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Preston S, Strudwick RM, Cox WAS. Medical Image sharing: What do the public see when reviewing radiographs? A pilot study. J Med Imaging Radiat Sci 2024:101423. [PMID: 38760315 DOI: 10.1016/j.jmir.2024.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 04/11/2024] [Accepted: 04/25/2024] [Indexed: 05/19/2024]
Abstract
INTRODUCTION Policymakers wish to extend access to medical records, including medical imaging. Appreciating how patients might review radiographs could be key to establishing future training needs for healthcare professionals and how image sharing could be integrated into practice. METHOD A pilot study in the UK using a survey was distributed to adult participants via the online research platform Prolific. All subjects were without prior professional healthcare experience. Participants reviewed ten radiographs (single projection only) and were asked a two-stage question. Firstly, if the radiograph was 'normal' or 'abnormal' and secondly, if they had answered 'abnormal', to identify the abnormality from a pre-determined list featuring generic terms for pathologies. RESULTS Fifty participants completed the survey. A mean of 65.8 % of participants were able to correctly identify if radiographs were normal or abnormal. Results in relation to the identification of a pathology were not as positive, but still notable with a mean of 46.4 % correctly identifying abnormalities. Qualitative data demonstrated that members of the public are enthralled with reviewing radiographs and intrigued to understand their performance in identifying abnormalities. CONCLUSION In the pilot, members of the public could identify if a radiograph is normal or abnormal to a reasonable standard. Further detailed interpretation of images requires supportive intervention. This pilot study suggests that patients can participate in image sharing as part of their care. Image sharing may be beneficial to the therapeutic relationship, aiding patient understanding and enhancing consultations between healthcare professional and patient. Further research is indicated.
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Affiliation(s)
- Scott Preston
- The Open University, Milton Keynes, MK7 6AA, United Kingdom.
| | - Ruth M Strudwick
- The University of Suffolk, Waterfront Building, Ipswich, Suffolk, United Kingdom
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Blanchard M, Koller CN, Azevedo PM, Prétat T, Hügle T. Development of a Management App for Postviral Fibromyalgia-Like Symptoms: Patient Preference-Guided Approach. JMIR Form Res 2024; 8:e50832. [PMID: 38639986 PMCID: PMC11069091 DOI: 10.2196/50832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/22/2023] [Accepted: 01/11/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Persistent fibromyalgia-like symptoms have been increasingly reported following viral infections, including SARS-CoV-2. About 30% of patients with post-COVID-19 syndrome fulfill the fibromyalgia criteria. This complex condition presents significant challenges in terms of self-management. Digital health interventions offer a viable means to assist patients in managing their health conditions. However, the challenge of ensuring their widespread adoption and adherence persists. This study responds to this need by developing a patient-centered digital health management app, incorporating patient preferences to enhance usability and effectiveness, ultimately aiming to improve patient outcomes and quality of life. OBJECTIVE This research aims to develop a digital health self-management app specifically for patients experiencing postviral fibromyalgia-like symptoms. By prioritizing patient preferences and engagement through the app's design and functionality, the study intends to facilitate better self-management practices and improve adherence. METHODS Using an exploratory study design, the research used patient preference surveys and usability testing as primary tools to inform the development process of the digital health solution. We gathered and analyzed patients' expectations regarding design features, content, and usability to steer the iterative app development. RESULTS The study uncovered crucial insights from patient surveys and usability testing, which influenced the app's design and functionality. Key findings included a preference for a symptom list over an automated chatbot, a desire to report on a moderate range of symptoms and activities, and the importance of an intuitive onboarding process. While usability testing identified some challenges in the onboarding process, it also confirmed the importance of aligning the app with patient needs to enhance engagement and satisfaction. CONCLUSIONS Incorporating patient feedback has been a significant factor in the development of the digital health app. Challenges encountered with user onboarding during usability testing have highlighted the importance of this process for user adoption. The study acknowledges the role of patient input in developing digital health technologies and suggests further research to improve onboarding procedures, aiming to enhance patient engagement and their ability to manage digital health resources effectively. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/32193.
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Affiliation(s)
- Marc Blanchard
- Department of Rheumatology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Cinja Nadana Koller
- Department of Rheumatology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Pedro Ming Azevedo
- Department of Rheumatology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Tiffany Prétat
- Department of Rheumatology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Thomas Hügle
- Department of Rheumatology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
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Humphrey G, Keane C, Gharibans A, Andrews CN, Benitez A, Mousa H, O'Grady G. Designing, Developing, and Validating a Set of Standardized Pictograms to Support Pediatric-Reported Gastroduodenal Symptoms. J Pediatr 2024; 267:113922. [PMID: 38242317 DOI: 10.1016/j.jpeds.2024.113922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 01/21/2024]
Abstract
OBJECTIVE To develop and validate a set of static and animated gastroduodenal symptom pictograms for children. STUDY DESIGN There were 3 study phases: 1: cocreation using experience design methods to develop pediatric gastroduodenal symptom pictograms (static and animated); 2: an online survey to assess acceptability, as well as face and content validity; and 3: a preference study. Phases 2 and 3 compared the novel pediatric pictograms with existing pictograms used with adult patients. RESULTS Eight children aged 6-15 years (5 female) participated in phase 1, and 69 children in phase 2 (median age 13 years: IQR 9-15); an additional 49 participants were included in phase 3 (median age 15: IQR 12-17). Face and content validity were higher for the pediatric static and animated pictogram sets compared with pre-existing adult pictograms (78% vs 78% vs 61%). Participants with worse gastric symptoms had superior comprehension of the pediatric pictograms (χ2 [8, N = 118] P < .001). All participants preferred the pediatric static pictogram set was over both the animated and adult sets (χ2 [2, N = 118] P < .001). CONCLUSIONS The cocreation phase resulted in the symptom concept confirmation and design of 10 acceptable static and animated gastroduodenal pictograms with high face and content validity when evaluated with children aged 6-18. Validity was superior when children reported more problematic symptoms. Therefore, these pictograms could be used in clinical and research practice to enable standardized symptom reporting for children with gastroduodenal disorders.
