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Problematic Social Media Use Among Italian Midadolescents: Protocol and Rationale of the SMART Project. 意大利中青少年使用社交媒体的问题:SMART 项目的协议和理由。
IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-09 DOI: 10.2196/58739
Valeria Donisi, Laura Salerno, Elisa Delvecchio, Agostino Brugnera
<p><strong>Background: </strong>Social media (SM) use constitutes a large portion of midadolescents' daily lives as a way of peer interaction. A significant percentage of adolescents experience intense or problematic social media use (PSMU), an etiologically complex behavior potentially associated with psychological distress. To date, studies longitudinally testing for risk or protective factors of PSMU, and collecting qualitative data are still scarce among midadolescents. Self-help interventions specifically targeting PSMU in this population and involving midadolescents in co-creation are needed.</p><p><strong>Objective: </strong>The 2-year SMART multicenter project aims to (1) advance knowledge on PSMU; (2) co-design an unguided self-help app for promoting awareness and functional SM use; and (3) test feasibility and provide preliminary findings on its effectiveness to further improve and adapt the app.</p><p><strong>Methods: </strong>The SMART project is organized in 3 phases: phase 1 will focus on knowledge advancement on PSMU and its risk and protective factors using a longitudinal design; phase 2 will explore adolescents perspectives using qualitative approach and will co-design an unguided self-help app for reducing PSMU, which will be evaluated and adapted in phase 3. Around 1500 midadolescents (aged 14-18 years) will be recruited in northern, central, and southern Italy to investigate the potential intra- and interpersonal psychological risk and protective factors for PSMU and define specific PSMU profiles and test for its association with psychological distress. Subjective (self-report) PSMU's psychosocial risk or protective factors will be assessed at 3 different time points and Ecological Momentary Assessment (EMA) will be used. Moreover, focus groups will be performed in a subsample of midadolescents to collect the adolescents' unique point of view on PSMU and experiences with SM. Those previous results will inform the self-help app, which will be co-designed through working groups with adolescents. Subsequently, the SMART app will be deployed and adapted, after testing its feasibility and potential effectiveness in a pilot study.</p><p><strong>Results: </strong>The project is funded by the Italian Ministry of University and Research as part of a national grant (PRIN, "Progetti di Rilevante Interesse Nazionale"). The research team received an official notice of research funding approval in July 2023 (Project Code 2022LC4FT7). The project was preregistered on Open Science Framework, while the ethics approval was obtained in November 2023. We started the enrollments in December 2023, with the final follow-up data to be collected within May 2025.</p><p><strong>Conclusions: </strong>The innovative aspects of the SMART project will deepen the conceptualization of PSMU and of its biopsychosocial antecedents among midadolescents, with relevant scientific, technological, and socioeconomic impacts. The advancement of knowledge and the develo
背景:社交媒体(SM)的使用在中青少年的日常生活中占有很大比重,是一种同伴互动方式。有相当一部分青少年经历过频繁使用社交媒体或有问题使用社交媒体的情况(PSMU),这是一种病因复杂的行为,可能与心理困扰有关。迄今为止,纵向测试 PSMU 风险或保护因素并收集定性数据的研究在中青少年中仍然很少。我们需要专门针对这一人群的 PSMU 采取自助干预措施,并让中青少年参与共同创造:为期 2 年的 SMART 多中心项目旨在:(1)增进对 PSMU 的了解;(2)共同设计一个无指导的自助应用程序,以促进对 SM 的认识和功能性使用;(3)测试其可行性并提供初步的有效性结论,以进一步改进和调整该应用程序:SMART项目分为三个阶段:第一阶段将采用纵向设计,重点关注有关PSMU及其风险和保护因素的知识增长;第二阶段将采用定性方法探讨青少年的观点,并共同设计一款用于减少PSMU的无指导自助应用程序,该应用程序将在第三阶段进行评估和调整。将在意大利北部、中部和南部招募约 1500 名中学生(14-18 岁),调查 PSMU 潜在的内部和人际心理风险和保护因素,确定 PSMU 的具体特征,并测试其与心理困扰的关联。将在三个不同的时间点对 PSMU 的社会心理风险或保护因素进行主观(自我报告)评估,并使用生态矩阵评估(EMA)。此外,还将对中青少年进行焦点小组讨论,以收集青少年对 PSMU 的独特观点以及与 SM 有关的经历。之前的研究结果将为自助应用程序提供参考,该应用程序将通过工作组与青少年共同设计。随后,SMART 应用程序将在试点研究中测试其可行性和潜在有效性,然后进行部署和调整:该项目由意大利大学与研究部资助,是国家基金(PRIN,"Progetti di Rilevante Interesse Nazionale")的一部分。研究小组于 2023 年 7 月收到了研究经费批准的正式通知(项目代码 2022LC4FT7)。该项目已在开放科学框架(Open Science Framework)上预先注册,并于 2023 年 11 月获得伦理批准。我们于 2023 年 12 月开始注册,并将在 2025 年 5 月内收集最终随访数据:SMART项目的创新之处将加深对PSMU及其在中青少年中的生物心理社会前因的概念化,并产生相关的科学、技术和社会经济影响。知识的进步和开发的 PSMU 自助应用程序将及时应对 COVID-19 大流行和人道主义危机导致的中学生孤独感和心理负担的增加:OSF Registries; https://osf.io/2ucnk/.International registered report identifier (irrid):DERR1-10.2196/58739。
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引用次数: 0
Establishing Priorities for Improving Data Collection and Measurement of Mental Health and Well-Being of Adolescents With Special Educational Needs Within Nonmainstream Schools: Protocol for a Delphi Study. 为改进非主流学校中有特殊教育需求的青少年的心理健康和幸福的数据收集和测量确定优先事项:德尔菲研究协议》。
IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-09 DOI: 10.2196/58610
Mairi C Jeffery, Jessica Deighton, Suzet Tanya Lereya

Background: There are more than 1.5 million children and young people in England with special educational needs (SEN), with over 160,000 young people in the United Kingdom attending a special school or alternative provision (AP) setting. Young people with SEN have been found to be at risk for poorer mental health and well-being than non-SEN peers. However, there is a range of both school-related and research challenges associated with identifying difficulties in a timely manner.

Objective: This Delphi study aims to determine a list of stakeholder priorities for improving school-based measurement of mental health and well-being among young people with SEN, at an aggregated level, within secondary special school or AP settings. A secondary objective is to inform the implementation of school-based well-being surveys, improve engagement in special schools or AP settings, and improve survey response rates among children and young people with SEN.

