Journal of Medical Internet Research最新文献

{"title":"The Role of AI in Nursing Education and Practice: Umbrella Review.","authors":"Rabie Adel El Arab, Omayma Abdulaziz Al Moosa, Fuad H Abuadas, Joel Somerville","doi":"10.2196/69881","DOIUrl":"10.2196/69881","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is rapidly transforming health care, offering substantial advancements in patient care, clinical workflows, and nursing education.</p><p><strong>Objective: </strong>This umbrella review aims to evaluate the integration of AI into nursing practice and education, with a focus on ethical and social implications, and to propose evidence-based recommendations to support the responsible and effective adoption of AI technologies in nursing.</p><p><strong>Methods: </strong>We included systematic reviews, scoping reviews, rapid reviews, narrative reviews, literature reviews, and meta-analyses focusing on AI integration in nursing, published up to October 2024. A new search was conducted in January 2025 to identify any potentially eligible reviews published thereafter. However, no new reviews were found. Eligibility was guided by the Sample, Phenomenon of Interest, Design, Evaluation, Research type framework; databases (PubMed or MEDLINE, CINAHL, Web of Science, Embase, and IEEE Xplore) were searched using comprehensive keywords. Two reviewers independently screened records and extracted data. Risk of bias was assessed with Risk of Bias in Systematic Reviews (ROBIS) and A Measurement Tool to Assess Systematic Reviews, version 2 (AMSTAR 2), which we adapted for systematic and nonsystematic review types. A thematic synthesis approach, conducted independently by 2 reviewers, identified recurring patterns across the included reviews.</p><p><strong>Results: </strong>The search strategy yielded 18 eligible studies after screening 274 records. These studies encompassed diverse methodologies and focused on nursing professionals, students, educators, and researchers. First, ethical and social implications were consistently highlighted, with studies emphasizing concerns about data privacy, algorithmic bias, transparency, accountability, and the necessity for equitable access to AI technologies. Second, the transformation of nursing education emerged as a critical area, with an urgent need to update curricula by integrating AI-driven educational tools and fostering both technical competencies and ethical decision-making skills among nursing students and professionals. Third, strategies for integration were identified as essential for effective implementation, calling for scalable models, robust ethical frameworks, and interdisciplinary collaboration, while also addressing key barriers such as resistance to AI adoption, lack of standardized AI education, and disparities in technology access.</p><p><strong>Conclusions: </strong>AI holds substantial promises for revolutionizing nursing practice and education. However, realizing this potential necessitates a strategic approach that addresses ethical concerns, integrates AI literacy into nursing curricula, and ensures equitable access to AI technologies. Limitations of this review include the heterogeneity of included studies and potential publication bias. Our ","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":" ","pages":"e69881"},"PeriodicalIF":5.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615699","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":"Environmental Impact of Physical Visits and Telemedicine in Nursing Care at Home: Comparative Life Cycle Assessment.","authors":"Egid M van Bree, Lynn E Snijder, Hans C Ossebaard, Evelyn A Brakema","doi":"10.2196/67538","DOIUrl":"10.2196/67538","url":null,"abstract":"<p><strong>Background: </strong>The health care sector contributes notably to environmental harms, impacting human and ecosystem health. Hence, countries increasingly set ambitions to transition to environmentally sustainable health care, focusing on resource use, energy consumption, and patient travel. Telemedicine is often considered a promising solution to reduce travel-related carbon emissions. However, underlying environmental impact assessments lack important components such as staff travel and fail to adhere to standardized conduct and reporting. Moreover, assessments of telemedicine use in primary care are scarce.</p><p><strong>Objective: </strong>This study aims to quantify and compare the environmental impact of physical visits and telemedicine visits in the context of domiciliary care and home nursing.</p><p><strong>Methods: </strong>We conducted a life cycle assessment following international ISO-14040/44 standards of all resources required per individual patient visit, either in person at the patient's home or via video calling with a dedicated user-friendly tablet. We collected anonymous user data in collaboration with a telemedicine service company, complemented by consulting staff members of four nursing organizations. Telemedicine visits were elementary in nature, such as supporting patients in taking their medication or structuring their daily agenda. We quantified average environmental impacts from cradle to grave, using the Environmental Footprint method, and verified the robustness of the comparison via uncertainty analysis. The variability of environmental impacts in different settings was explored using scenario analyses for the available minimum to maximum ranges.