S, Abd-Alrazaq A, Farooq F, Sheikh J. Overview of Artificial Intelligence-Driven Wearable Devices for Diabetes: Scoping Review. J Med Internet Res 2022; 24:e36010. [PMID: 35943772 PMCID: PMC9399882 DOI: 10.2196/36010] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 05/31/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Prevalence of diabetes has steadily increased over the last few decades with 1.5 million deaths reported in 2012 alone. Traditionally, analyzing patients with diabetes has remained a largely invasive approach. Wearable devices (WDs) make use of sensors historically reserved for hospital settings. WDs coupled with artificial intelligence (AI) algorithms show promise to help understand and conclude meaningful information from the gathered data and provide advanced and clinically meaningful analytics. Objective This review aimed to provide an overview of AI-driven WD features for diabetes and their use in monitoring diabetes-related parameters. Methods We searched 7 of the most popular bibliographic databases using 3 groups of search terms related to diabetes, WDs, and AI. A 2-stage process was followed for study selection: reading abstracts and titles followed by full-text screening. Two reviewers independently performed study selection and data extraction, and disagreements were resolved by consensus. A narrative approach was used to synthesize the data. Results From an initial 3872 studies, we report the features from 37 studies post filtering according to our predefined inclusion criteria. Most of the studies targeted type 1 diabetes, type 2 diabetes, or both (21/37, 57%). Many studies (15/37, 41%) reported blood glucose as their main measurement. More than half of the studies (21/37, 57%) had the aim of estimation and prediction of glucose or glucose level monitoring. Over half of the reviewed studies looked at wrist-worn devices. Only 41% of the study devices were commercially available. We observed the use of multiple sensors with photoplethysmography sensors being most prevalent in 32% (12/37) of studies. Studies reported and compared >1 machine learning (ML) model with high levels of accuracy. Support vector machine was the most reported (13/37, 35%), followed by random forest (12/37, 32%). Conclusions This review is the most extensive work, to date, summarizing WDs that use ML for people with diabetes, and provides research direction to those wanting to further contribute to this emerging field. Given the advancements in WD technologies replacing the need for invasive hospital setting devices, we see great advancement potential in this domain. Further work is needed to validate the ML approaches on clinical data from WDs and provide meaningful analytics that could serve as data gathering, monitoring, prediction, classification, and recommendation devices in the context of diabetes.
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Affiliation(s)
- Arfan Ahmed
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Sarah Aziz
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Faisal Farooq
- Center for Digital Health and Precision Medicine, Qatar Computing Research Institute, Doha, Qatar
| | - Javaid Sheikh
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
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Kang HS, Exworthy M. Wearing the Future—Wearables to Empower Users to Take Greater Responsibility for Their Health and Care: Scoping Review. JMIR Mhealth Uhealth 2022; 10:e35684. [PMID: 35830222 PMCID: PMC9330198 DOI: 10.2196/35684] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/20/2022] [Accepted: 06/08/2022] [Indexed: 12/14/2022] Open
Abstract
Background Wearables refer to devices that are worn by individuals. In the health care field, wearables may assist with individual monitoring and diagnosis. In fact, the potential for wearable technology to assist with health care has received recognition from health systems around the world, including a place in the strategic Long Term Plan shared by the National Health Service in England. However, wearables are not limited to specialist medical devices used by patients. Leading technology companies, including Apple, have been exploring the capabilities of wearable health technology for health-conscious consumers. Despite advancements in wearable health technology, research is yet to be conducted on wearables and empowerment. Objective This study aimed to identify, summarize, and synthesize knowledge on how wearable health technology can empower individuals to take greater responsibility for their health and care. Methods This study was a scoping review with thematic analysis and narrative synthesis. Relevant guidance, such as the Arksey and O’Malley framework, was followed. In addition to searching gray literature, we searched MEDLINE, EMBASE, PsycINFO, HMIC, and Cochrane Library. Studies were included based on the following selection criteria: publication in English, publication in Europe or the United States, focus on wearables, relevance to the research, and the availability of the full text. Results After identifying 1585 unique records and excluding papers based on the selection criteria, 20 studies were included in the review. On analysis of these 20 studies, 3 main themes emerged: the potential barriers to using wearables, the role of providers and the benefits to providers from promoting the use of wearables, and how wearables can drive behavior change. Conclusions Considerable literature findings suggest that wearables can empower individuals by assisting with diagnosis, behavior change, and self-monitoring. However, greater adoption of wearables and engagement with wearable devices depend on various factors, including promotion and support from providers to encourage uptake; increased short-term investment to upskill staff, especially in the area of data analysis; and overcoming the barriers to use, particularly by improving device accuracy. Acting on these suggestions will require investment and constructive input from key stakeholders, namely users, health care professionals, and designers of the technology. As advancements in technology to make wearables viable health care devices have only come about recently, further studies will be important for measuring the effectiveness of wearables in empowering individuals. The investigation of user outcomes through large-scale studies would also be beneficial. Nevertheless, a significant challenge will be in the publication of research to keep pace with rapid developments related to wearable health technology.