Methods: A mixed methods Delphi study will be conducted, including a scoping review and preliminary focus groups with school staff members and researchers to establish key issues. This will be followed by a 2-round Delphi survey to determine a list of stakeholder priorities for improving the measurement of mental health and well-being at an aggregate level within special schools and AP settings. A final stakeholder workshop will be held to discuss the findings. A list of recommendations will be drafted as a report for special schools and AP settings.

Results: The study has received ethical approval from the University College London Research Ethics Committee. The stage 1 scoping review has commenced. Recruitment for focus groups will begin in Autumn 2024. The first round of the Delphi survey will commence in early 2025, and the second round of the Delphi survey in the spring of 2025. The final workshop will commence in mid-2025 with final results expected in late 2025.

Conclusions: There is a need for clear recommendations for special schools and AP settings on priorities for improving the measurement of mental health and well-being problems among young people with SEN. There is also a need for recommendations to researchers implementing school-based well-being surveys, including the #BeeWell program, to enable them to improve their engagement in special schools and AP settings and ensure surveys are accessible.

International registered report identifier (irrid): PRR1-10.2196/58610.

背景:在英国,有 150 多万名儿童和青少年有特殊教育需要(SEN),其中有 16 万多名青少年在特殊学校或替代教育机构就读。与没有特殊教育需要的同龄人相比,有特殊教育需要的青少年面临着心理健康和幸福感较差的风险。然而,在及时发现困难方面,存在一系列与学校和研究相关的挑战:本德尔菲研究旨在确定一份利益相关者优先事项清单,以便在中等特殊学校或 AP 环境中,在综合层面上改进对有特殊教育需要的青少年的心理健康和幸福感的校本测量。次要目标是为校本幸福感调查的实施提供信息,提高特殊学校或特殊教育机构的参与度,并提高有特殊教育需要的儿童和青少年对调查的回复率:将采用德尔菲混合方法进行研究,包括范围审查以及与学校教职员工和研究人员进行初步焦点小组讨论,以确定关键问题。随后将进行两轮德尔菲调查,以确定利益相关者的优先事项清单,从而在特殊学校和学前教育机构的总体层面上改进对心理健康和幸福感的测量。最后将举办利益相关者研讨会,讨论调查结果。将起草一份建议清单,作为报告提供给特殊学校和特殊教育机构:该研究已获得伦敦大学学院研究伦理委员会的伦理批准。第一阶段的范围界定审查已经开始。焦点小组的招募工作将于 2024 年秋季开始。第一轮德尔菲调查将于 2025 年初开始,第二轮德尔菲调查将于 2025 年春季开始。最后的研讨会将于 2025 年年中开始,预计在 2025 年年末得出最终结果:有必要就改善有特殊教育需要青少年的心理健康和幸福问题测量的优先事项向特殊学校和学前教育机构提出明确的建议。此外,还需要向实施校本幸福感调查(包括#BeeWell项目)的研究人员提出建议,使他们能够更好地参与特殊学校和特殊教育机构的工作,并确保调查的可及性:PRR1-10.2196/58610。
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引用次数: 0
Feuerstein Instrumental Enrichment Program for People With Schizophrenia After the First Episode of Psychosis: Protocol for an Open-Label Intervention Study. 针对首次精神病发作后精神分裂症患者的 Feuerstein Instrumental Enrichment Program:开放标签干预研究协议》。
IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-06 DOI: 10.2196/57031
Ana Olivia Fonseca, July Silveira Gomes, Rafael Angulo Condoretti Barros Novaes, Cíntia Lopes Dias, Maria Eva de Miranda Alves Rodrigues, Ary Gadelha, Cristiano Noto

Background: Schizophrenia is a disorder associated with neurocognitive deficits that adversely affect daily functioning and impose an economic burden. Cognitive rehabilitation interventions, particularly during the early phases of illness, have been shown to improve cognition, functionality, and quality of life. The Feuerstein Instrumental Enrichment (FIE) program, based on the Mediated Learning Experience and the Structural Cognitive Modifiability theory, has been applied in various disorders, but its applicability in schizophrenia has not yet been clarified.

Objective: This study aims to investigate the effects of the FIE program on the functionality of patients with first-episode schizophrenia.

Methods: In total, 17 patients will be recruited for an open-label intervention consisting of twice-weekly sessions for 10 weeks. The primary outcome measure will be changes in the Goal Achievement Scale score. Maze task performance from the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) battery will serve as a secondary outcome measure. At the same time, changes in Positive and Negative Syndrome Scale scores and other MATRICS domains will be analyzed as exploratory outcomes. Assessments will be administered before and after the intervention, with a follow-up period of 6 months.

Results: This trial was preregistered in The Brazilian Registry of Clinical Trials (RBR-4gzhy4s). By February 2024, 11 participants were enrolled in the training. Recruitment is expected to be completed by May 2024. Data analysis will be conducted between May and September 2024. The results are expected to be published in January 2025.

Conclusions: This study may establish a protocol for the FIE program that uses mediation techniques for individuals in the early stages of schizophrenia. The results will add to the knowledge about strategies to promote cognitive skills and functional impairment in daily life.

International registered report identifier (irrid): DERR1-10.2196/57031.

背景:精神分裂症是一种与神经认知缺陷相关的疾病,会对日常功能产生不利影响并造成经济负担。认知康复干预,尤其是在疾病的早期阶段,已被证明可以改善认知、功能和生活质量。费尔斯坦工具强化(Feuerstein Instrumental Enrichment,FIE)计划以中介学习体验和结构认知可修改性理论为基础,已被应用于多种疾病,但其在精神分裂症中的适用性尚未明确:本研究旨在探讨FIE项目对首发精神分裂症患者功能的影响:总共将招募 17 名患者,进行开放标签干预,包括每周两次的课程,为期 10 周。主要结果测量指标为目标实现量表得分的变化。改善精神分裂症认知的测量和治疗研究(MATRICS)电池迷宫任务表现将作为次要结果测量指标。同时,还将分析积极与消极综合征量表评分和 MATRICS 其他领域的变化,作为探索性结果。评估将在干预前后进行,随访期为 6 个月:该试验已在巴西临床试验登记处(RBR-4gzhy4s)进行了预先登记。截至 2024 年 2 月,共有 11 名参与者参加了培训。预计招募工作将于 2024 年 5 月完成。数据分析将于 2024 年 5 月至 9 月进行。研究结果预计将于 2025 年 1 月公布:本研究可为精神分裂症早期患者使用调解技术的 FIE 计划制定方案。研究结果将增加人们对促进日常生活中认知技能和功能障碍的策略的了解:DERR1-10.2196/57031。
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引用次数: 0
Piloting the Inclusion of the Key Populations Unique Identifier Code in the South African Routine Health Information Management System: Protocol for a Multiphased Study. 在南非常规卫生信息管理系统中试行关键人群唯一识别码:多阶段研究协议》。
IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-06 DOI: 10.2196/55092
Mashudu Rampilo, Edith Phalane, Refilwe Nancy Phaswana-Mafuya