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Affiliation(s)
- Gayl Humphrey
- Department of Surgery, The University of Auckland, Aotearoa, New Zealand.
| | - Celia Keane
- Department of Surgery, The University of Auckland, Aotearoa, New Zealand; Te Whatu Ora: Te Tai Tokerau (Health New Zealand: Northland)
| | - Armen Gharibans
- Department of Surgery, The University of Auckland, Aotearoa, New Zealand; Alimetry Ltd, Auckland, Aotearoa, New Zealand; Perelman School of Medicine, University of Pennsylvania, PA
| | - Christopher N Andrews
- Alimetry Ltd, Auckland, Aotearoa, New Zealand; The Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Canada
| | - Alain Benitez
- Division of Gastroenterology, Children's Hospital of Philadelphia, Philadelphia; Perelman School of Medicine, University of Pennsylvania, PA
| | - Hayat Mousa
- Division of Gastroenterology, Children's Hospital of Philadelphia, Philadelphia; Perelman School of Medicine, University of Pennsylvania, PA
| | - Gregory O'Grady
- Department of Surgery, The University of Auckland, Aotearoa, New Zealand; Alimetry Ltd, Auckland, Aotearoa, New Zealand
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Anastasi JK, Capili B, Norton M, McMahon DJ, Marder K. Recruitment and retention of clinical trial participants: understanding motivations of patients with chronic pain and other populations. FRONTIERS IN PAIN RESEARCH 2024; 4:1330937. [PMID: 38606348 PMCID: PMC11006977 DOI: 10.3389/fpain.2023.1330937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/20/2023] [Indexed: 04/13/2024] Open
Abstract
This paper aims to present and discuss the issues, challenges, and strategies related to recruitment and retention in clinical trials involving participants with chronic pain. The randomized controlled clinical trial (RCT) is widely regarded as the gold standard for evaluating clinical interventions. However, it is crucial to acknowledge and address the challenges associated with recruiting and retaining participants. To prioritize the experience of the study population, targeted outreach strategies and a patient-centric approach are necessary. Researchers should consider incorporating recruitment and retention strategies during the study design phase. Implementing multi-pronged recruitment methods, leveraging relationships with community providers, and involving representatives of the patient population are helpful approaches. Effective communication and maintaining a professional environment are vital for optimizing engagement and supporting the successful execution of clinical trials involving participants with chronic pain.
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Affiliation(s)
- Joyce K. Anastasi
- Division of Special Studies in Symptom Management, New York University, New York, NY, United States
| | - Bernadette Capili
- Heilbrunn Family Center for Research Nursing, The Rockefeller University, New York, NY, United States
| | - Margaret Norton
- Division of Special Studies in Symptom Management, New York University, New York, NY, United States
- Department of Nursing, St. Joseph's University, Brooklyn, NY, United States
| | - Donald J. McMahon
- Division of Special Studies in Symptom Management, New York University, New York, NY, United States
| | - Karen Marder
- Irving Medical Center, Columbia University, New York, NY, United States
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Kocol D, Geiger S, Schweda A, Beckord J, Schadendorf T, Jansen C, Robitzsch A, Skoda EM, Teufel M, Bäuerle A. An e-mental health intervention to reduce depression symptoms in individuals with obesity: study protocol for the randomized, controlled, two-armed, confirmatory LightMood trial. Trials 2024; 25:149. [PMID: 38419096 PMCID: PMC10900592 DOI: 10.1186/s13063-024-07970-9] [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: 07/31/2023] [Accepted: 02/05/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Patients with obesity often experience psychological distress, specifically depression symptoms. Due to various barriers, such as limitations of healthcare offers, digital interventions, for example medical apps, can provide a suitable approach to support affected people. In the envisaged prospective randomized controlled trial, we aim to examine the efficacy of the LightMood intervention. The LightMood intervention is a manualized and user-centered, digital intervention for patients with obesity, with a duration of 4 months, which contains elements of cognitive behavioral therapy and mindfulness-based and skills-based exercises. We expect the LightMood intervention to be superior to treatment as usual (TAU) in terms of reducing depression symptoms. METHODS The trial incorporates four distinct measurement time points: the baseline assessment, the post-treatment assessment, and 1- and 3-month follow-up assessments. Furthermore, we implemented in-treatment assessments for both groups. Participants will be randomized into two groups (LightMood intervention vs TAU). The aim is to include 128 participants (64 per group) in the study. Inclusion criteria are patients who are obese, at least 18 years old, with a private Internet access, and with adequate digital literacy and show depression symptoms (PHQ ≥ 10). Exclusion criteria are weekly outpatient individual psychotherapy, obesity surgery within the last year or planned within the next 7 months, no private Internet access, and the prescription of a new psychotropic drug within the last 2 weeks. The primary outcome is the post-assessment reduction in depression symptoms. Secondary outcomes will include the improvement in self-efficacy, quality of life, mindfulness, reduction in eating disorder symptoms, and body mass index (BMI). Furthermore, we expect a positive development of depression symptoms throughout the different time points (T1, T2, and T3) in patients with obesity. DISCUSSION LightMood is an evidence-based, efficient, low-threshold online intervention that aims to reduce depression symptoms in people with obesity. Online interventions could offer a promising alternative to conventional face-to-face therapy. The primary objective of the current study is to add essential insight into the feasibility, efficacy, effectiveness, and acceptance of e-mental health interventions for people with obesity and depression symptoms. TRIAL REGISTRATION German Clinical Trial Register (DRKS), DRKS00029219. Registered on May 19, 2023.
