Cocreating an Automated mHealth Apps Systematic Review Process With Generative AI: Design Science Research Approach

BACKGROUND

The use of mobile devices for delivering health-related services (mobile health [mHealth]) has rapidly increased, leading to a demand for summarizing the state of the art and practice through systematic reviews. However, the systematic review process is a resource-intensive and time-consuming process. Generative artificial intelligence (AI) has emerged as a potential solution to automate tedious tasks.

OBJECTIVE

This study aimed to explore the feasibility of using generative AI tools to automate time-consuming and resource-intensive tasks in a systematic review process and assess the scope and limitations of using such tools.

METHODS

We used the design science research methodology. The solution proposed is to use cocreation with a generative AI, such as ChatGPT, to produce software code that automates the process of conducting systematic reviews.

RESULTS

A triggering prompt was generated, and assistance from the generative AI was used to guide the steps toward developing, executing, and debugging a Python script. Errors in code were solved through conversational exchange with ChatGPT, and a tentative script was created. The code pulled the mHealth solutions from the Google Play Store and searched their descriptions for keywords that hinted toward evidence base. The results were exported to a CSV file, which was compared to the initial outputs of other similar systematic review processes.

CONCLUSIONS

This study demonstrates the potential of using generative AI to automate the time-consuming process of conducting systematic reviews of mHealth apps. This approach could be particularly useful for researchers with limited coding skills. However, the study has limitations related to the design science research methodology, subjectivity bias, and the quality of the search results used to train the language model.

Singing off the same hymn sheet? Examining coherence in a talent development pathway (part 1)

Although there is research available into successful Talent Development Environments (TDEs), the data mostly reflects TDEs in elite academies, national groups or in a single successful club. This literature provides insight into the positive characteristics that are commonplace in these effective TDEs. However, little is known about the TDE surrounding an entire amateur national organization where athletes regularly compete across multiple teams, simultaneously representing at both domestic and international level. Importantly this added complexity increases the number of stakeholders across the pathway (e.g., school, club, international) creating a need for coherence throughout the TDE. Additionally considering the lack of research relating to females in talent development, we were interested from a pragmatic view, in examining the TDE of an amateur national hockey organization where young female athletes must navigate the pathway while simultaneously playing on multiple teams, contending with various coaches and contexts. The results suggest that the TDE provides a long term development experience supplemented with a good support network across all contexts. However, the alignment of expectations across contexts and the quality preparation of athletes in this TDE requires more attention to facilitate effective holistic athlete development.

Yoga for psychiatric disorders: from fad to evidence-based intervention?

There is growing evidence for yoga's neurobiological effects in people with psychiatric disorders. Postulated mechanisms of action include: (a) modulation of the hypothalamic-pituitary-adrenal (HPA) axis; (b) enhancement of GABAergic neurotransmission; (c) autonomic modulation; and (d) neuroendocrinological effects. Yoga as a therapeutic intervention in psychiatric disorders appears promising and merits further attention in clinical practice and research.

What About the Girls? Exploring the Gender Data Gap in Talent Development

Although there is an extensive literature about talent development, the lack of data pertaining to females is problematic. Indeed, the gender data gap can be seen in practically all domains including sport and exercise medicine. Evidence-based practice is the systematic reviewing of the best evidence in order to make informed choices about practice. Unfortunately, it may be that the data collected in sport is typically about male experiences, and not female; a rather unfortunate omission given that approximately half of the population is made up of women. When female athletes are underrepresented in research there are issues when making inferences about data collected in male dominated research domains to inform practice and policy for female athletes. In parallel, female sport participation is continually increasing worldwide. Recognizing the importance of evidence-based practice in driving policy and practice, and reflecting the gender data gap that is a consistent feature of (almost) all other domains, we were interested in examining whether a gender data gap exists in talent development research. The results suggest that a gender data gap exists in talent development research across all topics. Youth athlete development pathways may be failing to recognize the development requirements of females, particularly where female sports may be borrowing systems that are perceived to work for their male counterparts. In order to ensure robust evidence based practice in female youth sport there is a need to increase the visibility of female athletes in talent development literature.

