Interactive Journal of Medical Research最新文献

{"title":"Investigating the Association Between Mean Arterial Pressure on 28-Day Mortality Risk in Patients With Sepsis: Retrospective Cohort Study Based on the MIMIC-IV Database.","authors":"Qimin Chen, Wei Li, Ying Wang, Xianjun Chen, Dehua He, Ming Liu, Jia Yuan, Chuan Xiao, Qing Li, Lu Chen, Feng Shen","doi":"10.2196/63291","DOIUrl":"10.2196/63291","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is a globally recognized health issue that continues to contribute significantly to mortality and morbidity in intensive care units (ICUs). The association between mean arterial pressure (MAP) and prognosis among patients with patients is yet to be demonstrated.</p><p><strong>Objective: </strong>The aim of this study was to explore the association between MAP and 28-day mortality in ICU patients with sepsis using data from a large, multicenter database.</p><p><strong>Methods: </strong>This is a retrospective cohort study. We extracted data of 35,010 patients with sepsis from the MIMIC-IV (Medical Information Mart for Intensive Care) database between 2008 and 2019, according to the Sepsis 3.0 diagnostic criteria. The MAP was calculated as the average of the highest and lowest readings within the first 24 hours of ICU admission, and patients were divided into 4 groups based on the mean MAP, using the quadruple classification approach. Other worst-case indications from the first 24 hours of ICU admission, such as vital signs, severity of illness scores, laboratory indicators, and therapies, were also gathered as baseline data. The independent effects of MAP on 28-day mortality were explored using binary logistic regression and a two-piecewise linear model, with MAP as the exposure and 28-day mortality as the outcome variables, respectively. To address the nonlinearity relationship, curve fitting and a threshold effect analysis were performed.</p><p><strong>Results: </strong>A total of 34,981 patients with sepsis were included in the final analysis, the mean age was 66.67 (SD 16.01) years, and the 28-day mortality rate was 16.27% (5691/34,981). The generalized additive model and smoothed curve fitting found a U-shaped relationship between MAP and 28-day mortality in these patients. The recursive algorithm determined the low and high inflection points as 70 mm and 82 mm Hg, respectively. Our data demonstrated that MAP was negatively associated with 28-day mortality in the range of 34.05 mm Hg-69.34 mm Hg (odds ratio [OR] 0.93, 95% CI 0.92-0.94; P<.001); however, once the MAP exceeded 82 mm Hg, a positive association existed between MAP and 28-day mortality of patients with sepsis (OR 1.01; 95% CI 1.01-1.02, P=.002).</p><p><strong>Conclusions: </strong>There is a U-shaped association between MAP and the probability of 28-day mortality in patients with sepsis. Both the lower and higher MAP were related with a higher risk of mortality in patients with sepsis. These patients have a decreased risk of mortality when their MAP remains between 70 and 82 mm Hg.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e63291"},"PeriodicalIF":1.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568802","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":"How to Design Electronic Case Report Form (eCRF) Questions to Maximize Semantic Interoperability in Clinical Research.","authors":"Eugenia Rinaldi, Caroline Stellmach, Sylvia Thun","doi":"10.2196/51598","DOIUrl":"10.2196/51598","url":null,"abstract":"<p><strong>Unlabelled: </strong>Case report forms (CRFs) are the instruments used by research organizations worldwide to collect information about patients and study participants with the purpose of answering specific questions, assessing the efficacy and safety of medical products, and in general improving prevention and treatment in health care. To obtain significant research results out of the collected data, CRFs should be designed following the recommendations issued by regulatory authorities. However, we believe that semantic interoperability in CRFs has not yet been properly addressed. Within an international consortium comprising several COVID-19 cohorts, we scrutinized the questions included in the different CRFs with the purpose of establishing semantic interoperability across the different study data elements so that data could be merged and jointly analyzed. We realized that similar concepts were structured very differently across the different CRFs, making it hard to find and match the information. Based on the experience acquired, we developed 5 guiding principles on how to design CRFs to support semantic interoperability and increase data quality while also facilitating the sharing of data. Our aim in this viewpoint is to provide general suggestions that, in our opinion, should support researchers in designing CRFs. We conclude by urging authorities to establish an international coordination board for standards and interoperable clinical study data with competence in clinical data, interoperability standards, and data protection as part of a preparedness plan for future pandemics or other health threats.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e51598"},"PeriodicalIF":1.