JMIR Cancer最新文献

{"title":"Assessing the Accuracy, Completeness, and Reference Quality of GPT-4 and Google for Gynecologic Cancer Information: Comparative Quantitative Study.","authors":"Alexandra H Smick, Martins Ayoola, Rajeshree Rajpara, Isabel Lazo, Dana M Chase","doi":"10.2196/76471","DOIUrl":"10.2196/76471","url":null,"abstract":"<p><strong>Background: </strong>Patients with newly diagnosed gynecologic cancers often seek information online, but the quality of available resources may be inconsistent. Although GPT-4 may offer an alternative to traditional internet search engines, its performance remains largely under-studied in gynecologic oncology.</p><p><strong>Objective: </strong>This study aimed to compare the completeness, accuracy, and reference quality of responses generated by GPT-4 with those generated by Google in clinical scenarios involving a new diagnosis of a gynecologic cancer.</p><p><strong>Methods: </strong>Clinical scenarios representing early- and advanced-stage endometrial, ovarian, and cervical cancers were developed by gynecologic oncologists using publicly available patient education materials. Each scenario included 4 standardized questions addressing etiology, prognosis, treatment, and treatment efficacy. GPT-4 and Google were queried for each question, with new sessions for GPT-4 and private browsing for Google to minimize bias. Responses were independently evaluated by 4 gynecologic oncology experts who were blinded to each other's ratings. Accuracy was scored on a 6-point Likert scale; completeness and reference quality were scored on 3-point scales. Reference quality was categorized as low (commercial), medium (institutional or government), or high (peer reviewed). Optional free-text reviewer comments were collected and summarized descriptively to provide context for the quantitative findings. Descriptive statistics and Wilcoxon signed-rank tests were used for analysis.</p><p><strong>Results: </strong>Across 6 clinical scenarios and 21 standardized questions (N=84 total responses), GPT-4 outperformed Google across all evaluated domains. The median accuracy score was 6.00 (IQR 5.00-6.00) for GPT-4 and 5.00 (IQR 4.00-6.00) for Google (P=.04). The median completeness score was 3.00 (IQR 3.00-3.00) for GPT-4 and 2.00 (IQR 1.00-3.00) for Google (P=.009). Reference quality was also higher for GPT-4, with a median score of 3.00 (IQR 3.00-3.00) compared to 2.00 (IQR 2.00-2.00) for Google (P=.009). Reviewer comments noted that GPT-4 provided more accurate, comprehensive, and personalized responses, while Google returned less detailed content from general consumer health websites rather than peer-reviewed sources.</p><p><strong>Conclusions: </strong>GPT-4 may serve as a reliable and high-quality resource for information in gynecologic oncology. Compared to Google, it delivered more accurate and complete content, with higher-quality references. Further research is needed to assess the readability and accessibility of GPT-4-generated content across diverse patient populations.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"12 ","pages":"e76471"},"PeriodicalIF":2.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beta Testing an mHealth Symptom Management Intervention for People With Advanced Cancer: Single-Cohort Feasibility and Acceptability Study.","authors":"Sharla Wells-Di Gregorio, Tanya Smit, Sarah Baltimore, Don M Benson, Steve K Clinton, Ashley P Davenport, Kari L Kendra, Carolyn J Presley, Donald R Marks","doi":"10.2196/94676","DOIUrl":"10.2196/94676","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;People living with advanced cancer experience more frequent and severe symptoms than those with early-stage disease. Common, distressing symptoms include sleep difficulties, worry and uncertainty, fatigue, and depression. Cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) effectively manage these symptoms but are often too time intensive for patients with multiple appointments, limited energy, and competing priorities. Brief, mobile health (mHealth) interventions provide an accessible alternative, particularly for rural patients with limited access to palliative or psychosocial oncology services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Building on our successful in-person and Digital Video Disk-based pilot trial of a 3-session, integrated CBT-ACT symptom management intervention for patients with advanced cancer, Finding Our Center Under Stress (FOCUS), the current study evaluated the feasibility and acceptability of a 4-session mHealth version.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this single-cohort feasibility and acceptability study, people with advanced cancer were recruited from hospital-based oncology clinics representing 4 cancer types (breast, melanoma, multiple myeloma, and prostate). Baseline assessments included sociodemographic data, patient-reported outcomes for sleep (Insomnia Severity Index), anxiety (7-item Generalized Anxiety Disorder scale and Penn State Worry Questionnaire), fatigue (Fatigue Symptom Inventory), depression (Center for Epidemiological Studies Depression Scale), and a 7-day sleep diary completed in the app. Participants then completed 4 modules addressing sleep difficulties, worry and uncertainty, fatigue, and depression. Primary outcomes were feasibility and acceptability. Feasibility benchmarks included recruitment (50% enrollment), retention (70%), and app completion (50%). After 6 weeks, participants completed the Internet Evaluation and Utility Questionnaire, and a subset completed qualitative interviews about their experience with the FOCUS app. We report quantitative and qualitative findings and lessons learned from app development.