International Journal of Telemedicine and Applications最新文献

Background: Long COVID still challenges healthcare systems worldwide. Tailored treatments are scarce. In the ErgoLoCo study, we have developed and tested a telehealth-delivered occupational therapy intervention for people affected by long COVID. Acceptability from both recipients and providers is a prerequisite for implementing such new interventions.

Aim: This study is aimed at exploring the perceptions of people with long COVID and occupational therapists regarding the intervention's acceptability and telehealth delivery approaches.

Methods: Semistructured interviews were conducted with 13 participants who experience long COVID and received the ErgoLoCo intervention delivered as teletherapy sessions or prerecorded videos. Eight occupational therapists who guided the teletherapy sessions participated in a focus group. Materials were analyzed following qualitative descriptive methods and interpreted using the theoretical framework of acceptability (TFA).

Results: Occupational therapists and long COVID clients considered the occupational therapy approach a positive experience. While all participants in the teletherapy group found the occupational therapy approach helpful in coping with long COVID symptoms and regaining participation in meaningful occupations, perceptions varied in the group supplied with prerecorded videos. Some saw the intervention as helpful, but all emphasized the need for professional support from occupational therapists to use the program more effectively. The occupational therapists emphasized the need to tailor the therapy content to clients' needs to ensure effective and successful management of occupational challenges.

Discussion: The study highlights telehealth-delivered occupational therapy's potential benefits and challenges for individuals with long COVID. It contributes to understanding the challenges and potential of telehealth-delivered occupational therapy for long COVID rehabilitation. This study's key finding is the importance of personalized and professionally guided telehealth interventions. Trial Registration: German Clinical Trial Registry identifier DRKS00029990.

Background: A variety of patient populations receive allergen immunotherapy (AIT), but clinicians still lack an effective electronic platform to manage them.

Methods: We designed a platform based on the framework of value set extraction standardization, integration, and structurization. Average medication scoring (AMS) and other electronic medical records were developed and stored on a MySQL database. Data storage is hosted on cloud servers, linked to a mobile application, Bluetooth lung function monitoring, and a dedicated website that acts as a front-end.

Results: Since 2015, 23,847 patients in 48 hospitals with AIT prescriptions were included. Of these patients, the median age was 15 (interquartile range, 10-27) years. Allergic rhinitis was the most common disorder and accounted for 9753 (40.9%) of the cases. Five hundred and thirty-three basic data elements and six independent modules were constructed for the platform to facilitate the physicians in establishing SCIT projects, symptom scores, AMS, lung function tests, and follow-up appointments. One hundred and twelve drugs including 10 dosage forms were identified from an internal list of the dataset. The unit score was calculated based on the action mechanism of the medicine. The AMS formula has six parameters: total dose, frequency, period, unit score, unit dose, and follow-up days. A lower AMS suggests a better treatment efficacy.

Conclusion: The program presented our experience in developing, pilot testing, and evaluating an electronic AIT platform, and future research would indicate whether the template could be made more time efficient in clinical practice.

Objective: Anemia remains a major public health concern among pregnant women, significantly contributing to maternal and infant morbidity and mortality. With advances in digital technology, particularly machine learning (ML), there is potential to enhance early detection and prevention strategies. This scoping review is aimed at synthesizing the existing literature on the application of ML-based digital tools for predicting and preventing anemia in pregnant women.

Methods: Following the PRISMA-ScR guidelines, this review included articles from PubMed, Scopus, and Google Scholar published between 2015 and 2024. Eligibility criteria included studies using ML methods for anemia prediction in pregnant women. Extracted data included study population, ML algorithms used, and performance metrics. Due to the scoping nature of this review, risk of bias assessment was not conducted.

Results: A total of 11 studies met the inclusion criteria, utilizing various ML algorithms such as decision trees, random forest, support vector machines, naive Bayes, K-nearest neighbors, PART, fuzzy Tsukamoto, and boosting algorithms. Comparative analysis based on performance metrics (accuracy, precision, recall, F1-score, and AUC) identified boosting and random forest as the most effective models in resource-limited settings. However, heterogeneity in data sources, evaluation metrics, and populations limits generalizability.

Conclusions: ML-based models demonstrate considerable promise in predicting anemia among pregnant women. However, further validation across diverse datasets, clearer articulation of methodological strengths and limitations, and attention to implementation feasibility in low-resource settings are needed.

