Journal of Medical Internet Research最新文献

{"title":"Telehealth Use and Legal Considerations in Drug Health Services During Pandemics: Systematic Scoping Review.","authors":"Meryem Jefferies, Robert Graham, Marguerite Tracy, Scott Read, Mohammed Eslam, Mark W Douglas, Jacob George","doi":"10.2196/46394","DOIUrl":"10.2196/46394","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic impacted patients with substance use disorder (SUD) more than the general population and resulted in substantially increased emergency department admissions. Routine care of patients attending drug health services during the pandemic transitioned, with telehealth being important in delivering appropriate care. However, telehealth introduces unique risks such as privacy, confidentiality, and data safety. Providing health care through telehealth may fail if the legal impacts are not fully identified and acted on by health professionals. It also poses unintended risks for patients and can result in ineffectiveness, damages, medical negligence, and detracts from the best intentions of governments and health professionals. Understanding the legal framework ensures that medical professionals operate health care through telehealth within the law. Providing health care successfully through telehealth depends on the balance between innovation and legal compliance. By considering these aspects, clinicians and practitioners can provide effective and safe telehealth services during pandemics or any other natural disaster.</p><p><strong>Objective: </strong>We aimed to explore the legal impact of autonomy consent, confidentiality, privacy, data security, professional indemnity, and liability when delivering telehealth to patients with SUD. The scoping review also aimed to provide legal, ethical, and clinical considerations to minimize legal risks with using telehealth in drug health service outpatient settings.</p><p><strong>Methods: </strong>We performed a scoping review to provide an overview of existing research, statutes, and case laws for the incorporation of clinical, ethical, and legal considerations into telehealth use. Six databases for medical and 6 databases for legal publications were searched, as well as Australian national and selected international regulatory standards. Medical articles published up to June 2022 were included in this review. Our search yielded 1436 publications, 614 abstracts were reviewed, and 80 published studies met the inclusion criteria from 614 legal and medical search results. Current regulations related to technology use in drug health services, relevant cases, and international regulatory standards are discussed.</p><p><strong>Results: </strong>In total, 43 legal documents including 15 statutes, 4 case laws, and 37 medical publications were reviewed. The themes arising from the literature were consent and autonomy (20/80, 25%), confidentiality (8/80, 10%), privacy (8/80, 10%), data security (7/80, 9%), and professional indemnity issues (3/80, 4%) in telehealth use. Further, 24 studies identified legal issues associated with telehealth use in patients with SUD.</p><p><strong>Conclusions: </strong>Our review identified potential legal issues associated with telehealth use in patients with SUD. Several legal and medical research articles provide frameworks, codes of con","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"26 ","pages":"e46394"},"PeriodicalIF":5.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621903","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":"Concurrent Mentions of Vaping and Alcohol on Twitter: Latent Dirichlet Analysis.","authors":"Lynsie R Ranker, David Assefa Tofu, Manyuan Lu, Jiaxi Wu, Aruni Bhatnagar, Rose Marie Robertson, Derry Wijaya, Traci Hong, Jessica L Fetterman, Ziming Xuan","doi":"10.2196/51870","DOIUrl":"https://doi.org/10.2196/51870","url":null,"abstract":"<p><strong>Background: </strong>Co-use of alcohol and e-cigarettes (often called vaping) has been linked with long-term health outcomes, including increased risk for substance use disorder. Co-use may have been exacerbated by the COVID-19 pandemic. Social networking sites may offer insights into current perspectives on polysubstance use.</p><p><strong>Objective: </strong>The aims of this study were to investigate concurrent mentions of vaping and alcohol on Twitter (subsequently rebranded X) during a time of changing vaping regulations in the United States and the emergence of the COVID-19 pandemic.</p><p><strong>Methods: </strong>Tweets including both vape- and alcohol-related terms posted between October 2019 and September 2020 were analyzed using latent Dirichlet allocation modeling. Distinct topics were identified and described.</p><p><strong>Results: </strong>Three topics were identified across 6437 tweets: (1) flavors and flavor ban (n=3334, 51.8% of tweets), (2) co-use discourse (n=1119, 17.4%), and (3) availability and access regulation (n=1984, 30.8%). Co-use discussions often portrayed co-use as positive and prosocial. Tweets focused on regulation often used alcohol regulations for comparison. Some focused on the perceived overregulation of vaping (compared to alcohol), while others supported limiting youth access but not at the expense of adult access (eg, stronger age verification over product bans). Across topics, vaping was typically portrayed as less harmful than alcohol use. The benefits of flavors for adult smoking cessation were also discussed. The distribution of topics across time varied across both pre- and post-regulatory change and pre- and post-COVID-19 pandemic declaration periods, suggesting shifts in topic focus salience across time.