Background: The global community has set an ambitious goal to end HIV/AIDS as a public health threat by 2030. Significant progress has been achieved in pursuing these objectives; however, concerns remain regarding the lack of disaggregated routine data for key populations (KPs) for a targeted HIV response. KPs include female sex workers, transgender populations, gay men and other men who have sex with men, people who are incarcerated, and people who use drugs. From an epidemiological perspective, KPs play a fundamental role in shaping the dynamics of HIV transmission due to specific behaviors. In South Africa, routine health information management systems (RHIMS) do not include a unique identifier code (UIC) for KPs. The purpose of this protocol is to develop the framework for improved HIV monitoring and programming through piloting the inclusion of KPs UIC in the South African RHIMS.

Objective: This paper aims to describe the protocol for a multiphased study to pilot the inclusion of KPs UIC in RHIMS.

Methods: We will conduct a multiphased study to pilot the framework for the inclusion of KPs UIC in the RHIMS. The study has attained the University of Johannesburg Research Ethics Committee approval (REC-2518-2023). This study has four objectives, including a systematic review, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines (objective 1). Second, policy document review and in-depth stakeholder interviews using semistructured questionnaires (objective 2). Third, exploratory data analysis of deidentified HIV data sets (objective 3), and finally, piloting the framework to assess the feasibility of incorporating KPs UIC in RHIMS using findings from objectives 1, 2, and 3 (objective 4). Qualitative and quantitative data will be analyzed using ATLAS.ti (version 6; ATLAS.ti Scientific Software Development GmbH) and Python (version 3.8; Python Software Foundation) programming language, respectively.

Results: The results will encompass a systematic review of literature, qualitative interviews, and document reviews, along with exploratory analysis of deidentified routine program data and findings from the pilot study. The systematic review has been registered in PROSPERO (International Prospective Register of Systematic Reviews; CRD42023440656). Data collection is planned to commence in September 2024 and expected results for all objectives will be published by December 2025.

Conclusions: The study will produce a framework to be recommended for the inclusion of the KP UIC national rollout. The study results will contribute to the knowledge base around the inclusion of KPs UIC in RHIMS data.

Trial registration: PROSPERO CRD42023440656; https://tinyurl.com/msnppany.

International registered report identifier (irrid): PRR1-10.2196/55092.

