Journal of Medical Internet Research最新文献

{"title":"Impact of Digital Health on Patient-Provider Relationships in Respiratory Secondary Care Based on Qualitative and Quantitative Evidence: Systematic Review.","authors":"Michaela Senek, David Drummond, Hilary Pinnock, Kjeld Hansen, Anshu Ankolekar, Úna O'Connor, Apolline Gonsard, Oleksandr Mazulov, Katherina Bernadette Sreter, Christina Thornton, Pippa Powell","doi":"10.2196/70970","DOIUrl":"https://doi.org/10.2196/70970","url":null,"abstract":"<p><strong>Background: </strong>Digital health technology adoption has accelerated in respiratory care, particularly since the COVID-19 pandemic, supporting various applications from self-management to telerehabilitation. While these technologies have transformed health care delivery, their impact on the patient-provider relationship in specialist respiratory care remains poorly understood.</p><p><strong>Objective: </strong>This study aims to systematically review the literature on the impact of digital health technology on the patient-provider relationship in respiratory secondary care settings and to understand the factors that enhance or diminish this relationship.</p><p><strong>Methods: </strong>In December 2023, we conducted a systematic review following Cochrane methodology, searching MEDLINE, Embase, CINAHL, Cochrane databases, and PsycINFO. We included qualitative, quantitative, and mixed methods studies examining digital health interventions in respiratory secondary care. Trained volunteers from the European Respiratory Society CONNECT Clinical Research Collaboration performed screening and data extraction. We conducted a qualitative meta-synthesis of findings, followed by an abductive quantitative data analysis. A total of 3 stakeholder workshops were held to interpret findings collaboratively with patients and health care professionals.</p><p><strong>Results: </strong>From 15,779 papers screened, 97 met the inclusion criteria (55 qualitative/mixed-methods studies, 42 quantitative studies). Studies covered various respiratory conditions, including COPD (32%), asthma (26%), and COVID-19 (13%). Four main themes emerged: trust (foundational to the relationship), adoption factors (including clinical context and implementation drivers), confidence in technology (based on functionality and the evidence base), and connection (encompassing communication and a caring presence). Digital health technology can either enhance or diminish trust between patients and clinicians, with patients' perceptions of the motivations behind its implementation being crucial. While technology facilitated access and communication, remote consultations risked depersonalisation, particularly when not balanced with in-person interactions. Self-monitoring and access to information empowered patients and promoted more equitable patient-provider relationships.</p><p><strong>Conclusions: </strong>Digital health technology can either strengthen or weaken patient-provider relationships in respiratory care, with effects impacted by adoption factors, confidence in technology, connection, and patient empowerment. Maintaining trust in the era of digital care requires transparent implementation of motivations, consideration of individual circumstances, and reliable technology that supports rather than replaces the therapeutic relationship.</p><p><strong>Trial registration: </strong>PROSPERO CRD42024493664; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024493664.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e70970"},"PeriodicalIF":5.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential to Leverage Real-World Data for Pediatric Clinical Trials: A Proof-of-Concept Study.","authors":"Jens Declerck, Joanne Lee, Anando Sen, Avril Palmeri, Rianne Oostenbrink, Viviana Giannuzzi, Simon Woodworth, Salma Malik, Fenna Mahler, Beate Aurich, Rebecca Leary, Dipak Kalra, Volker Straub","doi":"10.2196/72573","DOIUrl":"https://doi.org/10.2196/72573","url":null,"abstract":"<p><strong>Background: </strong>Pediatric clinical research, especially in rare diseases, faces persistent challenges including the identification and recruitment of eligible patients, assessing protocol feasibility, and ensuring efficient trial execution. These issues are compounded by small, age-stratified populations and fragmented clinical data. Real-world data (RWD), especially when drawn from electronic health records (EHRs), present an opportunity to support innovative trial designs, such as real-world comparator arms and postmarketing surveillance. However, realizing this potential depends on the routine availability of structured, reusable clinical data.</p><p><strong>Objective: </strong>This proof-of-concept study aimed to assess the availability and structure of routine clinical data in European pediatric hospitals, focusing on data elements relevant for use in comparator arms and postmarketing surveillance studies. The study focused on 2 disease areas-neurofibromatosis (NF) and atopic dermatitis (AD)-as examples of rare and common conditions in children, respectively.