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607258","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":"Global Evidence on the Sustainability of Telemedicine in Outpatient and Primary Care During the First 2 Years of the COVID-19 Pandemic: Scoping Review Using the Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) Framework.","authors":"Daniela Valdes, Ankit Shanker, Ghofran Hijazi, Daniel Opoku Mensah, Tahir Bockarie, Ioana Lazar, Siti Aishah Ibrahim, Hamid Zolfagharinia, Rob Procter, Rachel Spencer, Jeremy Dale, Armina Paule, Liam Jonathon Medlin, Keerthana Tharuvara Kallottil","doi":"10.2196/45367","DOIUrl":"10.2196/45367","url":null,"abstract":"<p><strong>Background: </strong>The rapid implementation of telemedicine during the early stages of the COVID-19 pandemic raises questions about the sustainability of this intervention at the global level.</p><p><strong>Objective: </strong>This research examines the patient experience, health inequalities, and clinician-patient relationship in telemedicine during the COVID-19 pandemic's first 2 years, aiming to identify sustainability factors.</p><p><strong>Methods: </strong>This study was based on a prepublished protocol using the Joanna Briggs Institute (JBI) methodology for scoping reviews. We included academic and gray literature published between March 2020 and March 2022 according to these criteria: (1) population (any group); (2) concepts (patient experience, clinician-patient relationship, health inequalities); (3) context (telemedicine in primary and outpatient care); (4) excluding studies pertaining to surgery, oncology, and (inpatient) psychiatry. We searched Ovid Medline/PubMed (January 1, 2022), Web of Science (March 19, 2022), Google/Google Scholar (February and March 2022), and others. The risk of bias was not assessed as per guidance. We used an analysis table for the studies and color-coded tabular mapping against a health care technology adoption framework to identify sustainability (using double-blind extraction).</p><p><strong>Results: </strong>Of the 134 studies that met our criteria, 49.3% (66/134) reported no specific population group. Regarding the concepts, 41.8% (56/134) combined 2 of the concepts studied. The context analysis identified that 56.0% (75/134) of the studies referred to, according to the definition in the United Kingdom, an outpatient (ambulatory care) setting, and 34.3% (46/134) referred to primary care. The patient experience analysis reflected positive satisfaction and sustained access during lockdowns. The clinician-patient relationship impacts were nuanced, affecting interaction and encounter quality. When mapping to the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework, 81.3% (109/134) of the studies referenced the innovation's sustainability. Although positive overall, there were some concerns about sustainability based on quality, eHealth literacy, and access to health care for vulnerable migrants and the uninsured.</p><p><strong>Conclusions: </strong>We identified confusion between the concepts of patient experience and patient satisfaction; therefore, future research could focus on established frameworks to qualify the patient experience across the whole pathway and not just the remote encounter. As expected, our research found mainly descriptive analyses, so there is a need for more robust evidence methods identifying impacts of changes in treatment pathways. This study illustrates modern methods to decolonize academic research by using gray literature extracts in other languages. We acknowledge that the use of Google to identify gray literature at the global level ","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e45367"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576054","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":"French Versions of 4 English Questionnaires on Problematic Smartphone Use: Cross-Cultural Linguistic Translation and Adaptation Study.","authors":"Islam El Boudi, Mathilde Riant, Alexandre Bellier, Nicolas Vuillerme","doi":"10.2196/53958","DOIUrl":"10.2196/53958","url":null,"abstract":"<p><strong>Background: </strong>Excessive use of smartphones is recognized as a major problem in our modern society and can have dramatic consequences on the health of adolescents and young adults. Measuring problematic smartphone use in research and clinical practice is generally operationalized with self-reported questionnaires. In order to comprehensively assess the issue of problematic smartphone usage within the French population, it is imperative to employ validated French-language questionnaires. However, at this point, existing questionnaires are primarily available in English. Furthermore, to the best of our knowledge, these English questionnaires have yet to undergo validation processes for French-speaking cohorts.</p><p><strong>Objective: </strong>The aim of this study was to perform a cross-cultural translation of the Smartphone Addiction Scale, Nomophobia Questionnaire, Problematic Use of Mobile Phones scale, and Smartphone Addiction Proneness Scale to French.</p><p><strong>Methods: </strong>The translation process was performed using the forward/backward method. The first translation phase involved asking 4 independent French translators to translate the original English version of the questionnaires into French. In the second phase, the French version was backtranslated to English by a native English speaker. In the third phase, 2 concept experts were asked to comment and suggest modifications to the statements if necessary. Finally, the last version of the translated questionnaires was presented to 18 participants to assess the clarity, intelligibility, and acceptability of the translations.