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Effects of Smart Goggles Used at Bedtime on Objectively Measured Sleep and Self-Reported Anxiety, Stress, and Relaxation: Pre-Post Pilot Study. 睡前使用智能护目镜对客观测量的睡眠和自我报告的焦虑、压力和放松的影响:睡前试点研究
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-03 DOI: 10.2196/58461
Sharon Danoff-Burg, Elie Gottlieb, Morgan A Weaver, Kiara C Carmon, Duvia Lara Ledesma, Holly M Rus
<p><strong>Background: </strong>Insufficient sleep is a problem affecting millions. Poor sleep can trigger or worsen anxiety; conversely, anxiety can lead to or exacerbate poor sleep. Advances in innovative consumer products designed to promote relaxation and support healthy sleep are emerging, and their effectiveness can be evaluated accurately using sleep measurement technologies in the home environment.</p><p><strong>Objective: </strong>This pilot study examined the effects of smart goggles used at bedtime to deliver gentle, slow vibration to the eyes and temples. The study hypothesized that objective sleep, perceived sleep, self-reported stress, anxiety, relaxation, and sleepiness would improve after using the smart goggles.</p><p><strong>Methods: </strong>A within-participants, pre-post study design was implemented. Healthy adults with subclinical threshold sleep problems (N=20) tracked their sleep nightly using a polysomnography-validated noncontact biomotion device and completed daily questionnaires over two phases: a 3-week baseline period and a 3-week intervention period. During the baseline period, participants followed their usual sleep routines at home. During the intervention period, participants used Therabody SmartGoggles in "Sleep" mode at bedtime. This mode, designed for relaxation, delivers a gentle eye and temple massage through the inflation of internal compartments to create a kneading sensation combined with vibrating motors. Each night, the participants completed questionnaires assessing relaxation, stress, anxiety, and sleepiness immediately before and after using the goggles. Daily morning questionnaires assessed perceived sleep, complementing the objective sleep data measured every night.</p><p><strong>Results: </strong>Multilevel regression analysis of 676 nights of objective sleep parameters showed improvements during nights when the goggles were used compared to the baseline period. Key findings include sleep duration (increased by 12 minutes, P=.01); duration of deep sleep (increased by 6 minutes, P=.002); proportion of deep sleep (7% relative increase, P=.02); BodyScore, an age- and gender-normalized measure of deep sleep (4% increase, P=.002); number of nighttime awakenings (7% decrease, P=.02); total time awake after sleep onset (reduced by 6 minutes, P=.047); and SleepScore, a measure of overall sleep quality (3% increase, P=.02). Questionnaire responses showed that compared to baseline, participants felt they had better sleep quality (P<.001) and woke feeling more well-rested (P<.001). Additionally, participants reported feeling sleepier, less stressed, less anxious, and more relaxed (all P values <.05) immediately after using the goggles each night, compared to immediately before use. A standardized inventory administered before and after the 3-week intervention period indicated reduced anxiety (P=.03), confirming the nightly analysis.</p><p><strong>Conclusions: </strong>The use of smart goggles at bedtime sign
背景:睡眠不足是一个影响数百万人的问题。睡眠不足会引发或加重焦虑;相反,焦虑会导致或加剧睡眠质量差。旨在促进放松和支持健康睡眠的创新消费产品正在出现,它们的有效性可以在家庭环境中使用睡眠测量技术进行准确评估。目的:这项初步研究检验了睡前使用的智能护目镜对眼睛和太阳穴产生温和、缓慢振动的效果。该研究假设,使用智能护目镜后,客观睡眠、感知睡眠、自我报告的压力、焦虑、放松和困倦都会得到改善。方法:采用参与者内部、前后研究设计。有亚临床阈值睡眠问题的健康成人(N=20)使用多导睡眠仪验证的非接触式生物运动装置跟踪他们每晚的睡眠,并在两个阶段完成每日问卷调查:3周基线期和3周干预期。在基线期间,参与者在家遵循他们通常的睡眠习惯。在干预期间,参与者在睡前使用Therabody智能护目镜进行“睡眠”模式。这种模式是为放松而设计的,通过内部隔室的膨胀来提供温和的眼部和太阳穴按摩,与振动马达相结合,创造出一种按摩的感觉。每天晚上,参与者在使用护目镜之前和之后立即完成问卷,评估放松、压力、焦虑和困倦。每天早上的问卷评估感知睡眠,补充了每晚测量的客观睡眠数据。结果:对676个夜晚客观睡眠参数的多水平回归分析显示,与基线期相比,使用护目镜的夜晚有所改善。主要发现包括睡眠时间(增加了12分钟,P= 0.01);深度睡眠持续时间(增加6分钟,P= 0.002);深度睡眠比例(相对增加7%,P= 0.02);BodyScore,一种年龄和性别标准化的深度睡眠测量(增加4%,P= 0.002);夜间醒来次数(减少7%,P= 0.02);睡眠开始后总清醒时间(减少6分钟,P= 0.047);以及衡量整体睡眠质量的SleepScore(增加3%,P= 0.02)。问卷调查结果显示,与基线相比,参与者认为他们的睡眠质量更好(p结论:睡前使用智能护目镜显着改善了客观测量的睡眠指标和感知的睡眠质量。此外,参与者报告说,随着压力和焦虑的减少,放松的感觉增加了。未来的研究应扩大这一试点研究,以确认和扩大本简短报告中提出的初步证据。
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引用次数: 0
The Use of Social Media on Enhancing Dental Care and Practice Among Dental Professionals: Cross-Sectional Survey Study. 在牙科专业人员中使用社会媒体来加强牙科护理和实践:横断面调查研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-03 DOI: 10.2196/66121
Joseph Macadaeg Acosta, Palinee Detsomboonrat, Pagaporn Pantuwadee Pisarnturakit, Nipaporn Urwannachotima

Background: As digitalization continues to advance globally, the health care sector, including dental practice, increasingly recognizes social media as a vital tool for health care promotion, patient recruitment, marketing, and communication strategies.