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Affiliation(s)
- Dilara Kocol
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany.
| | - Sheila Geiger
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Adam Schweda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Jil Beckord
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Theresa Schadendorf
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Christoph Jansen
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Anita Robitzsch
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
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Srivastava U, Dasari S, Shah N. Learnings in Digital Health Design: Insights From a Pilot Web App for Structured Note-Taking for Patients With Rheumatoid Arthritis. JMIR Form Res 2023; 7:e49358. [PMID: 38015609 DOI: 10.2196/49358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/09/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Patients fail to accurately remember 40% to 80% of medical information relayed during doctor appointments, and most standard after-visit summaries fail to effectively help patients comply with behaviors to manage their health conditions. The value of technology to empower and engage patients in their health management has been shown, and here we apply technology to help patients remember and act upon information communicated during their medical appointments. OBJECTIVE We describe the development of WellNote, a digital notebook designed for patients to create a customized plan to manage their condition, plan for their appointments, track important actions (eg, medications and labs), and receive reminders for appointments and labs. METHODS For this pilot, we chose to focus on rheumatoid arthritis, a chronic condition that relies on many of these features. The development of WellNote followed a structured method based on design thinking and co-design principles, with the app built in close collaboration with patients and a physician partner to ensure clinical relevance. Our design process consisted of 3 rounds: patient and physician interviews, visual prototypes, and a functional pilot app. RESULTS Over the course of the design process, WellNote's features were refined, with the final version being a digital notebook designed for patients with rheumatoid arthritis to manage their health by helping them track medications and labs and plan for appointments. It features several pages, like a dashboard, patient profile, appointment notes, preplanning, medication management, lab tracking, appointment archives, reminders, and a pillbox for medication visualization. CONCLUSIONS WellNote's active and structured note-taking features allow patients to clearly document the information from their physician without detracting from the conversation, helping the patient to become more empowered and engaged in their health management. The co-design process empowered these stakeholders to share their needs and participate in the development of a solution that truly solves pain points for these groups. This viewpoint highlights the role of digital health tools and the co-design of new health care innovations to empower patients and support clinicians.
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Affiliation(s)
- Ujwal Srivastava
- Department of Computer Science, Stanford University, Stanford, CA, United States
| | - Shobha Dasari
- Department of Computer Science, Stanford University, Stanford, CA, United States
| | - Neha Shah
- Division of Immunology and Rheumatology, Stanford School of Medicine, Stanford, CA, United States
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Mendieta CV, de Vries E, Calvache JA, Ahmedzai SH, Prue G, McConnell T, Reid J. Co-Designing a Strategy for Implementing the SPARC Holistic Needs Assessment Tool in the Colombian Clinical Context. Healthcare (Basel) 2023; 11:2917. [PMID: 37998409 PMCID: PMC10671711 DOI: 10.3390/healthcare11222917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/02/2023] [Accepted: 11/04/2023] [Indexed: 11/25/2023] Open
Abstract
In Colombia, timely access to palliative care (PC) is hampered by difficulties in identifying and referring to necessary services. The SPARC (Sheffield Profile for Assessment and Referral for Care) instrument provides a holistic needs assessment to improve referrals for different forms of care. SPARC was recently validated in Colombian Spanish (SPARC-Sp) but has not yet been implemented in clinical practice. We undertook workshops that aimed to co-design an implementation strategy to inform a future trial testing SPARC-Sp in the Colombian healthcare system. Workshop attendees included patients, informal caregivers, healthcare professionals, volunteers, administrative staff and decision makers. Discussions within the workshops refined implementation and dissemination strategies for SPARC-Sp in practical scenarios. Results include the need for education, clarification and demystification of PC and the lack of time and skills of professionals to identify patients' needs. Attendees recognized SPARC-Sp as a valuable tool for highlighting patients' concerns, whose adaptations are needed in Colombia to address the low literacy of the population and specificities of the healthcare system. We proposed local adaptations to SPARC-Sp and produced five educational videos aimed at health professionals, patients and caregivers to strengthen understanding of holistic needs in PC while building a strategy for SPARC-Sp implementation in the Colombian context.