</p><p><strong>Results: </strong>During the forward translation step, the translation differences were minor. During the backward translation, the English native speaker correctly backtranslated 18 of the 33 items of the Smartphone Addiction Scale, 17 of the 20 items of the Problematic Use of Mobile Phones scale, and 13 of the 15 items of the Smartphone Addiction Proneness Scale. Backtranslation for the Nomophobia Questionnaire was less satisfactory, with only 10 out of 20 items that were correctly backtranslated. The linguistic verification step revealed a minimal modification for the 4 questionnaires. The participants also suggested few improvements that we have considered for the final version. We produced the final version directly after this step.</p><p><strong>Conclusions: </strong>We successfully adapted and effectively translated 4 questionnaires that assess problematic smartphone use to French. This step is a prerequisite for the validation of the French questionnaires. These adapted measures can serve as valuable research instruments for investigating and addressing issues related to problematic smartphone use in French-speaking countries and for making international comparisons.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e53958"},"PeriodicalIF":1.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517268","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":"Current Status and Future Directions of Ferroptosis Research in Breast Cancer: Bibliometric Analysis.","authors":"Jia-Yuan Luo, Yu-Long Deng, Shang-Yi Lu, Si-Yan Chen, Rong-Quan He, Di-Yuan Qin, Bang-Teng Chi, Gang Chen, Xia Yang, Wei Peng","doi":"10.2196/66286","DOIUrl":"10.2196/66286","url":null,"abstract":"<p><strong>Background: </strong>Ferroptosis, as a novel modality of cell death, holds significant potential in elucidating the pathogenesis and advancing therapeutic strategies for breast cancer.</p><p><strong>Objective: </strong>This study aims to comprehensively analyze current ferroptosis research and future trends, guiding breast cancer research advancements and innovative treatment strategies.</p><p><strong>Methods: </strong>This research used the R package Bibliometrix (Department of Economic and Statistical Sciences at the University of Naples Federico II), VOSviewer (Centre for Science and Technology Studies at Leiden University), and CiteSpace (Drexel University's College of Information Science and Technology), to conduct a bibliometric analysis of 387 papers on breast cancer and ferroptosis from the Web of Science Core Collection. The analysis covers authors, institutions, journals, countries or regions, publication volumes, citations, and keywords.</p><p><strong>Results: </strong>The number of publications related to this field has surged annually, with China and the United States collaborating closely and leading in output. Sun Yat-sen University stands out among the institutions, while the journal Frontiers in Oncology and the author Efferth T contribute significantly to the field. Highly cited papers within the domain primarily focus on the induction of ferroptosis, protein regulation, and comparisons with other modes of cell death, providing a foundation for breast cancer treatment. Keyword analysis highlights the maturity of glutathione peroxidase 4-related research, with breast cancer subtypes emerging as motor themes and the tumor microenvironment, immunotherapy, and prognostic models identified as basic themes. Furthermore, the application of nanoparticles serves as an additional complement to the basic themes.</p><p><strong>Conclusions: </strong>The current research status in the field of ferroptosis and breast cancer primarily focuses on the exploration of relevant theoretical mechanisms, whereas future trends and mechanisms emphasize the investigation of therapeutic strategies, particularly the clinical application of immunotherapy related to the tumor microenvironment. Nanotherapy has demonstrated significant clinical potential in this domain. Future research directions should deepen the exploration in this field and accelerate the clinical translation of research findings to provide new insights and directions for the innovation and development of breast cancer treatment strategies.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e66286"},"PeriodicalIF":1.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517267","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":"Increasing Participation and Completion Rates in Questionnaire Surveys of Primary Care Patients: Cluster-Randomized Study.","authors":"Paul Sebo, Benoit Tudrej, Augustin Bernard, Bruno Delaunay, Alexandra Dupuy, Claire Malavergne, Hubert Maisonneuve","doi":"10.2196/67981","DOIUrl":"10.2196/67981","url":null,"abstract":"<p><strong>Background: </strong>Participation and completion rates in questionnaire-based surveys are often low.</p><p><strong>Objective: </strong>This study aims to assess participation and completion rates for a survey using paper and mixed mode questionnaires with patients recruited by research assistants in primary care waiting rooms.</p><p><strong>Methods: </strong>This cluster-randomized study, conducted in 2023 in France, involved 974 patients from 39 practices randomized into 4 groups: \"paper with incentive\" (n=251), \"paper without incentive\" (n=368), \"mixed mode with tablet\" (n=187), and \"mixed mode with QR code\" (n=168). Analyses compared the combined paper group with the 2 mixed mode groups and the \"paper with incentive\" and \"paper without incentive\" groups. Logistic regressions were used to analyze participation and completion rates.