</p><p><strong>Conclusions: </strong>Co-use discussions on social media during this time of regulatory change and social upheaval typically portrayed both vaping and alcohol use in a positive light. It also included debates surrounding the differences in regulation of the 2 substances-particularly as it related to limiting youth access. Emergent themes from the analysis suggest that alcohol was perceived as more harmful but less regulated and more accessible to underage youth than vaping products. Frequent discussions and comparisons of the 2 substances as it relates to their regulation emphasize the still-evolving vaping policy landscape. Social media content analyses during times of change may help regulators and policy makers to better understand and respond to common concerns and potential misconceptions surrounding drug-related policies and accessibility.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"26 ","pages":"e51870"},"PeriodicalIF":5.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621444","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":"Association Between Daily Internet Use and Intrinsic Capacity Among Middle-Aged and Older Adults in China: Large Prospective Cohort Study.","authors":"Xing-Ling Chen, Jin Li, Shu-Ning Sun, Qiang-Qiang Zhao, Sheng-Rong Lin, Ling-Jun Wang, Zhong-Qi Yang, Shi-Hao Ni, Lu Lu","doi":"10.2196/54200","DOIUrl":"https://doi.org/10.2196/54200","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Intrinsic capacity (IC), as a comprehensive measure of an individual's functional ability, has gained prominence in the framework for healthy aging introduced by the World Health Organization (WHO). As internet usage continues to integrate into daily life, it is imperative to scrutinize the association between internet use and IC to effectively promote healthy aging among the middle-aged and older population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to investigate whether daily internet use in middle-aged and older adults delays or accelerates the decline in IC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Participants included in the China Health and Retirement Longitudinal Study (CHARLS) comprised individuals aged ≥45 years residing in China. We analyzed 4 years of CHARLS data from the first wave (May 2011-March 2012) to the third wave (July 2015-January 2016). Data from the first and third waves were used for longitudinal studies. Self-reported data encompassed internet use, frequency of use, and demographic baseline characteristics. In addition, the IC evaluation involved physical examination and blood test data. Initially, linear regression was used to assess the relationship between daily internet use and IC, followed by regression splines to explore potential nonlinear associations. Subgroup and sensitivity analyses were used to investigate the heterogeneity of IC in specific conditions and the robustness of our results. Mediation effect analysis was conducted to identify the factors that mediate the relationship between daily internet use and IC, focusing on social participation, physical activity, and health status.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 12,826 participants included in the longitudinal analyses, 12,305 (95.9%) did not use the internet, while 521 (4.1%) reported daily internet use with a mean age of 52.62 (SD 7.67) years. After adjusting for demographic variables, socioeconomic factors, lifestyle behaviors, and health conditions and examining the impact of daily internet use and frequency on changes in IC, our findings indicated important associations. Specifically, daily internet use is significantly linked to a slower decline in IC over time (marginal effect 1.58, 95% CI 1.03-2.12; P&lt;.001). Individuals with moderate and regular internet use frequency exhibit higher levels of maintenance in IC (marginal effect 0.74, 95% CI 0.45-1.03, P&lt;.001). In addition, the relationship between IC changes and internet use frequency demonstrated a nonlinear inverted U-shaped curve (nonlinear P=.003). Subgroup analysis further revealed that improvements in IC vary based on age and gender. Furthermore, mediation analysis denoted that more than 28.78% (95% CI 21.24-40.33) of the observed association is mediated by social participation (P&lt;.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The findings of our research underscore the potential benefits of consistent and moderate internet use in promoting and preserving","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"26 ","pages":"e54200"},"PeriodicalIF":5.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620585","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":"Influence of Blood Sampling Service Process Reengineering on Medical Services Supply: Quasi-Experimental Study.","authors":"Wenmin Liao, Rong He, Zhonglian He, Nan Shi, Dan Li, Aihua Zhuang, Feng Gan, Ying Sun, Chaofeng Li","doi":"10.2196/51412","DOIUrl":"https://doi.org/10.2196/51412","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Tertiary hospitals in China are confronted with significant challenges due to limited spatial capacity and workforce constraints, leading to saturated allocation of medical resources and restricted growth in medical service provision. The incorporation of digital health into medical service process reengineering (MSPR) marks a pivotal transformation and restructuring of conventional health service delivery models. Specifically, the application of MSPR to blood sampling services processes reengineering (BSSPR) holds promise for substantially enhancing the efficiency and quality of medical services through streamlining and optimizing these procedures. However, the comprehensive impact of