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Affiliation(s)
- Cindy V. Mendieta
- PhD Program in Clinical Epidemiology, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogota 110231, Colombia;
- Department of Nutrition and Biochemistry, Faculty of Sciences, Pontificia Universidad Javeriana, Bogota 110231, Colombia
| | - Esther de Vries
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
| | | | - Sam H. Ahmedzai
- Medical School, The University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK;
| | - Gillian Prue
- Medical Biology Centre, School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (G.P.); (T.M.)
| | - Tracey McConnell
- Medical Biology Centre, School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (G.P.); (T.M.)
| | - Joanne Reid
- Medical Biology Centre, School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (G.P.); (T.M.)
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Těšinová JK, Dobiášová K, Dušek Z, Tobiášová A. Development of telemedicine in the Czech Republic from patients' and other key stakeholders' perspective. Front Public Health 2023; 11:1202182. [PMID: 37937075 PMCID: PMC10626478 DOI: 10.3389/fpubh.2023.1202182] [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: 04/07/2023] [Accepted: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
Telemedicine is a way to improve healthcare outcomes with greater efficiency for both patients and care providers. The great potential of digital technologies also lies in strengthening the patient-centered approach. The early successes and benefits of telemedicine in the Czech Republic, amplified by the COVID-19, have contributed to the fact that wider implementation of telemedicine is already generally supported at the expert and public levels. Our research focuses on the identification of key issues in the implementation of telemedicine and the challenges of telemedicine in the future, from the perspective of patients and other stakeholders. The study is based on a qualitative research approach, combining focus groups with key stakeholders, patient panels and expert panels (2021-2022). The lack of rules and uncoordinated development of various activities proved to be the main barriers to the integration of telemedicine in the health system. This regulatory uncertainty can generate a number of problems in the patient-doctor relationship in practice, including ethical ones, and can also lead to inequalities in access to healthcare and affect the overall quality of care provided. Furthermore, it has been shown that patients' interests in the implementation of telemedicine are: 1. a predictable and reliable framework that guarantees them certainty and security in the provision of telemedicine services, 2. telemedicine solutions that increase the availability and efficiency of the care provided while bringing comfort, and 3. user-friendly and simple solutions. At the same time, patients want to understand the new environment and be active participants in the process of digital innovation, including the practical implementation of telemedicine. The research team has developed recommendations for further developments in the implementation of telemedicine that reflect the patient's interest and can be implemented at three levels - the health system, institutional, and community level. In countries with a well-developed and institutionalized patient movement, the community level can be represented by patient organizations, thus becoming the link between telemedicine policy making and implementation at the individual level of healthcare provision. For the further development of telemedicine, the development of a national strategy involving all key stakeholders, including patients, in the implementation has proven essential.
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Affiliation(s)
- Jolana Kopsa Těšinová
- Institute of Public Health and Medical Law, First Faculty of Medicine, Charles University, Prague, Czechia
| | - Karolína Dobiášová
- Institute of Public Health and Medical Law, First Faculty of Medicine, Charles University, Prague, Czechia
| | | | - Alena Tobiášová
- Institute of Public Health and Medical Law, First Faculty of Medicine, Charles University, Prague, Czechia
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Jahre LM, Lortz J, Rassaf T, Rammos C, Mallien C, Skoda EM, Teufel M, Bäuerle A. Needs and demands for mHealth cardiac health promotion among individuals with cardiac diseases: a patient-centred design approach. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2023; 4:393-401. [PMID: 37794866 PMCID: PMC10545514 DOI: 10.1093/ehjdh/ztad038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/05/2023] [Indexed: 10/06/2023]
Abstract
Aims Cardiovascular diseases are one of the main contributors to disability and mortality worldwide. Meanwhile, risk factors can be modified by lifestyle changes. mHealth is an innovative and effective way to deliver cardiac health promotion. This study aims to examine the needs and demands regarding the design and contents of an mHealth intervention for cardiac health promotion among individuals with cardiac diseases. Different clusters were determined and analysed in terms of the intention to use an mHealth intervention. Methods and results A cross-sectional study was conducted via a web-based survey. Three hundred and four individuals with coronary artery diseases (CADs) and/or congestive heart failure (CHF) were included in the data analysis. Descriptive statistics were applied to evaluate needs and demands regarding an mHealth intervention. A k-medoids cluster analysis was performed. Individuals with CAD and CHF favoured an mHealth intervention that supports its users permanently and is easily integrated into everyday life. Handheld devices and content formats that involve active user participation and regular updates were preferred. Three clusters were observed and labelled high, moderate, and low burden, according to their psychometric properties. The high burden cluster indicated higher behavioural intention towards use of an mHealth intervention than the other clusters. Conclusion The results of the study are a valuable foundation for the development of an mHealth intervention for cardiac health promotion following a user-centred design approach. Individuals with cardiac diseases report positive attitudes in the form of high usage intention regarding mHealth. Highly burdened individuals report a high intention to use such interventions.