Objective: This study aimed to investigate the use of social media and assess its impact on enhancing dental care and practice among dental professionals in the Philippines.

Methods: A cross-sectional survey was conducted among dental practitioners in the Philippines. The study used a 23-item questionnaire, which included 5 questions on dentists' background and demographic information and 18 questions regarding the use, frequency, and purpose of social media in patient advising and quality of care improvement. Data were analyzed using SPSS software, with frequency distributions and χ2 tests used to assess the association between social media use and demographic variables and the impact on dental practice.

Results: The 265 dental practitioners in this study were predominantly female (n=204, 77%) and aged between 20-30 years (n=145, 54.7%). Most of the participants were general practitioners (n=260, 98.1%) working in a private practice (n=240, 90.6%), with 58.5% (n=155) having 0-5 years of clinical experience. Social media use was significantly higher among younger practitioners (20-30 years old) compared to older age groups (P<.001), though factors such as sex, dental specialty, and years of clinical practice did not significantly influence use. The majority (n=179, 67.5%) reported using social media in their practice, primarily for oral health promotion and education (n=191, 72.1%), connecting with patients and colleagues (n=165, 62.3%), and marketing (n=150, 56.6%). Facebook (n=179, 67.5%) and YouTube (n=163, 61.5%) were the most frequented platforms for clinical information, with Twitter (subsequently rebranded X) being the least used (n=4, 1.5%). Despite widespread social media engagement, only 8.7% (n=23) trusted the credibility of web-based information, and 63.4% (n=168) perceived a potential impact on the patient-dentist relationship due to patients seeking information on the internet. Social media was also perceived to enhance practice quality, with users reporting significant improvements in patient care (P=.001).

Conclusions: The findings highlight that social media is widely used among younger dental practitioners, primarily for education, communication, and marketing purposes. While social media use is associated with perceived improvements in practice quality and patient care, trust in information on social media remains low, and concerns remain regarding its effect on patient relationships. It is recommended to establish enhanced guidelines and provide reliable web-based resources to help dental practitioners use social media effectively and responsibly.

