JMIR Formative Research最新文献

{"title":"An Internet-Based and Mobile Family Management Intervention for Mothers of Very Preterm Infants Hospitalized in the Neonatal Intensive Care Unit (the Preemie Progress Program): Pilot Randomized Controlled Trial.","authors":"Ashley Weber, Tamilyn Bakas, Qutaibah Oudat, Nehal A Parikh, Joshua Lambert, Heather L Tubbs-Cooley, Jared Rice, Kristin Voos, Matthew Rota, Heather C Kaplan","doi":"10.2196/66073","DOIUrl":"https://doi.org/10.2196/66073","url":null,"abstract":"<p><strong>Background: </strong>Flexible approaches to parenting training interventions in the neonatal intensive care unit (NICU), including family integrated care (FICare) models, are urgently needed across the globe. Many FICare trials inadvertently exclude parents with low resources who cannot commit to daily infant care (eg, 4-8 hours/day). Preemie Progress (PP) is a fully automated, video-based training program that allows parents to choose when and where they learn, without requiring parent bedside presence.</p><p><strong>Objective: </strong>This study aims to examine the feasibility of recruitment, retention, fidelity, and changes in outcomes during a pilot randomized controlled trial of PP, a video-based intervention aimed at training mothers of very preterm infants in evidence-based family management skills in the NICU.</p><p><strong>Methods: </strong>Mothers of infants born between 25 weeks and 0 days to 31 weeks and 6 days of gestation were enrolled in an NICU in the Midwestern United States. Electronic surveys were sent to collect maternal outcomes (Patient-Reported Outcomes Measurement Information System [PROMIS] 8a depression and anxiety scales) at baseline (T1), 14 days (T2) and 28 days (T3) after T1, and 30 days after NICU discharge (T4). Infant electronic health records were extracted to collect infant (ie, weight gain velocity at 36 weeks and receipt of mother's milk) and health care outcomes (ie, NICU length of stay as well as readmissions and emergency department visits within 30 days of discharge).</p><p><strong>Results: </strong>Of 123 eligible mothers, 64 (52%) were randomly assigned to 1 of 2 arms (PP: n=33, 52%; attention control [AC]: n=31, 48%). Loss to follow-up was 30% (10/33) in the PP arm and 13% (4/31) in the AC arm. PP mothers watched a mean 17.8 (SD 18.9) of 49 videos. PP retention was linked to higher fidelity. PP mothers showed trends toward greater reductions in anxiety 30 days after discharge (mean -7.54, SD 1.93; 95% CI -11.32 to -3.76) compared to AC mothers (mean -4.67, SD 1.59; 95% CI -7.80 to -1.55). PP infants trended toward greater receipt of exclusively mother's milk 28 days after baseline (PP: 14/26, 54%; AC: 10/28, 36%) and decreased NICU stay (PP: 57.2 days; AC: 68.3 days) but higher readmissions (PP: 4/33, 12%; AC: 2/31, 6%).</p><p><strong>Conclusions: </strong>We were able to recruit a diverse sample of mothers from a range of socioeconomic backgrounds, including mothers experiencing barriers to bedside presence. Recruitment goals were met. PP showed promising trends in improving maternal, infant, and health care outcomes. Additional studies are needed to optimize PP and study procedures to improve retention and fidelity. PP has the potential to support parent training outside of traditional FICare models or serve as a complement to structure the parent education pillar of adapted FICare models.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04638127; https://www.clinicaltrials","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e66073"},"PeriodicalIF":2.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119742","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}

{"title":"Effects of Using a Digital Peer-Supported App on Glycated Hemoglobin Changes Among Patients With Type 2 Diabetes: Prospective Single-Arm Pilot Study.","authors":"Shota Yoshihara, Kayoko Takahashi, Hiroyuki Kawaguchi, Nozomi Harai, Kyoichiro Tsuchiya","doi":"10.2196/72659","DOIUrl":"10.2196/72659","url":null,"abstract":"<p><strong>Background: </strong>Controlling glycated hemoglobin (HbA1c) levels can be challenging for patients with type 2 diabetes mellitus (T2DM). Peer support promotes HbA1c control, and a digital peer-supported app designed for group interactions may enable patients with T2DM to encourage one another to achieve better HbA1c outcomes. However, no studies have investigated the use of digital peer-supported apps to control HbA1c levels in patients with T2DM.</p><p><strong>Objective: </strong>This pilot study aimed to explore the effects of a digital peer-supported app on HbA1c control in patients with T2DM.</p><p><strong>Methods: </strong>This prospective single-arm pilot study enrolled patients with T2DM who owned smartphones and visited medical institutions in Japan. During the 3-month intervention, participants used a digital peer-supported app in addition to receiving standard care. This app allowed participants to share activity logs and concerns via a chat function to improve HbA1c levels through mutual engagement and encouragement. The primary outcome was the change in HbA1c levels, measured at health care facilities at baseline and after 3 months. The secondary outcomes were body weight and blood pressure, with the most recent data obtained from hospitals and clinics. Physical activity (≥1 hour/day) was assessed at the same time points using a self-reported questionnaire.