Interactive Journal of Medical Research最新文献

{"title":"Validation of a Brief Internet-Based Self-Report Measure of Maladaptive Personality and Interpersonal Schema: Confirmatory Factor Analysis.","authors":"Hyeonseong Kim,&nbsp;Seohyun Jeong,&nbsp;Inae Hwang,&nbsp;Kiyoung Sung,&nbsp;Woori Moon,&nbsp;Min-Sup Shin","doi":"10.2196/48425","DOIUrl":"10.2196/48425","url":null,"abstract":"<p><strong>Background: </strong>Existing digital mental health interventions mainly focus on the symptoms of specific mental disorders, but do not focus on Maladaptive Personalities and Interpersonal Schemas (MPISs). As an initial step toward considering personalities and schemas in intervention programs, there is a need for the development of tools for measuring core personality traits and interpersonal schemas known to cause psychological discomfort among potential users of digital mental health interventions. Thus, the MPIS was developed.</p><p><strong>Objective: </strong>The objectives of this study are to validate the MPIS by comparing 2 models of the MPIS factor structure and to understand the characteristics of the MPIS by assessing its correlations with other measures.</p><p><strong>Methods: </strong>Data were collected from 234 participants who were using web-based community sites in South Korea, including university students, graduate students, working professionals, and homemakers. All the data were gathered through web-based surveys. Confirmatory factor analysis was used to compare a single-factor model with a 5-factor model. Reliability and correlation analyses with other scales were performed.</p><p><strong>Results: </strong>The results of confirmatory factor analysis indicated that the 5-factor model (χ²₅₅₀=1278.1; Tucker-Lewis index=0.80; comparative fit index=0.81; and Root Mean Square Error of Approximation=0.07) was more suitable than the single-factor model (χ²₅₆₀=2341.5; Tucker-Lewis index=0.52; comparative fit index=0.54; and Root Mean Square Error of Approximation=0.11) for measuring maladaptive personality traits and interpersonal relationship patterns. The internal consistency of each factor of the MPIS was good (Cronbach α=.71-.88), and the correlations with existing measures were statistically significant. The MPIS is a validated 35-item tool for measuring 5 essential personality traits and interpersonal schemas in adults aged 18-39 years.</p><p><strong>Conclusions: </strong>This study introduced the MPIS, a concise and effective questionnaire capable of measuring maladaptive personality traits and interpersonal relationship schemas. Through analysis, the MPIS was shown to reliably assess these psychological constructs and validate them. Its web-based accessibility and reduced item count make it a valuable tool for mental health assessment. Future applications include its integration into digital mental health care services, allowing easy web-based administration and aiding in the classification of psychological therapy programs based on the obtained results.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05952063; https://www.clinicaltrials.gov/study/NCT05952063.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10576229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41169125","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":"Development of a Core Set of Quality Criteria for Virtual Reality Applications Designed for Older Adults: Multistep Qualitative Study.","authors":"Alina Napetschnig,&nbsp;Klara Brixius,&nbsp;Wolfgang Deiters","doi":"10.2196/45433","DOIUrl":"10.2196/45433","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality (VR) applications are gaining growing significance, particularly among older adults. These applications can provide valuable support to older adults by offering immersive VR content that positively influences various aspects of their daily lives, including activities of daily living. Furthermore, VR applications can contribute to the enhancement of cognitive and motor skills, ultimately leading to an improved quality of life for older individuals. Nevertheless, to ensure a positive impact, it is crucial to develop VR experiences that are tailored to the needs and preferences of the users.</p><p><strong>Objective: </strong>This study aims to develop a core set of quality criteria and guidelines for the development of user-centered VR applications specifically designed for older adults (target group).</p><p><strong>Methods: </strong>The multistep qualitative study design comprised several key stages, beginning with a systematic literature search. This was followed by a framework analysis aimed at identifying a core set of criteria. Subsequently, these criteria underwent validation through expert workshops. The outcomes achieved through this iterative process were organized and categorized into criteria, accompanied by explanations detailing the underlying categories or codes.