背景:全球社会已经制定了一个雄心勃勃的目标,即到 2030 年消除艾滋病毒/艾滋病这一公共卫生威胁。在实现这些目标的过程中已经取得了重大进展;然而,人们仍然担心缺乏关键人群(KPs)的分类常规数据来开展有针对性的艾滋病毒防治工作。关键人群包括女性性工作者、变性人、男同性恋者和其他男男性行为者、被监禁者和吸毒者。从流行病学的角度来看,KPs 在特定行为导致的 HIV 传播动态中发挥着根本性的作用。在南非,常规健康信息管理系统 (RHIMS) 并不包括 KPs 的唯一识别代码 (UIC)。本协议的目的是通过将 KPs UIC 纳入南非 RHIMS 系统的试点工作,为改进 HIV 监控和计划制定框架:本文旨在介绍将 KPs UIC 纳入 RHIMS 的多阶段试点研究方案:我们将开展一项多阶段研究,试行将 KPs UIC 纳入 RHIMS 的框架。这项研究已获得约翰内斯堡大学研究伦理委员会的批准(REC-2518-2023)。本研究有四个目标,其中包括根据 PRISMA(系统综述和元分析首选报告项目)指南进行系统综述(目标 1)。第二,使用半结构化问卷对政策文件进行回顾并对利益相关者进行深入访谈(目标 2)。第三,对去标识化的 HIV 数据集进行探索性数据分析(目标 3);最后,利用目标 1、2 和 3 的结果,对框架进行试点,以评估将 KPs UIC 纳入 RHIMS 的可行性(目标 4)。定性和定量数据将分别使用 ATLAS.ti(版本 6;ATLAS.ti 科学软件开发有限公司)和 Python(版本 3.8;Python 软件基金会)编程语言进行分析:结果:结果将包括对文献、定性访谈和文件审查的系统回顾,以及对去标识化常规项目数据和试点研究结果的探索性分析。该系统性综述已在 PROSPERO(系统性综述国际前瞻性注册;CRD42023440656)上注册。数据收集工作计划于 2024 年 9 月开始,所有目标的预期结果将于 2025 年 12 月公布:该研究将提出一个框架,建议将其纳入 KP UIC 的全国推广工作。研究结果将有助于建立将 KPs UIC 纳入 RHIMS 数据的知识库:PROSPERO CRD42023440656; https://tinyurl.com/msnppany.International 注册报告标识符 (irrid):PRR1-10.2196/55092。
{"title":"Piloting the Inclusion of the Key Populations Unique Identifier Code in the South African Routine Health Information Management System: Protocol for a Multiphased Study.","authors":"Mashudu Rampilo, Edith Phalane, Refilwe Nancy Phaswana-Mafuya","doi":"10.2196/55092","DOIUrl":"10.2196/55092","url":null,"abstract":"<p><strong>Background: </strong>The global community has set an ambitious goal to end HIV/AIDS as a public health threat by 2030. Significant progress has been achieved in pursuing these objectives; however, concerns remain regarding the lack of disaggregated routine data for key populations (KPs) for a targeted HIV response. KPs include female sex workers, transgender populations, gay men and other men who have sex with men, people who are incarcerated, and people who use drugs. From an epidemiological perspective, KPs play a fundamental role in shaping the dynamics of HIV transmission due to specific behaviors. In South Africa, routine health information management systems (RHIMS) do not include a unique identifier code (UIC) for KPs. The purpose of this protocol is to develop the framework for improved HIV monitoring and programming through piloting the inclusion of KPs UIC in the South African RHIMS.</p><p><strong>Objective: </strong>This paper aims to describe the protocol for a multiphased study to pilot the inclusion of KPs UIC in RHIMS.</p><p><strong>Methods: </strong>We will conduct a multiphased study to pilot the framework for the inclusion of KPs UIC in the RHIMS. The study has attained the University of Johannesburg Research Ethics Committee approval (REC-2518-2023). This study has four objectives, including a systematic review, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines (objective 1). Second, policy document review and in-depth stakeholder interviews using semistructured questionnaires (objective 2). Third, exploratory data analysis of deidentified HIV data sets (objective 3), and finally, piloting the framework to assess the feasibility of incorporating KPs UIC in RHIMS using findings from objectives 1, 2, and 3 (objective 4). Qualitative and quantitative data will be analyzed using ATLAS.ti (version 6; ATLAS.ti Scientific Software Development GmbH) and Python (version 3.8; Python Software Foundation) programming language, respectively.</p><p><strong>Results: </strong>The results will encompass a systematic review of literature, qualitative interviews, and document reviews, along with exploratory analysis of deidentified routine program data and findings from the pilot study. The systematic review has been registered in PROSPERO (International Prospective Register of Systematic Reviews; CRD42023440656). Data collection is planned to commence in September 2024 and expected results for all objectives will be published by December 2025.</p><p><strong>Conclusions: </strong>The study will produce a framework to be recommended for the inclusion of the KP UIC national rollout. The study results will contribute to the knowledge base around the inclusion of KPs UIC in RHIMS data.</p><p><strong>Trial registration: </strong>PROSPERO CRD42023440656; https://tinyurl.com/msnppany.</p><p><strong>International registered report identifier (irrid): </strong>PRR1-10.2196/55092.</p>","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Smartphone App for Prehospital ECG Transmission in ST-Elevation Myocardial Infarction Activation: Protocol for a Mixed Methods Study. 用于 ST 段抬高型心肌梗死激活的院前心电图传输的智能手机应用程序:混合方法研究协议》。
IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-06 DOI: 10.2196/55506
Hassan Mir, Katelyn J Cullen, Karen Mosleh, Rafi Setrak, Sanjit Jolly, Michael Tsang, Gregory Rutledge, Quazi Ibrahim, Michelle Welsford, Mathew Mercuri, J D Schwalm, Madhu K Natarajan
<p><strong>Background: </strong>Timely diagnosis and treatment for ST-elevation myocardial infarction (STEMI) requires a coordinated response from multiple providers. Rapid intervention is key to reducing mortality and morbidity. Activation of the cardiac catheterization laboratory may occur through verbal communication and may also involve the secure sharing of electrocardiographic images between frontline health care providers and interventional cardiologists. To improve this response, we developed a quick, easy-to-use, privacy-compliant smartphone app, that is SMART AMI-ACS (Strategic Management of Acute Reperfusion and Therapies in Acute Myocardial Infarction Acute Coronary Syndromes), for real-time verbal communication and sharing of electrocardiographic images among health care providers in Ontario, Canada. The app further provides information about diagnosis, management, and risk calculators for patients presenting with acute coronary syndrome.</p><p><strong>Objective: </strong>This study aims to integrate the app into workflow processes to improve communication for STEMI activation, resulting in decreased treatment times, improved patient outcomes, and reduced unnecessary catheterization laboratory activation and transfer.</p><p><strong>Methods: </strong>Implementation of the app will be guided by the Reach, Effectiveness, Acceptability, Implementation, and Maintenance (RE-AIM) framework to measure impact. The study will use quantitative registry data already being collected through the SMART AMI project (STEMI registry), the use of the SMART AMI app, and quantitative and qualitative survey data from physicians. Survey questions will be based on the Consolidated Framework for Implementation Research. Descriptive quantitative analysis and thematic qualitative analysis of survey results will be conducted. Continuous variables will be described using either mean and SD or median and IQR values at pre- and postintervention periods by the study sites. Categorical variables, such as false activation, will be described as frequencies (percentages). For each outcome, an interrupted time series regression model will be fitted to evaluate the impact of the app.</p><p><strong>Results: </strong>The primary outcomes of this study include the usability, acceptability, and functionality of the app for physicians. This will be measured using electronic surveys to identify barriers and facilitators to app use. Other key outcomes will measure the implementation of the app by reviewing the timing-of-care intervals, false "avoidable" catheterization laboratory activation rates, and uptake and use of the app by physicians. Prospective evaluation will be conducted between April 1, 2022, and March 31, 2023. However, for the timing- and accuracy-of-care outcomes, registry data will be compared from January 1, 2019, to March 31, 2023. Data analysis is expected to be completed in Fall 2024, with the completion of a paper for publication anticipated by the end of 2