</p><p><strong>Results: </strong>The study included 21 participants with a median age of 56 (IQR 51-61) years, of which 13 (61.9%) were female. After using the digital peer-supported app for 3 months, the participants' HbA1c levels significantly decreased from 7.1% (SD 0.6%) at baseline to 6.9% (SD 0.1%) (P=.04). Similarly, participants' body weight decreased from 70.7 (SD 12.7) kg to 69.9 (SD 12.4) kg (P =.004) through app use. Although blood pressure decreased slightly from 128.2 (SD 12.5) mm Hg to 126.0 (SD 12.9) mm Hg, this change was not statistically significant (P=.20). Additionally, the proportion of participants engaged in ≥1 hour of daily physical activity significantly increased from 23.5% (n=4) to 58.5% (n=10) (P=.03).</p><p><strong>Conclusions: </strong>In addition to receiving standard clinical care, the use of a digital peer-supported app may significantly lower HbA1c levels in patients with T2DM by promoting healthy behaviors.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e72659"},"PeriodicalIF":2.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of ChatGPT and Internet Research for Clinical Research and Decision-Making in Occupational Medicine: Randomized Controlled Trial.","authors":"Felix A Weuthen, Nelly Otte, Hanif Krabbe, Thomas Kraus, Julia Krabbe","doi":"10.2196/63857","DOIUrl":"10.2196/63857","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Artificial intelligence is becoming a part of daily life and the medical field. Generative artificial intelligence models, such as GPT-4 and ChatGPT, are experiencing a surge in popularity due to their enhanced performance and reliability. However, the application of these models in specialized domains, such as occupational medicine, remains largely unexplored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to assess the potential suitability of a generative large language model, such as ChatGPT, as a support tool for medical research and even clinical decisions in occupational medicine in Germany.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this randomized controlled study, the usability of ChatGPT for medical research and clinical decision-making was investigated using a web application developed for this purpose. Eligibility criteria were being a physician or medical student. Participants (N=56) were asked to work on 3 cases of occupational lung diseases and answer case-related questions. They were allocated via coin weighted for proportions of physicians in each group into 2 groups. One group researched the cases using an integrated chat application similar to ChatGPT based on the latest GPT-4-Turbo model, while the other used their usual research methods, such as Google, Amboss, or DocCheck. The primary outcome was case performance based on correct answers, while secondary outcomes included changes in specific question accuracy and self-assessed occupational medicine expertise before and after case processing. Group assignment was not traditionally blinded, as the chat window indicated membership; participants only knew the study examined web-based research, not group specifics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants of the ChatGPT group (n=27) showed better performance in specific research, for example, for potentially hazardous substances or activities (eg, case 1: ChatGPT group 2.5 hazardous substances that cause pleural changes versus 1.8 in a group with own research; P=.01; Cohen r=-0.38), and led to an increase in self-assessment with regard to specialist knowledge (from 3.9 to 3.4 in the ChatGPT group vs from 3.5 to 3.4 in the own research group; German school grades between 1=very good and 6=unsatisfactory; P=.047). However, clinical decisions, for example, whether an occupational disease report should be filed, were more often made correctly as a result of the participant's own research (n=29; eg, case 1: Should an occupational disease report be filed? Yes for 7 participants in the ChatGPT group vs 14 in their own research group; P=.007; odds ratio 6.00, 95% CI 1.54-23.36).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;ChatGPT can be a useful tool for targeted medical research, even for rather specific questions in occupational medicine regarding occupational diseases. However, clinical decisions should currently only be supported and not made by the large language model. Future systems should be critically ass","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e63857"},"PeriodicalIF":2.