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Venkatraman V, Heo H, Kaplan S, Parente BA, Lad SP. Digital Health for Patients Undergoing Spine Surgery: A Systematic Review. World Neurosurg 2024; 182:70-82. [PMID: 37967741 DOI: 10.1016/j.wneu.2023.11.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVE Digital health tools, including smartphone applications (apps), websites, and online search engines, are increasingly being utilized for health data collection and patient education. Studies have shown that these tools can help disseminate information widely and even help guide patients through acute surgical episodes. We aimed to search the literature to summarize available studies on using digital health tools for patients undergoing spine surgery. METHODS We conducted a systematic review of PubMed MEDLINE, Elsevier EMBASE, and Elsevier Scopus databases, as well as ClinicalTrials.gov up to March 11, 2022. RESULTS Forty-four full-text articles were included and qualitatively analyzed. Studies were broadly grouped into those that analyzed the quality of web-based materials for patients, the quality of YouTube videos for spine surgery, the development, feasibility, and implementation of mobile apps for patients, and randomized controlled trials for integrating mobile apps into perioperative care. CONCLUSIONS We presented a systematic review analyzing the current landscape of digital health for patients undergoing spine surgery. Internet patient education materials in searchable websites and YouTube videos are of poor quality, lacking in readability to the average patient and robustness of information needed for patients to make informed decisions about pursuing spine surgery. However, there lies promise in digital apps developed to guide patients through surgery and collect postoperative outcomes.
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Affiliation(s)
- Vishal Venkatraman
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Helen Heo
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Samantha Kaplan
- Medical Center Library & Archives, Duke University School of Medicine, Durham, NC, USA
| | - Beth A Parente
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Shivanand P Lad
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
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2
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Cho Y, Lavoie Smith EM, Zahrieh D, Chow SL, Williams DA, Saint Arnault D, Jiang Y. Electronic Patient-Reported Outcome Data Collection Systems in Oncology Clinical Trials: A Survey of Clinical Research Professionals (an Alliance Study). JCO Clin Cancer Inform 2023; 7:e2300007. [PMID: 37677111 PMCID: PMC10545018 DOI: 10.1200/cci.23.00007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 06/20/2023] [Accepted: 07/02/2023] [Indexed: 09/09/2023] Open
Abstract
PURPOSE To describe clinical research professionals (CRPs)' experiences with electronic patient-reported outcome (ePRO) data collection systems in oncology clinical trials and identify correlates of CRPs' attitude toward technology. METHODS An online survey was conducted among 210 CRPs from 125 National Cancer Institute-funded research sites. Measures included CRPs' demographic characteristics, working years, employment locations, and previous experiences with various types of ePROs. Their attitude toward technology was measured by the Technology Attitude Scale-Adapted. The Wilcoxon signed-rank test was used to compare two subdomains of attitude (perceived usefulness [PU] and perceived ease of use [PEU]). Multiple linear regression was used to explore correlates of (1) overall attitude, (2) PU, and (3) PEU. The significance level was 5%. RESULTS Participants' median age was 41 years (range, 21-67). Most were female (90%) and White (82%). More than half of the participants had previous experiences with web-based ePROs using patients' own devices (72%) or site-/sponsor-provided on-site devices (eg, kiosks or tablets; 64%). CRPs who were 60 years or older (β = -0.32, P < .05) or worked for 10-20 years (β = -0.11, P < .05) had relatively negative attitudes, controlling for other factors. Previous experiences with more ePRO types were associated with more positive attitudes (β = 0.08, P = .02). Similar correlates were found with PU but not with PEU. CONCLUSION This study revealed that CRPs had various experiences with ePRO systems and attitudes toward technology. Age, working years, and previous experiences with ePROs were correlates of overall attitude toward technology and PU. These findings suggest necessary targeted training to facilitate ePRO use in oncology clinical trials by improving CRPs' awareness and attitude toward technology.