Effectiveness trials: critical data to help understand how respiratory medicines really work?

Most of the information about the benefits, safety aspects, and cost effectiveness of pharmacological treatment in the respiratory field has been obtained from traditional efficacy studies, such as randomised controlled trials (RCT). The highly controlled environment of an RCT does not always reflect everyday practice. The collection, analysis, and application of effectiveness data to generate Real World Evidence (RWE) through pragmatic trials or observational studies therefore has the potential to improve decision making by regulators, payers, and clinicians.

Despite calls for more RWE, effectiveness data are not widely used in decision making in the respiratory field. Recent advances in data capture, curation, and storage combined with new analytical tools have now made it feasible for effectiveness data to become routine sources of evidence to supplement traditional efficacy data. In this paper, we will examine some of the current data gaps, diverse types of effectiveness data, look at proposed frameworks for the positioning of effectiveness data, as well as provide examples from therapeutic areas. We will give examples of both previous effectiveness studies and studies that are ongoing within the respiratory field. Effectiveness data hold the potential to address several evidentiary gaps related to the effectiveness, safety, and value of treatments in patients with respiratory diseases.

Differential research impact in cancer practice guidelines' evidence base: lessons from ESMO, NICE and SIGN

Background

This is an appraisal of the impact of cited research evidence underpinning the development of cancer clinical practice guidelines (CPGs) by the professional bodies of the European Society for Medical Oncology (ESMO), the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN).

Methods

A total of 101 CPGs were identified from ESMO, NICE and SIGN websites across 13 cancer sites. Their 9486 cited references were downloaded from the Web of Science Clarivate Group database, analysed on Excel (2016) using Visual Basic Application macros and imported onto SPSS (V.24.0) for statistical tests.

Results

ESMO CPGs mostly cited research from Western Europe, while the NICE and SIGN ones from the UK, Canada, Australia and Scandinavian countries. The ESMO CPGs cited more recent and basic research (eg, drugs treatment), in comparison with NICE and SIGN CPGs where older and more clinical research (eg, surgery) papers were referenced. This chronological difference in the evidence base is also in line with that ESMO has a shorter gap between the publication of the research and its citation on the CPGs. It was demonstrated that ESMO CPGs report more chemotherapy research, while the NICE and SIGN CPGs report more surgery, with the results being statistically significant.

Conclusions

We showed that ESMO, NICE and SIGN differ in their evidence base of CPGs. Healthcare professionals should be aware of this heterogeneity in effective decision-making of tailored treatments to patients, irrespective of geographic location across Europe.

Community Pharmacists' Involvement in Research in the United Kingdom

Puropse. To investigate the engagement of community pharmacists (CPs) with pharmacy research and identify barriers preventing them from doing so. In addition, to determine the training and research tools available to support CPs to take part in research. Methods. A questionnaire was designed and distributed to a sample of community pharmacies (n = 323) within five local authorities in England, and to a random sample of community pharmacies (n = 329) within Greater London in two stages. Descriptive statistics were used to analyse the data using Microsoft Excel. Following questionnaire completion, CPs were invited to take part in face-to-face and telephone interviews to further explore their views on research. Interviews were transcribed and analysed using coding and thematic analysis. Results. A total of 104 questionnaires were completed out of 652 distributed. Over half (56.7%) of respondents considered research to be important to their practice. Approximately 88% of respondents had completed some form of mandatory research in the past two years, while only 29% were involved in non-mandatory research. Over two-thirds (67.9%) wanted to engage with research in the future, with 22.2% of these being most interested in recruiting patients for research. Barriers to research included lack of time (90%) and lack of remuneration (60%). 20 community pharmacists were interviewed. Three themes were identified: 1. Interest in taking part in research; 2. Awareness, support and knowledge; 3. Resources as barriers. Conclusion. CPs recognise the importance of research in their current practice, however, the biggest barrier they face is time. Further training may be useful to ensure CPs are adequately prepared to undertake research activities.