</p><p><strong>Results: </strong>The quality criteria core set for older adults-friendly VR applications has been developed through an iterative process. It is divided into 2 distinct parts, each containing criteria categorized into specific areas. The first part includes the following categories: (1) quality assurance of medical/health content, (2) data protection provisions, (3) quality requirements, (4) consumer protection, and (5) interoperability. The second part includes the following categories: (1) graphic/quality, (2) 3D character/avatar, (3) providing in-game instructions and prompts, (4) interaction, (5) navigation, and (6) promotion of user motivation and loyalty to use. The results imply a differentiated scope as well as a differentiated granularity of the criteria.</p><p><strong>Conclusions: </strong>Considering the ongoing advancement of VR technology and the diverse needs within the older adult demographic, it is essential to assess the quality criteria core set results on an individual basis.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10568390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41123386","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":"Normal Workflow and Key Strategies for Data Cleaning Toward Real-World Data: Viewpoint.","authors":"Manping Guo,&nbsp;Yiming Wang,&nbsp;Qiaoning Yang,&nbsp;Rui Li,&nbsp;Yang Zhao,&nbsp;Chenfei Li,&nbsp;Mingbo Zhu,&nbsp;Yao Cui,&nbsp;Xin Jiang,&nbsp;Song Sheng,&nbsp;Qingna Li,&nbsp;Rui Gao","doi":"10.2196/44310","DOIUrl":"10.2196/44310","url":null,"abstract":"<p><p>With the rapid development of science, technology, and engineering, large amounts of data have been generated in many fields in the past 20 years. In the process of medical research, data are constantly generated, and large amounts of real-world data form a \"data disaster.\" Effective data analysis and mining are based on data availability and high data quality. The premise of high data quality is the need to clean the data. Data cleaning is the process of detecting and correcting \"dirty data,\" which is the basis of data analysis and management. Moreover, data cleaning is a common technology for improving data quality. However, the current literature on real-world research provides little guidance on how to efficiently and ethically set up and perform data cleaning. To address this issue, we proposed a data cleaning framework for real-world research, focusing on the 3 most common types of dirty data (duplicate, missing, and outlier data), and a normal workflow for data cleaning to serve as a reference for the application of such technologies in future studies. We also provided relevant suggestions for common problems in data cleaning.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10557005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41175065","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":"Outsourcing the Management of Reusable Medical Devices in a Chain-Wide Care Setting: Mixed Methods Feasibility Study.","authors":"Bart A C Noort, Paul Buijs, Oskar Roemeling","doi":"10.2196/41409","DOIUrl":"10.2196/41409","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Managing reusable medical devices incurs substantial health care costs and complexity, particularly in integrated care settings. This complexity hampers care quality, safety, and costs. Studying logistical innovations within integrated care can provide insights to medical devices use among staff effectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to establish the feasibility of a logistical intervention through outsourcing and a web portal. The goal was to provide insights into users' acceptability of the intervention, on whether the intervention was successfully implemented, and on the intervention's preliminary efficacy, thus benefiting practitioners and researchers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This paper presents a mixed methods feasibility study at a large chain-wide health care provider in the Netherlands. The intervention entailed outsourcing noncritical reusable medical devices and introducing a web portal for device management. A questionnaire gauged perceived ordering and delivery times, satisfaction with the ordering and delivery process, compliance with safety and hygiene certification, and effects on the care delivery process. Qualitative data in the form of observations, documentation, and interviews were used to identify implementing challenges. Using on-site stocktaking and data from information systems, we analyzed the utilization, costs, and rental time of medical devices before and after the intervention for wheelchairs and anti-pressure ulcer mattresses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Looking at the acceptability of the intervention, a high user satisfaction with the ordering and delivery process was reported (rated on a 5-point Likert scale). With respect to preliminary efficacy, we noted a reduction in the utilization of wheelchairs (on average, 1106, SD 106 fewer utilization d/mo), and a halted