Teledermatology is increasingly recognized as a valuable tool for expanding access to dermatologic care, particularly in underserved and remote settings. This randomized prospective cohort study, the first of its kind in the region, examined the diagnostic and treatment concordance of teledermatologists compared to in-clinic dermatologists, with a focus on the impact of image acquisition methods. A total of 360 adult patients presenting for dermatologic evaluation at the American University of Beirut Medical Center were enrolled. Each patient contributed three sets of skin lesion photographs: unassisted patient-taken, assisted patient-taken after brief standardized training, and resident-taken under clinical conditions. Using a store-and-forward model, teledermatologists reviewed one randomized image set per patient. Their diagnoses and treatment decisions were compared to in-person assessments, which served as the reference standard. Diagnostic concordance improved with image quality: 79% for unassisted patient images, 84% for assisted images, and 87% for resident-taken images. Treatment concordance similarly increased from 38% to 44% to 45%, while the need to request additional history declined from 64% to 47%. Acne showed the highest diagnostic match across all image types. These findings support the clinical validity of store-and-forward teledermatology and highlight the value of patient education in improving image quality and diagnostic outcomes. As the first regional study to systematically evaluate real-world image acquisition methods, it offers a practical roadmap for integrating teledermatology into routine dermatologic care.

The growing advancements in science, technology, innovation, and research are paralleled by a concerning rise in stress levels worldwide. Stress, an inevitable psychosocial factor, significantly affects human life, mental status, and overall physiosocial health. This research focuses on developing an accurate galvanic skin response (GSR) system to effectively identify and analyze stress levels. The core concept of GSR involves measuring the conductivity between skin contacts, where increased conductivity corresponds to heightened stress levels. Advanced algorithms are employed to efficiently convert these readings into digital formats for precise analysis. The system leverages the Kalman filter algorithm to reduce noise, ensuring smooth and reliable signals from raw GSR readings. A dynamic range normalization technique transforms filtered readings into a consistent scale (0-500) tailored to individual baseline values. This approach ensures that stable measurements are unaffected by noise using the Kalman filter, consistency across users despite physiological differences, and accurate, personalized stress-level detection through adaptive categorization. Tested on over 5000 samples, the system accurately identifies stress levels across defined ranges, established in collaboration with psychologist practitioners. This research culminates in developing an accurate and personalized stress detection and analysis system, providing actionable insights into stress management.

Introduction: Online video consultation (VC) use in pediatric care has increased recently, particularly following the COVID-19 pandemic. However, understanding parental perspectives on VC use with pediatricians, especially across geographical regions, remains crucial for effective VC implementation and reducing healthcare disparities. Methods: This mixed methods study combined an online survey (n = 96) and two focus groups (n = 17) to examine parental perceptions of VC with pediatricians in Israel. Based on the Telehealth Usability Questionnaire, the survey assessed user experience, usefulness, and satisfaction. Focus groups explored themes related to children's experiences, remote diagnosis, patient-physician communication, and VC use during emergencies. Results: While 82% of parents believed that VC saved time and 67% felt it improved access to healthcare, only 50% thought it met their healthcare needs. Parents in peripheral regions rated the usefulness of VC higher than those in central areas, particularly during times of security concerns. However, central region parents reported better user experiences. Parents with prior VC experience showed higher satisfaction and future use intention than non-preusers. Focus groups revealed that children often felt more comfortable with VC due to the familiar home environment, although parents expressed concerns about remote diagnosis accuracy and physician communication quality. Discussion: Our findings highlight geographic disparities in VC adoption and emphasize the need for targeted interventions to improve technical support and infrastructure in peripheral regions. While VC shows promise for enhancing healthcare accessibility, particularly during emergencies, success requires addressing technical barriers, strengthening privacy measures, and establishing clear guidelines for remote pediatric care delivery.

Background: Telepathology and digital pathology are increasingly utilised for routine diagnostics globally, improving patient safety and diagnostic efficiency. No research exists on the adoption of digital pathology in South Africa. Understanding the current use can help understand implementation needs and ensure equitable access to this modern diagnostic tool. This can help realise the technology's benefits across the diverse communities in South Africa. Methods: This was a nonexperimental descriptive study. Primary quantitative data were collected via a questionnaire distributed to South African histopathologists in August 2023. The questionnaire focused on participants' demographic information and the use of digital pathology by histopathologists in South Africa. Descriptive data analysis was performed. Results: The study comprised 71 histopathologists, representing 23% of all registered histopathologists in the country. There was a near-equal distribution of female and male histopathologists. Most of the participating histopathologists worked in the private sector. Nearly all of the histopathologists surveyed indicated some exposure to digital pathology (99%). Most participants use digital pathology for external quality assurance and training. The use of digital pathology as a routine diagnostic tool was noted by 22% of participants, although only 3% reported daily use. Conclusion: The current use and adoption of digital pathology by South African histopathologists are comparable to the international community. By increasing the use of digital pathology for routine diagnostic use, we can enhance the accuracy of diagnoses and improve healthcare outcomes for patients and healthcare professionals.