背景:ST段抬高型心肌梗死(STEMI)的及时诊断和治疗需要多个医疗服务提供者的协调响应。快速干预是降低死亡率和发病率的关键。心导管室的启动可通过口头交流进行,也可能涉及一线医疗服务提供者和介入心脏病专家之间心电图图像的安全共享。为了改善这种反应,我们开发了一款快速、易用、符合隐私保护标准的智能手机应用程序,即 SMART AMI-ACS(急性心肌梗死急性冠状动脉综合征急性再灌注和治疗策略管理),用于加拿大安大略省医疗服务提供者之间的实时口头交流和心电图图像共享。该应用程序还为急性冠状动脉综合征患者提供有关诊断、管理和风险计算器的信息:本研究旨在将该应用程序整合到工作流程中,以改善 STEMI 启动过程中的沟通,从而缩短治疗时间、改善患者预后、减少不必要的导管室启动和转运:方法:该应用程序的实施将以 "覆盖面、有效性、可接受性、实施和维护"(RE-AIM)框架为指导,以衡量其影响。该研究将使用 SMART AMI 项目(STEMI 登记)已收集的定量登记数据、SMART AMI 应用程序的使用情况以及来自医生的定量和定性调查数据。调查问题将以实施研究综合框架为基础。将对调查结果进行描述性定量分析和主题性定性分析。连续变量将按研究地点使用干预前和干预后的平均值和 SD 值或中位数和 IQR 值进行描述。分类变量(如错误激活)将用频率(百分比)来描述。对于每种结果,将拟合一个间断时间序列回归模型,以评估应用程序的影响:本研究的主要结果包括应用程序对医生的可用性、可接受性和功能性。这将通过电子调查来确定使用应用程序的障碍和促进因素。其他主要结果将通过审查护理时间间隔、错误的 "可避免 "导管室激活率以及医生对应用程序的接受和使用情况来衡量应用程序的实施情况。前瞻性评估将在 2022 年 4 月 1 日至 2023 年 3 月 31 日期间进行。不过,对于护理时机和准确性结果,将对 2019 年 1 月 1 日至 2023 年 3 月 31 日的登记数据进行比较。数据分析预计将于 2024 年秋季完成,论文预计将于 2024 年底完成并发表:结论:智能手机技术已很好地融入了临床实践,并被广泛使用。正在测试的拟议解决方案是安全的,并充分利用了智能手机的便利性。急诊科医生可以使用这款应用程序快速、安全、准确地传输信息,确保在 STEMI 启动时做出更快、更适当的决策:ClinicalTrials.gov NCT05290389;https://clinicaltrials.gov/study/NCT05290389.International 注册报告标识符 (irrid):DERR1-10.2196/55506。
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引用次数: 0
Digitizing Survivorship Care Plans Through the POST-Treatment Health Outcomes of Cancer Survivors (POSTHOC) Mobile App: Protocol for a Phase II Randomized Controlled Trial. 通过癌症幸存者治疗后健康结果(POSTHOC)移动应用程序实现幸存者护理计划数字化:第二阶段随机对照试验方案》。
IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-05 DOI: 10.2196/59222
Kaitlin H Chung, Shari M Youngblood, Carin L Clingan, Dana C Deighton, Virginia A Jump, Thushini Manuweera, Nicolette M McGeorge, Cynthia L Renn, Paula Y Rosenblatt, Aaron T Winder, Shijun Zhu, Ian R Kleckner, Amber S Kleckner
<p><strong>Background: </strong>Survivorship care plans (SCPs) are provided at the completion of cancer treatment to aid in the transition from active treatment to long-term survivorship. They describe the details of a patient's diagnosis and treatment and offer recommendations for follow-up appointments, referrals, and healthy behaviors. The plans are currently paper-based and become outdated as soon as a patient's health status changes. There is a need to digitize these plans to improve their accessibility, modifiability, and longevity. With current technology, SCPs can be linked to mobile devices and activity trackers so that patients can track health behaviors and compare them to their clinical goals, taking charge of their own health.</p><p><strong>Objective: </strong>A mobile app, POSTHOC (POST-Treatment Health Outcomes of Cancer Survivors), that digitizes the SCP was developed, with goals of integrating it with wearable technologies and electronic medical records. Herein, we are conducting a randomized controlled trial that evaluates the POSTHOC app versus the traditional SCP on total symptom burden in the early posttreatment period.</p><p><strong>Methods: </strong>We will recruit 54 patients who have recently completed curative therapy for cancer (any type) in person and remotely. They will be randomized 2:1, POSTHOC:usual care (unblinded). Those randomized to the POSTHOC group will receive their SCP via the app and will choose to focus on nutrition or exercise for the duration of the study based on their individual plan and personal preferences. Those randomized to the control group will get a paper-based plan. At baseline, 6 weeks, and 12 weeks, we will evaluate patient-reported outcomes, including total symptom burden (web-based questionnaire), diet (24-hour Automated Self-Administered [ASA24]), and physical activity (Fitbit Charge 6 [Google LLC]). We will also collect quantitative and qualitative feedback on the usability of the app from those in the POSTHOC arm to improve the app for future implementation studies, with a specific focus on patient-provider communication. For feasibility, we will calculate the percentage of patients who used the POSTHOC app at least 3 times per week. We will use linear mixed models to evaluate the effects of the POSTHOC app versus those of usual care on other outcomes at weeks 6 and 12.</p><p><strong>Results: </strong>This trial is open to accrual in the University of Maryland Medical System as of March 2024, and as of July 3, 2024, a total of 20 participants have consented.</p><p><strong>Conclusions: </strong>This study is among the first to digitize the SCP in a mobile app and test the effects of a mobile health-delivered behavioral health intervention on symptom burden in cancer survivors. Our results will provide evidence about the effects of health self-management on symptoms. This knowledge will be integral to larger randomized controlled studies, integration with the electronic medical record, a
背景:生存期护理计划(SCP)是在癌症治疗结束后提供的,目的是帮助患者从积极治疗过渡到长期生存期。它们描述了患者诊断和治疗的细节,并提供了后续预约、转诊和健康行为的建议。这些计划目前都是纸质的,一旦病人的健康状况发生变化就会过时。有必要将这些计划数字化,以提高其可访问性、可修改性和使用寿命。利用现有技术,SCP 可以与移动设备和活动追踪器相连接,这样患者就可以追踪健康行为,并将其与临床目标进行比较,从而掌握自己的健康状况:我们开发了一款名为 POSTHOC(癌症生存者治疗后健康结果)的移动应用程序,将 SCP 数字化,目的是将其与可穿戴技术和电子病历相结合。在此,我们将开展一项随机对照试验,评估 POSTHOC 应用程序与传统 SCP 对治疗后早期总症状负担的影响:我们将招募 54 名刚完成癌症(任何类型)治愈性治疗的患者,通过面谈和远程方式进行。他们将以 2:1 的比例随机分组,POSTHOC:常规护理(非盲法)。被随机分配到 POSTHOC 组的患者将通过应用程序接收 SCP,并在研究期间根据个人计划和个人喜好选择专注于营养或运动。被随机分配到对照组的人将获得一份纸质计划。在基线、6 周和 12 周时,我们将评估患者报告的结果,包括总症状负担(基于网络的问卷调查)、饮食(24 小时自动自我管理 [ASA24])和体力活动(Fitbit Charge 6 [Google LLC])。我们还将收集 POSTHOC 组患者对该应用程序可用性的定量和定性反馈,以便在未来的实施研究中改进该应用程序,并特别关注患者与医护人员之间的沟通。在可行性方面,我们将计算每周至少使用 POSTHOC 应用程序 3 次的患者比例。我们将使用线性混合模型来评估 POSTHOC 应用程序与常规护理在第 6 周和第 12 周时对其他结果的影响:截至 2024 年 3 月,该试验在马里兰大学医疗系统公开招募,截至 2024 年 7 月 3 日,共有 20 名参与者表示同意:本研究是首批将 SCP 数字化到移动应用程序中,并测试移动医疗提供的行为健康干预对癌症幸存者症状负担影响的研究之一。我们的研究结果将为健康自我管理对症状的影响提供证据。这些知识将为更大规模的随机对照研究、与电子病历的整合以及在全国范围内的实施起到不可或缺的作用:ClinicalTrials.gov NCT05499663; https://clinicaltrials.gov/ct2/show/NCT05499663.International 注册报告标识符 (irrid):DERR1-10.2196/59222。
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引用次数: 0
Challenges and Facilitation Approaches for the Participatory Design of AI-Based Clinical Decision Support Systems: Protocol for a Scoping Review. 基于人工智能的临床决策支持系统的参与式设计所面临的挑战和促进方法:范围审查协议》。
IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-05 DOI: 10.2196/58185
Tabea Rambach, Patricia Gleim, Sekina Mandelartz, Carolin Heizmann, Christophe Kunze, Philipp Kellmeyer

