PLOS digital health最新文献

{"title":"Evaluation of a Canadian social media platform for communicating perinatal health information during a pandemic.","authors":"Gemma Postill, Neesha Hussain-Shamsy, Stephanie Dephoure, Alison Wong, Eliane M Shore, Jeanette Cooper, Negin Pak, Christine Fahim, Danielle Kasperavicius, Tali Bogler","doi":"10.1371/journal.pdig.0000802","DOIUrl":"10.1371/journal.pdig.0000802","url":null,"abstract":"<p><p>Social media platforms, such as Instagram, are increasingly used as a source of health information; however, it is unclear how to effectively leverage these platforms during public health emergencies. @PandemicPregnancyGuide (PPG) was an Instagram account created by Canadian physicians to provide perinatal health information during the COVID-19 pandemic. We conducted a cross-sectional survey, and assessed Instagram analytics, to determine how and why users followed PPG and its impact on health decision-making. Respondents most valued posts explaining scientific articles in lay language and the delivery of content by medical experts. Topics of greatest interest were COVID-19 vaccination while pregnant (76%), COVID-19 infection during pregnancy (71%), and labour and delivery during the pandemic (69%). Respondents self-reported being more likely to use COVID-19 protective measures while pregnant (80%), receive COVID-19 vaccines in pregnancy (87%), and vaccinate their children against COVID-19 (58%) due to the information shared by PPG. Taken together, we demonstrate how healthcare professionals can effectively leverage social media to disseminate health information and improve uptake of public health recommendations. We recommend consideration of our findings in the development of future health-based social media platforms, particularly during public health emergencies or campaigns.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 4","pages":"e0000802"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805065","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":"Unsupervised machine learning identifies opioid taper reversal patterns in a longitudinal cohort (2008-2018).","authors":"Monika Ray, Joshua J Fenton, Patrick S Romano","doi":"10.1371/journal.pdig.0000785","DOIUrl":"10.1371/journal.pdig.0000785","url":null,"abstract":"<p><p>Chronic pain is commonly treated with long-term opioid therapy, but rapid opioid dose tapering has been associated with increased adverse events. Little is known about heterogeneity in the population of patients on high dose opioids and their response to different treatments. Our aim was to examine opioid dose management and other patient characteristics in a longitudinal, clinically diverse, national population of opioid dependent patients. We used spectral clustering, an unsupervised artificial intelligence (AI) approach, to identify patients in a national claims data warehouse who were on an opioid dose tapering regimen from 2008-2018. Due to the size and heterogeneity of our cohort, we did not impose any restrictions on the kind or number of clusters to be identified in the data. Of 113,618 patients with 12 consecutive months at a stable mean opioid dose of  ≥ 50 morphine milligram equivalents, 30,932 had one tapering period that began at the first 60-day period with  ≥ 15% reduction in average daily dose across overlapping 60-day windows through 7 months of follow-up. We identified 10 clusters that were similar in baseline characteristics but differed markedly in the magnitude, velocity, duration, and endpoint of tapering. A cluster comprising 42% of the sample, characterised by moderately rapid, steady tapering, often (73%) to a final dose of zero, had excess drug-related events, mental health events, and deaths, compared with a cluster comprising 55% of the sample, characterised by slow, steady tapering. Four clusters demonstrated tapers of various velocities followed by complete or nearly complete reversal, with combined drug-related event rates close to that of the slowest tapering cluster. Unsupervised AI methods, such as spectral clustering, are powerful to identify clinically meaningful patterns in opioid prescribing data and to highlight salient subpopulation characteristics for designing safe tapering protocols. They are especially useful for identifying rare events in large data. Our findings highlight the importance of considering tapering velocity along with duration and final dose and should stimulate research to understand the causes and consequences of taper reversals in the context of patient-centered care.