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Accuracy and Reliability of Real-World Digital Mobility Outcomes in Older Adults After Hip Fracture: Cross-Sectional Observational Study.","authors":"Martin A Berge, Anisoara Paraschiv-Ionescu, Cameron Kirk, Arne Küderle, Encarna Micó-Amigo, Clemens Becker, Andrea Cereatti, Silvia Del Din, Monika Engdal, Judith Garcia-Aymerich, Karoline B Grønvik, Clint Hansen, Jeffrey M Hausdorff, Jorunn L Helbostad, Carl-Philipp Jansen, Lars Gunnar Johnsen, Jochen Klenk, Sarah Koch, Walter Maetzler, Dimitrios Megaritis, Arne Müller, Lynn Rochester, Lars Schwickert, Kristin Taraldsen, Beatrix Vereijken","doi":"10.2196/67792","DOIUrl":"10.2196/67792","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Algorithms estimating real-world digital mobility outcomes (DMOs) are increasingly validated in healthy adults and various disease cohorts. However, their accuracy and reliability in older adults after hip fracture, who often walk slowly for short durations, is underexplored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study examined DMO accuracy and reliability in a hip fracture cohort considering walking bout (WB) duration, physical function, days since surgery, and walking aid use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In total, 19 community-dwelling participants were real-world monitored for 2.5 hours using a lower back wearable device and a reference system combining inertial modules, distance sensors, and pressure insoles. A total of 6 DMO estimates from 164 WBs from 58% (11/19) of the participants (aged 71-90 years; assessed 32-390 days after surgery; Short Physical Performance Battery [SPPB] scores of 3-12; gait speed range 0.39-1.34 m/s) were assessed against the reference system at the WB and participant level. We stratified by WB duration (all WBs, WBs of &gt;10 seconds, WBs of 10-30 seconds, and WBs of &gt;30 seconds) and lower versus higher SPPB scores and observed whether days since surgery and walking aid use affected DMO accuracy and reliability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Across WBs, walking speed and distance ranged from 0.25 to 1.29 m/s and from 1.7 to 436.5 m, respectively. Estimation of walking speed, cadence, stride duration, number of steps, and distance stratified by WB duration showed intraclass correlation coefficients (ICCs) ranging from 0.50 to 0.99 and mean relative errors (MREs) from -6.9% to 12.8%. Stride length estimation showed poor reliability, with ICCs ranging from 0.30 to 0.49 and MREs from 6.1% to 13.2%. Walking speed and distance ICCs in the higher-SPPB score group ranged from 0.85 to 0.99, and MREs ranged from -10.1% to -1.7%. In the lower-SPPB score group, walking speed and distance ICCs ranged from 0.17 to 0.99, and MREs ranged from 13.5% to 32.6%. There was no discernible effect of time since surgery or walking aid use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In total, 5 accurate and reliable real-world DMOs were identified in older adults after hip fracture: walking speed, cadence, stride duration, number of steps, and distance. Accuracy and reliability of most DMOs improved when excluding WBs of &lt;10 seconds and were higher for WBs of &gt;30 seconds than for WBs of 10 to 30 seconds and for participants with higher physical function. DMOs capture daily gait as early as 1 month after surgery also in people using walking aids. However, as most WBs in this cohort were short, there was a trade-off between improving accuracy and reliability by excluding short WBs and losing a substantial amount of data. These results have important implications for establishing the clinical validity of DMOs and evaluating the effects of interventions on daily-life gait, thereby facilitating the design of optimal ","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e67792"},"PeriodicalIF":2.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110856","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}

{"title":"Trends and Shifts in Swedish Telemedicine Consultations During the Pre-COVID-19, COVID-19, and Post-COVID-19 Periods: Retrospective Observational Study.","authors":"Adaora Uloma Asomugha, Annamaria Pakai","doi":"10.2196/60294","DOIUrl":"10.2196/60294","url":null,"abstract":"<p><strong>Background: </strong>In recent times, the telemedicine landscape has changed dramatically; it serves as a bridge, connecting health care providers and patients, especially during challenges such as the recent COVID-19 pandemic.</p><p><strong>Objective: </strong>This study seeks to explore the Swedish telemedicine landscape in terms of primary patient symptoms for teleconsultation and the patterns of telemedicine use in the periods before COVID-19, during COVID-19, and after COVID-19, including the primary care use dynamics with respect to the teleconsultations done.</p><p><strong>Methods: </strong>Secondary data was used in this observational retrospective study. The study population consisted of Swedish residents who had online telemedicine consultations. Telemedicine consultations were divided by text and video delivery; the period of analysis ranged from November 2018 to June 2023. The statistical methods used for the data analysis were descriptive analysis, 2-way cross tabulation, and a generalized linear model.