BSSPR has been infrequently quantified in existing research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to investigate the influence of BSSPR on the efficiency and quality of medical services and to elucidate the key informative technological support points underpinning BSSPR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were collected from both the new and old laboratory information systems from August 1, 2019, to December 31, 2021. A combination of statistical description, chi-square test, and t test was used to compare check-in time and waiting time of outpatients before and after the implementation of BSSPR. An interrupted time-series design was used to analyze the impact of BSSPR on medical service efficiency and quality, enabling the control of confounding variables, including changes in medical human resources and both long- and short-term temporal trends.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;BSSPR had an impact on the efficiency and quality of medical services. Notably, there was a significant increase in the number of patients receiving blood sampling services, with a daily service volume increase of ~150 individuals (P=.04). The average waiting time for patients decreased substantially from 29 (SD 36) to 11 (SD 11) minutes, indicating a marked improvement in patient experience. During the peak period, the number of patients receiving blood sampling services per working hour statistically increased from 9.56 to 16.77 (P&lt;.001). The interrupted time-series model results demonstrated a reduction in patients' waiting time by an average of 26.1 (SD 3.8; 95% CI -33.64 to -18.57) minutes. Although there was an initial decline in the number of outpatients admitted following BSSPR implementation, an upward trend was observed over time (β=1.13, 95% CI 0.91-1.36).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;BSSPR implementation for outpatients not only reduced waiting time and improved patients' experience but also augmented the hospital's capacity to provide medical services. This study's findings offer valuable insights into the potential advantages of BSSPR and underscore the significance of harnessing digital technologies to optimize medical service processes. This research serves as a foundational basis and provides scientific support for the p","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"26 ","pages":"e51412"},"PeriodicalIF":5.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621873","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":"Predicting Prefecture-Level Well-Being Indicators in Japan Using Search Volumes in Internet Search Engines: Infodemiology Study.","authors":"Myung Si Yang, Kazuya Taira","doi":"10.2196/64555","DOIUrl":"https://doi.org/10.2196/64555","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In recent years, the adoption of well-being indicators by national governments and international organizations has emerged as an important tool for evaluating state governance and societal progress. Traditionally, well-being has been gauged primarily through economic metrics such as gross domestic product, which fall short of capturing multifaceted well-being, including socioeconomic inequalities, life satisfaction, and health status. Current well-being indicators, including both subjective and objective measures, offer a broader evaluation but face challenges such as high survey costs and difficulties in evaluating at regional levels within countries. The emergence of web log data as an alternative source of well-being indicators offers the potential for more cost-effective, timely, and less biased assessments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to develop a model using internet search data to predict well-being indicators at the regional level in Japan, providing policy makers with a more accessible and cost-effective tool for assessing public well-being and making informed decisions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study used the Regional Well-Being Index (RWI) for Japan, which evaluates prefectural well-being across 47 prefectures for the years 2010, 2013, 2016, and 2019, as the outcome variable. The RWI includes a comprehensive approach integrating both subjective and objective indicators across 11 domains, including income, job, and life satisfaction. Predictor variables included z score-normalized relative search volume (RSV) data from Google Trends for words relevant to each domain. Unrelated words were excluded from the analysis to ensure relevance. The Elastic Net methodology was applied to predict RWI using RSVs, with α balancing ridge and lasso effects and λ regulating their strengths. The model was optimized by cross-validation, determining the best mix and strength of regularization parameters to minimize prediction error. Root mean square errors (RMSE) and coefficients of determination (R&lt;sup&gt;2&lt;/sup&gt;) were used to assess the model's predictive accuracy and fit.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;An analysis of Google Trends data yielded 275 words related to the RWI domains, and RSVs were collected for 211 words after filtering out irrelevant terms. The mean search frequencies for these words during 2010, 2013, 2016, and 2019 ranged from -1.587 to 3.902, with SDs between 3.025 and 0.053. The best Elastic Net model (α=0.1, λ=0.906, RMSE=1.290, and R&lt;sup&gt;2&lt;/sup&gt;=0.904) was built using 2010-2016 training data and 2-13 variables per domain. Applied to 2019 test data, it yielded an RMSE of 2.328 and R&lt;sup&gt;2&lt;/sup&gt; of 0.665.