</p><p><strong>Methods: </strong>An inventory of 113 high-value clinical data items was developed based on expert analysis of clinical protocols for NF, AD, and safety studies. These items were included in a structured web-based survey disseminated through the connect4children (c4c) National Hub network, reaching sites across. Europe. Respondents were asked to indicate how each data item is collected and stored: in structured/coded EHR fields, as free text, in external systems, or on paper.</p><p><strong>Results: </strong>Survey responses from 24 hospitals across 11 European countries revealed considerable variability in how data are captured and stored. While many general clinical and drug safety data elements-such as demographics, vital signs, and medication use-were often collected in structured formats, disease-specific and contextual variables were frequently captured as free text or not documented in a standardized way. For example, structured data capture was more prevalent for basic demographic and safety-related variables, whereas only a minority of sites recorded key disease-specific clinical details in a structured form. Lifestyle and family history data were among the least consistently documented. These gaps in structured data entry reduce the immediate reusability of EHR data for secondary research purposes.</p><p><strong>Conclusions: </strong>This study highlights gaps in the structured documentation of pediatric clinical data across European sites. While the routine collection of many variables is promising, the lack of structured and coded formats poses a barrier to reusing these data for observational studies or comparator arms. As a first step toward the broader integration of RWD into pediatric research, this study demonstrates the feasibility of assessing EHR data availability and sets the stage for future scaling across more diseases and sites.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e72573"},"PeriodicalIF":5.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Virtual Reality to Enhance Surgical Skills and Engagement in Orthopedic Education: Systematic Review and Meta-Analysis.","authors":"Ting Li, Jingxin Yan, Xin Gao, Hangyu Liu, Jin Li, Yuanting Shang, Xiaoyu Tang","doi":"10.2196/70266","DOIUrl":"https://doi.org/10.2196/70266","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Currently, virtual reality (VR) simulators are of increasing interest for surgical training, but there is no systematic review exploring the advantages and disadvantages of VR in orthopedic education.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This paper aims to explore the relationship between VR education and traditional education.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We searched PubMed, Embase, Web of Science, Cochrane library, Scopus, Chongqing VIP Database (VIP), Chinese National Knowledge Infrastructure (CNKI), and Wan Fang Database up to July 2024 for relevant studies. A total of 2 investigators independently conducted literature screening, data extraction, and risk of bias assessment for included studies in accordance with the PICOS framework (Population, Intervention, Comparison, Outcomes, and Study Design), followed by statistical synthesis of outcomes using RevMan 5.3 software (Cochrane Collaboration). The risk of bias evaluation adhered to the Cochrane Risk of Bias Tool (RoB 2.0) for randomized controlled trials, ensuring systematic appraisal of sequence generation, allocation concealment, blinding, incomplete outcome data, and selective reporting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 23 randomized controlled trials included 1091 participants in this meta-analysis. The majority of studies focused on the undergraduates (n=3) and trainees (n=8), resident doctors (n=10), and postgraduate doctors (n=2). A total of 3 studies were missing the age of participants, and 5 studies were also missing the duration data. The main outcome included knowledge scores, clinical operation scores, surgical design scores, and so on. The secondary outcomes were included course participation, learning efficiency, enhance clinical ability, and so on. Compared to traditional teaching, VR interventions resulted in significantly higher knowledge scores (standardized mean difference [SMD]=1.08, 95% CI 0.71-1.46; P&lt;.001). Furthermore, VR-based education yielded superior clinical operation scores (SMD=1.44, 95% CI 1.07-1.81; P&lt;.001) and surgical design scores (SMD=1.75, 95% CI 1.05-2.44; P&lt;.001). In addition, VR teaching enhanced clinical understanding (SMD=1.05, 95% CI 0.62-1.48; P&lt;.001) and clinical thinking ability (SMD=1.17, 95% CI 0.66-1.68; P&lt;.001) compared to traditional methods. Furthermore, VR teaching was associated with higher levels of teaching interest (odds ratio [OR]=4.17, 95% CI 2.16-8.04; P&lt;.001) and teaching satisfaction (OR 4.13, 95% CI 1.96-8.69; P&lt;.001) than traditional approaches. Finally, VR significantly enhanced the initiation of learning among students when compared with traditional teaching methods (SMD=1.15, 95% CI 0.91-1.39; P&lt;.