背景:随着数字化在全球范围内的持续推进,包括牙科诊所在内的卫生保健部门越来越认识到,社交媒体是促进卫生保健、招募患者、营销和沟通策略的重要工具。目的:本研究旨在调查社交媒体的使用情况,并评估其对菲律宾牙科专业人员加强牙科护理和实践的影响。方法:对菲律宾牙科从业人员进行横断面调查。该研究使用了一份23项调查问卷,其中包括5个关于牙医背景和人口统计信息的问题,以及18个关于社交媒体在患者建议和护理质量改善中的使用、频率和目的的问题。使用SPSS软件对数据进行分析,使用频率分布和χ2检验来评估社交媒体使用与人口统计变量以及对牙科实践的影响之间的关联。结果:本组265名牙科医生以女性为主(n=204, 77%),年龄在20 ~ 30岁之间(n=145, 54.7%)。大多数参与者是在私人诊所工作的全科医生(n=260, 98.1%) (n=240, 90.6%), 58.5% (n=155)具有0-5年的临床经验。与年龄较大的人群相比,年轻从业者(20-30岁)使用社交媒体的比例明显更高(结论:研究结果强调,社交媒体在年轻牙科从业者中广泛使用,主要用于教育、沟通和营销目的。虽然社交媒体的使用与实践质量和患者护理的感知改善有关,但对社交媒体上信息的信任仍然很低,并且人们仍然担心它对患者关系的影响。建议建立强化的指导方针,并提供可靠的网络资源,以帮助牙科医生有效和负责任地使用社会媒体。
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引用次数: 0
A Digital Parenting Intervention With Intimate Partner Violence Prevention Content: Quantitative Pre-Post Pilot Study. 数字育儿干预与亲密伴侣暴力预防内容:量化前后试点研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-03 DOI: 10.2196/58611
Moa Schafer, Jamie Lachman, Paula Zinser, Francisco Antonio Calderón Alfaro, Qing Han, Chiara Facciola, Lily Clements, Frances Gardner, Genevieve Haupt Ronnie, Ross Sheil
<p><strong>Background: </strong>Intimate partner violence (IPV) and violence against children are global issues with severe consequences. Intersections shared by the 2 forms of violence have led to calls for joint programming efforts to prevent both IPV and violence against children. Parenting programs have been identified as a key entry point for addressing multiple forms of family violence. Building on the IPV prevention material that has been integrated into the parenting program ParentText, a digital parenting chatbot, this pilot study seeks to explore parents' engagement with the IPV prevention content in ParentText and explore preliminary changes in IPV.</p><p><strong>Objective: </strong>This study aimed to assess parents' and caregivers' level of engagement with the IPV prevention material in the ParentText chatbot and explore preliminary changes in experiences and perpetration of IPV, attitudes toward IPV, and gender-equitable behaviors following the intervention.</p><p><strong>Methods: </strong>Caregivers of children aged between 0 and 18 years were recruited through convenience sampling by research assistants in Cape Town, South Africa, and by UNICEF (United Nations Children's Fund) Jamaica staff in 3 parishes of Jamaica. Quantitative data from women in Jamaica (n=28) and South Africa (n=19) and men in South Africa (n=21) were collected electronically via weblinks sent to caregivers' phones using Open Data Kit. The primary outcome was IPV experience (women) and perpetration (men), with secondary outcomes including gender-equitable behaviors and attitudes toward IPV. Descriptive statistics were used to report sociodemographic characteristics and engagement outcomes. Chi-square tests and 2-tailed paired dependent-sample t tests were used to investigate potential changes in IPV outcomes between pretest and posttest.</p><p><strong>Results: </strong>The average daily interaction rate with the program was 0.57 and 0.59 interactions per day for women and men in South Africa, and 0.21 for women in Jamaica. The rate of completion of at least 1 IPV prevention topic was 25% (5/20) for women and 5% (1/20) for men in South Africa, and 21% (6/28) for women in Jamaica. Exploratory analyses indicated significant pre-post reductions in overall IPV experience among women in South Africa (P=.01) and Jamaica (P=.01) and in men's overall harmful IPV attitudes (P=.01) and increases in men's overall gender-equitable behaviors (P=.02) in South Africa.</p><p><strong>Conclusions: </strong>To the best of our knowledge, this is the first pilot study to investigate user engagement with and indicative outcomes of a digital parenting intervention with integrated IPV prevention content. Study findings provide valuable insights into user interactions with the chatbot and shed light on challenges related to low levels of chatbot engagement. Indicative results suggest promising yet modest reductions in IPV and improvements in attitudes after the program. Further research
背景:亲密伴侣暴力(IPV)和暴力侵害儿童是具有严重后果的全球性问题。这两种形式的暴力有共同的交叉点,因此呼吁开展联合规划工作,以防止IPV和针对儿童的暴力行为。育儿计划已被确定为解决多种形式的家庭暴力的关键切入点。基于整合到育儿程序ParentText(一个数字育儿聊天机器人)中的IPV预防材料,本试点研究旨在探索家长对ParentText中IPV预防内容的参与情况,并探索IPV的初步变化。目的:本研究旨在评估家长和照顾者对ParentText聊天机器人中IPV预防材料的参与程度,并探讨干预后IPV经历和实施、对IPV的态度和性别平等行为的初步变化。方法:采用方便抽样的方法,由南非开普敦的研究助理和牙买加3个教区的联合国儿童基金会驻牙买加工作人员招募0 - 18岁儿童的照顾者。来自牙买加(n=28)和南非(n=19)的女性和南非(n=21)的定量数据通过使用开放数据工具包通过网络链接发送到护理人员的手机上以电子方式收集。主要结局是IPV经历(女性)和犯罪行为(男性),次要结局包括性别平等的行为和对IPV的态度。描述性统计用于报告社会人口学特征和参与结果。使用卡方检验和双尾配对依赖样本t检验来研究IPV结果在测试前后的潜在变化。结果:南非女性和男性与该计划的平均每日互动率分别为0.57次和0.59次,牙买加女性为0.21次。南非女性完成至少一项IPV预防主题的比例为25%(5/20),男性为5%(1/20),牙买加女性为21%(6/28)。探索性分析表明,在南非(P= 0.01)和牙买加(P= 0.01),男性总体有害的IPV态度(P= 0.01)和南非男性总体性别平等行为(P= 0.02)中,女性的总体IPV经历显著减少。结论:据我们所知,这是第一个调查用户参与和综合IPV预防内容的数字育儿干预的指示性结果的试点研究。研究结果为用户与聊天机器人的互动提供了有价值的见解,并阐明了与聊天机器人参与度低相关的挑战。指示性结果表明,在该计划后,IPV有希望适度减少,态度有所改善。进一步的研究使用随机对照试验是必要的,以确定因果关系。
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引用次数: 0
Quantifying the Regional Disproportionality of COVID-19 Spread: Modeling Study. 量化COVID-19传播的区域不相称性:建模研究
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-03 DOI: 10.2196/59230
Kenji Sasaki, Yoichi Ikeda, Takashi Nakano

Background: The COVID-19 pandemic has caused serious health, economic, and social consequences worldwide. Understanding how infectious diseases spread can help mitigate these impacts. The Theil index, a measure of inequality rooted in information theory, is useful for identifying geographic disproportionality in COVID-19 incidence across regions.

Objective: This study focused on capturing the degrees of regional disproportionality in incidence rates of infectious diseases over time. Using the Theil index, we aim to assess regional disproportionality in the spread of COVID-19 and detect epicenters where the number of infected individuals was disproportionately concentrated.

Methods: To quantify the degree of disproportionality in the incidence rates, we applied the Theil index to the publicly available data of daily confirmed COVID-19 cases in the United States over a 1100-day period. This index measures relative disproportionality by comparing daily regional case distributions with population proportions, thereby identifying regions where infections are disproportionately concentrated.

Results: Our analysis revealed a dynamic pattern of regional disproportionality in the confirmed cases by monitoring variations in regional contributions to the Theil index as the pandemic progressed. Over time, the index reflected a transition from localized outbreaks to widespread transmission, with high values corresponding to concentrated cases in some regions. We also found that the peaks in the Theil index often preceded surges in confirmed cases, suggesting its potential utility as an early warning signal.

Conclusions: This study demonstrated that the Theil index is one of the effective indices for quantifying regional disproportionality in COVID-19 incidence rates. Although the Theil index alone cannot fully capture all aspects of pandemic dynamics, it serves as a valuable tool when used alongside other indicators such as infection and hospitalization rates. This approach allows policy makers to monitor regional disproportionality efficiently, offering insights for early intervention and targeted resource allocation.