</p><p><strong>Results: </strong>During the pandemic, the number of teleconsultations concerning general, unspecified symptoms increased in comparison to the other analyzed symptoms, signaling a change in care-seeking behavior under epidemiological pressure. General health-related issues were the most pronounced symptom across all periods: 186.9 of 1000 consultations before COVID-19, 1264.6 of 1000 consultations during COVID-19, and 319.2 of 1000 consultations after COVID-19. There was no significant main effect of COVID-19 period on the number of telemedicine consultation meetings (F2=1.653; P=.38). The interaction effect between delivery type and period was statistically significant (F2=14.723; P<.001).</p><p><strong>Conclusions: </strong>The findings are in favor of the COVID-19 pandemic having had a considerable effect on telemedicine use. Telemedicine could subsequently be used more often for general health consultations and acute conditions. Video consultations were more prominent because of the importance of bidirectional communication. The study suggests that there was a transformation of patterns of demand for health care; there is a necessity for health care systems to respond to these changes.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e60294"},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging Technology to Engage Supplemental Nutrition Assistance Program Consumers With Children at Farmers Markets: Qualitative Community-Engaged Approach to App Development.","authors":"Callie Ogland-Hand, Jillian Schulte, Owusua Yamoah, Kathryn Poppe, Timothy H Ciesielski, Regan Gee, Ana Claudia Zubieta, Darcy A Freedman","doi":"10.2196/70104","DOIUrl":"10.2196/70104","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Fruit and vegetable consumption is lower than national trends among people receiving Supplemental Nutrition Assistance Program (SNAP) benefits due to economic and physical access barriers. Monetary nutrition incentive programs at farmers markets aim to reduce these barriers to improve diet quality among SNAP consumers. We leveraged community-engaged methods to collaboratively design a mobile app to increase the use of both nutrition incentive programs and farmers markets among SNAP households with children. This population represents about 35% of all SNAP households providing the dual benefit of improving diet for both adults and children.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;In this paper, we share the iterative, community-engaged development process used to design a technology intervention that encourages the integration of farmers markets into the food shopping routines of SNAP consumers with children.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Our qualitative community-engaged approach was informed by human-centered design, following the inspiration and ideation phases of this framework. In the \"inspiration\" phase, we worked with community nutrition experts to define both the goal of and target audience for the app (ie, SNAP households with children). In the subsequent \"ideation\" phase, we completed 3 stages of data collection. We developed 2 interface prototypes and received feedback from end users on design and usability preferences before selecting a baseline model. Additional feedback gathered from qualitative interviews with 20 SNAP consumers with children was incorporated into the app's version 1 (V1) development. We then shared V1 with SNAP consumers, children, and farmers market managers to test the app's functionality, design, and utility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the \"inspiration\" phase, the community nutrition partners identified SNAP consumers with children younger than 18 years as the target population for the app. In the \"ideation\" phase, we successfully created V1 through 3 stages of a qualitative, community-engaged process. First, about 75% (n=3) of SNAP consumers and all farmers market managers selected a grocery shopping design option for the layout of the app. Second, we integrated features identified by SNAP consumers with children into the app design, such as market information (ie, location with GPS address links, hours, website), likely available market inventory, market events, and grocery shopping checklists. Finally, we obtained recommendations for future versions of the app, including real-time changes in market hours, additional notification options, and grocery list personalization during a demonstration of V1. Both SNAP consumers and farmers market managers expressed interest in the app's launch and utility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;It is feasible for community nutrition researchers to successfully design a community-engaged mobile app with the assistance of software develop","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e70104"},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent Treatment of Opioid and Tobacco Use Disorder in a Telemedicine Clinic: Case Report of Breaking Through Barriers.","authors":"Darcy Michero, Laura Monico, Peyton Pielsticker, Larissa J Mooney, Suzette Glasner","doi":"10.2196/72872","DOIUrl":"https://doi.org/10.2196/72872","url":null,"abstract":"<p><strong>International registered report identifier (irrid): </strong>RR2-10.1177/20552076241258400.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e72872"},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078028","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}