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study demonstrates the effectiveness of using internet search log data through the Elastic Net machine learning method to predict the RWI in Japanese prefectures with high accuracy, offering a rapid and cost-efficient alternative","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"26 ","pages":"e64555"},"PeriodicalIF":5.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621891","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":"Effectiveness and Feasibility of Digital Pulmonary Rehabilitation in Patients Undergoing Lung Cancer Surgery: Systematic Review and Meta-Analysis.","authors":"Taiping Lu, Ting Deng, Yangyang Long, Jin Li, Anmei Hu, Yufan Hu, Li Ouyang, Huiping Wang, Junliang Ma, Shaolin Chen, Jiale Hu","doi":"10.2196/56795","DOIUrl":"10.2196/56795","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pulmonary rehabilitation (PR) has been shown to effectively support postsurgical recovery in patients with lung cancer (LC) at various stages. While digital PR programs offer a potential solution to traditional challenges, such as time and space constraints, their efficacy and feasibility for patients undergoing LC surgery remain unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This systematic review aims to assess the feasibility and effectiveness of digital PR programs for individuals undergoing LC surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic review was conducted, retrieving data from 6 English and 4 Chinese databases from their inception to January 1, 2024. References in related studies were also manually reviewed. The primary outcomes assessed were physical capacity, lung function, and the incidence of postoperative pulmonary complications (PPCs). The secondary outcomes were compliance, hospital stay, chest tube duration, anxiety, depression, and quality of life. Where applicable, recruitment and withdrawal rates were also evaluated. Meta-analysis and descriptive analysis were used to assess the outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 5 randomized controlled trials and 6 quasi-experimental studies (n=1063) were included, with 4 studies being included in the meta-analyses. Our meta-analyses revealed that digital PR reduced the decline in 6-minute walk distance (6-MWD) by an average of 15 m compared with routine PR programs from admission to discharge, demonstrating a clinically significant improvement in physical capacity (mean difference -15.00, 95% CI -25.65 to -4.34, P=.006). Additionally, digital PR was associated with a reduction (26/58, 45%) in the likelihood of PPCs (risk ratio 0.45, 95% CI 0.30-0.66, P&lt;.001) and a reduction of 1.53 days in chest tube duration (mean difference -1.53, 95% CI -2.95 to -0.12, P=.03), without a statistically significant effect on postoperative hospital stay (mean difference -1.42, 95% CI -3.45 to 0.62, P=.17). Descriptive analyses suggested that digital PR has the potential to improve knowledge, lung function, quality of life, and self-efficacy, while reducing depression and anxiety. Notably, digital PR was found to be a safe, feasible, and acceptable supplementary intervention. Despite challenges with low recruitment, digital PR enhanced exercise compliance, increased patient satisfaction, and lowered dropout rates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This systematic review is the first comprehensive analysis to suggest that digital PR is a safe, feasible, acceptable, and effective intervention for promoting recovery in patients with LC after surgery. Digital PR has the potential to be a valuable supplement, expanding access to traditional PR programs. Future research should prioritize the development of interactive and inclusive digital solutions tailored to diverse age groups and educational backgrounds. Rigorous studies, including large-scale, high-quality","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"26 ","pages":"e56795"},"PeriodicalIF":5.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621855","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":"Impact of Internet Hospital Consultations on Outpatient Visits and Expenses: Quasi-Experimental Study.","authors":"Yayuan Liu, Haofeng Jin, Zhuoyuan Yu, Yu Tong","doi":"10.2196/57609","DOIUrl":"https://doi.org/10.2196/57609","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Internet hospital consultations are emerging in China as a new channel for patients to access health care services. Unlike third-party health care platforms such as Haodf, Teladoc Health, and MDLive, internet hospitals seamlessly integrate patients' offline medical records with online consultations, offering a cohesive online and offline health care experience. However, its impact on outpatient visits remains ambiguous. While it may encourage outpatient visits due to better continuity of care, it could also reduce face-to-face visits because of the convenience of online consultations. Given that patients in China have the autonomy to freely choose their health care providers, it is critical for hospitals to understand the effect of this telehealth technology on outpatient visits.