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Affiliation(s)
- Lisa Maria Jahre
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Julia Lortz
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - Christos Rammos
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - Charlotta Mallien
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
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Zilber S, Woleben K, Johnson SC, de Souza CFM, Boyce D, Freiert K, Boggs C, Messahel S, Burnworth MJ, Afolabi TM, Kayani S. Leigh syndrome global patient registry: uniting patients and researchers worldwide. Orphanet J Rare Dis 2023; 18:264. [PMID: 37667390 PMCID: PMC10476366 DOI: 10.1186/s13023-023-02886-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 08/25/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Leigh Syndrome (LS) is a rare genetic neurometabolic disorder, that leads to the degeneration of the central nervous system and subsequently, early death. LS can be caused by over 80 mutations in mitochondrial or nuclear DNA. Patient registries are important for many reasons, such as studying the natural history of the disease, improving the quality of care, and understanding the healthcare burden. For rare diseases, patient registries are significantly important as patient numbers are small, and funding is limited. Cure Mito Foundation started a global patient registry for LS in September 2021 to identify and learn about the LS patient population, facilitate clinical trial recruitment, and unite international patients and researchers. Priorities were to allow researchers and industry partners to access data at no cost through a clear and transparent process, active patient engagement, and sharing of results back to the community. RESULTS Patient registry platform, survey design, data analysis process, and patient recruitment strategies are described. Reported results include demographics, diagnostic information, symptom history, loss of milestones, disease management, healthcare utilization, quality of life, and caregiver burden for 116 participants. Results show a high disease burden, but a relatively short time to diagnosis. Despite the challenges faced by families impacted by Leigh syndrome, participants, in general, are described as having a good quality of life and caregivers are overall resilient, while also reporting a significant amount of stress. CONCLUSION This registry provides a straightforward, no-cost mechanism for data sharing and contacting patients for clinical trials or research participation, which is important given the recruitment challenges for clinical trials for rare diseases. This is the first publication to present results from a global patient registry for Leigh Syndrome, with details on a variety of patient-specific and caregiver outcomes reported for the first time. Additionally, this registry is the first for any mitochondrial disease with nearly 70% of participants residing outside of the United States. Future efforts include continued publication of results and further collaboration with patients, industry partners, and researchers.
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Affiliation(s)
- Sophia Zilber
- Cure Mito Foundation, 6808 Old Glory Ct., McKinney, TX, 75071, USA.
| | - Kasey Woleben
- Cure Mito Foundation, 6808 Old Glory Ct., McKinney, TX, 75071, USA.
| | - Simon C Johnson
- Faculty of Health and Life Sciences, Northumbria University, A521A Ellison Building, Newcastle Upon Tyne, NE1 8ST, UK
- University of Washington, Seattle, WA, USA
| | | | - Danielle Boyce
- Cure Mito Foundation, 6808 Old Glory Ct., McKinney, TX, 75071, USA
- Biomedical Informatics and Data Science Section, Johns Hopkins University School of Medicine, 2024 East Monument St. S 1-200, Baltimore, MD, 21205, USA
| | - Kevin Freiert
- Cure Mito Foundation, 6808 Old Glory Ct., McKinney, TX, 75071, USA
| | - Courtney Boggs
- Cure Mito Foundation, 6808 Old Glory Ct., McKinney, TX, 75071, USA
| | - Souad Messahel
- Peter O'Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, J4.122, Dallas, TX, 75390-8802, USA
| | - Melinda J Burnworth
- Department of Pharmacy Practice, Midwestern University College of Pharmacy, Glendale Campus, 19555 N. 59th Ave, Glendale, AZ, 85308, USA
| | - Titilola M Afolabi
- Department of Pharmacy Practice, Midwestern University College of Pharmacy, Glendale Campus, 19555 N. 59th Ave, Glendale, AZ, 85308, USA
- Phoenix Children's Hospital, Arizona, USA
| | - Saima Kayani
- Cure Mito Foundation, 6808 Old Glory Ct., McKinney, TX, 75071, USA
- University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
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11
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Sittig DF, Boxwala A, Wright A, Zott C, Desai P, Dhopeshwarkar R, Swiger J, Lomotan EA, Dobes A, Dullabh P. A lifecycle framework illustrates eight stages necessary for realizing the benefits of patient-centered clinical decision support. J Am Med Inform Assoc 2023; 30:1583-1589. [PMID: 37414544 PMCID: PMC10436138 DOI: 10.1093/jamia/ocad122] [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: 12/13/2022] [Revised: 06/06/2023] [Accepted: 06/23/2023] [Indexed: 07/08/2023] Open
Abstract
The design, development, implementation, use, and evaluation of high-quality, patient-centered clinical decision support (PC CDS) is necessary if we are to achieve the quintuple aim in healthcare. We developed a PC CDS lifecycle framework to promote a common understanding and language for communication among researchers, patients, clinicians, and policymakers. The framework puts the patient, and/or their caregiver at the center and illustrates how they are involved in all the following stages: Computable Clinical Knowledge, Patient-specific Inference, Information Delivery, Clinical Decision, Patient Behaviors, Health Outcomes, Aggregate Data, and patient-centered outcomes research (PCOR) Evidence. Using this idealized framework reminds key stakeholders that developing, deploying, and evaluating PC-CDS is a complex, sociotechnical challenge that requires consideration of all 8 stages. In addition, we need to ensure that patients, their caregivers, and the clinicians caring for them are explicitly involved at each stage to help us achieve the quintuple aim.