Developing an evidence base of best practices for integrating computerized systems into the exam room: a systematic review

OBJECTIVE

The introduction of health information technology systems, electronic health records in particular, is changing the nature of how clinicians interact with patients. Lack of knowledge remains on how best to integrate such systems in the exam room. The purpose of this systematic review was to (1) distill "best" behavioral and communication practices recommended in the literature for clinicians when interacting with patients in the presence of computerized systems during a clinical encounter, (2) weigh the evidence of each recommendation, and (3) rank evidence-based recommendations for electronic health record communication training initiatives for clinicians.

METHODS

We conducted a literature search of 6 databases, resulting in 52 articles included in the analysis. We extracted information such as study setting, research design, sample, findings, and implications. Recommendations were distilled based on consistent support for behavioral and communication practices across studies.

RESULTS

Eight behavioral and communication practices received strong support of evidence in the literature and included specific aspects of using computerized systems to facilitate conversation and transparency in the exam room, such as spatial (re)organization of the exam room, maintaining nonverbal communication, and specific techniques that integrate the computerized system into the visit and engage the patient. Four practices, although patient-centered, have received insufficient evidence to date.

DISCUSSION AND CONCLUSION

We developed an evidence base of best practices for clinicians to maintain patient-centered communications in the presence of computerized systems in the exam room. Further work includes development and empirical evaluation of evidence-based guidelines to better integrate computerized systems into clinical care.

Trans-catheter aortic valve implantation: Contemporary practice and the future

With increasing life expectancy, the epidemic of valvular heart disease, especially aortic stenosis (AS), is becoming more prevalent. Transcatheter aortic valve implantation (TAVI) has emerged as an alternative therapy for patients with significant aortic valve disease. It offers a less invasive procedure in comparison to surgical aortic valve replacement (sAVR) and an attractive substitute from the patient's perspective. The evidence for TAVI in inoperable and high risk surgical patients is now established and in the intermediate risk group has been accumulating rapidly and is looking favourable for TAVI. However, the full 'TAVI story' is still unfolding. Technological advances in devices and delivery systems are evolving with the aim to improve the function and durability of TAVI and to simplify the procedure while enhancing safety. The incidence of vascular injury and pacemaker requirement post TAVI remains an issue and further development in this regard is therefore of utmost importance, particularly as lower risk and potentially younger patients are treated. Moreover, the evidence concerning long-term durability of the TAVI prostheses continues to accumulate. Whilst TAVI is proving to be an invaluable tool for inoperable and high risk patients, more trial evidence is needed before it encompases lower risk populations and moreover, its use as a first line treatment worldwide in most healthcare systems is limited by the costs associated with the prosthesis.

A review and critique of assessment instruments for patients with persistent pain

BACKGROUND

Early identification of individuals at risk of developing persistent pain is important to decrease unnecessary treatment costs and disability. However there is scant comprehensive information readily available to assist clinicians to choose appropriate assessment instruments with sound psychometric and clinical properties.

OBJECTIVE

A national insurer commissioned the development of a compendium of assessment instruments to identify adults with, or at-risk of developing, persistent pain. This paper reports on the instrument identification and review process.

METHODS

A comprehensive systematic literature review was undertaken of assessment instruments for persistent pain of noncancer origin, and their developmental literature. Only assessment instruments which were developed for patients with pain, or tested on them, were included. A purpose-built 'Ready Reckoner' scored psychometric properties and clinical utility.

RESULTS

One hundred sixteen potentially useful instruments were identified, measuring severity, psychological, functional and/or quality of life constructs of persistent pain. Forty-five instruments were short-listed, with convincing psychometric properties and clinical utility. There were no standard tests for psychometric properties, and considerable overlap of instrument purpose, item construct, wording, and scoring.

CONCLUSION

No one assessment instrument captured all the constructs of persistent pain. While the compendium focuses clinicians' choices, multiple instruments are required for comprehensive assessment of adults with persistent pain.