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Affiliation(s)
- Harjeevan Singh Kang
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- Health Services Management Centre, University of Birmingham, Birmingham, United Kingdom
| | - Mark Exworthy
- Health Services Management Centre, University of Birmingham, Birmingham, United Kingdom
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Moglia A, Georgiou K, Marinov B, Georgiou E, Berchiolli RN, Satava RM, Cuschieri A. 5G in Healthcare: from COVID-19 to Future Challenges. IEEE J Biomed Health Inform 2022; 26:4187-4196. [PMID: 35675255 DOI: 10.1109/jbhi.2022.3181205] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Worldwide up to May 2022 there have been 515 million cases of COVID-19 infection and over 6 million deaths. The World Health Organization estimated that 115,000 healthcare workers died from COVID-19 from January 2020 to May 2021. This toll on human lives prompted this review on 5G based networking primarily on major components of healthcare delivery: diagnosis, patient monitoring, contact tracing, diagnostic imaging tests, vaccines distribution, emergency medical services, telesurgery and robot-assisted tele-ultrasound. The positive impact of 5G as core technology for COVID-19 applications enabled exchange of huge data sets in fangcang (cabin) hospitals and real-time contact tracing, while the low latency enhanced robot-assisted tele-ultrasound, and telementoring during ophthalmic surgery. In other instances, 5G provided a supportive technology for applications related to COVID-19, e.g., patient monitoring. The feasibility of 5G telesurgery was proven, albeit by a few studies on real patients, in very low samples size in most instances. The important future applications of 5G in healthcare include surveillance of elderly people, the immunosuppressed, and nano- oncology for Internet of Nano Things (IoNT). Issues remain and these require resolution before routine clinical adoption. These include infrastructure and coverage; health risks; security and privacy protection of patients' data; 5G implementation with artificial intelligence, blockchain, and IoT; validation, patient acceptance and training of end-users on these technologies.
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Braun BJ, Grimm B, Hanflik AM, Richter PH, Sivananthan S, Yarboro SR, Marmor MT. Wearable technology in orthopedic trauma surgery - An AO trauma survey and review of current and future applications. Injury 2022; 53:1961-1965. [PMID: 35307166 DOI: 10.1016/j.injury.2022.03.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 02/02/2023]
Abstract
The use of wearable sensors to track activity is increasing. Therefore, a survey among AO Trauma members was conducted to provide an overview of their current utilization and determine future needs and directions. A cross sectional expert opinion survey was administered to members of AO Trauma. Respondents were surveyed concerning their experience, subspeciality, current use characteristics, as well as future needs concerning wearable technology. Three hundred and thirty-three survey sets were available for analysis (Response Rate 16.2%). 20.7% of respondents already use wearable technology as part of their clinical treatment. The most prevalent technology was accelerometry combined with smartphones (75.4%) to measure general patient activity. To facilitate the use of wearable technology in the future, the most pressing issues were cost, patient compliance and validity of results. Wearable activity monitors are currently being used in trauma surgery. Surgeons employing these technologies mostly measure simple activity or activity associated parameters. Cost was the greatest perceived barrier to implementation. Further research, especially concerning the interpretation of the outcome values obtained, is required to facilitate wearable activity monitoring as an objective patient outcome measurement tool.
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Affiliation(s)
- Benedikt J Braun
- University Hospital Tuebingen on Behalf of the Eberhard-Karls-University Tuebingen, BG Hospital, Schnarrenbergstr. 95, Tuebingen 72076, Germany.
