DIGITAL HEALTH最新文献

Background: Wearables and smart devices could complement face-to-face prenatal care appointments by monitoring pregnant women's health, especially since pregnancy may be a vulnerable time when mental health issues and pregnancy-related anxiety may arise.

Aim: The aim of this study was to analyze the extent whether the willingness of women to use smart devices for pregnancy care monitoring differs between those with pregnancy-related anxiety and those without.

Methods: A survey was conducted to ascertain participant's general characteristics, attitudes toward smart devices, the willingness to use them, and the level of pregnancy-related anxiety (PRAQ-R2). Associations between the willingness and pregnancy-related anxiety parameters were analyzed.

Results: Completed questionnaires from 210 women were included in the analysis. A significant difference between women showing high and low levels of pregnancy-related anxiety was observed in terms of their willingness to use a smartwatch (median score 4.00; interquartile range (IQR) 4.00-5.00 vs. 4.00; IQR 3.00-4.00; P = .02), smart contraction counter (median score 4.00; IQR 3.00-5.00 vs. 3.00; IQR 3.00-4.00; P = .02), smart blood pressure monitor (median score 5.00; IQR 3.00-5.00 vs. 4.00; IQR 3.00-4.00; P = .003) or sleep tracker (median score 4.00; IQR 3.00-5.00 vs. 3.00; IQR 2.00-4.00; P = .007). Overall, anxious women showed significantly higher willingness to use smart devices in the context of prenatal care.

Conclusions: The data suggest that pregnant women are receptive to using smart devices to enhance their prenatal care, particularly those experiencing higher levels of anxiety. This study serves as an initial step in evaluating attitudes toward these devices. As a follow-up, it is recommended that acceptance and feasibility studies are conducted alongside the further development of existing and new pregnancy-specific wearables.

Background: At present, artificial intelligence (AI) plays a significant role in the diagnosis, treatment, and prognosis of lymphoma. This study quantitatively analyzed the research hotspots and future trends in this field by using bibliometric software. The aim is to offer researchers a full understanding of the current research along with suggestions for future directions.

Methods: All relevant articles of AI in lymphoma research were retrieved from the Web of Science Core Collection database from 2010 to 2024. Bibliometric visualization analysis of all retrieved data was conducted by using the "bibliometrix" package in R (version 4.4.1), CiteSpace (version 6.4.R1), and VOSviewer (version 1.6.20).

Results: Analysis of 662 publications shows that AI in lymphoma research is currently on rapid development. The United States and China are ahead of other countries in terms of the number of articles and citations. Jiang Huiyan from Northeastern University (China) and Michel Meignan from Assistance Publique-Hôpitaux de Paris (France) are the most prolific and highly cited authors in this field. Recent hotspots focus on molecular expression and imaging histology, while the emerging directions are molecular mechanisms and chemotherapeutic strategies in lymphoma.

Conclusions: This study comprehensively analyzes the hotspots and trends of AI research in lymphoma, which is shifting from radiomics toward molecular mechanisms and AI-optimized chemotherapy. In the future, it is necessary to meet the practical clinical demands and promote the integration of AI.

Background: Digital health interventions for self-management have reported improvement in medication adherence, but further studies have reported that this is not sustained. Clarity is needed on the effectiveness of digital health interventions (DHIs) for medication adherence and the characteristics of successful DHIs.

Objective: This review aimed to evaluate the effectiveness of DHIs versus standard care in supporting medication adherence in community-based adults.

Methods: Studies of DHIs that included community-based adults (18 + years) that required prescribed medications and either used, or have access to, technology to manage their illness were included for review. A literature search was conducted across eight key databases. Studies were pooled in statistical meta-analysis using a random effects model. Pooled results were estimated by subgroup analyses defined by study design, intervention duration and intervention type (platform).

Results: Thirteen studies were included in the final meta-analysis (N = 1320). There was no statistically significant effect of DHIs on medication adherence. Subgroup analyses showed no increase in medication adherence observed in the intervention group. However, a small significant increase in medication adherence was observed in the control group in studies of 6-month duration.

Conclusions: The impact of DHIs on medication adherence is unclear. More rigorous clinical evidence is required to understand the impact of DHIs on medication adherence over longer durations, and further studies exploring the impact of platform type on medication adherence are required, with consideration given to the potential of Artificial Intelligence (AI)-driven diagnostics and analytics in the future.

Objectives: While internet-based interventions have been used for more than 10 years in Dutch forensic psychiatric outpatient care, it is not clear if, why and for whom they work. The objective of this study was to investigate whether the addition of an internet-based intervention to forensic psychiatric outpatient treatment as usual (TAU) resulted in better treatment outcomes in regulatory emotional self-efficacy, treatment readiness and aggression.