Telerobotic spinal surgery (TSS) has emerged as a transformative approach for spinal interventions that combines robotics and telecommunication to enable remote surgery with enhanced precision and accessibility. This technology can potentially address the challenges of complex spinal conditions by providing minimally invasive solutions and delivering specialized surgical expertise across geographical boundaries. However, technical complexities related to communication and latency, haptic feedback, and system integration need to be addressed. Ethical and regulatory considerations also require careful navigation. Despite these challenges, the limited number of available clinical studies demonstrates the feasibility and efficacy of TSS, particularly with the use of 5G technology. Further research and clinical trials are needed to fully evaluate and validate the outcomes and effectiveness of TSS. With ongoing efforts in research and development, TSS has the potential to revolutionize spine surgery and improve patient care. In this review, we present the role and the challenges of TSS in spinal surgery.

Background: Low birth weight remains a health concern in the Special Region of Yogyakarta, Indonesia. Effective management of low birth weight cases is crucial, yet community-based health programs face challenges in addressing this issue. Purpose: This study is aimed at exploring the needs, experience, and perspectives of healthcare providers regarding low birth weight prevention programs. Methods: This was a qualitative descriptive study. Data were collected from June to December 2023 in Kulon Progo District, Yogyakarta, Indonesia. Data were collected through a focus group discussion with nine midwives. Triangulation was conducted with 12 breastfeeding mothers, one nutritionist, and one head of the primary health center through in-depth interviews. Each discussion and interview were recorded, transcribed, and subjected to thematic analysis to identify key themes. Results: Three themes were discovered in this study: programmatic initiatives of healthcare providers; poor knowledge, attitude, and practice with limited resources and access; enhancing the use of teleconsultations. Programmatic initiatives from primary healthcare centers have focused on preventing low birth weight through targeted outreach, education, and prenatal care for at-risk mothers. However, the persistent challenge of insufficient human resources for health has hindered the effectiveness and reach of these efforts. To enhance LBW prevention strategies, the needs of digital technology by integrating digital tools and electronic health records are imperative. Conclusion: Effectively managing low birth weight requires utilization of technology to strengthen healthcare interventions. Digital solutions enhance communication, broaden service reach, and enable timely support, especially in underserved areas. Incorporating these tools into health programs improves the delivery and accessibility of care, presenting a valuable approach to advancing maternal and child health outcomes.

Orthotic treatment, particularly for ankle injuries, often relies on devices such as ankle-foot orthoses (AFOs) to support and stabilize the foot and ankle. Given the high prevalence of lower extremity injuries, especially in sports, and the diagnostic challenges faced by clinicians, there is a pressing need for intelligent systems that aid in accurate assessment and personalized management. Misdiagnosis and suboptimal treatment of ankle conditions, including fractures and sprains, can lead to long-term complications and hinder recovery. This study presents TeleOrtho, a knowledge-based expert system designed to provide personalized diagnosis, treatment recommendations, and recovery plans for ankle injuries, integrating transcutaneous electrical nerve stimulation (TENS) therapy to enhance rehabilitation. The system was implemented using Flutter for cross-platform deployment and Python for expert rule modeling, and it features a user-friendly interface for both clinicians and patients. Diagnostic accuracy and treatment pathways were validated through two published case scenarios, confirming the system's alignment with medical guidelines. Static and dynamic testing demonstrated consistent functionality, and initial usability assessment indicated high user satisfaction (average SUS score: 85.3/100). The expert system reliably identified injury types based on structured symptom input and suggested individualized recovery plans. These results affirm the potential of TeleOrtho to reduce diagnostic errors, improve therapy adherence, and enhance clinical decision-making. Future work will focus on integrating imaging analysis, expanding the knowledge base to include additional orthopedic conditions, and conducting clinical trials for broader validation.