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 4","pages":"e0000785"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805068","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":"GPS navigation assistance is associated with driving mobility in older drivers.","authors":"Sol Morrissey, Stephen Jeffs, Rachel Gillings, Mizanur Khondoker, Anuraj Varshney, Mary Fisher-Morris, Ed Manley, Michael Hornberger","doi":"10.1371/journal.pdig.0000768","DOIUrl":"10.1371/journal.pdig.0000768","url":null,"abstract":"<p><p>Maintaining driving mobility is essential for maintaining independence and wellbeing within older age. However, cognitive decline caused by age-related neurophysiological changes typically causes older drivers to self-regulate their driving and reduce their driving mobility. Electronic navigation assistance technologies, such as Sat-Nav, are increasingly popular amongst older drivers and can potentially alleviate cognitive demands amongst older drivers to enhance driving mobility. Yet despite the growing usage of navigation assistance technologies amongst older drivers, little research has been conducted to establish how and when they are used by older drivers, and it is not known whether they can offset cognitive decline to promote driving mobility. 895 older drivers (mean age: 71.04) were recruited for a prospective cohort study. Participants self-reported their navigation assistance usage as well as their driving mobility (frequency, space), before completing objective cognitive assessments (allocentric and egocentric orientation, recognition and source memory) and a subjective spatial orientation ability questionnaire. We establish profiles of older driver navigation assistance usage, showing that a considerable majority of older drivers use navigation assistance - with the majority using it for some journeys, and most commonly for the entire journey to a new destination. We show that navigation assistance usage is associated with worse subjective orientation ability, but not objective cognitive performance, and is positively associated with greater driving mobility. Importantly, we demonstrate that within individuals with poor wayfinding ability, navigation assistance usage is associated with increased driving mobility. In conclusion, navigation assistance usage is associated with increased driving mobility within healthy older drivers and is relied upon more by individuals with lower wayfinding confidence. As navigation assistance devices can specifically enhance driving frequency in individuals with worse wayfinding ability, who are more likely to reduce their driving, they should be recommended to older adults and integrated into comprehensive strategies for promoting driving independence in the older adult population.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 4","pages":"e0000768"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782121","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":"Perinatal mental health care goes digital: Opportunities for digital health to revolutionize the care delivery for healthier pregnancies and outcomes.","authors":"Bindu Chanagala, Suneet P Chauhan, Sheehan D Fisher, Matthew Hoffman, Martin G Frasch","doi":"10.1371/journal.pdig.0000773","DOIUrl":"10.1371/journal.pdig.0000773","url":null,"abstract":"","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 4","pages":"e0000773"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765929","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":"Correction: Specialty-specific Evaluation of Virtual care Outcomes: A retrospective QUality and safety analysis (S-EVOQUe).","authors":"Shawn Mondoux, Frank Battaglia, Anastasia Gayowsky, Natasha Clayton, Cailin Langmann, Paul Miller, Alim Pardhan, Julie Mathews, Alex Drossos, Keerat Grewal","doi":"10.1371/journal.pdig.0000827","DOIUrl":"10.1371/journal.pdig.0000827","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1371/journal.pdig.0000708.].</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 4","pages":"e0000827"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765928","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":"Diffusion models enable zero-shot pose estimation for lower-limb prosthetic users.","authors":"Tianxun Zhou, Muhammad Nur Shahril Iskandar, Keng-Hwee Chiam","doi":"10.1371/journal.pdig.0000745","DOIUrl":"10.1371/journal.pdig.0000745","url":null,"abstract":"<p><p>Quantitative gait analysis is important for assessing and rehabilitating lower-limb prosthetic users, but markerless motion capture has been challenging for this population due to the difficulty in detecting prosthetic joints using models trained primarily on able-bodied individuals. This study proposes a zero-shot method leveraging generative diffusion models to transform prosthetic limb images into able-bodied representations that standard pose estimation models can detect, eliminating the need for additional data collection or model retraining. Videos of unilateral transfemoral and transtibial amputees walking were obtained publicly from YouTube. For each video frame, an edge map was generated and used as input to a ControlNet diffusion model, generating a synthetic image resembling an able-bodied person while preserving the person's original pose. These synthetic images were then passed through OpenPose. The