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 64.7% (11/17) of the approached patients enrolled, and 70% (7/10) completed more than half of the app. Participants rated FOCUS highly for ease of understanding (mean 3.83/4, SD 0.41), convenience (mean 3.67/4, SD 0.82), and utility (mean 3.33/4, SD 0.82). All participants would recommend the app to others and would use it again for future problems. Favorite components included patient videos and the Sleep and Worry and Uncertainty Modules. Suggested improvements included video quality (lighting and sound), sleep diary usability, and additional professional guidance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The FOCUS intervention was successfully delivered via mobile technology and demonstrated feasibility and acceptability in beta testing. The FOCUS mHealth app offers an evidence-based, acces","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"12 ","pages":"e94676"},"PeriodicalIF":2.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' Reply: Urological Content Accuracy as an Unmeasured Dimension in Generative AI Chatbot Communication About Sexual Health After Prostate Cancer.","authors":"Mats Christiansen, Henrik Eriksson, Lisbeth Fagerström","doi":"10.2196/109004","DOIUrl":"10.2196/109004","url":null,"abstract":"","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"12 ","pages":"e109004"},"PeriodicalIF":2.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urological Content Accuracy as an Unmeasured Dimension in Generative AI Chatbot Communication About Sexual Health After Prostate Cancer.","authors":"Bilgi Isler, Ahmet Murat Bayraktar","doi":"10.2196/108419","DOIUrl":"10.2196/108419","url":null,"abstract":"","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"12 ","pages":"e108419"},"PeriodicalIF":2.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI Agents for Multimodal Oncology Diagnosis: Toward Transparent and Traceable Clinical Decision Support.","authors":"Liuyang Yang, Liyu Shan, Xiangmei Yao, Renbin Zhao, Zengzheng Li, Shuai Feng, Yajie Wang","doi":"10.2196/103545","DOIUrl":"10.2196/103545","url":null,"abstract":"<p><p>Cancer diagnosis depends on data from radiology, digital pathology, molecular profiling, laboratory testing, and longitudinal clinical records. AI performs well in selected tasks, but most systems remain narrow and disconnected from the iterative reasoning required in oncology. This Viewpoint defines an AI agent as a feedback-driven system that maintains task state, selects among governed tools, observes results, and revises its plan under explicit safety constraints. This definition separates agents from multimodal foundation models, retrieval-augmented generation, and fixed workflow automation. We organize the discussion across multimodal data collection, preprocessing, fusion and representation learning, and diagnostic decision support. We distinguished agent-level evidence, component- or infrastructure-level evidence, and prospective propositions throughout. Clinical translation will require resilient failure handling, guideline version control, prospective evaluation, computational and workflow feasibility, and clinician authority over final decisions. The near-term opportunity is therefore transparent and traceable clinical decision support rather than autonomous cancer diagnosis.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"12 ","pages":"e103545"},"PeriodicalIF":2.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Physical Activity Engagement and Promotion Among Cancer Survivors in Cardio-Oncology Care: Qualitative Study.","authors":"Macy K Tetrick, Daniel Addison, Rujul Singh, Sara M St George, Vanina Pavia, Anvitha Gogineni, Peter Washington, Sanam M Ghazi, Olivia Preston, James L Fisher, Roberto M Benzo","doi":"10.2196/104332","DOIUrl":"10.2196/104332","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cardiovascular disease and cancer are leading causes of morbidity and mortality worldwide, with cancer survivors facing elevated cardiovascular risk due to shared risk factors and cardiotoxic treatments. Physical activity (PA) is a well-established strategy to improve cardiovascular health and survivorship outcomes; however, most cancer survivors do not meet recommended PA guidelines. Understanding multilevel influences on PA engagement and promotion is essential to improving implementation in cardio-oncology care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to examine barriers and facilitators to PA engagement and promotion in cancer survivorship from both survivor and medical team perspectives using the Capability, Opportunity, Motivation-Behavior (COM-B) framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A descriptive qualitative study was conducted with 12 cancer survivors and 12 medical team members involved