Background: In the last few years, there has been an increasing interest in the development of artificial intelligence (AI)-based clinical decision support systems (CDSS). However, there are barriers to the successful implementation of such systems in practice, including the lack of acceptance of these systems. Participatory approaches aim to involve future users in designing applications such as CDSS to be more acceptable, feasible, and fundamentally more relevant for practice. The development of technologies based on AI, however, challenges the process of user involvement and related methods.

Objective: The aim of this review is to summarize and present the main approaches, methods, practices, and specific challenges for participatory research and development of AI-based decision support systems involving clinicians.

Methods: This scoping review will follow the Joanna Briggs Institute approach to scoping reviews. The search for eligible studies was conducted in the databases MEDLINE via PubMed; ACM Digital Library; Cumulative Index to Nursing and Allied Health; and PsycInfo. The following search filters, adapted to each database, were used: Period January 01, 2012, to October 31, 2023, English and German studies only, abstract available. The scoping review will include studies that involve the development, piloting, implementation, and evaluation of AI-based CDSS (hybrid and data-driven AI approaches). Clinical staff must be involved in a participatory manner. Data retrieval will be accompanied by a manual gray literature search. Potential publications will then be exported into reference management software, and duplicates will be removed. Afterward, the obtained set of papers will be transferred into a systematic review management tool. All publications will be screened, extracted, and analyzed: title and abstract screening will be carried out by 2 independent reviewers. Disagreements will be resolved by involving a third reviewer. Data will be extracted using a data extraction tool prepared for the study.

Results: This scoping review protocol was registered on March 11, 2023, at the Open Science Framework. The full-text screening had already started at that time. Of the 3,118 studies screened by title and abstract, 31 were included in the full-text screening. Data collection and analysis as well as manuscript preparation are planned for the second and third quarter of 2024. The manuscript should be submitted towards the end of 2024.

Conclusions: This review will describe the current state of knowledge on participatory development of AI-based decision support systems. The aim is to identify knowledge gaps and provide research impetus. It also aims to provide relevant information for policy makers and practitioners.

International registered report identifier (irrid): DERR1-10.2196/58185.

背景:最近几年,人们对开发基于人工智能(AI)的临床决策支持系统(CDSS)越来越感兴趣。然而,要在实践中成功实施这些系统还存在一些障碍,包括这些系统缺乏认可度。参与式方法旨在让未来的用户参与设计临床决策支持系统(CDSS)等应用程序,使其更易于接受、更可行、从根本上更贴近实践。然而,基于人工智能的技术发展对用户参与过程和相关方法提出了挑战:本综述旨在总结和介绍临床医生参与研究和开发基于人工智能的决策支持系统的主要方式、方法、实践和具体挑战:本综述将采用乔安娜-布里格斯研究所(Joanna Briggs Institute)的综述方法。我们通过 PubMed、ACM Digital Library、Cumulative Index to Nursing and Allied Health 和 PsycInfo 等数据库对符合条件的研究进行了检索。每个数据库都使用了以下搜索过滤器:时间为 2012 年 1 月 1 日至 2023 年 10 月 31 日,仅限英语和德语研究,有摘要。范围界定审查将包括涉及基于人工智能的 CDSS(混合型和数据驱动型人工智能方法)的开发、试点、实施和评估的研究。临床工作人员必须以参与的方式参与其中。在进行数据检索的同时,还将进行人工灰色文献检索。然后将潜在的出版物导出到参考文献管理软件中,并删除重复的文献。之后,获得的论文集将转入系统综述管理工具。将对所有出版物进行筛选、提取和分析:标题和摘要筛选将由两名独立审稿人进行。如有异议,将由第三位审稿人参与解决。将使用为研究准备的数据提取工具提取数据:本范围综述协议于 2023 年 3 月 11 日在开放科学框架注册。当时全文筛选工作已经开始。在通过标题和摘要筛选出的 3118 项研究中,有 31 项被纳入全文筛选。数据收集和分析以及稿件准备工作计划于 2024 年第二和第三季度进行。稿件应于 2024 年底提交:本综述将描述基于人工智能的决策支持系统参与式开发的知识现状。目的是找出知识差距并提供研究动力。国际注册报告标识符(irrid):DERR1-10.2196/58185。
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引用次数: 0
Dexmedetomidine Versus Midazolam for End-of-Life Sedation and Agitation: Protocol for a Randomized Controlled Trial (The DREAMS Trial). 右美托咪定与咪达唑仑治疗临终镇静和躁动:随机对照试验(DREAMS 试验)方案》。
IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-04 DOI: 10.2196/55129
Benjamin Thomas, Greg Barclay, Wing-Shan Angela Lo, Judy Mullan, Kylie Mansfield
<p><strong>Background: </strong>Sedation at the end of life is used to relieve distressing symptoms including agitation and delirium. Standard care may include infused benzodiazepines or antipsychotics. These agents often result in deep sedation with loss of interaction with loved ones, which may be distressing.</p><p><strong>Objective: </strong>The DREAMS (Dexmedetomidine for the Reduction of End-of-life Agitation and for optiMised Sedation) trial aimed to compare the sedative and antidelirium effects of the alpha-2 agonist dexmedetomidine, a novel palliative care sedative, compared with midazolam, a benzodiazepine when administered by subcutaneous infusion at the end of life, with doses of both agents targeting lighter, or potentially interactive sedation.</p><p><strong>Methods: </strong>Participants were recruited from adult inpatients admitted for end-of-life care under a palliative care team in regional New South Wales, Australia. Inclusion criteria included patients older than 18 years, with a preference for lighter sedation at the end of life. Exclusion criteria included severe cardiac dysfunction (contraindication to dexmedetomidine). Participants consented and were placed on a treatment-pending list. Upon experiencing terminal deterioration, patients were randomized to either arm 1 (dexmedetomidine) or arm 2 (midazolam) as their treatment arm. These treatments were administered by continuous subcutaneous infusion. The level of consciousness and agitation of the patients were measured by the Richmond Agitation-Sedation Scale-Palliative version and the Memorial Delirium Assessment Score. Richmond Agitation-Sedation Scale-Palliative version assessments were performed by both nursing and medical staff, while Memorial Delirium Assessment Score assessments were carried out by medical staff only. Families and patients were asked to complete, as able, a patient comfort assessment form, to gauge perceptions of distress. Data were collected and matched with the breakthrough medication doses administered, along with qualitative comments in the medical record. In addition, the study tracked symptoms and patient functional status that were recorded as part of the Palliative Care Outcomes Collaborative, a national tracking project for monitoring symptom outcomes in palliative care.</p><p><strong>Results: </strong>The DREAMS trial was funded in May 2020, approved by the ethics committee in November 2020, and started recruiting participants in May 2021. Data collection commenced in May 2021 and is anticipated to continue until December 2024. Publication of results is anticipated from 2024 to 2026.</p><p><strong>Conclusions: </strong>The evidence base for sedative dosing in palliative care for distress and agitation is not robust, with standard care based primarily on clinical experience and not robust scientific evidence. This study is important because it will compare a standard and a novel sedative used in end-of-life treatment. By assessing the poten
背景:临终镇静用于缓解包括躁动和谵妄在内的痛苦症状。标准护理可能包括输注苯二氮卓类药物或抗精神病药物。这些药物通常会导致深度镇静,失去与亲人的互动,这可能会令人痛苦:DREAMS(右美托咪定用于减少临终躁动和选择性镇静)试验旨在比较α-2受体激动剂右美托咪定(一种新型姑息治疗镇静剂)与咪达唑仑(一种苯二氮卓类药物)在临终时皮下注射的镇静和抗谵妄效果,两种药物的剂量都以较轻或潜在的交互镇静为目标:从澳大利亚新南威尔士地区姑息治疗小组收治的临终关怀成人住院患者中招募参与者。纳入标准包括年龄在18岁以上、在生命末期偏好轻度镇静的患者。排除标准包括严重的心脏功能障碍(右美托咪定禁忌症)。参与者同意并被列入治疗待定名单。患者病情最终恶化后,被随机分配到治疗组 1(右美托咪定)或治疗组 2(咪达唑仑)。这些治疗都是通过持续皮下注射进行的。患者的意识水平和躁动程度由里士满躁动镇静量表姑息版和纪念性谵妄评估评分进行测量。里士满躁动镇静量表-姑息版的评估由护理人员和医护人员共同完成,而纪念性谵妄评估分数的评估仅由医护人员完成。在条件允许的情况下,还要求家属和患者填写患者舒适度评估表,以了解他们对痛苦的感受。收集的数据与所使用的突破性药物剂量以及病历中的定性评论相匹配。此外,该研究还对姑息治疗结果协作项目(Palliative Care Outcomes Collaborative)中记录的症状和患者功能状态进行了追踪:DREAMS 试验于 2020 年 5 月获得资助,2020 年 11 月获得伦理委员会批准,2021 年 5 月开始招募参与者。数据收集工作于 2021 年 5 月开始,预计将持续到 2024 年 12 月。预计将于2024年至2026年公布结果:姑息治疗中针对窘迫和躁动的镇静剂剂量的证据基础并不牢固,标准护理主要基于临床经验,而非可靠的科学证据。这项研究之所以重要,是因为它将对用于临终治疗的标准镇静剂和新型镇静剂进行比较。通过评估这两种镇静剂的潜在疗效和益处,该研究旨在通过提供有针对性的镇静剂来改善临终患者与其亲人之间的沟通,从而优化临终质量:澳大利亚新西兰临床试验注册中心 ACTRN12621000052831;https://uat.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380889.International 注册报告标识符 (irrid):DERR1-10.2196/55129。
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引用次数: 0
Identifications of Similarity Metrics for Patients With Cancer: Protocol for a Scoping Review. 确定癌症患者的相似性指标:范围审查协议》。
IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-04 DOI: 10.2196/58705
Iryna Manuilova, Jan Bossenz, Annemarie Bianka Weise, Dominik Boehm, Cosima Strantz, Philipp Unberath, Niklas Reimer, Patrick Metzger, Thomas Pauli, Silke D Werle, Susann Schulze, Sonja Hiemer, Arsenij Ustjanzew, Hans A Kestler, Hauke Busch, Benedikt Brors, Jan Christoph