背景:2019冠状病毒病大流行在全球范围内造成了严重的健康、经济和社会后果。了解传染病如何传播有助于减轻这些影响。Theil指数是一种基于信息理论的不平等衡量标准,有助于确定不同地区COVID-19发病率的地理不均衡。目的:本研究的重点是捕获传染病发病率的区域不相称程度随时间的变化。使用Theil指数,我们的目标是评估COVID-19传播的区域不相称性,并检测感染人数不成比例地集中的中心。方法:为了量化发病率的不成比例程度,我们将Theil指数应用于美国1100天内每日确诊COVID-19病例的公开数据。该指数通过比较每日区域病例分布与人口比例来衡量相对不相称性,从而确定感染不成比例地集中的区域。结果:我们的分析通过监测随着大流行的进展,各地区对泰尔指数的贡献的变化,揭示了确诊病例中区域不相称的动态模式。随着时间的推移,该指数反映了从局部疫情到广泛传播的转变,高值对应于某些地区的集中病例。我们还发现,Theil指数的峰值往往先于确诊病例的激增,这表明其作为早期预警信号的潜在效用。结论:本研究表明,Theil指数是量化COVID-19发病率区域不均衡的有效指标之一。虽然单独的Theil指数不能完全反映大流行动态的所有方面,但当与感染率和住院率等其他指标一起使用时,它是一个有价值的工具。这种方法使决策者能够有效地监测区域不均衡,为早期干预和有针对性的资源分配提供见解。
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引用次数: 0
ChatGPT's Attitude, Knowledge, and Clinical Application in Geriatrics Practice and Education: Exploratory Observational Study. ChatGPT在老年医学实践教育中的态度、知识及临床应用:探索性观察研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-03 DOI: 10.2196/63494
Huai Yong Cheng
<p><strong>Background: </strong>The increasing use of ChatGPT in clinical practice and medical education necessitates the evaluation of its reliability, particularly in geriatrics.</p><p><strong>Objective: </strong>This study aimed to evaluate ChatGPT's trustworthiness in geriatrics through 3 distinct approaches: evaluating ChatGPT's geriatrics attitude, knowledge, and clinical application with 2 vignettes of geriatric syndromes (polypharmacy and falls).</p><p><strong>Methods: </strong>We used the validated University of California, Los Angeles, geriatrics attitude and knowledge instruments to evaluate ChatGPT's geriatrics attitude and knowledge and compare its performance with that of medical students, residents, and geriatrics fellows from reported results in the literature. We also evaluated ChatGPT's application to 2 vignettes of geriatric syndromes (polypharmacy and falls).</p><p><strong>Results: </strong>The mean total score on geriatrics attitude of ChatGPT was significantly lower than that of trainees (medical students, internal medicine residents, and geriatric medicine fellows; 2.7 vs 3.7 on a scale from 1-5; 1=strongly disagree; 5=strongly agree). The mean subscore on positive geriatrics attitude of ChatGPT was higher than that of the trainees (medical students, internal medicine residents, and neurologists; 4.1 vs 3.7 on a scale from 1 to 5 where a higher score means a more positive attitude toward older adults). The mean subscore on negative geriatrics attitude of ChatGPT was lower than that of the trainees and neurologists (1.8 vs 2.8 on a scale from 1 to 5 where a lower subscore means a less negative attitude toward aging). On the University of California, Los Angeles geriatrics knowledge test, ChatGPT outperformed all medical students, internal medicine residents, and geriatric medicine fellows from validated studies (14.7 vs 11.3 with a score range of -18 to +18 where +18 means that all questions were answered correctly). Regarding the polypharmacy vignette, ChatGPT not only demonstrated solid knowledge of potentially inappropriate medications but also accurately identified 7 common potentially inappropriate medications and 5 drug-drug and 3 drug-disease interactions. However, ChatGPT missed 5 drug-disease and 1 drug-drug interaction and produced 2 hallucinations. Regarding the fall vignette, ChatGPT answered 3 of 5 pretests correctly and 2 of 5 pretests partially correctly, identified 6 categories of fall risks, followed fall guidelines correctly, listed 6 key physical examinations, and recommended 6 categories of fall prevention methods.</p><p><strong>Conclusions: </strong>This study suggests that ChatGPT can be a valuable supplemental tool in geriatrics, offering reliable information with less age bias, robust geriatrics knowledge, and comprehensive recommendations for managing 2 common geriatric syndromes (polypharmacy and falls) that are consistent with evidence from guidelines, systematic reviews, and other types of studies
背景:在临床实践和医学教育中越来越多地使用ChatGPT,需要对其可靠性进行评估,特别是在老年医学中。目的:本研究旨在通过三种不同的方法评估ChatGPT在老年医学中的可信度:用2个老年综合征(多药和跌倒)小视频评估ChatGPT的老年医学态度、知识和临床应用。方法:我们使用加州大学洛杉矶分校的老年病态度和知识工具来评估ChatGPT的老年病态度和知识,并将其与文献中报道的医学生、住院医师和老年病研究员的表现进行比较。我们还评估了ChatGPT在2例老年综合征(多药和跌倒)中的应用。结果:老年医学态度的平均总分显著低于实习生(医学生、内科住院医师和老年医学研究员);1-5分,2.7 vs 3.7;1 =非常不同意;5 =非常同意)。老年医学积极态度的平均分值高于实习生(医学生、内科住院医师和神经科医师);4.1 vs 3.7(从1到5分,得分越高意味着对老年人的态度越积极)。ChatGPT的老年病学消极态度的平均分值低于受训人员和神经科医生(1.8比2.8,分值越低表示对衰老的消极态度越少)。在加州大学洛杉矶分校的老年医学知识测试中,ChatGPT的表现优于所有医科学生、内科住院医生和老年医学研究员(14.7比11.3,得分范围为-18到+18,+18意味着所有问题都回答正确)。关于多药小插曲,ChatGPT不仅展示了潜在不适当药物的扎实知识,而且准确识别了7种常见的潜在不适当药物以及5种药物-药物和3种药物-疾病相互作用。ChatGPT漏诊5例药物-疾病和1例药物-药物相互作用,并产生2例幻觉。关于跌倒小短文,ChatGPT正确回答了5项预测试中的3项,部分正确回答了5项预测试中的2项,识别了6类跌倒风险,正确遵循了跌倒指南,列出了6项关键的身体检查,并推荐了6类预防跌倒的方法。结论:本研究表明,ChatGPT可以成为老年病学的一种有价值的补充工具,提供可靠的信息,年龄偏差较小,丰富的老年病学知识,并为管理两种常见的老年综合征(多药和跌倒)提供全面的建议,这些建议与指南、系统评价和其他类型的研究的证据一致。ChatGPT作为一种教育和临床资源的潜力可以极大地造福学员、卫生保健提供者和非专业人员。在将ChatGPT广泛应用于老年医学教育和实践之前,需要使用gpt - 40、更大的老年医学问题集和更多的老年综合征进行进一步的研究,以扩大和证实这些发现。
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引用次数: 0
Promoting Digital Health Data Literacy: The Datum Project. 促进数字卫生数据素养:数据项目。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-03 DOI: 10.2196/60832
Daniel Powell, Laiba Asad, Elissa Zavaglia, Manuela Ferrari