Methods: A multicentre mixed-methods pilot randomized controlled trial was used to compare TAU to TAU with the addition of the internet-based intervention 'Dealing with Aggression'. Thirty forensic psychiatric outpatients, treated in four Dutch organizations for aggression regulation problems, were included. Three validated questionnaires were administered at baseline, mid-treatment, post-treatment and follow-up. Semi-structured interviews with patients and therapists from the experimental condition were conducted to gain in-depth insight into the quantitative results.

Results: No differences between groups on the outcome measures were found. Often-mentioned reasons for ineffectiveness were suboptimal integration in treatment and the requirement of cognitive and reflective skills. However, several patients reported having experienced benefits from the intervention, mostly because treatment was repeated, combined with new insights in their behaviour.

Conclusions: Although the trial was underpowered due to issues with recruitment, no proof for effectiveness of the internet-based intervention was found. Moreover, mostly highly motivated and relative cognitive skilled patients participated, indicating that internet-based interventions might fit only a select number of patients. New insights into why and for whom internet-based interventions might work were identified, providing points of improvement for intervention design and implementation in practice.

Objective: This study was designed to systematically evaluate the reliability and quality of content related to sleep disorders on four leading Chinese short-form video platforms (TikTok, Bilibili, Kwai, and Xiaohongshu) to inform strategies to improve the dissemination of accurate health information in China.

Methods: A cross-sectional analysis was conducted in March 2025, in which 400 short videos related to sleep disorders were identified and included. These videos were published between 2022 and 2025 on four major short-form video platforms. Video quality was assessed using the Global Quality Scale (GQS), JAMA benchmark criteria (JAMA), and a modified version of the DISCERN tool. Influencing factors were examined using Spearman correlation analysis and Poisson regression, with all multiple comparisons adjusted using the Bonferroni correction.

Results: Video popularity metrics and quality scores (GQS, JAMA, modified DISCERN) were significantly higher on TikTok than on other platforms (Adjusted P < .001). The quality of videos produced by physicians (64%) was better than that of laypersons (Adjusted P < .005), with the quality of videos produced by Traditional Chinese Medicine (TCM) practitioners significantly higher than that of Clinical medicine practitioners (Adjusted P < .05). The highest quality scores were found for videos presented as expert commentary (52%). After Bonferroni correction, quality differences among specific "disease knowledge" categories were no longer statistically significant (Adjusted P > .05). Although user interaction metrics showed a statistically significant correlation with quality scores (Adjusted P < .001), the Spearman correlation coefficients were weak to moderate (r = .18-.33), indicating the practical association was limited.

Conclusions: Information on sleep disorders on Chinese short-video platforms is of low quality. These findings are specific to the Chinese digital ecosystem and may not be generalizable to global platforms. Content posted by medical professionals (especially TCM practitioners) was associated with higher reliability scores, suggesting a potential role for professional oversight in improving the quality of sleep disorder information on short video platforms.

Background: Informal caregivers of older adults with serious health conditions, particularly stroke, dementia, and fractures, often experience substantial caregiving stress. Online platforms may offer an accessible and effective means of supporting caregivers and reducing stress.

Objective: This study aimed to evaluate the effectiveness of a newly developed online platform in reducing caregiver stress and enhancing caregiver preparedness and competence. It also examined factors associated with platform use, as well as user satisfaction and engagement.

Methods: A longitudinal open-trial design was employed, with assessments conducted at baseline, 3-month follow-up, and 15-month follow-up. Primary outcomes included caregiver stress, preparedness, and competence. User profiles were examined by comparing characteristics between users and non-users of the platform. User satisfaction and engagement were also assessed.

Results: Of the 287 caregivers, 61% used the online platform. Compared with non-users, users showed a significant reduction in caregiving stress and greater improvements in caregiver competence, while no significant difference was found in caregiver preparedness. Users were more likely to be younger, employed full-time, have upper secondary education or above, report a monthly household income of HK$25,000 or higher, and have no chronic illness. At the 15-month follow-up, users reported high levels of satisfaction with the platform.

Conclusions: The online platform effectively reduced caregiver stress and improved caregiver competence, with high user satisfaction. Further enhancements, such as increased multimedia content on practical caregiving preparation, may be needed to improve caregiver preparedness outcomes.

Background: Obesity is strongly associated with impaired physical function and increased health risks. Functional performance tests such as the Timed Up and Go (TUG), Five Times Sit-to-Stand (5xSTS), and 4-Meter Walk Test (4MWT) are essential for evaluating mobility, strength, and gait speed. Although widely used in clinical practice, the reliability of remote tele-assessment of these tests in adults with obesity remains unclear.