| | - Bernd Grimm
- Human Motion, Orthopaedics, Sports Medicine and Digital Methods Group, Luxembourg, Institute of Health, Transversal activities, Luxembourg, Luxembourg
| | - Andrew M Hanflik
- Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Downey Medical Center, Kaiser Permanente Downey, CA, United States
| | - Peter H Richter
- Department of Orthopaedic Surgery, University of Ulm, Ulm, Germany
| | | | | | - Meir T Marmor
- Orthopaedic Trauma Institute (OTI), San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, United States
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Stuart T, Hanna J, Gutruf P. Wearable devices for continuous monitoring of biosignals: Challenges and opportunities. APL Bioeng 2022; 6:021502. [PMID: 35464617 PMCID: PMC9010050 DOI: 10.1063/5.0086935] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 03/29/2022] [Indexed: 12/17/2022] Open
Abstract
The ability for wearable devices to collect high-fidelity biosignals continuously over weeks and months at a time has become an increasingly sought-after characteristic to provide advanced diagnostic and therapeutic capabilities. Wearable devices for this purpose face a multitude of challenges such as formfactors with long-term user acceptance and power supplies that enable continuous operation without requiring extensive user interaction. This review summarizes design considerations associated with these attributes and summarizes recent advances toward continuous operation with high-fidelity biosignal recording abilities. The review also provides insight into systematic barriers for these device archetypes and outlines most promising technological approaches to expand capabilities. We conclude with a summary of current developments of hardware and approaches for embedded artificial intelligence in this wearable device class, which is pivotal for next generation autonomous diagnostic, therapeutic, and assistive health tools.
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Affiliation(s)
- Tucker Stuart
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
| | - Jessica Hanna
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
| | - Philipp Gutruf
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
- Department of Electrical and Computer Engineering, University of Arizona, Tucson, Arizona 85721, USA
- Bio5 Institute, University of Arizona, Tucson, Arizona 85721, USA
- Neuroscience GIDP, University of Arizona, Tucson, Arizona 85721, USA
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Daniore P, Nittas V, von Wyl V. Enrollment and retention of participants in remote digital health studies: a scoping review and framework proposal (Preprint). J Med Internet Res 2022; 24:e39910. [PMID: 36083626 PMCID: PMC9508669 DOI: 10.2196/39910] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/12/2022] [Accepted: 07/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Paola Daniore
- Institute for Implementation Science in Healthcare, University of Zurich, Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Zurich, Switzerland
| | - Vasileios Nittas
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Viktor von Wyl
- Institute for Implementation Science in Healthcare, University of Zurich, Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Kulkarni P, Kirkham R, McNaney R. Opportunities for Smartphone Sensing in E-Health Research: A Narrative Review. SENSORS 2022; 22:s22103893. [PMID: 35632301 PMCID: PMC9147201 DOI: 10.3390/s22103893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 12/10/2022]
Abstract
Recent years have seen significant advances in the sensing capabilities of smartphones, enabling them to collect rich contextual information such as location, device usage, and human activity at a given point in time. Combined with widespread user adoption and the ability to gather user data remotely, smartphone-based sensing has become an appealing choice for health research. Numerous studies over the years have demonstrated the promise of using smartphone-based sensing to monitor a range of health conditions, particularly mental health conditions. However, as research is progressing to develop the predictive capabilities of smartphones, it becomes even more crucial to fully understand the capabilities and limitations of using this technology, given its potential impact on human health. To this end, this paper presents a narrative review of smartphone-sensing literature from the past 5 years, to highlight the opportunities and challenges of this approach in healthcare. It provides an overview of the type of health conditions studied, the types of data collected, tools used, and the challenges encountered in using smartphones for healthcare studies, which aims to serve as a guide for researchers wishing to embark on similar research in the future. Our findings highlight the predominance of mental health studies, discuss the opportunities of using standardized sensing approaches and machine-learning advancements, and present the trends of smartphone sensing in healthcare over the years.
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Elnakib S, Vecino-Ortiz AI, Gibson DG, Agarwal S, Trujillo AJ, Zhu Y, Labrique A. A novel score for mobile health applications to predict and prevent mortality: Further validation and adaptation to US population using the US NHANES dataset. J Med Internet Res 2022; 24:e36787. [PMID: 35483022 PMCID: PMC9240932 DOI: 10.2196/36787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/14/2022] [Accepted: 04/28/2022] [Indexed: 11/28/2022] Open
Abstract
Background The C-Score, which is an individual health score, is based on a predictive model validated in the UK and US populations. It was designed to serve as an individualized point-in-time health assessment tool that could be integrated into clinical counseling or consumer-facing digital health tools to encourage lifestyle modifications that reduce the risk of premature death. Objective Our study aimed to conduct an external validation of the C-Score in the US population and expand the original score to improve its predictive capabilities in the US population. The C-Score is intended for mobile health apps on wearable devices. Methods We conducted a literature review to identify relevant variables that were missing in the original C-Score. Subsequently, we used data from the 2005 to 2014 US National Health and Nutrition Examination Survey (NHANES; N=21,015) to test the capacity of the model to predict all-cause mortality. We used NHANES III data from 1988 to 1994 (N=1440) to conduct an external validation of the test. Only participants with complete data were included in this study. Discrimination and calibration tests were conducted to assess the operational characteristics of the adapted C-Score from receiver operating curves and a design-based goodness-of-fit test. Results Higher C-Scores were associated with reduced odds of all-cause mortality (odds ratio 0.96, P<.001). We found a good fit of the C-Score for all-cause mortality with an area under the curve (AUC) of 0.72. Among participants aged between 40 and 69 years, C-Score models had a good fit for all-cause mortality and an AUC >0.72. A sensitivity analysis using NHANES III data (1988-1994) was performed, yielding similar results. The inclusion of sociodemographic and clinical variables in the basic C-Score increased the AUCs from 0.72 (95% CI 0.71-0.73) to 0.87 (95% CI 0.85-0.88). Conclusions Our study shows that this digital biomarker, the C-Score, has good capabilities to predict all-cause mortality in the general US population. An expanded health score can predict 87% of the mortality in the US population. This model can be used as an instrument to assess individual mortality risk and as a counseling tool to motivate behavior changes and lifestyle modifications.