Unlabelled: With the increased use of digital health innovations in Canadian health care, educating health care users, professionals, and researchers on the ethical challenges and privacy implications of these tools is essential. The Datum project, funded by the Fondation Barreau du Quebec, was created to help these actors better understand legal and ethical issues regarding the collection, use, and disclosure of digital health data for the purposes of scientific research, thereby enhancing literacy around data privacy. The project consists of a multimedia website divided into legislation and policy documents and narrative-based video content. Users can access the core legislation and policies governing the collection and use of health care data geared toward researchers and health practitioners. Users can also view the narrative-based video content explaining key concepts related to digital health data. The Datum project makes an original contribution to the field of law and ethics in health science research by using novel approaches, such as learning health systems and data banks, to improve equity in health care delivery and by generating multimedia content aimed at encouraging health care users to become better consumers and supporting the collective use of their data. The Datum project also promotes digital literacy as a digital communication tool, which has the significant potential to improve health outcomes, bridge the digital divide, and reduce health inequities.

未标记:随着加拿大医疗保健中数字健康创新的使用越来越多,教育医疗保健用户、专业人员和研究人员了解这些工具的伦理挑战和隐私影响至关重要。Datum项目由魁北克巴罗基金会资助,旨在帮助这些行为者更好地了解为科学研究目的收集、使用和披露数字健康数据的法律和伦理问题,从而提高数据隐私方面的素养。该项目包括一个多媒体网站,分为立法和政策文件以及以叙事为基础的视频内容。用户可以访问管理收集和使用面向研究人员和卫生从业人员的卫生保健数据的核心立法和政策。用户还可以查看基于叙述的视频内容,解释与数字健康数据相关的关键概念。Datum项目对卫生科学研究中的法律和伦理领域作出了原创性贡献,它采用新颖的方法,例如学习卫生系统和数据库,以改善卫生保健服务的公平性,并生成多媒体内容,鼓励卫生保健用户成为更好的消费者,并支持集体使用其数据。Datum项目还促进将数字扫盲作为一种数字通信工具,这在改善卫生成果、弥合数字鸿沟和减少卫生不平等方面具有巨大潜力。
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引用次数: 0
Artificial Intelligence-Powered Training Database for Clinical Thinking: App Development Study. 临床思维的人工智能训练数据库:应用程序开发研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-03 DOI: 10.2196/58426
Heng Wang, Danni Zheng, Mengying Wang, Hong Ji, Jiangli Han, Yan Wang, Ning Shen, Jie Qiao
<p><strong>Background: </strong>With the development of artificial intelligence (AI), medicine has entered the era of intelligent medicine, and various aspects, such as medical education and talent cultivation, are also being redefined. The cultivation of clinical thinking abilities poses a formidable challenge even for seasoned clinical educators, as offline training modalities often fall short in bridging the divide between current practice and the desired ideal. Consequently, there arises an imperative need for the expeditious development of a web-based database, tailored to empower physicians in their quest to learn and hone their clinical reasoning skills.</p><p><strong>Objective: </strong>This study aimed to introduce an app named "XueYiKu," which includes consultations, physical examinations, auxiliary examinations, and diagnosis, incorporating AI and actual complete hospital medical records to build an online-learning platform using human-computer interaction.</p><p><strong>Methods: </strong>The "XueYiKu" app was designed as a contactless, self-service, trial-and-error system application based on actual complete hospital medical records and natural language processing technology to comprehensively assess the "clinical competence" of residents at different stages. Case extraction was performed at a hospital's case data center, and the best-matching cases were differentiated through natural language processing, word segmentation, synonym conversion, and sorting. More than 400 teaching cases covering 65 kinds of diseases were released for students to learn, and the subjects covered internal medicine, surgery, gynecology and obstetrics, and pediatrics. The difficulty of learning cases was divided into four levels in ascending order. Moreover, the learning and teaching effects were evaluated using 6 dimensions covering systematicness, agility, logic, knowledge expansion, multidimensional evaluation indicators, and preciseness.</p><p><strong>Results: </strong>From the app's first launch on the Android platform in May 2019 to the last version updated in May 2023, the total number of teacher and student users was 6209 and 1180, respectively. The top 3 subjects most frequently learned were respirology (n=606, 24.1%), general surgery (n=506, 20.1%), and urinary surgery (n=390, 15.5%). For diseases, pneumonia was the most frequently learned, followed by cholecystolithiasis (n=216, 14.1%), benign prostate hyperplasia (n=196, 12.8%), and bladder tumor (n=193, 12.6%). Among 479 students, roughly a third (n=168, 35.1%) scored in the 60 to 80 range, and half of them scored over 80 points (n=238, 49.7%). The app enabled medical students' learning to become more active and self-motivated, with a variety of formats, and provided real-time feedback through assessments on the platform. The learning effect was satisfactory overall and provided important precedence for establishing scientific models and methods for assessing clinical thinking skills in the futu
背景:随着人工智能(AI)的发展,医学进入了智能医学时代,医学教育、人才培养等各个方面也在被重新定义。即使对经验丰富的临床教育工作者来说,临床思维能力的培养也是一项艰巨的挑战,因为线下培训模式往往无法弥合当前实践与理想之间的鸿沟。因此,迫切需要快速开发基于网络的数据库,以使医生能够在他们的探索中学习和磨练他们的临床推理技能。目的:本研究旨在引入一款集会诊、体检、辅助检查、诊断为一体的app“学医库”,结合人工智能和医院实际完整病历,构建一个人机交互的在线学习平台。方法:“学医库”app基于医院实际完整病历,结合自然语言处理技术,设计一款非接触式、自助式、试错式的系统应用,对住院医师不同阶段的“临床能力”进行综合评估。在医院的病例数据中心进行病例提取,并通过自然语言处理、分词、同义词转换和排序来区分最匹配的病例。发布教学案例400余例,涉及疾病65种,学科涵盖内科、外科学、妇产科、儿科学。学习案例的难度由高到低分为四个层次。并从系统性、敏捷性、逻辑性、知识拓展性、多维度评价指标、严谨性6个维度对学与教效果进行评价。结果:从2019年5月在安卓平台首次上线到2023年5月最后一次更新,教师和学生用户总数分别为6209和1180。学习频次最高的前3名分别是呼吸内科(n=606, 24.1%)、普外科(n=506, 20.1%)和泌尿外科(n=390, 15.5%)。肺炎是最常见的疾病,其次是胆囊结石(216例,14.1%)、良性前列腺增生(196例,12.8%)和膀胱肿瘤(193例,12.6%)。在479名学生中,大约三分之一(n=168, 35.1%)的分数在60 ~ 80分之间,一半(n=238, 49.7%)的分数在80分以上。该应用程序使医学生的学习变得更加积极主动,具有多种形式,并通过平台上的评估提供实时反馈。学习效果总体满意,为今后建立科学的临床思维能力评估模型和方法提供了重要的借鉴。结论:人工智能与医学教育的整合无疑将有助于教育流程的重组;促进教育生态系统的演进;为自主学习、互动交流、教育资源共享提供新的便捷途径。
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引用次数: 0
International Expert Consensus on Relevant Health and Functioning Concepts to Assess in Users of Tobacco and Nicotine Products: Delphi Study. 评估烟草和尼古丁产品使用者的相关健康和功能概念的国际专家共识:德尔菲研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-02 DOI: 10.2196/58614
Vivienne Law, Esther F Afolalu, Linda Abetz-Webb, Lee Andrew Wemyss, Andrew Turner, Christelle Chrea