increase in the utilization of anti-pressure ulcer mattresses. In addition, nurses who used the web portal reported shorter ordering times for wheelchairs (-2.7 min) and anti-pressure ulcer mattresses (-3.1 min), as well as shorter delivery times for wheelchairs (-0.5 d). Moreover, an increase in device certification was reported (average score of 1.9, SD 1.0), indicating higher levels of safety and hygiene standards. In theory, these improvements should translate into better outcomes in terms of costs and the quality of care. However, we were unable to establish a reduction in total care costs or a reduced rental time per device. Furthermore, respondents did not identify improvements in safety or the quality of care. Although implementation challenges related to the diverse supply base and complexities with different care financers were observed, the overall implementation of the intervention was considered successful.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study confirms the feasibility of our intervention, in terms of acceptability, implementation success, and preliminary efficacy.","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10548324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41167432","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 Artificial Intelligence Exercise Coaching Mobile App: Development and Randomized Controlled Trial to Verify Its Effectiveness in Posture Correction.","authors":"Han Joo Chae,&nbsp;Ji-Been Kim,&nbsp;Gwanmo Park,&nbsp;David Michael O'Sullivan,&nbsp;Jinwook Seo,&nbsp;Jung-Jun Park","doi":"10.2196/37604","DOIUrl":"10.2196/37604","url":null,"abstract":"<p><strong>Background: </strong>Insufficient physical activity due to social distancing and suppressed outdoor activities increases vulnerability to diseases like cardiovascular diseases, sarcopenia, and severe COVID-19. While bodyweight exercises, such as squats, effectively boost physical activity, incorrect postures risk abnormal muscle activation joint strain, leading to ineffective sessions or even injuries. Avoiding incorrect postures is challenging for novices without expert guidance. Existing solutions for remote coaching and computer-assisted posture correction often prove costly or inefficient.</p><p><strong>Objective: </strong>This study aimed to use deep neural networks to develop a personal workout assistant that offers feedback on squat postures using only mobile devices-smartphones and tablets. Deep learning mimicked experts' visual assessments of proper exercise postures. The effectiveness of the mobile app was evaluated by comparing it with exercise videos, a popular at-home workout choice.</p><p><strong>Methods: </strong>Twenty participants were recruited without squat exercise experience and divided into an experimental group (EXP) with 10 individuals aged 21.90 (SD 2.18) years and a mean BMI of 20.75 (SD 2.11) and a control group (CTL) with 10 individuals aged 22.60 (SD 1.95) years and a mean BMI of 18.72 (SD 1.23) using randomized controlled trials. A data set with over 20,000 squat videos annotated by experts was created and a deep learning model was trained using pose estimation and video classification to analyze the workout postures. Subsequently, a mobile workout assistant app, Home Alone Exercise, was developed, and a 2-week interventional study, in which the EXP used the app while the CTL only followed workout videos, showed how the app helps people improve squat exercise.</p><p><strong>Results: </strong>The EXP significantly improved their squat postures evaluated by the app after 2 weeks (Pre: 0.20 vs Mid: 4.20 vs Post: 8.00, P=.001), whereas the CTL (without the app) showed no significant change in squat posture (Pre: 0.70 vs Mid: 1.30 vs Post: 3.80, P=.13). Significant differences were observed in the left (Pre: 75.06 vs Mid: 76.24 vs Post: 63.13, P=.02) and right (Pre: 71.99 vs Mid: 76.68 vs Post: 62.82, P=.03) knee joint angles in the EXP before and after exercise, with no significant effect found for the CTL in the left (Pre: 73.27 vs Mid: 74.05 vs Post: 70.70, P=.68) and right (Pre: 70.82 vs Mid: 74.02 vs Post: 70.23, P=.61) knee joint angles.</p><p><strong>Conclusions: </strong>EXP participants trained with the app experienced faster improvement and learned more nuanced details of the squat exercise. The proposed mobile app, offering cost-effective self-discovery feedback, effectively taught users about squat exercises without expensive in-person trainer sessions.