zero-shot approach achieved substantial reductions in keypoint coordinate errors of 37% for transtibial and 76% for transfemoral prosthetic limbs compared to OpenPose on the original videos. The method enabled the identification and quantification of key gait deviations such as reduced knee flexion and altered kinematics timing between prosthetic and intact limbs. While the results demonstrate the feasibility of markerless gait analysis for lower-limb prosthetic users, the study's findings are based on a limited dataset of publicly available videos, and caution should be exercised in generalizing the results to broader populations due to the varying nature of prosthetic designs. Nonetheless, this approach has the potential to facilitate personalized rehabilitation using standard consumer cameras and existing pose estimation models.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 3","pages":"e0000745"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756279","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":"Patient and clinician perceptions of telehealth in musculoskeletal physiotherapy services - A systematic review of the evidence-base.","authors":"Anthony Smith, Sue Innes","doi":"10.1371/journal.pdig.0000789","DOIUrl":"10.1371/journal.pdig.0000789","url":null,"abstract":"<p><p>Telehealth has been at the forefront of healthcare delivery since the Covid-19 pandemic with a prompt shift in transition from face-to-face delivery to remote contact. This critical review aims to understand patient and clinician views of telehealth adoption regarding effectiveness and satisfaction within musculoskeletal (MSK) physiotherapy services. A systematic process was used to search for evidence within 6 databases (CINAHL, PyscINFO, Medline, AMED, EMCARE, EMBASE) utilising clear inclusion and exclusion criteria in August 2024. Articles published in English between 2019-2024 were searched, a total of 394 articles were identified and 10 articles were included in the review. Methodological quality was evaluated using the CASP, JBI and QuADS tools. Findings were evaluated via consensus and showed clear patient and clinician satisfaction with positive themes of reduced travel, reduced physical burden, flexibility/accessibility and negative themes of reduced physical contact, computer literacy and privacy infringements. Quality analysis identified non-response bias, sampling bias, and participants mix as risks to overall validity. Telehealth has shown to be an effective and transformative model of healthcare delivery for musculoskeletal services, especially in improving access and convenience for patients. Implications for practice suggest a need for a hybrid model of care, enhanced training, and improved data security. Future research should focus on satisfaction within condition specific musculoskeletal health, overall cost-effectiveness, health equity, and the integration of advanced technologies to ensure telehealth can be a sustainable and inclusive part of the healthcare landscape moving forwards.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 3","pages":"e0000789"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756238","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":"Effectiveness and user experience of a virtual reality intervention in a cohort of patients with chronic musculoskeletal pain syndromes.","authors":"Tiffany Prétat, Pedro Ming Azevedo, Chris Lovejoy, Thomas Hügle","doi":"10.1371/journal.pdig.0000788","DOIUrl":"10.1371/journal.pdig.0000788","url":null,"abstract":"<p><p>Chronic musculoskeletal pain (CMP) syndromes, including fibromyalgia, present diverse physical and psychological symptoms often resistant to pharmacological treatment. To retrospectively evaluate the effectiveness and user experience of Virtual Reality (VR) in reducing pain and anxiety in CMP patients and identify predictors of positive response. Data from 91 CMP patients in a 2-week interdisciplinary pain program were analyzed (78% met fibromyalgia criteria). Pain and anxiety were assessed using Numerical Rating Scales (NRS 0-10) before and after VR. Follow-up interviews were conducted after one month. An unsupervised machine learning model explored response patterns. VR led to a moderate but significant short-term reduction in anxiety and pain (median NRS -1.0, p < 0.001). A reduction of ≥3 NRS points occurred in 25% (anxiety) and 14% (pain). High baseline anxiety (NRS ≥ 7) correlated with greater pain reduction (median -2.0, p = 0.01). After one month, half of the patients reported sustained benefits. Catastrophizing and benzodiazepine use were linked to improved anxiety outcomes. Machine learning identified a most responsive cluster, characterized by patients with nociplastic pain, alexithymia, and anxiety. VR provided moderate short- and mid-term benefits for anxiety and pain in CMP patients, particularly in those with nociplastic pain and high baseline anxiety.