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Affiliation(s)
- Shatha Elnakib
- Department of International Health., Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street.E8620, Baltimore, US
| | - Andres I Vecino-Ortiz
- Department of International Health., Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street.E8620, Baltimore, US
| | - Dustin G Gibson
- Department of International Health., Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street.E8620, Baltimore, US
| | - Smisha Agarwal
- Department of International Health., Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street.E8620, Baltimore, US
| | - Antonio J Trujillo
- Department of International Health., Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street.E8620, Baltimore, US
| | - Yifan Zhu
- Department of International Health., Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street.E8620, Baltimore, US
| | - Alain Labrique
- Department of International Health., Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street.E8620, Baltimore, US
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Ploderer B, Rezaei Aghdam A, Burns K. Patient-Generated Health Photos and Videos Across Health and Well-being Contexts: Scoping Review. J Med Internet Res 2022; 24:e28867. [PMID: 35412458 PMCID: PMC9044143 DOI: 10.2196/28867] [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: 03/17/2021] [Revised: 10/15/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Patient-generated health data are increasingly used to record health and well-being concerns and engage patients in clinical care. Patient-generated photographs and videos are accessible and meaningful to patients, making them especially relevant during the current COVID-19 pandemic. However, a systematic review of photos and videos used by patients across different areas of health and well-being is lacking. Objective This review aims to synthesize the existing literature on the health and well-being contexts in which patient-generated photos and videos are used, the value gained by patients and health professionals, and the challenges experienced. Methods Guided by a framework for scoping reviews, we searched eight health databases (CINAHL, Cochrane Library, Embase, PsycINFO, PubMed, MEDLINE, Scopus, and Web of Science) and one computing database (ACM), returning a total of 28,567 studies. After removing duplicates and screening based on the predefined inclusion criteria, we identified 110 relevant articles. Data were charted and articles were analyzed following an iterative thematic approach with the assistance of NVivo software (version 12; QSR International). Results Patient-generated photos and videos are used across a wide range of health care services (39/110, 35.5% articles), for example, to diagnose skin lesions, assess dietary intake, and reflect on personal experiences during therapy. In addition, patients use them to self-manage health and well-being concerns (33/110, 30%) and to share personal health experiences via social media (36/110, 32.7%). Photos and videos create significant value for health care (59/110, 53.6%), where images support diagnosis, explanation, and treatment (functional value). They also provide value directly to patients through enhanced self-determination (39/110, 35.4%), social (33/110, 30%), and emotional support (21/110, 19.1%). However, several challenges emerge when patients create, share, and examine photos and videos, such as limited accessibility (16/110, 14.5%), incomplete image sets (23/110, 20.9%), and misinformation through photos and videos shared on social media (17/110, 15.5%). Conclusions This review shows that photos and videos engage patients in meaningful ways across different health care activities (eg, diagnosis, treatment, and self-care) for various health conditions. Although photos and videos require effort to capture and involve challenges when patients want to use them in health care, they also engage and empower patients, generating unique value. This review highlights areas for future research and strategies for addressing these challenges.