in oncology care. Semistructured interviews explored experiences, perceptions, and practices related to PA across the cancer care continuum. Rapid qualitative analysis was used to identify themes, which were mapped to COM-B domains. Participants also completed surveys assessing PA, cardiovascular health (Life's Essential 8 [LE8]), and sociodemographic factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Survivors had a mean age of 65.3 (SD 12.6) years and were evenly distributed by sex. PA engagement varied, with 42% (5/12) of survivors meeting recommended guidelines. The mean modified LE8-derived cardiovascular health score was 71.3 (SD 11.9), reflecting a standardized 6-domain composite (diet, PA, nicotine exposure, sleep, BMI, and blood pressure) calculated identically for all 12 participants. Across COM-B domains, physical limitation was the most commonly reported capability barrier (12/12 survivors), while current engagement in PA was the most prevalent capability facilitator (12/12 survivors). Opportunity was shaped by access to PA resources and social support, with social environment being the most frequently cited facilitator (12/12 survivors; 9/12 medical team members) and lack of access to PA resources being the most common barrier among medical team members (9/12). Motivation reflected perceived health outcomes as the most prevalent facilitator across both groups (12/12 survivors; 7/12 medical team members), alongside competing concerns such as safety and emotional responses. Medical team members' ability to promote PA was influenced by survivor readiness, clinical context, and resource availability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;PA engagement in cardio-oncology is shaped by dynamic interactions among capability, opportunity, and motivation across survivor and medical team member contexts. Although PA is widely valued, sustained engagement remains limited due to fluctuating symptoms, environmental constraints, and clinical uncertainties. Interventions should prioritize flexible, survivor-centered appro","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"12 ","pages":"e104332"},"PeriodicalIF":2.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multimethod Evaluation to Assess Feasibility, Acceptability, and Preliminary Efficacy of HPVVaxFacts, a Tailored Mobile Web App, for Parents With Unvaccinated Children: Pilot 2-Arm Randomized Controlled Trial.","authors":"Jennifer Cunningham-Erves, Pamela C Hull, Amanda F Dempsey, Tatsuki Koyama, Lili Sun, Mariya Chalise, Elizabeth C Stewart, Jessica L Jones, Douglas Landsittel, Meredith Smalls, Freneka F Minter, Lindsay S Mayberry, Lora Harnack, Michael J Hook, Janet Cates, Tammy Van Maanen, Taylor Burnett, Consuelo H Wilkins","doi":"10.2196/78910","DOIUrl":"10.2196/78910","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Mobile health (mHealth) interventions may improve provider-parent communication on human papillomavirus (HPV) vaccination to reduce concerns, and increase intention and uptake. HPVVaxFacts (233 Analytics) is a novel, mobile web app delivering tailored education based on the Health Belief Model and Theory of Reasoned Action, addressing parental concerns preclinic visit.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to assess the feasibility, acceptability, and preliminary efficacy of HPVVaxFacts among parents of adolescents aged 9-17 years.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a pilot, randomized controlled trial in 2 urban Tennessee clinics from June to September 2023 comparing 2 groups: tailored education via HPVVaxFacts mobile web app (intervention, n=27), and nutrition education (attention control, n=30). Eligible parents had or were caregivers to a child aged 9 to 17 years unvaccinated against HPV, had a mobile phone, had an upcoming clinic visit, and spoke English. The recruitment strategy was patient intake software-Phreesia (Phreesia, Inc) and eClinicalWorks (eClinicalWorks). Although unblinded, parents could deduce their study arm assignment. Providers were blinded. Feasibility, acceptability, and preliminary efficacy (HPV vaccine knowledge, concerns, intentions, and vaccination rates) were assessed using multimethod evaluation. Parents were assessed at baseline and immediately post intervention via surveys. Vaccination rates were assessed at 12 months post intervention via electronic health records. Nineteen parent interviews were conducted up to 9 months post intervention. A clinic staff consultation (n=6) was 1 month post intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 57 enrolled parents, most were female (52/57, 91%), non-Hispanic White (44/57, 77%), had ≤US $80,000 household income (32/57, 56%), and had some college or less (27/57, 47%). In total, 81% (29/36) of parents viewed HPVVaxFacts. Post intervention, HPV vaccine initiation was higher in the intervention group compared to the attention control group (48% vs 17%; difference 0.24; 95% CI 0.03-0.46; &lt;i&gt;P&lt;/i&gt;=.01). Parents in the HPVVaxFacts arm demonstrated a greater reduction in knowledge (ie, knowledge increase; mean change: -0.6 vs 0.1) and concern scores (mean change: -3.4 vs -1.4) than those in the nutrition education arm. However, between-arm differences were not statistically significant (&lt;i&gt;P&lt;/i&gt;=.13 and &lt;i&gt;P&lt;/i&gt;=.14, respectively). The majority found the study protocol and HPVVaxFacts acceptable. Benefits of HPVVaxFacts include confirming their decision to vaccinate, supporting parent-child discussion on the vaccine, and answering questions preclinic visit or offering questions for the provider. Study protocol delivery and mobile web app instructions were suggested areas for improvement. Barriers for HPVVaxFacts use include content in English only and digital format.