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 3","pages":"e0000788"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756284","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":"The behavioural and cognitive impacts of digital educational interventions in the emergency department: A systematic review.","authors":"Sophie Cleff, Shubhang Sreeranga, Ibtisam Mahmoud, Abdullatif Hassan, Laury Gueyie Noutiamo, Elie Fadel, Jennifer Turnbull, Esli Osmanlliu","doi":"10.1371/journal.pdig.0000772","DOIUrl":"10.1371/journal.pdig.0000772","url":null,"abstract":"<p><p>Ensuring patients and their caregivers understand the health information they receive is an important part of every clinical visit. Digital educational interventions like video discharge instructions, follow-up text messaging, or interactive web-based modules (WBMs) have the potential to improve information retention and influence behaviour. This study aims to systematically evaluate the impact of these interventions on patient and caregiver cognition and behaviour, as well as identify the characteristics of successful interventions and observe how success is measured. In December of 2022, a systematic literature search was conducted in several databases (Cochrane, Embase, MEDLINE (Ovid), Web of Science, ClinicalTrials.gov, and Google Scholar) for randomized controlled trials (RCTs) published between 2012 and 2022. In 2024, an identical search was performed for articled published between 2022 and 2024. Studies testing patient- and caregiver-facing digital educational interventions in the emergency department for behavioural and cognitive outcomes were included. Data from 35 eligible studies encompassing 12,410 participants were analyzed and assessed for bias using the Cochrane RoB2.0 tool. Video was used in 22 studies (63%), making it the most common modality. Seventy-three percent (16/22) of these studies reported statistically significant improvements in their primary outcomes. Text messaging was used in eight studies, with two (25%) reporting significant improvement in their primary outcomes. WBMs and apps were used in seven studies, 71% (5/7) of which reported statistically significant improvements in primary outcomes. Statistically significant improvements in cognitive outcomes were reported in 64% (18/28) of applicable studies, compared with 17% (4/23) for behavioural outcomes. The results suggest that digital educational interventions can positively impact cognitive outcomes in the emergency department. Video, WBM, and app modalities appear particularly effective. However, digital educational interventions may not yet effectively change behaviour. Establishing guidelines for evaluating the quality of digital educational interventions, and the formal adoption of existing reporting guidelines, could improve study quality and consistency in this emerging field. Registration The study is registered with PROSPERO ID #CRD42023338771.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 3","pages":"e0000772"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733530","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 flexible framework for minimal biomarker signature discovery from clinical omics studies without library size normalisation.","authors":"Daniel Rawlinson, Chenxi Zhou, Myrsini Kaforou, Kim-Anh Lê Cao, Lachlan J M Coin","doi":"10.1371/journal.pdig.0000780","DOIUrl":"10.1371/journal.pdig.0000780","url":null,"abstract":"<p><p>Application of transcriptomics, proteomics and metabolomics technologies to clinical cohorts has uncovered a variety of signatures for predicting disease. Many of these signatures require the full 'omics data for evaluation on unseen samples, either explicitly or implicitly through library size normalisation. Translation to low-cost point-of-care tests requires development of signatures which measure as few analytes as possible without relying on direct measurement of library size. To achieve this, we have developed a feature selection method (Forward Selection-Partial Least Squares) which generates minimal disease signatures from high-dimensional omics datasets with applicability to continuous, binary or multi-class outcomes. Through extensive benchmarking, we show that FS-PLS has comparable performance to commonly used signature discovery methods while delivering signatures which are an order of magnitude smaller. We show that FS-PLS can be used to select features predictive of library size, and that these features can be used to normalize unseen samples, meaning that the features in the complete model can be measured in isolation for making new predictions. By enabling discovery of small, high-performance signatures, FS-PLS addresses an important impediment for the further development of precision medical care.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 3","pages":"e0000780"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733527","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}