Background: A Delphi study was conducted to reach a consensus among international clinical and health care experts on the most important health and functioning self-reported concepts when evaluating a switch from smoking cigarettes to using smoke-free tobacco and/or nicotine products (sf-TNPs).

Objective: The aim of this research was to identify concepts considered important to measure when assessing the health and functioning status of users of tobacco and/or nicotine products.

Methods: Experts (n=105), including health care professionals, researchers, and policy makers, from 26 countries with professional experience and knowledge of sf-TNPs completed a 3-round, adapted Delphi panel. Online surveys combining quantitative (MaxDiff best-worst scaling and latent class analysis) and qualitative assessments were used to rank and achieve alignment on the importance of 69 health and functioning concepts. All experts participating in round I completed round II, and 101 (95%) completed round III.

Results: The round I analysis identified 36 (52%) out of 69 concepts that were refined for the round II assessment. The highest-ranked concepts reflected health-related impacts, while the lowest-ranked ranked concepts were related to aesthetics and social impacts. Round II ranking reinforced the importance of concepts relating to health impacts, and the analysis resulted in 20 concepts retained for round III assessment. In round III, the 4 highest-ranked concepts were cardiovascular symptoms, shortness of breath, chest pain, and worry about smoking-related diseases and impact on general health, and they made up 50% of the total score in the MaxDiff analysis. Experts reported likelihood of seeing measurable levels of change in the final 20 concepts with a switch to an sf-TNP. The majority of experts felt it was "likely" or "extremely likely" to observe changes in concepts such as gum problems (74/101, 73%), phlegm or mucus while coughing or not coughing (72/101, 71%), general perception of well-being (72/101, 71%), and throat irritation or sore throat (72/101, 71%). Latent class analysis revealed subgroups of experts with different perceptions of the relative importance of the concepts, which varied depending on professional specialty and geographic region. For example, 74% (14/19) of oncologists aligned with the subgroup prioritizing physical health symptoms, while 71% (12/17) of experts from Asia aligned with the subgroup considering both physical health and psychosocial aspects.

Conclusions: This study identified key concepts to be considered in the development of a new measurement instrument to assess the self-reported health and functioning status of individuals using sf-TNPs. The findings contribute to the scientific evidence base for understanding and evaluating both the individual and public health impacts of sf-TNPs.