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This meta-analysis emphasizes VR as an excellent orthopedic educational tool. It significantly enhances both theoretical knowledge and practical skills, while also markedly increasing student engagement and satisfaction. Therefore, adopting VR tech","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e70266"},"PeriodicalIF":5.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Burden Electronic Health Record Strategies for Engaging Oncologists in Digital Health Behavior Change Interventions: Qualitative Interview Study.","authors":"Monisola Jayeoba, Courtney L Scherr, Allison J Carroll, Elyse Daly, Savanna Kerstiens, Siobhan M Phillips, Brian Hitsman, Sofia F Garcia, Bonnie Spring, Maia Jacobs","doi":"10.2196/65975","DOIUrl":"https://doi.org/10.2196/65975","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Digital health behavior change interventions play an important role in helping cancer survivors improve their quality of life and reduce the risk of cancer recurrence. Clinician-patient communication is central to promoting the uptake of and adherence to digital health behavior change interventions. However, oncologists face significant barriers, including time constraints, knowledge gaps, and conversational uneasiness that limit risk behavior and health behavior change conversations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This qualitative study aims to explore oncologists' preferences for discussing and monitoring risk behaviors with cancer survivors, with a specific focus on conversations about digital health behavior change interventions. This study also aims to explore oncologists' informational and technological support requirements to facilitate these conversations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted semistructured interviews with 18 oncologists who provide cancer care in a large National Cancer Institute-designated comprehensive cancer center. The transcripts and interview notes were analyzed through an iterative thematic analysis to generate relevant themes and categories.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified 2 major themes with 7 subthemes. The first theme focused on oncologists' desired roles in promoting health behavior change, while the second theme addressed the support needs to facilitate conversations about risk and health promotion. Oncologists expressed a desire for 2 action-oriented communication mechanisms for promoting digital health behavior change with their patients: referring patients to interventions and reinforcing intervention goals longitudinally. To facilitate risk behavior and health behavior change conversations, their support needs included a preference for low-burden, electronic health record-integrated tools providing timely updates on patient enrollment and progress. The participating oncologists requested a tailored conversation aid for patient communication and parallel systems combining electronic health record messaging with print materials. They also emphasized the need for automated recommender systems to identify and refer eligible patients and reminder systems to prompt timely discussions with patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Oncologists are motivated and well-positioned to support patients' health behavior change but have unmet informational and technological requirements. On the basis of oncologists' perspectives, our findings provide actionable, user-centered, low-burden strategies for facilitating oncologist-patient conversations about digital health behavior change interventions. We make recommendations for integrating these strategies directly into the electronic medical record system, with the goal of amplifying oncologists' influential roles in motivating health behavior change among survivors. These scalable strategies may be applicable ","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e65975"},"PeriodicalIF":5.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' Understanding of Health Information in Online Medical Records and Patient Portals: Analysis of the 2022 Health Information National Trends Survey.","authors":"Katerina Andreadis, Nancy Buderer, Aisha Tene Langford","doi":"10.2196/62696","DOIUrl":"https://doi.org/10.2196/62696","url":null,"abstract":"<p><strong>Background: </strong>The 21st Century Cures Act mandated instant digital access for patients to see their test results and clinical notes (eg, via patient portals). Entirely using and understanding such health information requires some degree of personal health literacy.</p><p><strong>Objective: </strong>This study aims to assess the associations between ease of understanding online health information and various factors, including sociodemographics, health-related variables, numeracy, and technology-related factors.