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Affiliation(s)
- Dean F Sittig
- McWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | | | - Adam Wright
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Courtney Zott
- NORC at the University of Chicago, Bethesda, Maryland, USA
| | - Priyanka Desai
- NORC at the University of Chicago, Bethesda, Maryland, USA
| | | | - James Swiger
- Center for Evidence and Practice Improvement, Agency for Healthcare Research and Quality, Rockville, Maryland, USA
| | - Edwin A Lomotan
- Center for Evidence and Practice Improvement, Agency for Healthcare Research and Quality, Rockville, Maryland, USA
| | - Angela Dobes
- Crohn’s & Colitis Foundation, New York, New York, USA
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12
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Pillai M, Griffin AC, Kronk CA, McCall T. Toward Community-Based Natural Language Processing (CBNLP): Cocreating With Communities. J Med Internet Res 2023; 25:e48498. [PMID: 37540551 PMCID: PMC10439463 DOI: 10.2196/48498] [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: 04/25/2023] [Revised: 06/15/2023] [Accepted: 07/21/2023] [Indexed: 08/05/2023] Open
Abstract
Rapid development and adoption of natural language processing (NLP) techniques has led to a multitude of exciting and innovative societal and health care applications. These advancements have also generated concerns around perpetuation of historical injustices and that these tools lack cultural considerations. While traditional health care NLP techniques typically include clinical subject matter experts to extract health information or aid in interpretation, few NLP tools involve community stakeholders with lived experiences. In this perspective paper, we draw upon the field of community-based participatory research, which gathers input from community members for development of public health interventions, to identify and examine ways to equitably involve communities in developing health care NLP tools. To realize the potential of community-based NLP (CBNLP), research and development teams must thoughtfully consider mechanisms and resources needed to effectively collaborate with community members for maximal societal and ethical impact of NLP-based tools.
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Affiliation(s)
- Malvika Pillai
- Center for Biomedical Informatics Research, Stanford University School of Medicine, Stanford, CA, United States
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Ashley C Griffin
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
- Department of Health Policy, Stanford University School of Medicine, Stanford, CA, United States
| | - Clair A Kronk
- Center for Medical Informatics, Yale School of Medicine, New Haven, CT, United States
| | - Terika McCall
- Center for Medical Informatics, Yale School of Medicine, New Haven, CT, United States
- Division of Health Informatics, Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States
- Section of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, United States
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13
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Denecke K, Romero OR, Merolli M, Miron-Shatz T, Gabarron E, Petersen C. How Participatory Health Informatics Catalyzes One Digital Health. Yearb Med Inform 2023; 32:48-54. [PMID: 38147849 PMCID: PMC10751117 DOI: 10.1055/s-0043-1768727] [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: 12/28/2023] Open
Abstract
OBJECTIVE To identify links between Participatory Health Informatics (PHI) and the One Digital Health framework (ODH) and to show how PHI could be used as a catalyst or contributor to ODH. METHODS We have analyzed the addressed topics within the ODH framework in previous IMIA Yearbook contributions from our working group during the last 10 years. We have matched main themes with the ODH's framework three perspectives (individual health and wellbeing, population and society, and ecosystem). RESULTS PHI catalysts ODH individual health and wellbeing perspective by providing a more comprehensive view on human health, attitudes, and relations between human health and animal health. Integration of specific behavior change techniques or gamification strategies in digital solutions are effective to change behaviors which address the P5 paradigm. PHI supports the population and society perspective through the engagement of the various stakeholders in healthcare. At the same time, PHI might increase a risk for health inequities due to technologies inaccessible to all equally and challenges associated with this. PHI is a catalyst for the ecosystem perspective by contributing data into the digital health data ecosystem allowing for analysis of interrelations between the various data which in turn might provide links among all components of the healthcare ecosystem. CONCLUSION Our results suggest that PHI can and will involve topics relating to ODH. As the ODH concept crystalizes and becomes increasingly influential, its themes will permeate and become embedded in PHI even more. We look forward to these developments and co-evolution of the two frameworks.
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Affiliation(s)
| | - Octavio Rivera Romero
- Instituto de Ingeniería Informática (I3US), Universidad de Sevilla, Sevilla, Spain
- Electronic Technology Department, Universidad de Sevilla, Sevilla, Spain
| | - Mark Merolli
- Department of Physiotherapy, School of Health Sciences, the University of Melbourne, Australia
- Centre for Digital Transformation of Health, The University of Melbourne, Australia
| | - Talya Miron-Shatz
- Faculty of Business Administration, Ono Academic College, Israel
- Winton Centre for Risk and Evidence Communication, Cambridge University, England
| | - Elia Gabarron
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
- Department of Education, ICT and Learning, Østfold University College, Halden, Norway
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14
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Meskó B, Topol EJ. The imperative for regulatory oversight of large language models (or generative AI) in healthcare. NPJ Digit Med 2023; 6:120. [PMID: 37414860 DOI: 10.1038/s41746-023-00873-0] [Citation(s) in RCA: 77] [Impact Index Per Article: 77.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023] Open
Abstract
The rapid advancements in artificial intelligence (AI) have led to the development of sophisticated large language models (LLMs) such as GPT-4 and Bard. The potential implementation of LLMs in healthcare settings has already garnered considerable attention because of their diverse applications that include facilitating clinical documentation, obtaining insurance pre-authorization, summarizing research papers, or working as a chatbot to answer questions for patients about their specific data and concerns. While offering transformative potential, LLMs warrant a very cautious approach since these models are trained differently from AI-based medical technologies that are regulated already, especially within the critical context of caring for patients. The newest version, GPT-4, that was released in March, 2023, brings the potentials of this technology to support multiple medical tasks; and risks from mishandling results it provides to varying reliability to a new level. Besides being an advanced LLM, it will be able to read texts on images and analyze the context of those images. The regulation of GPT-4 and generative AI in medicine and healthcare without damaging their exciting and transformative potential is a timely and critical challenge to ensure safety, maintain ethical standards, and protect patient privacy. We argue that regulatory oversight should assure medical professionals and patients can use LLMs without causing harm or compromising their data or privacy. This paper summarizes our practical recommendations for what we can expect from regulators to bring this vision to reality.