</p><p><strong>Results: </strong>Of the 974 patients recruited, 822 (women: 536/821, 65.3%; median age 52, IQR 37-68 years) agreed to participate (participation rate=84.4%), with no significant differences between groups. Overall, 806 patients (98.1%) answered all 48 questions. Completion rates were highest in the combined paper group (99.8%) compared to mixed mode groups (96.8% for paper or tablet, 93.3% for paper or QR code; P<.001). There was no significant difference in completion rates between the \"paper with incentive\" and \"paper without incentive\" groups (100% vs 99.7%).</p><p><strong>Conclusions: </strong>Recruiting patients in waiting rooms with research assistants resulted in high participation and completion rates across all groups. Mixed mode options did not enhance participation or completion rates but may offer logistical advantages. Future research should explore incentives and mixed-mode strategies in diverse settings.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e67981"},"PeriodicalIF":1.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505931","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":"Comparing Digital Versus Face-to-Face Delivery of Systemic Psychotherapy Interventions: Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Pieter Erasmus, Moritz Borrmann, Jule Becker, Lars Kuchinke, Gunther Meinlschmidt","doi":"10.2196/46441","DOIUrl":"10.2196/46441","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;As digital mental health delivery becomes increasingly prominent, a solid evidence base regarding its efficacy is needed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to synthesize evidence on the comparative efficacy of systemic psychotherapy interventions provided via digital versus face-to-face delivery modalities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for searching PubMed, Embase, Cochrane CENTRAL, CINAHL, PsycINFO, and PSYNDEX and conducting a systematic review and meta-analysis. We included randomized controlled trials comparing mental, behavioral, and somatic outcomes of systemic psychotherapy interventions using self- and therapist-guided digital versus face-to-face delivery modalities. The risk of bias was assessed with the revised Cochrane Risk of Bias tool for randomized trials. Where appropriate, we calculated standardized mean differences and risk ratios. We calculated separate mean differences for nonaggregated analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We screened 3633 references and included 12 articles reporting on 4 trials (N=754). Participants were youths with poor diabetic control, traumatic brain injuries, increased risk behavior likelihood, and parents of youths with anorexia nervosa. A total of 56 outcomes were identified. Two trials provided digital intervention delivery via videoconferencing: one via an interactive graphic interface and one via a web-based program. In total, 23% (14/60) of risk of bias judgments were high risk, 42% (25/60) were some concerns, and 35% (21/60) were low risk. Due to heterogeneity in the data, meta-analysis was deemed inappropriate for 96% (54/56) of outcomes, which were interpreted qualitatively instead. Nonaggregated analyses of mean differences and CIs between delivery modalities yielded mixed results, with superiority of the digital delivery modality for 18% (10/56) of outcomes, superiority of the face-to-face delivery modality for 5% (3/56) of outcomes, equivalence between delivery modalities for 2% (1/56) of outcomes, and neither superiority of one modality nor equivalence between modalities for 75% (42/56) of outcomes. Consequently, for most outcome measures, no indication of superiority or equivalence regarding the relative efficacy of either delivery modality can be made at this stage. We further meta-analytically compared digital versus face-to-face delivery modalities for attrition (risk ratio 1.03, 95% CI 0.52-2.03; P=.93) and number of sessions attended (standardized mean difference -0.11; 95% CI -1.13 to -0.91; P=.83), finding no significant differences between modalities, while CIs falling outside the range of the minimal important difference indicate that equivalence cannot be determined at this stage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Evidence on digital and face-to-face modalities for systemic psychotherapy interventions is largely heterogeneous,","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e46441"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494371","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":"Exploring Barriers to Patients' Progression in the Cardiac Rehabilitation Journey From Health Care Providers' Perspectives: Qualitative Study.","authors":"Shri Harini Ramesh, Darwin Jull, Hélène Fournier, Fateme Rajabiyazdi","doi":"10.2196/66164","DOIUrl":"10.2196/66164","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases are one of the leading causes of mortality globally. Cardiac rehabilitation (CR) programs are crucial for patients recovering from cardiac events, as they help reduce the risk of recurrent events and support patient recovery. The patient's journey in CR spans the stages before, during, and after the program. Patients have to progress through each stage of CR programs successfully to complete the entire CR journey and get the full benefits of CR programs, but numerous barriers within this journey can hinder patient progression.</p><p><strong>Objective: </strong>This study aims to explore the barriers to progression at all stages of the CR patient journey from the perspectives of health care providers involved in CR care.