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Affiliation(s)
- Bernd Ploderer
- School of Computer Science, Queensland University of Technology, Brisbane, Australia
| | - Atae Rezaei Aghdam
- School of Information Systems, Queensland University of Technology, Brisbane, Australia
| | - Kara Burns
- Centre for Digital Transformation of Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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Schönenberger KA, Cossu L, Prendin F, Cappon G, Wu J, Fuchs KL, Mayer S, Herzig D, Facchinetti A, Bally L. Digital Solutions to Diagnose and Manage Postbariatric Hypoglycemia. Front Nutr 2022; 9:855223. [PMID: 35464035 PMCID: PMC9021863 DOI: 10.3389/fnut.2022.855223] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/14/2022] [Indexed: 11/29/2022] Open
Abstract
Postbariatric hypoglycemia (PBH) is an increasingly recognized late metabolic complication of bariatric surgery, characterized by low blood glucose levels 1-3 h after a meal, particularly if the meal contains rapid-acting carbohydrates. PBH can often be effectively managed through appropriate nutritional measures, which remain the cornerstone treatment today. However, their implementation in daily life continues to challenge both patients and health care providers. Emerging digital technologies may allow for more informed and improved decision-making through better access to relevant data to manage glucose levels in PBH. Examples include applications for automated food analysis from meal images, digital receipts of purchased food items or integrated platforms allowing the connection of continuously measured glucose with food and other health-related data. The resulting multi-dimensional data can be processed with artificial intelligence systems to develop prediction algorithms and decision support systems with the aim of improving glucose control, safety, and quality of life of PBH patients. Digital innovations, however, face trade-offs between user burden vs. amount and quality of data. Further challenges to their development are regulatory non-compliance regarding data ownership of the platforms acquiring the required data, as well as user privacy concerns and compliance with regulatory requirements. Through navigating these trade-offs, digital solutions could significantly contribute to improving the management of PBH.
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Affiliation(s)
- Katja A. Schönenberger
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Luca Cossu
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Francesco Prendin
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Giacomo Cappon
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Jing Wu
- Institute of Computer Science, University of St. Gallen, St. Gallen, Switzerland
| | - Klaus L. Fuchs
- ETH AI Center, Swiss Federal Institute of Technology (ETH) Zurich, Zurich, Switzerland
- Technology Studies, School of Humanities and Social Sciences, University of St. Gallen, St. Gallen, Switzerland
| | - Simon Mayer
- Institute of Computer Science, University of St. Gallen, St. Gallen, Switzerland
| | - David Herzig
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrea Facchinetti
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Lia Bally
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Randine P, Sharma A, Hartvigsen G, Johansen HD, Årsand E. Information and Communication Technology-based Interventions for Chronic Diseases Consultation: Scoping Review. Int J Med Inform 2022; 163:104784. [DOI: 10.1016/j.ijmedinf.2022.104784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 04/08/2022] [Accepted: 04/24/2022] [Indexed: 11/15/2022]
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Jovanovic M, Mitrov G, Zdravevski E, Lameski P, Colantonio S, Kampel M, Tellioglu H, Florez-Revuelta F. Ambient Assisted Living: A Scoping Review of Artificial Intelligence Models, Domains, Technology and Concerns (Preprint). J Med Internet Res 2022; 24:e36553. [DOI: 10.2196/36553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 08/15/2022] [Accepted: 09/23/2022] [Indexed: 11/13/2022] Open
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Using discrete-choice experiments to elicit preferences for digital wearable health technology for self-management of chronic kidney disease. Int J Technol Assess Health Care 2022; 38:e77. [DOI: 10.1017/s0266462322003233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Objectives
Wearable digital health technologies (DHTs) have the potential to improve chronic kidney disease (CKD) management through patient engagement. This study aimed to investigate and elicit preferences of individuals with CKD toward wearable DHTs designed to support self-management of their condition.
Methods
Using the results of our review of the published literature and after conducting qualitative patient interviews, five-choice attributes were identified and included in a discrete-choice experiment. The design consisted of 10-choice tasks, each comprising two hypothetical technologies and one opt-out scenario. We collected data from 113 adult patients with CKD stages 3–5 not on dialysis and analyzed their responses via a latent class model to explore preference heterogeneity.
Results
Two patient segments were identified. In all preference segments, the most important attributes were the device appearance, format, and type of information provided. Patients within the largest preference class (70 percent) favored information provided in any format except the audio, while individuals in the other class preferred information in text format. In terms of the style of engagement with the device, both classes wanted a device that provides options rather than telling them what to do.
Conclusions
Our analysis indicates that user preferences differ between patient subgroups, supporting the case for offering a different design of the device for different patients’ strata, thus moving away from a one-size-fits-all service provision. Furthermore, we showed how to leverage the information from user preferences early in the R&D process to inform and support the provision of nuanced person-centered wearable DHTs.