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Affiliation(s)
- Bertalan Meskó
- The Medical Futurist Institute, Budapest, Hungary.
- Department of Behavioural Sciences, Semmelweis University, Budapest, Hungary.
| | - Eric J Topol
- Scripps Research Translational Institute, Scripps Research, La Jolla, CA, USA
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15
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Zhu Y, Li S, Zhang R, Bao L, Zhang J, Xiao X, Jiang D, Chen W, Hu C, Zou C, Zhang J, Zhu Y, Wang J, Liang J, Yang Q. Enhancing doctor-patient relationships in community health care institutions: the Patient Oriented Four Habits Model (POFHM) trial-a stepped wedge cluster randomized trial protocol. BMC Psychiatry 2023; 23:476. [PMID: 37380993 DOI: 10.1186/s12888-023-04948-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/10/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND The poor relationship between doctors and patients is a long-standing, global problem. However, current interventions tend to focus on the training of physicians, while patient-targeted interventions still need to be improved. Considering that patients play a significant role in outpatient consultations, we developed a protocol to assess the effectiveness of the Patient Oriented Four Habits Model (POFHM) in improving doctor-patient relationships. METHODS A cross-sectional incomplete stepped-wedge cluster randomized trial design will be conducted in 8 primary healthcare institutions (PHCs). Following phase I of "usual care" as control measures for each PHC, either a patient- or doctor-only intervention will be implemented in phase II. In phase III, both patients and doctors will be involved in the intervention. This study will be conducted simultaneously in Nanling County and West Lake District. The primary outcomes will be evaluated after patients complete their visit: (1) patient literacy, (2) sense of control and (3) quality of doctor-patient communication. Finally, a mixed-effects model and subgroup analysis will be used to evaluate the effectiveness of the interventions. DISCUSSION Fostering good consultation habits for the patient is a potentially effective strategy to improve the quality of doctor-patient communication. This study evaluates the implementation process and develops a rigorous quality control manual using a theoretical domain framework under the collective culture of China. The results of this trial will provide substantial evidence of the effectiveness of patient-oriented interventions. The POFHM can benefit the PHCs and provide a reference for countries and regions where medical resources are scarce and collectivist cultures dominate. TRIAL REGISTRATION AsPredicted #107,282 on Sep 18, 2022; https://aspredicted.org/QST_MHW.
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Affiliation(s)
- Yunying Zhu
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Sisi Li
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Ruotong Zhang
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Lei Bao
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Jin Zhang
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Xiaohua Xiao
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Dongdong Jiang
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Wenxiao Chen
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Chenying Hu
- Community Health Service Center in Jiangcun Street, Hangzhou, 310050, Zhejiang Province, China
| | - Changli Zou
- Community Health Service Center in Sandun Town, Hangzhou, 310030, Zhejiang Province, China
| | - Jingna Zhang
- Community Health Service Center in Liuxia Street, Hangzhou, Zhejiang Province, 310050, China
| | - Yong Zhu
- Xu Zhen Town Center Health Center, Wuhu, 241306, Anhui Province, China
| | - Jianqiu Wang
- Community Health Service Center in Jishan Town, Wuhu, 241307, Anhui Province, China
| | - Jinchun Liang
- Nanling County Traditional Chinese Medicine Hospital, Wuhu, 241307, Anhui Province, China
| | - Qian Yang
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China.
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16
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Dahlberg M, Lek M, Malmqvist Castillo M, Bylund A, Hasson H, Riggare S, Reinius M, Wannheden C. Objectives and outcomes of patient-driven innovations published in peer-reviewed journals: a qualitative analysis of publications included in a scoping review. BMJ Open 2023; 13:e071363. [PMID: 37263703 PMCID: PMC10255190 DOI: 10.1136/bmjopen-2022-071363] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/20/2023] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES The aim of this study was to gain a deeper understanding of the objectives and outcomes of patient-driven innovations that have been published in the scientific literature, focusing on (A) the unmet needs that patient-driven innovations address and (B) the outcomes for patients and healthcare that have been reported. METHODS We performed an inductive qualitative content analysis of scientific publications that were included in a scoping review of patient-driven innovations, previously published by our research group. The review was limited to English language publications in peer-reviewed journals, published in the years 2008-2020. RESULTS In total, 83 publications covering 21 patient-driven innovations were included in the analysis. Most of the innovations were developed for use on an individual or community level without healthcare involvement. We created three categories of unmet needs that were addressed by these innovations: access to self-care support tools, open sharing of information and knowledge, and patient agency in self-care and healthcare decisions. Eighteen (22%) publications reported outcomes of patient-driven innovations. We created two categories of outcomes: impact on self-care, and impact on peer interaction and healthcare collaboration. CONCLUSIONS The patient-driven innovations illustrated a diversity of innovative approaches to facilitate patients' and informal caregivers' daily lives, interactions with peers and collaborations with healthcare. As our findings indicate, patients and informal caregivers are central stakeholders in driving healthcare development and research forward to meet the needs that matter to patients and informal caregivers. However, only few studies reported on outcomes of patient-driven innovations. To support wider implementation, more evaluation studies are needed, as well as research into regulatory approval processes, dissemination and governance of patient-driven innovations.