{"title":"Incidence, Prognostic Factors, and Treatment Impact on Survival in Natural Killer/T-Cell Lymphoma: Population-Based Study in the United States.","authors":"Yi Zhao, Yi Zhong, Mengqi Xiong, Linlin Huang, Xiujin Ye, Jingsong He","doi":"10.2196/70129","DOIUrl":"10.2196/70129","url":null,"abstract":"<p><strong>Background: </strong>Natural killer/T-cell lymphoma (NKTL) is a rare malignancy of mature natural killer/T-cells, predominantly found in Asian and South/Central American populations, with limited studies conducted in Europe and the United States.</p><p><strong>Objective: </strong>The aim of this study is to present an overview of the incidence rate, demographic and clinical characteristics, treatment options, overall survival (OS), and factors influencing OS of NKTL in the United States.</p><p><strong>Methods: </strong>We used data from the Surveillance, Epidemiology, and End Results 17 database to analyze NKTL cases recorded between 2000 and 2020. In a cohort of 1162 patients with NKTL, we calculated the incidence rates and performed statistical analyses to evaluate OS, the effect of radiotherapy and chemotherapy on survival, and lymphoma-specific survival.</p><p><strong>Results: </strong>The mean annual incidence rate of NKTL in the United States was 0.067 per 100,000, with higher rates observed in men compared to women, and an increase noted with age. However, there has been no significant rise in incidence over recent years. Significant racial disparities were observed, with higher incidence rates in non-Hispanic Asian or Pacific Islanders and Hispanic people. The median survival time for patients with NKTL was 21 months, with a 5-year OS rate of 39.5%, which has shown improvement in recent years. Key independent prognostic factors impacting patient survival included age at diagnosis, clinical stage, nasal type presentation, presence of systemic symptoms, and treatment modality. Patients receiving combined radiotherapy and chemotherapy exhibited the best outcomes, with a median OS of 138 months and a 5-year OS rate of 58%. This survival benefit remained consistent even in patients with stage I/localized nasal type lymphoma, achieving a 5-year OS rate of 73.3%.</p><p><strong>Conclusions: </strong>The incidence of NKTL has remained stable in recent years. Patients with the nasal type generally experience better survival outcomes. The use of combined radiotherapy and chemotherapy appears to enhance survival, though further validation through prospective multicenter clinical trials is necessary.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e70129"},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing the MyCancerGene Digital Health Portal to Improve Patients' Understanding of Germline Cancer Genetic Test Results: Development, User, and Usability Testing Study.","authors":"Phillip Trieu, Dominique Fetzer, Briana McLeod, Kathryn Schweickert, Lauren Gutstein, Brian Egleston, Susan Domchek, Linda Fleisher, Lynne Wagner, Kuang-Yi Wen, Cara Cacioppo, Jessica E Ebrahimzadeh, Dana Falcone, Claire Langer, Elisabeth Wood, Kelsey Karpink, Shelby Posen, Enida Selmani, Angela R Bradbury","doi":"10.2196/56282","DOIUrl":"10.2196/56282","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The use of multigene panels has significantly increased the likelihood that genetic testing will leave patients with uncertainties regarding test interpretation, implications, and recommendations, which will change over time. Effective longitudinal care models are needed to provide patients with updated information and to obtain patient and family history updates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To bridge this gap, we aimed to develop a patient- and genetic provider-informed digital genetic health portal (GHP), MyCancerGene, to improve longitudinal patient understanding of and responses to genetic testing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used a 5-step process to develop MyCancerGene. To better understand their interest in and willingness to use a digital GHP, we surveyed 307 patients who completed genetic testing (step 1). We completed qualitative interviews with 10 patients and a focus group with 17 genetic providers to inform the content and function of MyCancerGene (step 2). Next, we developed initial intervention content (step 3) and completed user testing of intervention content with 25 providers and 28 patients (step 4). After developing the prototype intervention, we completed usability testing with 8 patients for their feedback on the final content, functions, and ease of use (step 5).