背景:在评估从吸烟转向使用无烟烟草和/或尼古丁产品(sf-TNPs)时,进行了一项德尔菲研究,以在国际临床和卫生保健专家之间就最重要的健康和功能自我报告概念达成共识。目的:本研究的目的是确定在评估烟草和/或尼古丁产品使用者的健康和功能状况时被认为重要的测量概念。方法:来自26个国家具有sf-TNPs专业经验和知识的专家(n=105),包括卫生保健专业人员、研究人员和政策制定者完成了3轮适应性德尔菲小组。在线调查结合了定量(MaxDiff最佳-最差尺度和潜在类别分析)和定性评估,对69个健康和功能概念的重要性进行了排名并实现了一致性。所有参加第一轮的专家完成了第二轮,101名(95%)完成了第三轮。结果:第一轮分析确定了69个概念中的36个(52%),为第二轮评估进行了改进。排名最高的概念反映了与健康有关的影响,而排名最低的概念则与美学和社会影响有关。第二轮排名加强了与健康影响有关的概念的重要性,分析结果为第三轮评估保留了20个概念。在第三轮中,排名最高的4个概念是心血管症状、呼吸短促、胸痛和担心吸烟相关疾病及其对一般健康的影响,它们在MaxDiff分析中占总分的50%。专家们报告说,在转换到sf-TNP后,可能会在最后的20个概念中看到可测量水平的变化。大多数专家认为“可能”或“极有可能”观察到诸如牙龈问题(74/ 101,73%),咳嗽或不咳嗽时痰或粘液(72/ 101,71%),总体幸福感(72/ 101,71%)以及喉咙刺激或喉咙痛(72/ 101,71%)等概念的变化。潜在类分析揭示了对概念的相对重要性有不同看法的专家小组,这取决于专业专业和地理区域。例如,74%(14/19)的肿瘤学家与优先考虑身体健康症状的亚组保持一致,而71%(12/17)的亚洲专家与同时考虑身体健康和社会心理方面的亚组保持一致。结论:本研究确定了在开发一种新的测量工具来评估使用sf-TNPs的个人自我报告的健康和功能状态时需要考虑的关键概念。这些发现为理解和评估sf-TNPs对个人和公共健康的影响提供了科学证据基础。
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引用次数: 0
The Physical Activity at Work (PAW) Program in Thai Office Workers: Mixed Methods Process Evaluation Study. 泰国办公室工作人员的体力活动(PAW)计划:混合方法过程评估研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-02 DOI: 10.2196/57604
Katika Akksilp, Thomas Rouyard, Wanrudee Isaranuwatchai, Ryota Nakamura, Falk Müller-Riemenschneider, Yot Teerawattananon, Cynthia Chen
<p><strong>Background: </strong>An increasing number of multicomponent workplace interventions are being developed to reduce sedentary time and promote physical activity among office workers. The Physical Activity at Work (PAW) trial was one of these interventions, but it yielded an inconclusive effect on sedentary time after 6 months, with a low uptake of movement breaks, the main intervention component.</p><p><strong>Objective: </strong>This study investigates the factors contributing to the outcomes of the PAW cluster randomized trial.</p><p><strong>Methods: </strong>Following the Medical Research Council's guidance for process evaluation of complex interventions, we used a mixed methods study design to evaluate the PAW study's recruitment and context (how job nature and cluster recruitment affected movement break participation), implementation (dose and fidelity), and mechanisms of impact (assessing how intervention components affected movement break participation and identifying the facilitators and barriers to participation in the movement breaks). Data from accelerometers, pedometers, questionnaires, on-site monitoring, and focus group discussions were used for the evaluation. Linear mixed effects models were used to analyze the effects of different intervention components on the movement breaks. Subsequently, qualitative analysis of the focus group discussions provided additional insights into the relationship between the intervention components.</p><p><strong>Results: </strong>The participation in movement breaks declined after the third week, averaging 12.7 sessions (SD 4.94) per participant per week for the first 3 weeks, and continuing to decrease throughout the intervention. On-site monitoring confirmed high implementation fidelity. Analysis of Fitbit data revealed that each additional movement break was associated with a reduction of 6.20 (95% CI 6.99-5.41) minutes in sedentary time and an increase of 245 (95% CI 222-267) steps. Regarding the mechanisms of impact, clusters with higher baseline sedentary time demonstrated greater participation in movement breaks, while those with frequent out-of-office duties showed minimal engagement. Moreover, clusters with enthusiastic and encouraging movement break leaders were associated with a 24.1% (95% CI 8.88%-39.4%) increase in participation. Environmental and organizational support components using posters and leaders' messages were ineffective, showing no significant change in percentage participation in movement breaks (4.49%, 95% CI -0.49% to 9.47% and 1.82%, 95% CI -2.25% to 5.9%, respectively). Barriers such as high workloads and meetings further hindered participation, while the facilitators included participants' motivation to feel active and the perceived health benefits from movement breaks.</p><p><strong>Conclusions: </strong>Despite high fidelity, the PAW trial did not significantly reduce sedentary time, with limited uptake of movement breaks due to context-related challenges,
背景:正在开发越来越多的多组分工作场所干预措施,以减少办公室工作人员的久坐时间并促进身体活动。工作中的体力活动(PAW)试验就是这些干预措施之一,但它在6个月后对久坐时间产生了不确定的影响,主要干预措施是运动休息时间较低。目的:探讨影响PAW聚类随机试验结果的因素。方法:根据医学研究委员会对复杂干预过程评估的指导,我们采用混合方法研究设计来评估PAW研究的招募和背景(工作性质和集群招募如何影响运动中断的参与)、实施(剂量和保真度)和影响机制(评估干预成分如何影响运动中断的参与,并确定参与运动中断的促进因素和障碍)。来自加速计、计步器、问卷调查、现场监测和焦点小组讨论的数据被用于评估。采用线性混合效应模型分析不同干预成分对运动断裂的影响。随后,对焦点小组讨论的定性分析为干预成分之间的关系提供了更多的见解。结果:第三周后,运动休息的参与率下降,前3周平均每个参与者每周12.7次(SD 4.94),并在整个干预过程中继续下降。现场监测证实实施保真度高。对Fitbit数据的分析显示,每增加一次运动休息,就会减少6.20分钟(95% CI 6.99-5.41)的久坐时间,增加245步(95% CI 222-267)。关于影响的机制,久坐时间越长的群体表现出更多的运动休息,而那些经常外出工作的群体表现出最小的参与。此外,具有热情和鼓励的运动休息领导者的集群与24.1% (95% CI 8.88%-39.4%)的参与率增加相关。使用海报和领导者信息的环境和组织支持组件是无效的,在运动休息的参与百分比上没有显着变化(分别为4.49%,95% CI -0.49%至9.47%和1.82%,95% CI -2.25%至5.9%)。高工作量和会议等障碍进一步阻碍了参与者的参与,而促进因素包括参与者感到活跃的动机以及从运动休息中感受到的健康益处。结论:尽管保真度很高,但PAW试验并没有显著减少久坐时间,由于与环境相关的挑战、无效的环境支持和COVID-19大流行期间的高工作量,运动休息的吸收有限。
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引用次数: 0
Quality Assessment of Medical Institutions' Websites Regarding Prescription Drug Misuse of Glucagon-Like Peptide-1 Receptor Agonists by Off-Label Use for Weight Loss: Website Evaluation Study. 医疗机构超说明书滥用胰高血糖素样肽-1受体激动剂处方药减肥网站质量评价:网站评价研究
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-01 DOI: 10.2196/68792
Rie Oyama, Tsuyoshi Okuhara, Emi Furukawa, Hiroko Okada, Takahiro Kiuchi