</p><p><strong>Methods: </strong>This cross-sectional study used data from the National Cancer Institute's 2022 Health Information National Trends Survey (HINTS), a nationally representative survey of US adults that tracks individuals' access and use of their health information. Data was collected from March to December 2022. The survey was conducted across various US settings using a stratified multistage sampling technique to ensure national representation. Our analysis included 3016 respondents with data for all variables of interest. We conducted bivariate and multivariate analyses to assess the odds of finding health information in online medical records or patient portals as \"very easy\" to understand compared with \"not very easy.\"</p><p><strong>Results: </strong>In the multivariate analysis, age group (with the 35-49 years group being 1.9 times more likely compared to the ≥75 years group; P=.03), female birth sex (1.4 times more likely; P=.04), ease of understanding medical statistics (8.5 times more likely for those finding it \"very easy\"; P<.001), patient-provider communication score (increase of 1.1 odds per 1 unit increase; P<.001), and mode of accessing online records (1.8 times more likely via an app and 1.4 times more likely via both an app and website, P=.01 and P=.003, respectively, versus using a website alone) were significant predictors for finding health information \"very easy\" to understand.</p><p><strong>Conclusions: </strong>Sociodemographic factors, numeracy, patient-provider communication, and method of accessing online records were associated with ease of understanding health information in online medical records or patient portals. Findings from this study may inform interventions to make patient portals and online medical records more patient-centered and easier to navigate.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e62696"},"PeriodicalIF":5.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Differences in Expert Perspectives on AI Training in Medical Education: Secondary Analysis of a Multinational Delphi Study.","authors":"Qi Chwen Ong, Chin-Siang Ang, Nai Ming Lai, Rifat Atun, Josip Car","doi":"10.2196/78155","DOIUrl":"https://doi.org/10.2196/78155","url":null,"abstract":"","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e78155"},"PeriodicalIF":5.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating User Interactions and Adoption Patterns of Generative AI in Health Care Occupations Using Claude: Cross-Sectional Study.","authors":"Gabriel Alain, James Crick, Ella Snead, Catherine C Quatman-Yates, Carmen E Quatman","doi":"10.2196/73918","DOIUrl":"https://doi.org/10.2196/73918","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Generative artificial intelligence (GenAI) systems like Anthropic's Claude and OpenAI's ChatGPT are rapidly being adopted in various sectors, including health care, offering potential benefits for clinical support, administrative efficiency, and patient information access. However, real-world adoption patterns and the extent to which GenAI is used for health care-related tasks remain poorly understood and distinct from performance benchmarks in controlled settings. Understanding these organic usage patterns is key for assessing GenAI's impact on health care delivery and patient-provider dynamics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to quantify the real-world frequency and scope of health care-related tasks performed using Anthropic's Claude GenAI. We sought to (1) measure the proportion of Claude interactions related to health care tasks versus other domains; (2) identify specific health care occupations (as per O*NET classifications) with high associated interaction volumes; (3) assess the breadth of task adoption within roles using a \"digital adoption rate\"; and (4) interpret these findings considering the inherent ambiguity regarding user identity (ie, professionals vs public) in the dataset.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We performed a cross-sectional analysis of more than 4 million anonymized user conversations with Claude (ie, including both free and pro subscribers) from December 2024 to January 2025, using a publicly available dataset from Anthropic's Economic Index research. Interactions were preclassified by Anthropic's proprietary Clio model into standardized occupational tasks mapped to the US Department of Labor's O*NET database. The dataset did not allow differentiation between health care professionals and the general public as users. We focused on interactions mapped to O*NET Healthcare Practitioners and Technical Occupations. Main outcomes included the proportion of interactions per health care occupation, proportion of overall health care interaction versus other categories, and the digital adoption rate (ie, distinct tasks performed via GenAI divided by the total possible tasks per occupation).