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to analyze the impact of patients' adoption of internet hospital consultations on their outpatient frequency and expenses, and whether these impacts vary between urban and rural patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The data used in this study were collected from a public tertiary hospital situated in a southeastern county of China, covering internet hospital consultations from January 2021 to October 2022, and offline outpatient records from January 2020 to October 2022. The dataset also includes patient demographic information. To estimate the causal effect, we used a quasi-experimental design, combining the difference-in-differences (DiD) analysis with the propensity score matching (PSM). After performing PSM, 2065 pairs of patients (4130 patients) were obtained for data analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our findings highlight 3 key results. First, patients' adoption of internet hospital consultations increases their frequency of outpatient visits by 2.4% per month (P&lt;.001), and the associated expenses by 15.5% per month (P&lt;.001). Second, such positive effects are more pronounced for patients residing in rural areas. Specifically, for every 1% increase in the distance between patients' residences and the county government (an urban center), the positive effect on monthly outpatient visits increases by 0.3% (P=.06), and the positive effect on monthly outpatient expenses increases by 2.4% (P=.03). Third, our post hoc analysis shows that rural patients living in areas with higher local health care quality experience a mitigated positive effect of internet hospital consultations, compared with those in areas with lower health care quality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study extends the research scope of telehealth technologies by investigating internet hospitals, which are characterized by the integration of online and offline services. Our findings suggest that patients' adoption of internet hospital consultations is associated with an increase in both the frequency and expenses of outpatient visits. In addition, these effects vary based on patients' urban-rural sta","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"26 ","pages":"e57609"},"PeriodicalIF":5.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621871","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":"Participation in eHealth Communication Interventions Among Patients Undergoing Hemodialysis: Scoping Review.","authors":"Anne Deinboll, Cathrine Fredriksen Moe, Mette Spliid Ludvigsen","doi":"10.2196/51900","DOIUrl":"https://doi.org/10.2196/51900","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;eHealth communication interventions have been shown to offer individuals with chronic kidney disease the opportunity to embrace dialysis therapies with greater confidence, the potential to obtain better clinical outcomes, and an increased quality of life. eHealth is an emerging field that offers diverse, flexible designs and delivery options. However, existing evidence on eHealth communication among patients undergoing hemodialysis is sparse and scattered and lacks systematization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This scoping review aims to identify and map the current evidence on patient participation in eHealth communication interventions. We aimed to map the associations between interventions and electronic health records, the participative role of individuals living with chronic kidney disease and undergoing hemodialysis, and the barriers to and facilitators of patient involvement in eHealth communication with health care professionals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study used the Joanna Briggs Institute methodology for conducting a scoping review. Studies eligible for inclusion were those that included adult patients (aged &gt;18 y) undergoing all types of hemodialysis, including prescheduled in-center hemodialysis and conventional home-based hemodialysis. Systematic searches were completed in Ovid MEDLINE, Ovid Embase, EBSCOhost CINAHL with Full Text, Scopus, and ProQuest Dissertations and Theses. Extracted data from the included studies were presented in figures and tables along with descriptions that responded to the research questions. This review was reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 9 peer-reviewed studies were included. The main result was a low participative patient role and a vaguely described link to electronic health records. The key participative facilitators were availability of and access to the intervention; security, trust, and confidence; patient knowledge of their health situation and use of self-care; and patient preparedness for an uncertain future health situation and the ability to relate to family and friends about it. The key participative barriers were lack of availability of and access to information, mistrust and lack of safety, lack of knowledge of health situation and self-care, and relational issues. All barriers and facilitators were related to health literacy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This scoping review summarizes 4 specific and 3 nonspecific eHealth communication interventions developed and evaluated in various studies involving patients receiving hemodialysis. A knowledge gap exists between low levels of patient participation in eHealth communication and patients' limited access to electronic health records. eHealth communication interventions should implement patient participation and focus on the fact th","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"26 ","pages":"e51900"},"PeriodicalIF":5.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621886","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":"Enhancement of the Performance of Large Language Models in Diabetes Education through Retrieval-Augmented Generation: Comparative Study.","authors":"Dingqiao Wang, Jiangbo Liang, Jinguo Ye, Jingni Li, Jingpeng Li, Qikai Zhang, Qiuling Hu, Caineng Pan, Dongliang Wang, Zhong Liu, Wen Shi, Danli Shi, Fei Li, Bo Qu, Yingfeng Zheng","doi":"10.2196/58041","DOIUrl":"10.2196/58041","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) demonstrated advanced performance in processing clinical information. However, commercially available LLMs lack specialized medical knowledge and remain susceptible to generating inaccurate information. Given the need for self-management in diabetes, patients commonly seek information online. We introduce the Retrieval-augmented Information System for Enhancement (RISE) framework and evaluate its performance in enhancing LLMs to provide accurate responses to diabetes-related inquiries.