</p><p><strong>Results: </strong>Compared to a single physical visit in the studied setting, a telemedicine visit contributed less to global warming (0.1 vs 0.3 kg of carbon dioxide equivalents [kgCO<sub>2</sub>eq]; -60%), particulate matter formation (6.2 * 10<sup>-9</sup> vs 1.8 * 10<sup>-8</sup> disease incidence; -60%), and fossil resource use (1.8 vs 4.4 megajoules; -60%). Mineral/metal resource use was higher for telemedicine than for physical visits (1.1 * 10<sup>-5</sup> vs 4.0 * 10<sup>-6</sup> kg antimony equivalent; +180%). Only water use was not consistently different in the uncertainty analysis. Scenario analyses indicated that telemedicine's environmental impact could become similar to physical visits only in urban settings (1-3 km of travel distance) with 50%-100% car commuting (0.1-0.4 vs 0.2-0.7 kgCO<sub>2</sub>eq). In rural settings (5-15 km of travel distance, 80%-100% car commute), physical visits' environmental impact was higher (1.0-3.5 kgCO<sub>2</sub>eq), mostly even for mineral/metal resource use.</p><p><strong>Conclusions: </strong>Using telemedicine for domiciliary care and home nursing mostly reduces its environmental impact compared to physical visits. Benefits are larger in rural settings, where travel distances between patients are l","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e67538"},"PeriodicalIF":5.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780155","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":"Changes in Physical Activity, Heart Rate, and Sleep Measured by Activity Trackers During the COVID-19 Pandemic Across 34 Countries: Retrospective Analysis.","authors":"Bastien Wyatt, Nicolas Forstmann, Nolwenn Badier, Anne-Sophie Hamy, Quentin De Larochelambert, Juliana Antero, Arthur Danino, Vincent Vercamer, Paul De Villele, Benjamin Vittrant, Thomas Lanz, Fabien Reyal, Jean-François Toussaint, Lidia Delrieu","doi":"10.2196/68199","DOIUrl":"10.2196/68199","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic disrupted behavior within populations, affecting physical activity (PA), heart rate (HR), and sleep characteristics in particular. Activity trackers provide unique insights into these changes, enabling large-scale, real-time monitoring.</p><p><strong>Objective: </strong>This study aims to analyze the associations between the features of the COVID-19 pandemic worldwide and PA, HR, and sleep parameters, using data collected from activity trackers over a 3-year period.</p><p><strong>Methods: </strong>We performed a retrospective analysis using anonymized data collected from the 208,818 users of Withings Steel HR activity trackers, spanning 34 countries, over a 3-year period from January 2019 to March 2022. Key metrics analyzed included daily step counts, average heart rate, and sleep duration. The statistical methods used included descriptive analyses, time-trend analysis, and mixed models to evaluate the impact of restriction measures, controlling for potential confounders such as sex, age, and seasonal variations.</p><p><strong>Results: </strong>We detected a significant decrease in PA, with a 12.3% reduction in daily step count (from 5802 to 5082 steps/d) over the 3 years. The proportion of sedentary individuals increased from 38% (n=14,177) in 2019 to 52% (n=19,510) in 2020 and remained elevated at 51% (n=18,972) in 2022, while the proportion of active individuals dropped from 8% (n=2857) to 6% (n=2352) in 2020 before returning to 8% (n=2877) in 2022. In 2022, the global population had not returned to prepandemic PA levels, with a noticeable persistence of inactivity. During lockdowns, HR decreased by 1.5%, which was associated with lower activity levels. Sleep duration increased during restrictions, particularly in the countries with the most severe lockdowns (eg, an increase of 15 min in countries with stringent measures compared to 5 min in less restricted regions).</p><p><strong>Conclusions: </strong>The sustained decrease in PA and its physiological consequences highlight the need for public health strategies to mitigate the long-term effects of the measures taken during the pandemic. Despite the gradual lifting of restrictions, PA levels have not fully recovered, with lasting implications for global health. If similar circumstances arise in the future, priority should be given to measures for effectively increasing PA to counter the increase in sedentary behavior, mitigate health risks, and prevent the rise of chronic diseases.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e68199"},"PeriodicalIF":5.