</p><p><strong>Trial registration: </strong>Clinical Research Information Service KCT0008178 (retrospectively registered); https://cris.nih.go.kr/cri","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10523222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10224097","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":"Animated Videos Based on Food Processing for Guidance of Brazilian Adults: Validation Study.","authors":"Maria Fernanda Gomes da Silva,&nbsp;Luciana Neri Nobre,&nbsp;Edson da Silva","doi":"10.2196/49092","DOIUrl":"10.2196/49092","url":null,"abstract":"<p><strong>Background: </strong>Ultraprocessed foods (UPFs) contribute almost one-fifth of the calories consumed by the Brazilian population. This consumption has been favored by aspects such as the ease of acquisition and low cost of this food group. Initiatives focused on supporting and promoting healthy eating practices have been implemented. Among them, the availability of educational resources is an important strategy to maximize the effectiveness of these actions in the field of food and nutrition education (FNE).</p><p><strong>Objective: </strong>This study aims to describe the development and validation process of animated videos based on the NOVA food classification for FNE actions aimed at Brazilian adults.</p><p><strong>Methods: </strong>This methodological study was developed in the following 4 phases: planning, preproduction, production, and postproduction. In the planning phase, a literature review was con-ducted on the topic and to define the content to be covered. The design of the material was based on the cognitive theory of multimedia learning. In the preproduction phase, video scripts were developed and evaluated by 7 content specialists. In the production phase, videos were developed based on the assessed scripts and then assessed by 3 multimedia production specialists. In the postproduction phase, the videos were evaluated by 15 representatives of the target audience. All results obtained in the evaluation phases were analyzed using the content validity index (CVI).</p><p><strong>Results: </strong>We developed 3 animated videos covering the following themes: food processing levels, food categories according to processing levels, and UPFs and their impact on health. In the evaluation by the content specialists, the scripts of videos 1, 2, and 3 obtained CVIs at the scale level and average method equal to 0.96, 0.98, and 0.98, respectively. When the animated videos were evaluated by multimedia production specialists and representatives of the target audience, these indexes were equal to 1.0. These results attest to the videos' adequacy and quality in communicating the addressed content.</p><p><strong>Conclusions: </strong>The animated videos developed and validated in this study proved to be adequate for their purpose. Thus, it is expected that they will be an important instrument for FNE actions aimed at an adult audience and for disseminating the Dietary Guidelines for the Brazilian Population.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10520766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10578851","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":"Mobile Apps Aimed at Preventing and Handling Unintentional Injuries in Children Aged <7 Years: Systematic Review.","authors":"Annett Schulze,&nbsp;Ann-Kathrin Lindemann,&nbsp;Fabian Brand,&nbsp;Johanna Geppert,&nbsp;Axel Menning,&nbsp;Paula Stehr,&nbsp;Doreen Reifegerste,&nbsp;Constanze Rossmann","doi":"10.2196/45258","DOIUrl":"10.2196/45258","url":null,"abstract":"<p><strong>Background: </strong>Despite various global health crises, the prevention and handling of unintentional childhood injuries remains an important public health objective. Although several systematic reviews have examined the effectiveness of different child injury prevention measures, these reviews did not address the evaluation of mobile communication intervention tools. Whether and how mobile apps were evaluated provides information on the extent to which communication theories, models, and evidence-based knowledge were considered. Previous studies have shown that the effectiveness of mobile apps increases when theories and evidence are considered during their development.</p><p><strong>Objective: </strong>This systematic review aimed to identify research on mobile apps dealing with the prevention and handling of unintentional injuries in children and examine the theoretical and methodological approaches thereof. In addition, this review analyzed the different needs of various target groups of the mobile apps described in the articles.</p><p><strong>Methods: </strong>In total, 8 electronic databases, ranging from interdisciplinary to medical and technical as well as social sciences databases, were searched for original research articles or brief reports in peer-reviewed journals or conference proceedings. Moreover, this review encompassed a systematic scan of articles published in the BMJ journal Injury Prevention. These steps were followed by a snowball search based on the literature references in the articles identified through the initial screening. The articles had to be written in English or German, published between 2008 and 2021, and evaluate mobile apps dealing with the prevention and handling of unintentional child injuries. The identified 5 studies were analyzed by 5 independent researchers using an inductive approach. Furthermore, the quality of the studies was assessed using the Mixed Methods Appraisal Tool.