</p><p><strong>Objective: </strong>This study aimed to evaluate the potential of the RISE framework, an information retrieval and augmentation tool, to improve the LLM's performance to accurately and safely respond to diabetes-related inquiries.</p><p><strong>Methods: </strong>The RISE, an innovative retrieval augmentation framework, comprises 4 steps: rewriting query, information retrieval, summarization, and execution. Using a set of 43 common diabetes-related questions, we evaluated 3 base LLMs (GPT-4, Anthropic Claude 2, Google Bard) and their RISE-enhanced versions respectively. Assessments were conducted by clinicians for accuracy and comprehensiveness and by patients for understandability.</p><p><strong>Results: </strong>The integration of RISE significantly improved the accuracy and comprehensiveness of responses from all 3 base LLMs. On average, the percentage of accurate responses increased by 12% (15/129) with RISE. Specifically, the rates of accurate responses increased by 7% (3/43) for GPT-4, 19% (8/43) for Claude 2, and 9% (4/43) for Google Bard. The framework also enhanced response comprehensiveness, with mean scores improving by 0.44 (SD 0.10). Understandability was also enhanced by 0.19 (SD 0.13) on average. Data collection was conducted from September 30, 2023 to February 5, 2024.</p><p><strong>Conclusions: </strong>The RISE significantly improves LLMs' performance in responding to diabetes-related inquiries, enhancing accuracy, comprehensiveness, and understandability. These improvements have crucial implications for RISE's future role in patient education and chronic illness self-management, which contributes to relieving medical resource pressures and raising public awareness of medical knowledge.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":" ","pages":"e58041"},"PeriodicalIF":5.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco and Alcohol Content in Top Vietnamese YouTube Music Videos: Content Analysis.","authors":"Thi Phuong Thao Tran, Thu Trang Vu, Yachao Li, Lucy Popova","doi":"10.2196/55555","DOIUrl":"10.2196/55555","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Seeing portrayals of tobacco and alcohol in music videos (MVs) may reduce perceived risks, increase susceptibility, and lead to the initiation of tobacco and alcohol use among adolescents and young adults. Previous studies have predominantly concentrated on assessing tobacco and alcohol contents in English-language MVs within Western countries. However, many other countries have not only been influenced by the English music market but have also produced music in their native languages, and this content remains underexamined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to investigate the prevalence of tobacco- and alcohol-related content in top Vietnamese MVs on YouTube from 2013 to 2021, to describe how tobacco and alcohol are portrayed in these MVs, and to examine associations between these portrayals and MV characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 410 Vietnamese MVs, including the top 40 or 50 most viewed released each year between 2013 and 2021, were analyzed. General information, such as the song name, its release date and ranking, age restriction, musical genre, and type of MV, was collected. We examined tobacco and alcohol content in the MVs, with specific details such as tobacco types, their brands, as well as the number, age, sex, and roles of individuals smoking or drinking.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 410 MVs, 36 (8.8%) contained tobacco-related content and 136 (33.2%) featured alcohol-related content. Additionally, 28 (6.8%) out of 410 MVs included both tobacco and alcohol content. The prevalence of videos with tobacco and alcohol content fluctuated over the years. In MVs with tobacco-related content, a higher proportion of hip-hop or rap songs contained tobacco-related content (n=6, 30%) compared to other music genres. In MVs with tobacco-related content, cigarettes were the most frequently shown product (n=28, 77.8%), and smoking scenes were often depicted at parties (n=13, 36.1%) and during dancing and singing scenes (n=12, 33.3%). Among the 31 MVs portraying actual tobacco use, tobacco use was typically depicted with 1 person, often a young adult male, while 38.7% (n=12) showed singer(s) smoking. For MVs with alcohol-related content, there was a high proportion showing alcohol images at parties, bars, or pubs (n=96, 70.6%). Among 87 MVs containing drinking scenes, 60.9% (n=53) involved groups of young adults of both sexes, and 64% (n=56) depicted singers drinking. Additionally, only 2 (5.6%) MVs included health warnings about tobacco harm, and 2 MVs (1.5%) included warnings about drinking restricted to individuals 18 years and above.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The notable prevalence of tobacco and alcohol content in leading Vietnamese YouTube MVs raises concerns, especially as most of this content is portrayed without any warnings. The study underscores a regulatory gap in addressing such content on the internet, emphasizing the urgent need for stricter","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"26 ","pages":"e55555"},"PeriodicalIF":5.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}