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780151","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":"Effect of Home-Based Virtual Reality Training on Upper Extremity Recovery in Patients With Stroke: Systematic Review.","authors":"Jiaqi Huang, Yixi Wei, Ping Zhou, Xiaokuo He, Hai Li, Xijun Wei","doi":"10.2196/69003","DOIUrl":"10.2196/69003","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Stroke is a leading cause of long-term disability, often resulting in upper extremity dysfunction. Traditional rehabilitation methods often face challenges such as limited patient access to resources and lack of sustained motivation. Home-based virtual reality (VR) training is gaining traction as an innovative, sustainable, and interactive alternative. However, the effect of home-based VR, specifically for upper extremity recovery in patients with stroke, remains insufficiently explored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This systematic review aims to synthesize existing evidence to evaluate the impact of home-based VR interventions on upper extremity function recovery in patients with stroke.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This systematic review followed the guidelines of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). A comprehensive literature search was conducted across PubMed, Web of Science, Scopus, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) Ultimate databases, targeting English-language randomized controlled trials (RCTs) published up to June 30, 2024. Eligible studies involved patients with stroke with upper extremity dysfunction who received home-based VR interventions. Data extraction was performed by 2 independent reviewers, and study quality was assessed using the Physiotherapy Evidence Database scale. Due to heterogeneity in study designs and outcome measures, a narrative synthesis was performed instead of a meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 8 RCTs with 392 participants were included. This review shows that home-based VR training positively affects upper extremity function recovery in patients with stroke, especially in motor control improvement. Customized VR systems were more effective than commercial VR systems in patients with moderate to severe disorders. Although studies generally showed positive results, differences in intervention protocols and small sample sizes limited the validity of results. The effect of VR therapy also varied based on the VR system type, intervention intensity, and the functional level of patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This systematic review shows that home-based VR training has a positive impact on upper extremity rehabilitation for patients with stroke, particularly in those with varying degrees of dysfunction. However, heterogeneity in study design and differences in outcome measures affect the reliability of the current conclusions. Future studies should include larger, standardized RCTs with long-term follow-up to assess their continued effects. Future research should explore how VR technology can be integrated into comprehensive rehabilitation programs, focusing on patient-centered approaches that incorporate sustainable, personalized technology, and support services to optimize recovery outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;PROSPERO CRD42024526650; htt","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":" ","pages":"e69003"},"PeriodicalIF":5.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615697","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":"Modernizing the Staging of Parkinson Disease Using Digital Health Technology.","authors":"John Michael Templeton, Christian Poellabauer, Sandra Schneider, Morteza Rahimi, Taofeek Braimoh, Fhaheem Tadamarry, Jason Margolesky, Shanna Burke, Zeina Al Masry","doi":"10.2196/63105","DOIUrl":"https://doi.org/10.2196/63105","url":null,"abstract":"<p><p>Due to the complicated nature of Parkinson disease (PD), a number of subjective considerations (eg, staging schemes, clinical assessment tools, or questionnaires) on how best to assess clinical deficits and monitor clinical progression have been published; however, none of these considerations include a comprehensive, objective assessment of all functional areas of neurocognition affected by PD (eg, motor, memory, speech, language, executive function, autonomic function, sensory function, behavior, and sleep). This paper highlights the increasing use of digital health technology (eg, smartphones, tablets, and wearable devices) for the classification, staging, and monitoring of PD. Furthermore, this Viewpoint proposes a foundation for a new staging schema that builds from multiple clinically implemented scales (eg, Hoehn and Yahr Scale and Berg Balance Scale) for ease and homogeneity, while also implementing digital health technology to expand current staging protocols. This proposed staging system foundation aims to provide an objective, symptom-specific assessment of all functional areas of neurocognition via inherent device capabilities (eg, device sensors and human-device interactions). As individuals with PD may manifest different symptoms at different times across the spectrum of neurocognition, the modernization of assessments that include objective, symptom-specific monitoring is imperative for providing personalized medicine and maintaining individual quality of life.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e63105"},"PeriodicalIF":5.