Objective: This study aimed to determine the inter- and intra-rater reliability of tele-assessment compared with face-to-face assessment for commonly used functional performance tests in adults with obesity.

Methods: A repeated-measures observational study was conducted with 82 adults with obesity. Participants performed TUG, 5xSTS, and 4MWT tests both in a clinical setting and remotely at home using video-based tele-assessment.

Results: Inter-rater reliability was good for TUG (ICC = 0.826) and 5xSTS (ICC = 0.880), and moderate for 4MWT (ICC = 0.743). Intra-rater reliability across two tele-assessments was excellent for TUG (ICC = 0.910) and 5xSTS (ICC = 0.902), and good for 4MWT (ICC = 0.858).

Conclusion: Tele-assessment provides a reliable alternative to face-to-face assessment of functional performance tests in adults with obesity. These findings support the integration of remote functional testing into digital health practice, expanding access to mobility and strength evaluations for populations with limited access to in-person care.

Clinical trial registration: Not applicable.

Background: Cervical cancer remains a leading cause of cancer morbidity and mortality among women worldwide, with an estimated 661,021 new cases and 348,189 deaths in 2022. In China's health-resource-limited areas, a substantial share of the population remains hard to reach, and the effectiveness of data-driven identification and digital outreach for this hard-to-reach population is uncertain.

Objective: This study aims to (a) use ID-card-based record linkage to identify women who have never undergone cervical cancer screening and (b) evaluate whether the integrated digital intervention reduces redundant repeat screening while improving women's knowledge, attitudes and practices (KAP) in health-resource-limited areas.

Methods: We will conduct a quasi-experimental controlled trial including an external historical control cohort and two individually randomised digital intervention arms in 11 sites. Women will be identified by matching unique ID-card numbers across the national screening registry and local household records. Newly screened eligible women will be randomly allocated to one of two intervention arms: (a) tailored digital interventions and (b) generic digital interventions, while an external historical cohort (January 2022-December 2023) from the same sites, before implementation of the digital platform, will serve as the control arm.

Results: Recruitment began on 15 April 2025. The trial plans to recruit 142,417 participants (122,817 in the historical control cohort and 9800 in each intervention arm). Baseline surveys commenced on 15 April 2025 and will continue until December 2026.

Conclusions: If effective, this study will be among the first to evaluate a full-process digital health intervention that combines algorithm-based identification with a web-plus-WeChat platform for cervical-cancer screening in resource-limited areas of China. The findings could inform programme development and benefit hard-to-reach populations.

Background: Regular monitoring of blood pressure (BP) provides early detection of hypertension. Automated cuff-based oscillometric devices are commonly used for simplicity and reduced observer subjectivity. However, these devices can be uncomfortable, prompting the development of non-invasive, cuffless BP monitoring in smartwatches. Current validation standards, including ISO 81060-2:2018 and IEEE 1708TM-2019, specify accuracy criteria, yet most studies focus on short-term performance and do not address their long-term stability across the calibration period.

Objective: This prospective single-arm study aimed to assess the long-term accuracy and stability of BP measurements obtained from a smartwatch throughout its recommended calibration interval.

Methods: Thirty-seven participants completed a 28-day protocol, consisting of an initial calibration on day 0 followed by 27 consecutive days of paired measurements of systolic BP (SBP) and diastolic BP (DBP). BP was simultaneously measured using a Samsung Galaxy Watch 5 and a validated reference sphygmomanometer Omron M4. Accuracy was assessed against ISO and IEEE standards, and the recalibration test consistent with European Society of Hypertension (ESH) guidelines was performed using the last three measurements before scheduled recalibration.

Results: The smartwatch met the accuracy criteria based on ISO and IEEE standards in all but one measure, with mean absolute differences, mean differences (MD), and standard deviations for SBP and DBP within acceptable limits. Bland-Altman analysis revealed negligible MD for SBP (-0.34 mmHg) and DBP (0.62 mmHg), with minimal drift over the calibration period (-0.19 mmHg for SBP and 1.02 mmHg for DBP). However, when reference BP was 10 mmHg away from the calibration point, MD was 3.4 mmHg for SBP and 5.1 mmHg for DBP.

Conclusions: The smartwatch demonstrated acceptable long-term stability and accuracy for BP monitoring and trend tracking. However, accuracy declined as values diverged from the calibration point. Cuff-based confirmation is advised when BP fluctuates substantially or when diagnostic or therapeutic decisions are planned.

Trial registration: ClinicalTrials.gov NCT06098092.