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Health care-related tasks accounted for 2.58% of total analyzed GenAI conversations, significantly lower than domains such as computing (37.22%). Within health care, interaction frequency varied notably by role. Occupations emphasizing patient education and guidance exhibited the highest proportion, including dietitians and nutritionists (6.61% of health care conversations), nurse practitioners (5.63%), music therapists (4.54%), and clinical nurse specialists (4.53%). Digital adoption rates (task breadth) ranged widely across top health care roles (13.33%-65%), averaging 16.92%, below the global average (21.13%). Tasks associated with medical records and health information technicians had the highest adoption rate (65.0%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e73918"},"PeriodicalIF":5.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"25 Years of Digital Health Toward Universal Health Coverage in Low- and Middle-Income Countries: Rapid Systematic Review.","authors":"Bry Sylla, Ouedraogo Ismaila, Gayo Diallo","doi":"10.2196/59042","DOIUrl":"https://doi.org/10.2196/59042","url":null,"abstract":"<p><strong>Background: </strong>Over the last 25 years, digital health interventions in low- and middle-income countries have undergone substantial transformations propelled by technological advancements, increased internet accessibility, and a deeper appreciation of the benefits of digital tools in enhancing health care availability.</p><p><strong>Objective: </strong>This study aims to examine the evolution, impact, and prospects of digital health interventions in low- and middle-income countries, highlighting their role in improving health care accessibility and equity.</p><p><strong>Methods: </strong>A retrospective analysis of digital health initiatives scanning the past two and a half decades focused on the progression from basic SMS platforms to sophisticated mobile health apps and other health digital interventions. Relevant literature and case studies were reviewed to elucidate key milestones, successes, challenges, and opportunities in advancing digital health initiatives in low- and middle-income regions.</p><p><strong>Results: </strong>Digital health initiatives in low- and middle-income countries initially targeted specific health concerns, such as malaria diagnosis and treatment, through text-based platforms, demonstrating their efficacy in reaching remote and marginalized communities. With the proliferation of mobile phone ownership and internet access, these interventions evolved into comprehensive mobile health apps, facilitating self-care support, patient education, chronic disease monitoring, and remote consultations. The COVID-19 pandemic further accelerated the adoption of digital health interventions, particularly in disseminating health information, supporting contact tracing efforts, and enabling virtual consultations to alleviate strain on health care systems.</p><p><strong>Conclusions: </strong>The future of digital health interventions in low- and middle-income countries holds immense promise, fueled by emerging technologies such as artificial intelligence, machine learning, and blockchain. However, challenges persist in ensuring equitable access to digital health technologies, addressing disparities in digital literacy, and establishing robust health care infrastructure. Collaboration among governments, health care providers, technology innovators, and communities is essential to overcome these challenges and harness the full potential of digital health to improve health care outcomes in low- and middle-income countries.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e59042"},"PeriodicalIF":5.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Gender-Specific Daily Care Preferences: Topic Modeling Study.","authors":"Kyungmi Woo, Se Hee Min, Aeri Kim, Subin Choi, Gregory L Alexander, Terrence O'Malley, Maria D Moen, Maxim Topaz","doi":"10.2196/64160","DOIUrl":"https://doi.org/10.2196/64160","url":null,"abstract":"<p><strong>Background: </strong>Daily preferences are a reflection of how adults wish to have their needs and values addressed, contributing to joy and satisfaction in their daily lives. Clinical settings often regard older adults as a uniform group, neglecting the diversity within this population, which results in a shortfall of person-centered care that overlooks their distinct daily care preferences. At the heart of person-centered care lies the imperative to comprehend and integrate these preferences into the care process. Recognizing and addressing gender differences in older adults is critical to customizing care plans, thereby optimizing quality of life and well-being for individuals. This study addresses the need to understand the diverse daily care preferences of adults, particularly among older populations, who represent a growing demographic with unique needs and interests.</p><p><strong>Objective: </strong>This study aims to identify and analyze the key themes and daily care preferences from unstructured adult text narratives with a focus on uncovering gender-specific variations.