Background: Understanding the similarities of patients with cancer is essential to advancing personalized medicine, improving patient outcomes, and developing more effective and individualized treatments. It enables researchers to discover important patterns, biomarkers, and treatment strategies that can have a significant impact on cancer research and oncology. In addition, the identification of previously successfully treated patients supports oncologists in making treatment decisions for a new patient who is clinically or molecularly similar to the previous patient.

Objective: The planned review aims to systematically summarize, map, and describe existing evidence to understand how patient similarity is defined and used in cancer research and clinical care.

Methods: To systematically identify relevant studies and to ensure reproducibility and transparency of the review process, a comprehensive literature search will be conducted in several bibliographic databases, including Web of Science, PubMed, LIVIVIVO, and MEDLINE, covering the period from 1998 to February 2024. After the initial duplicate deletion phase, a study selection phase will be applied using Rayyan, which consists of 3 distinct steps: title and abstract screening, disagreement resolution, and full-text screening. To ensure the integrity and quality of the selection process, each of these steps is preceded by a pilot testing phase. This methodological process will culminate in the presentation of the final research results in a structured form according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) flowchart. The protocol has been registered in the Journal of Medical Internet Research.

Results: This protocol outlines the methodologies used in conducting the scoping review. A search of the specified electronic databases and after removing duplicates resulted in 1183 unique records. As of March 2024, the review process has moved to the full-text evaluation phase. At this stage, data extraction will be conducted using a pretested chart template.

Conclusions: The scoping review protocol, centered on these main concepts, aims to systematically map the available evidence on patient similarity among patients with cancer. By defining the types of data sources, approaches, and methods used in the field, and aligning these with the research questions, the review will provide a foundation for future research and clinical application in personalized cancer care. This protocol will guide the literature search, data extraction, and synthesis of findings to achieve the review's objectives.

International registered report identifier (irrid): DERR1-10.2196/58705.