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Woodcock E. Barriers and Facilitators to Automated Self-Scheduling: Consensus from a Delphi Panel of Key Stakeholders. PERSPECTIVES IN HEALTH INFORMATION MANAGEMENT 2022; 19:1m. [PMID: 35440921 PMCID: PMC9013230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Automated self-scheduling may benefit healthcare organizations, yet uptake has been slow. The aim of this study was to develop a consensus statement regarding the organizational-level determinants of implementation success based on the collective knowledge of experts. A three-stage modified Delphi method was used to reach consensus on the top determinants of implementation of self-scheduling solutions by healthcare organizations. A panel of 53 experts representing 41 academic health systems identified barriers and facilitators involving the organization's inner and outing settings, as well as the characteristics of the intervention and the individuals engaged in the solution. Offering convenience for patients is the leading enabler for organizations to implement the technology. The consensus may aid healthcare organizations and suppliers engaged in adopting and developing self-scheduling technology to improve implementation success. Further research is recommended to diagnose and examine each barrier and facilitator and how these factors interact. OBJECTIVE The aim of this study was to develop a consensus statement regarding the determinants of implementation success based on the collective knowledge of experts working in the field. METHODS A Delphi panel was constructed based on selected participants employed by academic health systems and experienced with self-scheduling implementation. Panelists were recruited based on participation in an educational event that featured the topic. Purposive and snowball sampling were used. Panelists participated in surveys collected over three rounds. An 80 percent agreement among panelists and interquartile range (IQR) <1 determined the barriers and facilitators. The top-10 determinants were presented in rank order. RESULTS Between January 6, 2021, and May 26, 2021, 53 panelists representing 41 academic health systems participated in three rounds of surveys to reach consensus on the barriers and facilitators to implementation of self-scheduling by healthcare organizations in the United States. In round one, panelists documented 530 determinants. In round two, the determinants were grouped into 72 barriers and 85 facilitators, each of which participants rated on a five-point Likert scale. Fifteen determinants met the 80 percent threshold and 1.0 IQR. The final round concluded with a top-10, rank-ordered listing of determinants (seven facilitators and three barriers) that also incorporated a median rating score using five-point Likert scale. CONCLUSION A three-stage modified Delphi method was used to reach consensus on the top determinants of implementation of self-scheduling solutions by academic health systems. The consensus may aid healthcare organizations and suppliers engaged in adopting and developing self-scheduling technology to improve implementation success. Further research is recommended to diagnose and examine each barrier and facilitator and how these factors interact.
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Howard J, Murashov V, Cauda E, Snawder J. Advanced sensor technologies and the future of work. Am J Ind Med 2022; 65:3-11. [PMID: 34647336 DOI: 10.1002/ajim.23300] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/27/2021] [Accepted: 09/30/2021] [Indexed: 01/09/2023]
Abstract
Exposure science is fundamental to the field of occupational safety and health. The measurement of worker exposures to hazardous agents informs effective workplace risk mitigation strategies. The modern era of occupational exposure measurement began with the invention of the personal sampling device, which is still widely used today in the practice of occupational hygiene. Newer direct-reading sensor devices are incorporating recent advances in transducers, nanomaterials, electronics miniaturization, portability, batteries with high-power density, wireless communication, energy-efficient microprocessing, and display technology to usher in a new era in exposure science. Commercial applications of new sensor technologies have led to a variety of health and lifestyle management devices for everyday life. These applications are also being investigated as tools to measure occupational and environmental exposures. As the next-generation placeable, wearable, and implantable sensor technologies move from the research laboratory to the workplace, their role in the future of work will be of increasing importance to employers, workers, and occupational safety and health researchers and practitioners. This commentary discusses some of the benefits and challenges of placeable, wearable, and implantable sensor technologies in the future of work.