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784395","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":"Psychological Factors Influencing Appropriate Reliance on AI-enabled Clinical Decision Support Systems: Experimental Web-Based Study Among Dermatologists.","authors":"Alisa Küper, Georg Christian Lodde, Elisabeth Livingstone, Dirk Schadendorf, Nicole Krämer","doi":"10.2196/58660","DOIUrl":"https://doi.org/10.2196/58660","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI)-enabled decision support systems are critical tools in medical practice; however, their reliability is not absolute, necessitating human oversight for final decision-making. Human reliance on such systems can vary, influenced by factors such as individual psychological factors and physician experience.</p><p><strong>Objective: </strong>This study aimed to explore the psychological factors influencing subjective trust and reliance on medical AI's advice, specifically examining relative AI reliance and relative self-reliance to assess the appropriateness of reliance.</p><p><strong>Methods: </strong>A survey was conducted with 223 dermatologists, which included lesion image classification tasks and validated questionnaires assessing subjective trust, propensity to trust technology, affinity for technology interaction, control beliefs, need for cognition, as well as queries on medical experience and decision confidence.</p><p><strong>Results: </strong>A 2-tailed t test revealed that participants' accuracy improved significantly with AI support (t₂₂₂=-3.3; P<.001; Cohen d=4.5), but only by an average of 1% (1/100). Reliance on AI was stronger for correct advice than for incorrect advice (t₂₂₂=4.2; P<.001; Cohen d=0.1). Notably, participants demonstrated a mean relative AI reliance of 10.04% (139/1384) and a relative self-reliance of 85.6% (487/569), indicating a high level of self-reliance but a low level of AI reliance. Propensity to trust technology influenced AI reliance, mediated by trust (indirect effect=0.024, 95% CI 0.008-0.042; P<.001), and medical experience negatively predicted AI reliance (indirect effect=-0.001, 95% CI -0.002 to -0.001; P<.001).</p><p><strong>Conclusions: </strong>The findings highlight the need to design AI support systems in a way that assists less experienced users with a high propensity to trust technology to identify potential AI errors, while encouraging experienced physicians to actively engage with system recommendations and potentially reassess initial decisions.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e58660"},"PeriodicalIF":5.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784413","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":"Patient Factors Associated With the Use of Online Portal Health Information in the Postpandemic Era: Cross-Sectional Analysis of a National Survey.","authors":"Ishana Maini, Kevin Gilotra, Gelareh Sadigh","doi":"10.2196/60472","DOIUrl":"https://doi.org/10.2196/60472","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients' electronic access to their health information can improve long-term health outcomes. Few studies have evaluated barriers that may limit access to portal health information before the COVID-19 pandemic such as preference for in-person visits, lack of perceived need to use a patient portal system, and lack of comfort or experience with computers. With the increased use of telehealth during the pandemic, patients' comfort with portal applications and digital health literacy has improved.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The purpose of this study was to assess the prevalence of portal use and factors associated with patients' portal access after the COVID-19 pandemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study used data from the 2022 National Cancer Institute's Health Information National Trends Survey (HINTS 6). Adult patients (aged ≥18 years) who responded to the survey question about patient portal access were included. A multivariate logistic regression analysis was performed to determine characteristics associated with portal access.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total number of 5958 patients were included (weighted n=245,721,106), with a mean age of 48.2 (20.1) years and were mostly female (119,538,392/236,138,857, 50.6%) and white (167,163,482/227,232,636, 73.6%). Overall, 61.3% (150,722,178/245,721,106) of all respondents reported accessing portals over the last 12 months and 43.7% (82,620,907/188,860,031) used multiple portals. Most participants (135,011,661/150,104,795, 89.9%) reported using portals to access test results, followed by viewing clinical notes (104,541,142/149,867,276, 69.8%) downloading personal health information (47,801,548/150,017,130, 31.9%). The likelihood of portal use significantly increased by 24.9% points (95% CI 19.4-30.5) when patients were offered access to portals by health care providers or insurers compared with those not offered access or did not know if they were offered access. The likelihood of portal use also increased by 19.5% points (95% CI 15.1-23.9) among patients with a health care provider encouraging them to access portals, compared to patients who did not receive encouragement to do so. Having a college education versus education below college level and living in metropolitan areas versus nonmetropolitan regions increased the probability of portal use by 6.9% points (95% CI 3.1-10.8) and 6.9% points (95% CI 1.3-12.6), respectively. Of note, males (compared with females) and those of Hispanic background (compared with non-Hispanic individuals) were less likely to be offered portal access by 10.8% points (95% CI 6.3-15.2) and 6.9% points (95% CI 1.7-12.1), respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study demonstrates that most Americans use patient portals, though certain patient populations such as those with less than college degree education or living in nonmetropolitan areas continue to face greater difficulty accessing them. Intervention","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e60472"},"PeriodicalIF":5.