背景:了解癌症患者的相似性对于推进个性化医疗、改善患者预后以及开发更有效的个性化治疗方法至关重要。它使研究人员能够发现重要的模式、生物标记物和治疗策略,从而对癌症研究和肿瘤学产生重大影响。此外,对以前成功治疗过的患者进行鉴定有助于肿瘤学家对临床或分子上与以前的患者相似的新患者做出治疗决定:计划中的综述旨在系统地总结、绘制和描述现有证据,以了解在癌症研究和临床治疗中如何定义和使用患者相似性:为了系统地识别相关研究并确保综述过程的可重复性和透明度,我们将在多个文献数据库(包括 Web of Science、PubMed、LIVIVO 和 MEDLINE)中进行全面的文献检索,时间跨度为 1998 年至 2024 年 2 月。在最初的重复删除阶段之后,将使用 Rayyan 进行研究筛选阶段,该阶段包括 3 个不同的步骤:标题和摘要筛选、分歧解决和全文筛选。为确保筛选过程的完整性和质量,每个步骤之前都有一个试点测试阶段。根据 PRISMA-ScR(Preferred Reporting Items for Systematic Reviews and Meta-Analyses 扩展至范围综述)流程图,这一方法论过程最终将以结构化的形式展示最终研究成果。该协议已在《医学互联网研究杂志》(Journal of Medical Internet Research)上注册:本协议概述了进行范围界定综述所使用的方法。对指定电子数据库进行检索并删除重复内容后,共获得 1183 条唯一记录。截至 2024 年 3 月,综述过程已进入全文评估阶段。在此阶段,将使用预先测试的图表模板进行数据提取:范围界定审查协议以这些主要概念为中心,旨在系统地绘制有关癌症患者相似性的现有证据图。通过定义该领域所使用的数据来源、方法和手段的类型,并将其与研究问题相结合,该综述将为个性化癌症护理的未来研究和临床应用奠定基础。本协议将指导文献检索、数据提取和研究结果的综合,以实现综述的目标:DERR1-10.2196/58705。
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引用次数: 0
Patterns of Use of e-Cigarettes and Their Respiratory Effects: Protocol for an Umbrella Review. 电子烟的使用模式及其对呼吸系统的影响:电子烟使用模式及其对呼吸系统的影响:总括审查议定书》。
IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-04 DOI: 10.2196/60325
Giusy Rita Maria La Rosa, Riccardo Polosa, Renée O'Leary
<p><strong>Background: </strong>Electronic nicotine delivery systems (ENDS)-e-cigarettes or vapes-have been shown to substantially reduce or eliminate many toxins compared with cigarette smoke, but simultaneously ENDS use also produces their own unique toxins. Yet the patterns of use among people who use ENDS are not homogeneous. Some people who use ENDS also smoke cigarettes (dual use). Other people who formerly smoked cigarettes are completely substituting ENDS (exclusive use). A small number of people who have never smoked cigarettes are using ENDS (naïve use of nicotine). Each of these patterns of use results in different exposures to toxins. Unfortunately, epidemiological studies routinely group together any ENDS use regardless of other tobacco use.</p><p><strong>Objective: </strong>This umbrella review primarily aims to present all the evidence available on the respiratory effects of ENDS use by adults based on their pattern of use: dual use, exclusive use, and naïve use. With each of these patterns of use, are there benefits, no changes, or harmful effects on respiratory functioning? Our objective is to provide clinicians with a detailed analysis of how different patterns of ENDS use impact respiratory functioning and to point to the best sources of evidence.</p><p><strong>Methods: </strong>This umbrella review follows the Methods for Overviews of Reviews framework and the PRIOR (Preferred Reporting Items for Overviews of Reviews) statement. Systematic reviews published since 2019 will be searched across 4 databases and 3 gray literature sources. Additional searches will include citation chasing, references lists, and referrals from respiratory specialists. The quality of included reviews will be evaluated using the AMSTAR2 (A Measurement Tool to Assess Systematic Reviews) checklist. We will document biases in 3 areas: protocol deviations, biases from the Oxford Catalogue of Bias, and internal data discrepancies. Two reviewers will independently conduct the search and quality assessments. Our analysis will focus on reviews rated as moderate or high confidence by AMSTAR2. We will use the Vote Counting Direction of Effect method to manage expected data heterogeneity, assessing whether ENDS use is beneficial or detrimental, or has no effect on respiratory functions based on the pattern of use.</p><p><strong>Results: </strong>The review is expected to be completed by December 2024. The database search was concluded in April 2024, and data extraction and bias assessment were completed in June 2024. The analysis phase is planned to be completed by October 2024.</p><p><strong>Conclusions: </strong>A thorough and comprehensive assessment of the evidence will better inform the contentious debate over the respiratory effects of ENDS providing much needed clarity by linking their effects to specific usage patterns. This analysis is particularly crucial in understanding the risks associated with continued cigarette smoking.</p><p><strong>Trial registr
背景:与香烟烟雾相比,电子尼古丁输送系统(ENDS)--电子香烟或电子烟雾器--已被证明可大大减少或消除许多毒素,但同时使用ENDS也会产生其自身特有的毒素。然而,ENDS 使用者的使用模式并不一致。一些使用 ENDS 的人同时也吸香烟(双重用途)。另一些人以前吸香烟,现在则完全替代 ENDS(独家使用)。少数从未吸过烟的人也在使用 ENDS(尼古丁的天真使用)。每种使用模式都会导致不同的毒素暴露。遗憾的是,流行病学研究通常将ENDS的使用归为一类,而不考虑其他烟草使用情况:本综述的主要目的是根据成人使用ENDS的模式(双重使用、独家使用和天真使用),介绍有关成人使用ENDS对呼吸系统影响的所有现有证据。在每一种使用模式下,对呼吸功能是有益、无变化还是有害?我们的目标是向临床医生详细分析不同的 ENDS 使用模式如何影响呼吸功能,并指出最佳的证据来源:本综述遵循综述方法框架和 PRIOR(综述首选报告项目)声明。将在 4 个数据库和 3 个灰色文献来源中检索自 2019 年以来发表的系统综述。其他检索将包括引文追逐、参考文献列表和呼吸科专家的转介。我们将使用 AMSTAR2(评估系统性综述的测量工具)核对表评估所收录综述的质量。我们将记录三个方面的偏差:方案偏差、牛津偏差目录中的偏差以及内部数据差异。两名审稿人将独立进行检索和质量评估。我们的分析将侧重于被 AMSTAR2 评为中度或高度可信的综述。我们将使用 "效应方向计票法 "管理预期的数据异质性,根据使用模式评估ENDS的使用是有益还是有害,或者对呼吸功能没有影响:审查预计将于 2024 年 12 月完成。数据库搜索于 2024 年 4 月完成,数据提取和偏倚评估于 2024 年 6 月完成。分析阶段计划于 2024 年 10 月完成:通过将ENDS的影响与具体的使用模式联系起来,对证据进行彻底、全面的评估将为有关ENDS对呼吸系统影响的争论提供更好的信息,从而提供急需的清晰度。这项分析对于了解与持续吸烟相关的风险尤为重要:PROSPERO CRD42024540034;https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=540034.International 注册报告标识符(irrid):DERR1-10.2196/60325。
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引用次数: 0
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JMIR Research Protocols
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