</p><p><strong>Methods: </strong>This study used 4350 deidentified, unstructured textual data from MyDirectives (MyDirectives, Inc), an interactive online platform. Advanced topic modeling techniques were used to extract meaningful themes, and gender-specific term frequency and distribution were examined to identify gender differences in these elements.</p><p><strong>Results: </strong>The study sample included 2883 women (mean age 63.02, SD 13.69 years) and 1467 men (mean age 67.07, SD 11.73 years). Our analysis identified six major themes: (1) \"entertainment\" (12.14%, 528/4350), (2) \"music\" (10.39%, 452/4350), (3) \"personal interests and memories\" (38.18%, 1661/4350), (4) \"intimate relationships\" (14.92%, 649/4350), (5) \"natural comforts\" (16.18%, 704/4350), and (6) \"emotional, cultural, and spiritual foundations\" (8.18%, 356/4350). Gender differences were evident: women were more likely to express preferences for \"personal interests and memories\" (40.7% vs 33.3%), \"natural comforts\" (18.4% vs 11.9%), and \"emotional and spiritual foundations\" (9.3% vs 6.1%) than men. Men expressed stronger preferences for \"entertainment\" (18.1% vs 9.1%) and \"music\" (16.8% vs 7.2%). Common terms across all participants included \"dog,\" \"love,\" \"friends,\" and \"book.\" Notably, the study revealed significant gender differences in daily care preferences, especially regarding familial relationships and entertainment choices.</p><p><strong>Conclusions: </strong>The findings underscore the importance of recognizing individual daily care preferences in person-centered care, particularly regarding gender. Understanding these preferences is crucial for improving care quality and patient satisfaction, thereby enhancing the overall quality of life for adults receiving care across our health care system.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e64160"},"PeriodicalIF":5.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aligning With the Goals of the Planetary Health Concept Regarding Ecological Sustainability and Digital Health: Scoping Review.","authors":"Mathea Berger, Jan Peter Ehlers, Julia Nitsche","doi":"10.2196/71795","DOIUrl":"10.2196/71795","url":null,"abstract":"<p><strong>Background: </strong>Climate change, driven by greenhouse gas emissions, threatens human health and biodiversity. While the digitalization of health care, including telemedicine and artificial intelligence, offers sustainability benefits, it also raises concerns about energy use and electronic waste. Balancing these factors is key to a sustainable health care future.</p><p><strong>Objective: </strong>The objective of this review was to examine the extent to which digitalization in the health care sector influences environmental sustainability. Specifically, it aimed to assess how digitalization can contribute to reducing the health care sector's impact on global climate change. From these findings, conclusions were drawn regarding the extent to which digitalization aligns with the objectives of the Planetary Health movement and how these 2 movements may mutually reinforce each other.</p><p><strong>Methods: </strong>A scoping review guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines using databases such as PubMed and Scopus was conducted, and 58 quantitative studies from 2009 to 2024 were analyzed for environmental, social, and economic outcomes aligned with Planetary Health goals.</p><p><strong>Results: </strong>This review analyzed 58 studies on the environmental impact of digitalization in health care primarily focusing on telemedicine, which was examined in 91% (53/58) of the studies. Most studies (56/58, 97%) quantified transport-related emissions avoided through digitalization, with some also assessing emissions from health care facilities, medical equipment, and energy consumption. Findings indicated that telemedicine significantly reduces carbon dioxide emissions, with total avoided emissions amounting to approximately 830 million kg. A substantial proportion of the studies (36/58, 62%) focused on social aspects, highlighting factors such as patient satisfaction, time efficiency, and overall convenience. In addition, economic considerations were analyzed in 48% (28/58) of the studies, emphasizing cost reductions and resource optimization. However, only 12% (7/58) of the studies evaluated the full life cycle impact of digital technologies, highlighting the need for further research on their long-term environmental sustainability.</p><p><strong>Conclusions: </strong>This review calls for further research beyond telemedicine, advocating for life cycle analyses and actionable strategies for a sustainable digitalization in health care systems. The Planetary Health framework is highlighted as a guide for ensuring sustainable digital transformation in health care.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e71795"},"PeriodicalIF":5.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}