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Affiliation(s)
- Marie Dahlberg
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Madelen Lek
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Moa Malmqvist Castillo
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Ami Bylund
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Henna Hasson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
- Unit for Implementation and Evaluation, Center for Epidemiology and Community Medicine, Region Stockholm, Stockholms Lans Landsting, Stockholm, Sweden
| | - Sara Riggare
- Participatory eHealth and Health Data, Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Maria Reinius
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Carolina Wannheden
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
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The impact of necrotizing soft tissue infections on the lives of survivors: a qualitative study. Qual Life Res 2023:10.1007/s11136-023-03371-8. [PMID: 36840905 DOI: 10.1007/s11136-023-03371-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 02/26/2023]
Abstract
PURPOSE Necrotizing soft tissue infections (NSTI) are potentially lethal infections marked by local tissue destruction and systemic sepsis, which require aggressive treatment. Survivors often face a long recovery trajectory. This study was initiated to increase understanding of the long-term impact of NSTI on health related quality of life (HRQoL), and how care may be improved. METHODS Thematic analysis was applied to qualitative data from 25 NSTI-survivors obtained through two focus groups (n = 14) and semi-structured interviews (n = 11). RESULTS The median age of the participants was 49 years, 14 were female. The median time since diagnosis was 5 years. Initial misdiagnosis was common, causing delay to treatment. Survivors experienced long-term physical consequences (scarring, cognitive impairment, fatigue, sleeping problems, recurrent infections), psychological consequences (traumatic stress symptoms, fear of relapse, adjusting to an altered appearance, sexual issues) and social and relational consequences (changes in social contacts, a lack of understanding). The disease also had a major psychological impact on family members, as well as major financial impact in some. There was a strong desire to reflect on 'mistakes' in case of initial misdiagnosis. To improve care, patient and family centered care, smooth transitions after discharge, and the availability of understandable information were deemed important. CONCLUSION This study reveals that NSTI have a large impact on physical and psychosocial wellbeing of survivors and their relatives. Except for a few differences (misdiagnosis, fear for re-infection and actual re-infection), the patient experience of patients with NSTI is largely similar to those of burn survivors. Thus, questionnaires to assess HRQoL in burn survivors may be used in future NSTI studies.
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Fischer A, Elbeji A, Aguayo G, Fagherazzi G. Recommendations for Successful Implementation of the Use of Vocal Biomarkers for Remote Monitoring of COVID-19 and Long COVID in Clinical Practice and Research. Interact J Med Res 2022; 11:e40655. [PMID: 36378504 PMCID: PMC9668331 DOI: 10.2196/40655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/30/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic accelerated the use of remote patient monitoring in clinical practice or research for safety and emergency reasons, justifying the need for innovative digital health solutions to monitor key parameters or symptoms related to COVID-19 or Long COVID. The use of voice-based technologies, and in particular vocal biomarkers, is a promising approach, voice being a rich, easy-to-collect medium with numerous potential applications for health care, from diagnosis to monitoring. In this viewpoint, we provide an overview of the potential benefits and limitations of using voice to monitor COVID-19, Long COVID, and related symptoms. We then describe an optimal pipeline to bring a vocal biomarker candidate from research to clinical practice and discuss recommendations to achieve such a clinical implementation successfully.
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Affiliation(s)
- Aurelie Fischer
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Abir Elbeji
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Gloria Aguayo
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Guy Fagherazzi
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
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Hanchard M. Issue-networks as omitted publics in the construction of #rarediseaseday discourse. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.18433.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background: Over 450 million people worldwide have a rare disease. Yet despite healthcare policy rhetoric placing an onus on inclusive public engagement, rare disease publics are often engaged as data sources or product/service consumers. Meanwhile, various rare disease actors congregate around ‘Rare Disease Day’ each year – a global event with various online and offline talks, workshops, and sessions. In 2021, ~4.3 million tweets marked Twitter as a locus of exchange for the event. Methods: To examine public discourse around the event, the paper draws on social network and qualitative analyses of 40,366 Twitter tweets/retweets about rare disease day 2021 posted between 10-Feb-2021 and 10-Mar-2021, analysing them through a controversy theory lens. After identifying particularly influential Twitter users and groups, the paper examines their textual and visual communication strategies. Results: It funds three distinct orientations to rare disease discourse on Twitter (mission, awareness, and actor). In doing so, the paper locates a gap in direct engagement between medical authority and patients. Conclusions: It suggests that each orientation towards the discourse around rare disease day 2021 might be used by policymakers and researchers to engage with rare disease publics on social media in a more inclusive way as a pathway to better healthcare provision.
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