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our study suggests HPV","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"12 ","pages":"e78910"},"PeriodicalIF":2.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Like a Clinical Nurse Consultant in Your Pocket\"-Parents' and Health Care Providers' Perceptions of a Co-Designed Smartphone App Following Treatment for Pediatric Cancer: Mixed Methods Evaluation Study.","authors":"Hannah Pring, Cinzia R De Luca, Georgia Taylor, Chris Williams, Megan Nagarajah, David D Eisenstat, Maria C McCarthy","doi":"10.2196/90177","DOIUrl":"10.2196/90177","url":null,"abstract":"<p><strong>Background: </strong>Pediatric cancer presents many challenges for young patients and families that extend beyond active treatment. Families report significant unmet information and supportive care needs at the end of treatment (EOT). Digital health solutions, such as patient apps, offer a potential solution to address current gaps in care.</p><p><strong>Objective: </strong>This study aimed to develop and test a smartphone app called LotusLab, designed to improve access to survivorship information for parents of childhood cancer survivors aged 0 to 18 years, and for young people (aged 12 years and older) at the EOT. In addition, this study aimed to examine parents' and health care providers' (HCPs) perceptions of LotusLab during β-testing to inform further app development and refinement.</p><p><strong>Methods: </strong>Participants were invited to explore the content and key functionality of LotusLab, including an embedded patient-reported outcome measure (PROM). Evaluation of the usability, acceptability, usefulness, and feasibility of the app was conducted through quantitative surveys and qualitative semistructured interviews.</p><p><strong>Results: </strong>Participants comprised 8 parents whose children had completed cancer treatment, and 9 HCPs. All participants (100%) \"agreed\" or \"strongly agreed\" that the app was acceptable; however, HCPs reported more neutral acceptability responses compared with parents. Parents scored app usability more highly, with a mean System Usability Scale (SUS) score of 86.88 (SD 8.74), than HCPs' mean SUS score of 66.39 (SD 10.16). A common perceived benefit of LotusLab was the provision of trusted information and psychosocial resources. Suggestions for improvement included adding a search function, enhancing the layout, and adding additional topics. All parents completed the app-embedded PROM. Both cohorts noted the value of the PROM in enhancing EOT consultations, while highlighting considerations for the effective integration of and response to PROM data.</p><p><strong>Conclusions: </strong>Initial data indicate that LotusLab is easy for parents to use and provides value through the provision of EOT information and the opportunity to enhance the use of the PROM. Consistent with the co-design methodology, these findings are guiding the ongoing development and implementation of LotusLab.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"12 ","pages":"e90177"},"PeriodicalIF":2.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Health Interventions and Psychosocial Outcomes in Women With Breast Cancer: Systematic Review.","authors":"Rocío Zúñiga-Tapia, Mercè Boixadós, Eulàlia Hernández Encuentra","doi":"10.2196/96858","DOIUrl":"10.2196/96858","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Breast cancer and its treatment can negatively affect women's quality of life (QoL), including physical, psychological, and social well-being. Digital health interventions have been increasingly used to provide supportive care, but their effectiveness on QoL and related psychosocial outcomes remains unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This review aimed to evaluate the effectiveness of digital health interventions on QoL in women with breast cancer and to assess their effects on anxiety, depression, and self-efficacy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This systematic review was registered in PROSPERO (CRD420250578307) and conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. PsycINFO, Web of Science, Scopus, LILACS, and SciELO were searched in September 2025. Eligible studies were randomized controlled trials (RCTs) or controlled quasi-experimental studies with preintervention and postintervention assessments that evaluated digital health interventions in women with breast cancer during or up to 1 year after active treatment and reported QoL outcomes. Two reviewers independently screened all records (interrater agreement &gt;90%) and extracted data using a standardized template, with independent verification by a second reviewer. Risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2) for RCTs and the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool for the quasi-experimental study; findings were synthesized narratively following the Synthesis Without Meta-analysis (SWiM) guideline.