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In surveys conducted in step 1, 90% of patients with positive results reported interest in a digital GHP, and over 75% of participants with variants of uncertain significance or uninformative negative results reported similar interest. The most frequently reported advantages among patients were increasing accessibility, convenience, and efficiency (103/224, 46%); keeping genetic information organized (54/224, 24.1%); and increasing or maintaining patient understanding of the information (38/224, 17%). In qualitative interviews (step 2), both patients and genetic providers endorsed the benefit of the tool for updating personal and family history and for providers to share new risk information, test interpretation, or other medical changes. Patient and provider input informed eight key components of the tool: (1) Landing Page, (2) Summary of Care page, (3) My Genetic Test Results page, (4) My Family History page, (5) Provide an Update page, (6) Review an Update page, (7) Resources page, and (8) the Screenings Tracker. They also recommended key functions, including the ability to download and print materials and the inclusion of reminders and engagement functions. Potential challenges identified by patients included privacy and security concerns (67/206, 32.5%) and the potential for electronic information to generate distress (20/206, 9.7%). While patients were comfortable with updates (ie, even variant reclassification upgrades or clinically significant results), 44% (11/25) of genetic providers were uncomfortable sharing variant reclassification upgrades through MyCancerGene.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e56282"},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003029","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}

{"title":"Evaluating the Acceptability and Utility of a Personalized Wellness App (Aspire2B) Using AI-Enabled Digital Biomarkers: Engagement Enhancement Pilot Study.","authors":"Calissa J Leslie-Miller, Shellen R Goltz, Pamela L Barrios, Christopher C Cushing, Teena Badshah, Corey T Ungaro, Shankang Qu, Yulia Berezhnaya, Tristin D Brisbois","doi":"10.2196/63471","DOIUrl":"10.2196/63471","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;There is significant global interest in promoting wellness, with digital solutions like mobile health apps being broadly downloaded; yet, there is a challenge in maintaining engagement for long-term behavior change. Developing a widely accepted mobile wellness app is imperative for advancing personalized wellness interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The primary objective of this study was to evaluate the Aspire2B wellness app (powered by Salus Optima), designed to exceed industry standards for participant engagement by incorporating evidence-based behavior change strategies and to assess its acceptability (eg, liking the face scan) and utility (eg, willing to use the face scan technology for other health insights) as a digital health solution.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Participants aged 18-65 years, who were smartphone and fitness tracker users, were recruited in the United States during March-May 2022. Participants received US $5 compensation for downloading the app, with no further incentive for usage. Following completion of onboarding (ie, survey questions about lifestyle behaviors), participants were placed in either a nutrition, sleep, or fitness 4-week challenge. During the challenge, participants used various app features at their own will, such as a facial scan for wellness insights (eg, heart rate and biological age), recipes, and workout videos. These interactions with the app were cumulatively evaluated as engagement metrics. Participants were also asked to answer offboarding questions to evaluate any changes to lifestyle behaviors and experience using the app features (eg, acceptability of face scan experience).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of the 398 people who created an account, 85.9% (342/398) completed onboarding and a face scan. Following this, 74.9% (298/398) of users completed additional survey questions about current wellness behaviors. Notably, interaction with the app was relatively stable from week 2 to 4 (173/398, 43.5%), outperforming industry standards by roughly 3×. In addition, on average, participants completed 2.1-2.7 face scans per week, with approximately 7% (24/342) of participants maintaining regular use of face scan technology for 4 weeks. In users who completed offboarding questions, 88.8% (111/125) found Aspire2B credible, 64.8% (81/125) liked the face scan experience, 7.2% (9/125) disliked the face scan experience, and 83.2% (104/125) said they would use face scan technology for other insights into their health.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;These findings highlight strong initial engagement with Aspire2B, followed by significant sustained user engagement over a 4-week period. Furthermore, users indicated high levels of credibility and willingness to use face scan technology for wellness insights. These findings collectively demonstrate the capability of a personalized wellness app using AI-enabled digital biomarkers and evidence-supported behav","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e63471"},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}