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Affiliation(s)
- John Howard
- Office of the Director, National Institute for Occupational Safety and Health, Washington District of Columbia USA
| | - Vladimir Murashov
- Office of the Director, National Institute for Occupational Safety and Health, Washington District of Columbia USA
| | - Emanuele Cauda
- Center for Direct Reading and Sensor Technologies, Pittsburgh Mining Research Division National Institute for Occupational Safety and Health Pittsburgh Pennsylvania USA
| | - John Snawder
- Center for Direct Reading and Sensor Technologies, Health Effects Laboratory Division National Institute for Occupational Safety and Health Cincinnati Ohio USA
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DURSUN N, YILMAZ E. Cerrahi Hemşireliği Alanında Giyilebilir Teknoloji Kullanımı. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2021. [DOI: 10.38079/igusabder.948675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Ali A, Dindoust D, Grant J, Clarke D. Delivering epilepsy care in low-resource settings: the role of technology. Expert Rev Med Devices 2021; 18:13-23. [PMID: 34851222 DOI: 10.1080/17434440.2021.2013198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The implementation of technology in the field of epileptology has traditionally focused on its use for diagnosis and treatment and has, unsurprisingly, been capital-intensive, making it therefore mainly implementable in advanced high-income countries. Because of technological innovations over the past 20 years there has been almost a paradigm shift, particularly in access to and the potential for implementing relevant technology in lesser developed environments. Nearly 80% of people living with epilepsy live in low and middle-income countries. AREAS COVERED The challenge and the purpose of this paper is to discuss how technology can be implemented into lesser-resourced contexts not only cost-effectively but in a cost-saving way while also building capacity and thus sustainability. EXPERT OPINION The rate of technological advancement presents the risk of progressive widening of the technology and care gaps between advanced and lesser developed regions. Implementing technology is both about finding relevant appropriate technologies for the individual contexts of a diverse range of countries but also about repurposing low-tech technologies for application in epilepsy care in these areas. Finally exciting advances such as autonomous driving, digital twinning and robotic surgery will likely transform epilepsy care in several lower-resourced settings in the next 5-10 years.
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Affiliation(s)
- Amza Ali
- Departments of Medicine, Kingston Public Hospital and University of the West Indies, Mona, Jamaica
| | | | - Justin Grant
- Rotman School of Management, University of Toronto, Toronto, Canada
| | - Dave Clarke
- Dell Medical School, University of Texas, Austin, Texas, USA
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Cudejko T, Button K, Willott J, Al-Amri M. Applications of Wearable Technology in a Real-Life Setting in People with Knee Osteoarthritis: A Systematic Scoping Review. J Clin Med 2021; 10:5645. [PMID: 34884347 PMCID: PMC8658504 DOI: 10.3390/jcm10235645] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 12/12/2022] Open
Abstract
With the growing number of people affected by osteoarthritis, wearable technology may enable the provision of care outside a traditional clinical setting and thus transform how healthcare is delivered for this patient group. Here, we mapped the available empirical evidence on the utilization of wearable technology in a real-world setting in people with knee osteoarthritis. From an analysis of 68 studies, we found that the use of accelerometers for physical activity assessment is the most prevalent mode of use of wearable technology in this population. We identify low technical complexity and cost, ability to connect with a healthcare professional, and consistency in the analysis of the data as the most critical facilitators for the feasibility of using wearable technology in a real-world setting. To fully realize the clinical potential of wearable technology for people with knee osteoarthritis, this review highlights the need for more research employing wearables for information sharing and treatment, increased inter-study consistency through standardization and improved reporting, and increased representation of vulnerable populations.
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Affiliation(s)
- Tomasz Cudejko
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, College House, King George V Drive East, Heath Park, Cardiff CF14 4EP, UK; (K.B.); (J.W.); (M.A.-A.)
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Chandrasekaran R, Katthula V, Moustakas E. Too old for technology? Use of wearable healthcare devices by older adults and their willingness to share health data with providers. Health Informatics J 2021; 27:14604582211058073. [PMID: 34802315 DOI: 10.1177/14604582211058073] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Wearable healthcare devices offer tremendous promise to effectively track and improve the well-being of older adults. Yet, little is known about the use of wearable devices by older adults. Drawing upon a national survey in US with 1481 older adults, we examine the use of wearable healthcare devices and the key predictors of use viz. sociodemographic factors, health conditions, and technology self-efficacy. We also examine if the predictors are associated with elders' willingness to share health data from wearable devices with healthcare providers. We find low level of wearable use (17.49%) among US older adults. We find significant positive associations between technology self-efficacy, health conditions, and demographic factors (gender, race, education, and annual household income) and use of wearable devices. Men were less likely (OR = 0.62, 95% CI 0.36-1.04) and Asians were more likely (OR = 2.60, 95% CI 0.89-7.64) to use wearables, as did healthy adults (OR = 1.98, 95% CI 1.37-2.87). Those who electronically communicated with their doctors (OR = 1.86, 95% CI 1.16-2.97), and those who searched online for health information (OR = 1.79, 95% CI 1.03-3.10) were more likely to use wearables. Though 80.15% of wearable users are willing to share health data with providers, those with greater technology self-efficacy and favorable attitudes toward exercise are more willing.