</p><p><strong>Results: </strong>A total of 5 articles were included and assessed with regard to overall quality of theoretical and methodological foundations, assessed variables, the focal app's architecture, and the needs of the study participants. The overall study quality was moderate, although part of this classification was due to a lack of details reported in the studies. Each study examined 1 mobile app aimed at parents and other caregivers. Each study assessed at least 1 usability- or user experience-related variable, whereas the needs of the included study participants were detailed in only 20% (1/5) of the cases. However, none of the studies referred to theories such as the Technology Acceptance Model during the development of the apps.</p><p><strong>Conclusions: </strong>The future development and evaluation of apps dealing with the prevention and handling of child injuries should combine insights into existing models on user experience and usability with established theories on mobile information behavior. T","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10512123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10160263","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":"Rapidly Deteriorating Degenerative Cervical Myelopathy Following Ventricular Shunt Revision for Hydrocephalus: Case Report.","authors":"Tanzil Rujeedawa,&nbsp;Oliver Mowforth,&nbsp;Mark Kotter,&nbsp;Benjamin Davies","doi":"10.2196/48222","DOIUrl":"https://doi.org/10.2196/48222","url":null,"abstract":"<p><p>A female patient in her early 40s presented with a several-month history of gait unsteadiness and dragging her left leg. She had a background of congenital hydrocephalus, treated with a ventriculoatrial shunt. On examination, she had increased tone and brisk reflexes in the lower limbs and a positive Hoffmann sign. A computed tomography (CT) scan and shunt series x-rays identified hydrocephalus secondary to a disconnected shunt. Magnetic resonance imaging (MRI) of her cervical spine was also performed as part of the workup for her presenting symptoms and demonstrated features compatible with degenerative cervical myelopathy (DCM). The patient subsequently underwent a shunt revision. Following the operation, her walking and hand function deteriorated over a period of several weeks. She consequently underwent an anterior cervical decompression and fusion for DCM, which partially improved her symptoms. The sequence of events suggests that the shunt surgery may have precipitated a worsening of the DCM. Possible explanations include spinal cord injury related to neck extension or hypoperfusion during intubation and general anesthesia or the loss of cerebrospinal fluid cushioning following the reinstitution of effective cerebrospinal fluid shunting. Surgeons should be alert to this possibility and offer prompt surgical intervention for DCM if required.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10495845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10236549","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":"Mobile Health-Supported Active Syndrome Surveillance for COVID-19 Early Case Finding in Addis Ababa, Ethiopia: Comparative Study.","authors":"Haileleul Bisrat, Tsegahun Manyazewal, Abebaw Fekadu","doi":"10.2196/43492","DOIUrl":"10.2196/43492","url":null,"abstract":"<p><strong>Background: </strong>Since most people in low-income countries do not have access to reliable laboratory services, early diagnosis of life-threatening diseases like COVID-19 remains challenging. Facilitating real-time assessment of the health status in a given population, mobile health (mHealth)-supported syndrome surveillance might help identify disease conditions earlier and save lives cost-effectively.</p><p><strong>Objective: </strong>This study aimed to evaluate the potential use of mHealth-supported active syndrome surveillance for COVID-19 early case finding in Addis Ababa, Ethiopia.</p><p><strong>Methods: </strong>A comparative cross-sectional study was conducted among adults randomly selected from the Ethio telecom list of mobile phone numbers. Participants underwent a comprehensive phone interview for COVID-19 syndromic assessments, and their symptoms were scored and interpreted based on national guidelines. Participants who exhibited COVID-19 syndromes were advised to have COVID-19 diagnostic testing at nearby health care facilities and seek treatment accordingly. Participants were asked about their test results, and these were cross-checked against the actual facility-based data. Estimates of COVID-19 detection by mHealth-supported syndromic assessments and facility-based tests were compared using Cohen Kappa (κ), the receiver operating characteristic curve, sensitivity, and specificity analysis.