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780187","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":"Infoveillance of COVID-19 Infections in Dentistry Using Platform X: Descriptive Study.","authors":"Alghalia Al-Mansoori, Ola Al Hayk, Sharifa Qassmi, Sarah M Aziz, Fatima Haouari, Tawanda Chivese, Faleh Tamimi, Alaa Daud","doi":"10.2196/54650","DOIUrl":"https://doi.org/10.2196/54650","url":null,"abstract":"<p><strong>Background: </strong>The effect of the COVID-19 pandemic on the well-being of dental professionals and patients has been difficult to track and quantify. X (formerly known as Twitter) proved to be a useful infoveillance tool for tracing the impact of the COVID-19 pandemic worldwide.</p><p><strong>Objective: </strong>This study aims to investigate the use of X to track COVID-19 infections and deaths associated with dental practices.</p><p><strong>Methods: </strong>English Tweets reporting infections or deaths associated with the dental practice were collected from January 1, 2020, to March 31, 2021. Tweets were searched manually using the X Pro search engine (previously known as TweetDeck [X Corp], Twitter Inc, and TweetDeck Ltd) and automatically using a tweet crawler on the X Academic Research application programming interface. Queries included keywords on infection or death of dental staff and patients caused by COVID-19. Tweets registering events on infection or death of dentists, dental staff, and patients as part of their conversation were included.</p><p><strong>Results: </strong>A total of 5641 eligible tweets were retrieved. Of which 1583 (28.1%) were deemed relevant after applying the inclusion and exclusion criteria. Of the relevant tweets, 311 (19.6%) described infections at dental practices, where 1168 (86.9%) infection cases were reported among dentists, 134 (9.9%) dental staff, and 41 (3.1%) patients. The majority of reported infections occurred in the United States, India, and Canada, affecting individuals aged 20-51 years. Among the 600 documented deaths, 253 (42.2%) were dentists, 22 (3.7%) were dental staff, and 7 (1.2%) were patients. The countries with the highest number of deaths were the United States, Pakistan, and India, with an affected age range of 23-83 years.</p><p><strong>Conclusions: </strong>The data suggest that analyses of X information in populations of affected areas may provide useful information regarding the impact of a pandemic on the dental profession and demonstrate a correlation with suspected and confirmed infection or death cases. Platform X shows potential as an early predictor for disease spread. However, further research is required to confirm its validity.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e54650"},"PeriodicalIF":5.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780104","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":"Investigating Measurement Equivalence of Smartphone Sensor-Based Assessments: Remote, Digital, Bring-Your-Own-Device Study.","authors":"Lito Kriara, Frank Dondelinger, Luca Capezzuto, Corrado Bernasconi, Florian Lipsmeier, Adriano Galati, Michael Lindemann","doi":"10.2196/63090","DOIUrl":"https://doi.org/10.2196/63090","url":null,"abstract":"<p><strong>Background: </strong>Floodlight Open is a global, open-access, fully remote, digital-only study designed to understand the drivers and barriers in deployment and persistence of use of a smartphone app for measuring functional impairment in a naturalistic setting and broad study population.</p><p><strong>Objective: </strong>This study aims to assess measurement equivalence properties of the Floodlight Open app across operating system (OS) platforms, OS versions, and smartphone device models.</p><p><strong>Methods: </strong>Floodlight Open enrolled adult participants with and without self-declared multiple sclerosis (MS). The study used the Floodlight Open app, a \"bring-your-own-device\" (BYOD) solution that remotely measured MS-related functional ability via smartphone sensor-based active tests. Measurement equivalence was assessed in all evaluable participants by comparing the performance on the 6 active tests (ie, tests requiring active input from the user) included in the app across OS platforms (iOS vs Android), OS versions (iOS versions 11-15 and separately Android versions 8-10; comparing each OS version with the other OS versions pooled together), and device models (comparing each device model with all remaining device models pooled together). The tests in scope were Information Processing Speed, Information Processing Speed Digit-Digit (measuring reaction speed), Pinching Test (PT), Static Balance Test, U-Turn Test, and 2-Minute Walk Test. Group differences were assessed by permutation test for the mean difference after adjusting for age, sex, and self-declared MS disease status.