Background: Misuse of glucagon-like peptide-1 receptor agonists (GLP-1RAs) has emerged globally as individuals increasingly use these drugs for weight loss because of unrealistic and attractive body images advertised and shared on the internet.

Objective: This study assesses the quality of information and compliance with Japan's medical advertising guidelines on the websites of medical institutions that prescribe GLP-1RAs off-label for weight loss.

Methods: Websites were identified by searching Google and Yahoo! by using keywords related to GLP-1RAs and weight loss in August 2024. The quality of information on these websites was assessed using the DISCERN instrument. To comply with Japan's medical advertising guidelines, we evaluated whether the 5 mandatory items for advertisements of self-paid medical treatments involving the off-label use of drugs were stated and whether there were any exaggerated claims. The content of the exaggerated advertisements was categorized into themes.

Results: Of the 87 websites included, only 1 website stated all 5 mandatory items. Websites listing "ineligible for the relief system for sufferers from adverse drug reactions" had the lowest percentage at 9% (8/87), while 83% (72/87) of the websites listed exaggerated advertisements. Approximately 69% (60/87) of the websites suggested that no exercise or dietary therapy was required, 24% (21/87) suggested that using GLP-1RAs is a natural and healthy method, and 31% (27/87) of the websites provided the author's personal opinions on the risks of using GLP-1RAs. The mean total DISCERN score for all 87 websites was 32.6 (SD 5.5), indicating low quality. Only 1 website achieved a good rating, and 9 websites were rated as fair. The majority of the websites were rated as poor (72 websites) or very poor (5 websites).

Conclusions: We found that the quality of information provided by the websites of medical institutions prescribing GLP-1RAs off-label for weight loss was very low and that many websites violated Japan's medical advertising guidelines. The prevalence of exaggerated advertisements, which may lead consumers to believe that they can lose weight without dietary or exercise therapy, suggests the risk of GLP-1RA misuse among consumers. Public institutions and health care providers should monitor and regulate advertisements that violate guidelines and provide accurate information regarding GLP-1RAs, obesity, and weight loss.

背景:胰高血糖素样肽-1受体激动剂(GLP-1RAs)的滥用已经在全球范围内出现,因为人们越来越多地使用这些药物来减肥,因为互联网上广告和分享的不切实际和迷人的身体图像。目的:本研究评估医疗机构网站上关于GLP-1RAs超说明书减肥的信息质量和对日本医疗广告指南的遵守情况。方法:通过搜索b谷歌和Yahoo!在2024年8月使用GLP-1RAs和减肥相关的关键词。使用DISCERN工具对这些网站上的信息质量进行评估。为了符合日本的医疗广告准则,我们评估了涉及超说明书用药的自费医疗广告的5个强制性项目是否被陈述,以及是否存在夸大的说法。夸张广告的内容被划分为主题。结果:在纳入的87个网站中,只有1个网站填写了全部5项必填项。列出“不符合药物不良反应救济制度”的网站比例最低,为9%(8/87),而列出夸大广告的网站比例为83%(72/87)。约69%(60/87)的网站建议不需要运动或饮食治疗,24%(21/87)的网站建议使用GLP-1RAs是一种自然和健康的方法,31%(27/87)的网站提供了作者对使用GLP-1RAs的风险的个人看法。87个网站的平均总分为32.6 (SD 5.5),表明质量较低。只有1个网站获得了良好的评价,9个网站被评为一般。大多数网站被评为差(72个)或非常差(5个)。结论:我们发现医疗机构网站提供的GLP-1RAs超说明书减肥处方信息质量很低,许多网站违反了日本的医疗广告准则。夸大广告的盛行,可能会让消费者相信他们不需要饮食或运动治疗就能减肥,这表明消费者滥用GLP-1RA的风险。公共机构和卫生保健提供者应监测和规范违反指南的广告,并提供有关GLP-1RAs、肥胖和减肥的准确信息。
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