</p><p><strong>Methods: </strong>This qualitative study involved semistructured interviews with health care providers involved in CR care from July 2023 to January 2024. A purposive maximal variation sampling method was used to target providers with diverse demographics and specialties. Snowball sampling was used to recruit participants, leveraging the existing networks of participants. Each interview lasted between 30 and 45 minutes. Interviews were recorded, transcribed verbatim, and analyzed using an inductive thematic analysis approach. Data analysis was conducted from August 2023 to February 2024.</p><p><strong>Results: </strong>Ten health care providers, comprising 7 females and 3 males, were interviewed. Their roles included physician, program director, nurse manager, clinical manager, nurse coordinator, nurse, physiotherapist, and kinesiologist. The analysis identified four overarching themes related to barriers to progression in the CR journey: (1) patients not being referred to CR programs, (2) patients not enrolling in CR programs, (3) patients dropping out of CR programs, and (4) patients' lack of adherence to lifestyle changes post-CR programs.</p><p><strong>Conclusions: </strong>In light of the growing interest in technological interventions in CR programs, we proposed 4 potential technological solutions to address the barriers to progression identified in our analysis. These solutions aim to provide a foundation for future research to guide the development of effective technologies and enhance patient progression within the CR journey.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e66164"},"PeriodicalIF":1.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473176","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":"Use of Clinical Public Databases in Hidradenitis Suppurativa Research.","authors":"Xu Liu, Linghong Guo, Xian Jiang","doi":"10.2196/70282","DOIUrl":"10.2196/70282","url":null,"abstract":"<p><p>In this viewpoint, we argue that recent studies using clinical public databases have revolutionized our understanding of hidradenitis suppurativa (HS), a chronic inflammatory skin condition with significant impacts on patients' quality of life. Our key messages are as follows: (1) these databases enable large-scale studies integrating genetic, epidemiological, and clinical data, providing crucial insights into HS's genetic predispositions, comorbidities, and treatment outcomes; (2) findings highlight a strong genetic component, with mutations in the γ-secretase complex playing a key role in HS pathogenesis and shaping targeted therapies; (3) studies also reveal elevated risks for comorbidities like obesity, diabetes, cardiovascular disease, and systemic inflammation in patients with HS, with diet-driven inflammatory pathways potentially exacerbating disease severity; (4) while these databases offer unprecedented research opportunities, limitations such as data representativeness and quality must be considered; (5) nonetheless, their benefits outweigh potential drawbacks, allowing the identification of rare comorbidities, disease progression patterns, and personalized treatment strategies; and (6) increased funding for HS research is crucial to harness these databases' full potential, develop targeted therapies, and ultimately improve patient outcomes. As HS's impact is disproportionate to current research investments, we believe advocating for more resources and addressing database limitations will be key to advancing HS understanding and care.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e70282"},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450936","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":"An Automated Clinical Laboratory Decision Support System for Test Utilization, Medical Necessity Verification, and Payment Processing.","authors":"Safedin Beqaj, Rojeet Shrestha, Tim Hamill","doi":"10.2196/46007","DOIUrl":"10.2196/46007","url":null,"abstract":"<p><p>Physicians could improve the efficiency of the health care system if a reliable resource were available to aid them in better understanding, selecting, and interpreting the diagnostic laboratory tests. It has been well established and widely recognized that (1) laboratory testing provides 70%-85% of the objective data that physicians use in the diagnosis and treatment of their patients; (2) orders for laboratory tests in the United States have increased, with an estimated volume of 4-5 billion tests per year; (3) there is a lack of user-friendly tools to guide physicians in their test selection and ordering; and (4) laboratory test overutilization and underutilization continue to represent a pervasive source of inefficiency in the health care system. These inappropriate test orders not only lead to slower or incorrect diagnoses for patients but also add a significant financial burden. In addition, many ordered tests are not reimbursed by Medicare because they are inappropriate for the medical condition or were ordered with the incorrect International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnostic code, not meeting the medical necessity. Therefore, current clinical laboratory test ordering procedures experience a quality gap. Often, providers do not have access to an appropriate tool that uses evidence-based guidelines or algorithms to ensure that tests are not duplicated, overused, or underused. This viewpoint lays out the potential use of an automated laboratory clinical decision support system that helps providers order the right test for the right disease and documents the right reason or medical necessity to pay for the testing.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":" ","pages":"e46007"},"PeriodicalIF":1.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984782","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}