</p><p><strong>Results: </strong>Overall, 1976 participants using 206 different device models were included in the analysis. Differences in test performance between subgroups were very small or small, with percent differences generally being ≤5% on the Information Processing Speed, Information Processing Speed Digit-Digit, U-Turn Test, and 2-Minute Walk Test; <20% on the PT; and <30% on the Static Balance Test. No statistically significant differences were observed between OS platforms other than on the PT (P<.001). Similarly, differences across iOS or Android versions were nonsignificant after correcting for multiple comparisons using false discovery rate correction (all adjusted P>.05). Comparing the different device models revealed a statistically significant difference only on the PT for 4 out of 17 models (adjusted P≤.001-.03).</p><p><strong>Conclusions: </strong>Consistent with the hypothesis that smartphone sensor-based measurements obtained with different devices are equivalent, this study showed no evidence of a systematic lack of measurement equivalence across OS platforms, OS versions, and device models on 6 active tests included in the Floodlight Open app. These results are compatible with the use of smartphone-based tests in a bring-your-own-device setting, but more formal tests of equivalence would be needed.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e63090"},"PeriodicalIF":5.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780107","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":"Wearable Activity Tracker-Based Interventions for Physical Activity, Body Composition, and Physical Function Among Community-Dwelling Older Adults: Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Ran Li, Yangan Li, Lu Wang, Lijuan Li, Chenying Fu, Danrong Hu, Quan Wei","doi":"10.2196/59507","DOIUrl":"https://doi.org/10.2196/59507","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The global aging population faces great challenges. Wearable activity trackers have emerged as tools to promote physical activity among older adults, potentially improving health outcomes. However, the effectiveness of such interventions on physical activity, body composition, and physical function among community-dwelling older adults remains debated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study conducted a systematic review and meta-analysis to evaluate the impact of wearable activity tracker-based interventions on physical activity, body composition, and physical function among community-dwelling older adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We searched the PubMed, Embase, Web of Science, and CENTRAL databases from inception until January 2025 to identify related randomized controlled trials. The outcomes were focused on physical activity (physical activity time, daily step count, and daily sedentary time); body composition (BMI and body fat); and physical function (timed up and go test and chair stand test). Subgroup analysis by different controls (usual care or conventional interventions) and different follow-ups (immediate or short term) were performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total 23 trials with 4566 participants were eligible for analysis. Compared to usual care, there was lo- to moderate-certainty evidence that the wearable activity tracker-based interventions significantly increased physical activity time (standardized mean difference [SMD]=0.28, 95% CI 0.10-0.47; P=.003) and daily step counts (SMD=0.58, 95% CI 0.33-0.83; P&lt;.001) immediately after intervention, while no significant improvements were observed in daily sedentary time (mean difference [MD]=-1.56, 95% CI -10.88 to 7.76; I&lt;sup&gt;2&lt;/sup&gt;=0%; P=.74). These interventions were at least as effective as conventional interventions but did not show superiority. Compared with usual care, the interventions using wearable activity trackers only demonstrated a notable increase in daily step count over short-term follow-up (SMD=0.23, 95% CI 0.11-0.36; P&lt;.001). As for body composition and physical function, there was low- to moderate-certainty evidence that the wearable activity tracker-based interventions did not have a greater impact on BMI (MD=0.40, 95% CI -0.08 to 0.89; P=.11), body fat (MD=0.67, 95% CI -0.54 to 1.87; P=.28), the timed up and go test (MD=0.14, 95% CI -0.87 to 1.16; P=.78), or the chair stand test (SMD=-0.31, 95% CI -0.62 to 0; P=.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This systematic review and meta-analysis indicate that wearable activity tracker-based interventions were effective in enhancing physical activity with low to moderate certainty, but did not significantly impact body composition or physical function, with low to moderate certainty, among community-dwelling older adults, particularly immediately after intervention. This intervention showed a more pronounced impact when compared to usual care, rather than to conv","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e59507"},"PeriodicalIF":5.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780191","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}