</p><p><strong>Results: </strong>A total of 2741 adults (n=1476, 53.8% men and n=1265, 46.2% women) were interviewed through the mHealth platform during the period from December 2021 to February 2022. Among them, 1371 (50%) had COVID-19 symptoms at least once and underwent facility-based COVID-19 diagnostic testing as self-reported, with 884 (64.5%) confirmed cases recorded in facility-based registries. The syndrome assessment model had an optimal likelihood cut-off point sensitivity of 46% (95% CI 38.4-54.6) and specificity of 98% (95% CI 96.7-98.9). The area under the receiver operating characteristic curve was 0.87 (95% CI 0.83-0.91). The level of agreement between the mHealth-supported syndrome assessment and the COVID-19 test results was moderate (κ=0.54, 95% CI 0.46-0.60).</p><p><strong>Conclusions: </strong>In this study, the level of agreement between the mHealth-supported syndromic assessment and the actual laboratory-confirmed results for COVID-19 was found to be reasonable, at 89%. The mHealth-supported syndromic assessment of COVID-19 represents a potential alternative method to the standard laboratory-based confirmatory diagnosis, enabling the early detection of COVID-19 cases in hard-to-reach communities, and informing patients about self-care and disease management in a cost-effective manner. These findings can guide future research efforts in developing and integrating digital health into continuous active surveillance of emerging infectious diseases.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10464850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10472881","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":"Web-Based Application Based on Human-in-the-Loop Deep Learning for Deidentifying Free-Text Data in Electronic Medical Records: Development and Usability Study.","authors":"Leibo Liu,&nbsp;Oscar Perez-Concha,&nbsp;Anthony Nguyen,&nbsp;Vicki Bennett,&nbsp;Victoria Blake,&nbsp;Blanca Gallego,&nbsp;Louisa Jorm","doi":"10.2196/46322","DOIUrl":"https://doi.org/10.2196/46322","url":null,"abstract":"<p><strong>Background: </strong>The narrative free-text data in electronic medical records (EMRs) contain valuable clinical information for analysis and research to inform better patient care. However, the release of free text for secondary use is hindered by concerns surrounding personally identifiable information (PII), as protecting individuals' privacy is paramount. Therefore, it is necessary to deidentify free text to remove PII. Manual deidentification is a time-consuming and labor-intensive process. Numerous automated deidentification approaches and systems have been attempted to overcome this challenge over the past decade.</p><p><strong>Objective: </strong>We sought to develop an accurate, web-based system deidentifying free text (DEFT), which can be readily and easily adopted in real-world settings for deidentification of free text in EMRs. The system has several key features including a simple and task-focused web user interface, customized PII types, use of a state-of-the-art deep learning model for tagging PII from free text, preannotation by an interactive learning loop, rapid manual annotation with autosave, support for project management and team collaboration, user access control, and central data storage.</p><p><strong>Methods: </strong>DEFT comprises frontend and backend modules and communicates with central data storage through a filesystem path access. The frontend web user interface provides end users with a user-friendly workspace for managing and annotating free text. The backend module processes the requests from the frontend and performs relevant persistence operations. DEFT manages the deidentification workflow as a project, which can contain one or more data sets. Customized PII types and user access control can also be configured. The deep learning model is based on a Bidirectional Long Short-Term Memory-Conditional Random Field (BiLSTM-CRF) with RoBERTa as the word embedding layer. The interactive learning loop is further integrated into DEFT to speed up the deidentification process and increase its performance over time.</p><p><strong>Results: </strong>DEFT has many advantages over existing deidentification systems in terms of its support for project management, user access control, data management, and an interactive learning process. Experimental results from DEFT on the 2014 i2b2 data set obtained the highest performance compared to 5 benchmark models in terms of microaverage strict entity-level recall and F₁-scores of 0.9563 and 0.9627, respectively. In a real-world use case of deidentifying clinical notes, extracted from 1 referral hospital in Sydney, New South Wales, Australia, DEFT achieved a high microaverage strict entity-level F₁-score of 0.9507 on a corpus of 600 annotated clinical notes. Moreover, the manual annotation process with preannotation demonstrated a 43% increase in work efficiency compared to the process without preannotation.</p><p><strong>Conclusions: </strong>DEFT is d","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10576704","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}