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 408 records were identified, and 15 studies were included: 14 RCTs and 1 quasi-experimental study. Sample sizes ranged from 35 to 394 participants. Ten studies evaluated internet-based approaches such as websites or apps; 3 used text messaging (eg, WhatsApp [WhatsApp LLC] or WeChat [Tencent Technology, Shenzhen Company Limited]), 1 used virtual reality, and 1 used an email listserve. The direction of effect favored the digital intervention for QoL in 8 of the 15 studies. Self-efficacy was assessed in 5 studies and favored the intervention in only 1, with the effect not maintained at follow-up. Anxiety, depression, or emotional distress were assessed in 13 studies, with a favorable direction of effect in 5. Retention rates ranged from 68.6% to 100%. Among the 14 RCTs, 3 were judged at high overall risk of bias, and 11 raised some concerns; none was at low risk. The quasi-experimental study had a serious overall risk of bias. Certainty of evidence was low for QoL and emotional outcomes and very low for self-efficacy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Digital health interventions may provide modest, short-term improvements in some dimensions of QoL in women with breast cancer. Favorable effects appeared more often in interventions with active therapeutic components or professional support; howeve","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"12 ","pages":"e96858"},"PeriodicalIF":2.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer Clinician Experiences With Telehealth Across Oncology Specialties: Cross-Sectional Survey Study.","authors":"Benjamin Baker, Sakshith Reddy Chintala, Sarah Azari, James D Murphy, Hala Madanat, Maria Elena Martinez, Richard M Cripps, Aditya Bagrodia, Humberto Parada, Juan Javier-DesLoges","doi":"10.2196/94610","DOIUrl":"10.2196/94610","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Telehealth use expanded rapidly during the COVID-19 pandemic and has since become integrated into routine oncology care. However, clinician experiences and confidence with telehealth may vary across oncology subspecialties, and these differences remain incompletely characterized.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to evaluate telehealth perceptions, decision-making factors, and confidence across oncology clinicians from multiple specialties at a single academic cancer center.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a cross-sectional survey of oncology clinicians at the University of California San Diego Moores Cancer Center. A 27-item Qualtrics questionnaire was distributed by email to attending physicians, fellows, and advanced practice providers across surgical, medical, radiation, and palliative oncology. Survey domains included telehealth coordination, technical quality, communication effectiveness, confidence in remote physical examination, and factors influencing visit modality selection. Quantitative responses were summarized descriptively, and open-ended responses underwent thematic analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 114 invited clinicians, 57 (50%) complete responses were analyzed. Among 57 respondents, 86% (n=49) were physicians. Specialties included surgical oncology (n=21, 36.8%), medical oncology (n=18, 31.6%), radiation oncology (n=16, 28.1%), and palliative care (n=2, 3.5%). Telehealth coordination was rated easy or very easy by 78.9% (n=45) of clinicians. Audio and video quality were rated good or very good by 71.9% (n=41) and 57.9% (n=33), respectively. Technical issues prompted at least occasional conversion to audio-only visits for 86% (n=49) of respondents, and 17.5% (n=10) of clinicians reported frequent conversion. Communication satisfaction was high (n=48, 84.2%), yet only 50.9% (n=29) reported moderate or high confidence in performing a virtual physical examination. The need for physical examination (n=53, 93%) and patient travel distance (n=45, 78.9%) were the most influential factors in offering telehealth visits. Confidence varied by specialty and clinical phase: moderate or high confidence was reported by surgical oncology clinicians in 52.4% (11/21) of preoperative and 71.4% (15/21) of postoperative responses, by medical oncology clinicians in 77.8% (14/18) of prechemotherapy and 76.5% (13/17) of during chemotherapy responses, and by radiation oncology clinicians in 87.5% (14/16) of preradiation and 93.8% (15/16) of during radiation responses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Oncology clinicians reported generally positive experiences with telehealth, although confidence and use patterns varied across specialties and phases of care. Telehealth is viewed as a complementary modality when physical examination is not essential. Improvements in technical reliability and interpreter integration may enhance equitable access and support continued telehealth ","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"12 ","pages":"e94610"},"PeriodicalIF":2.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}