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Affiliation(s)
| | - Vipanchi Katthula
- Center for Health Information Management & Systems, University of Illinois at Chicago, Chicago, IL, USA
| | - Evangelos Moustakas
- Centre of Innovation and Excellence, 156575Middlesex University, Dubai, United Arab Emirates
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Locsin RC, Soriano GP, Juntasopeepun P, Kunaviktikul W, Evangelista LS. Social transformation and social isolation of older adults: Digital technologies, nursing, healthcare. Collegian 2021; 28:551-558. [PMID: 34720647 DOI: 10.1016/j.colegn.2021.01.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The incidence of social isolation among older adults is on the rise in today's health care climate. Consequently, preventing or ameliorating social isolation through technology in this age group is now being discussed as a significant social and health issue. Aim The purpose of the opinion paper is to clarify social transformation through technology and shed light on a new reality for older adults in situations of social isolation. Our goal is to persuade the reader that our position on this topic is a valid one. We support our claims with practice-based evidence and published research studies. Methods To do so, we checked the most recent literature, most of which came from the last decade. Our literature survey focused primarily on what is known about technology and how technology can affect social transformation and perceptions of social isolation. Findings Two dominant transformative realities became the focal points: the precarious implications of loneliness for older adults and the emerging reality of social change through digital technology central to eHealth and mHealth. Discussion To benefit from new technologies and reduce the detrimental effects of social isolation, we must engage older adults in a meaningful way and adapt the system of smart devices to reflect the specific physiological and psychological characteristics of the ageing population. Conclusion Older adults need to comprehend the meanings of their social experiences to preserve their active lifestyle. Human interactions may be desirable, but technological dominance may also minimize the adverse effects of social isolation.
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Affiliation(s)
- Rozzano C Locsin
- Faculty of Nursing, Chiangmai University, Chiang Mai, Thailand.,Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.,Florida Atlantic University, Boca Raton, FL, USA
| | - Gil P Soriano
- College of Nursing, San Beda University, Manila, Philippines
| | | | | | - Lorraine S Evangelista
- Lena Finke Distinguished Chair for Nursing Arts, School of Nursing University of Texas Medical Branch, Galveston, TX, USA
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Itoh S, Miwa H, Wu VX, Okuyama A, Watanabe K, Ikeuchi T, Wakui T. Acceptance of care technologies to support activities of daily living by middle-aged and older adults in Japan: A cross-sectional study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2021. [DOI: 10.1016/j.ijnsa.2021.100042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Gurubhagavatula I, Barger LK, Barnes CM, Basner M, Boivin DB, Dawson D, Drake CL, Flynn-Evans EE, Mysliwiec V, Patterson PD, Reid KJ, Samuels C, Shattuck NL, Kazmi U, Carandang G, Heald JL, Van Dongen HP. Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society. J Clin Sleep Med 2021; 17:2283-2306. [PMID: 34666885 PMCID: PMC8636361 DOI: 10.5664/jcsm.9512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022]
Abstract
CITATION Risks associated with fatigue that accumulates during work shifts have historically been managed through working time arrangements that specify fixed maximum durations of work shifts and minimum durations of time off. By themselves, such arrangements are not sufficient to curb risks to performance, safety, and health caused by misalignment between work schedules and the biological regulation of waking alertness and sleep. Science-based approaches for determining shift duration and mitigating associated risks, while addressing operational needs, require: (1) a recognition of the factors contributing to fatigue and fatigue-related risks; (2) an understanding of evidence-based countermeasures that may reduce fatigue and/or fatigue-related risks; and (3) an informed approach to selecting workplace-specific strategies for managing work hours. We propose a series of guiding principles to assist stakeholders with designing a shift duration decision-making process that effectively balances the need to meet operational demands with the need to manage fatigue-related risks.
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Affiliation(s)
- Indira Gurubhagavatula
- Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Corporal Michael Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Laura K. Barger
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Christopher M. Barnes
- Department of Management and Organization, Foster School of Business, University of Washington, Seattle, WA, USA
| | - Mathias Basner
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Diane B. Boivin
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Drew Dawson
- Appleton Institute, Central Queensland University, Wayville, SA, Australia
| | | | - Erin E. Flynn-Evans
- Fatigue Countermeasures Laboratory, NASA Ames Research Center, Moffett Field, CA, USA
| | - Vincent Mysliwiec
- STRONG STAR ORU, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, TX, USA
| | - P. Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathryn J. Reid
- Center for Circadian and Sleep Medicine, Department of Neurology, Division of Sleep Medicine, Northwestern University, Chicago, IL, USA
| | - Charles Samuels
- Centre for Sleep and Human Performance, Calgary, Alberta, Canada
| | - Nita Lewis Shattuck
- Operations Research Department, Naval Postgraduate School, Monterey, CA, USA
| | - Uzma Kazmi
- American Academy of Sleep Medicine, Darien, IL, USA
| | | | | | - Hans P.A. Van Dongen
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
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