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Affiliation(s)
- Youmin Cho
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX
| | | | - David Zahrieh
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN
| | - Selina L. Chow
- Alliance Protocol Operations Office, University of Chicago, Chicago, IL
| | | | | | - Yun Jiang
- School of Nursing, University of Michigan, Ann Arbor, MI
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3
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Zhang L, McLeod HL, Liu KK, Liu WH, Huang HX, Huang YM, Sun SS, Chen XP, Chen Y, Liu FZ, Jian X. Effect of Physician-Pharmacist Participation in the Management of Ambulatory Cancer Pain Through a Digital Health Platform: Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e24555. [PMID: 34398796 PMCID: PMC8406114 DOI: 10.2196/24555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 05/01/2021] [Accepted: 07/15/2021] [Indexed: 12/14/2022] Open
Abstract
Background Self-management of ambulatory cancer pain is full of challenges. Motivated by the need for better pain management, we developed a WeChat-supported platform, Medication Housekeeper (MediHK), to enhance communication, optimize outcomes, and promote self-management in the home setting. Objective We conducted a randomized controlled trial to assess whether the joint physician-pharmacist team through MediHK would provide better self-management of ambulatory patients with cancer pain. Methods Patients were randomly assigned to either an intervention group or control group. During the 4-week study period, the pharmacist would send 24-hour pain diaries daily, adverse drug reaction (ADR) forms every 3 days, and the Brief Pain Inventory form every 15 days to patients in the intervention group via MediHK. If a patient needed a change in drug/dosage or treatment of an ADR after the comprehensive review, the pharmacist would propose pharmacological interventions to the attending physician, who was then responsible for prescribing or adjusting pain medications. If no adjustments were needed, the pharmacist provided appropriate targeted education based on knowledge deficits. Patients in the control group received conventional care and did not receive reminders to fill out the forms. However, if the control group patients filled out a form via MediHK, the pain management team would review and respond in the same way as for the intervention group. The primary outcomes included pain intensity and pain interference in daily life. Secondary outcomes included patient-reported outcome measures, medication adherence, ADRs, and rehospitalization rates. Results A total of 100 patients were included, with 51 (51%) in the intervention group and 49 (49%) in the control group. The worst pain scores, least pain scores, and average pain scores in the intervention group and the control group were statistically different, with median values of 4 (IQR 3-7) vs 7 (IQR 6-8; P=.001), 1 (IQR 0-2) vs 2 (IQR 1-3; P=.02), and 2 (IQR 2-4) vs 4 (IQR 3-5; P=.001), respectively, at the end of the study. The pain interference on patients' general activity, mood, relationships with others, and interests was reduced, but the difference was not statistically significant compared with the control group (Ps=.10-.76). The medication adherence rate increased from 43% to 63% in the intervention group, compared with an increase of 33% to 51% in the control group (P<.001). The overall number of ADRs increased at 4 weeks, and more ADRs were monitored in the intervention group (P=.003). Rehospitalization rates were similar between the 2 groups. Conclusions The joint physician-pharmacist team operating through MediHK improved pain management. This study supports the feasibility of integrating the internet into the self-management of cancer pain. Trial Registration Chinese Clinical Trial Registry ChiCTR1900023075; https://www.chictr.org.cn/showproj.aspx?proj=36901
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Affiliation(s)
- Lu Zhang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China.,Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Howard L McLeod
- Geriatric Oncology Consortium, Tampa, FL, United States.,Taneja College of Pharmacy, University of South Florida, Tampa, FL, United States.,Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, Changsha, China
| | - Ke-Ke Liu
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China.,Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Wen-Hui Liu
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hang-Xing Huang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China.,Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Ya-Min Huang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China.,Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Shu-Sen Sun
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China.,Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.,College of Pharmacy and Health Sciences, Western New England University, Boston, MA, United States
| | - Xiao-Ping Chen
- Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.,Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, Changsha, China
| | - Yao Chen
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
| | - Fang-Zhou Liu
- College of Information Science and Engineering, Hunan Normal University, Changsha, China
| | - Xiao Jian
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China.,Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Kneuertz PJ, Jagadesh N, Perkins A, Fitzgerald M, Moffatt-Bruce SD, Merritt RE, D'Souza DM. Improving patient engagement, adherence, and satisfaction in lung cancer surgery with implementation of a mobile device platform for patient reported outcomes. J Thorac Dis 2020; 12:6883-6891. [PMID: 33282391 PMCID: PMC7711421 DOI: 10.21037/jtd.2020.01.23] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Active patient engagement may improve their perioperative experience and outcomes. We sought to evaluate the use of a mobile device application (App) for patient engagement and patient reported outcomes (PROs) assessment following robotic lung cancer surgery. Methods Patients with suspected lung cancer undergoing robotic resection between January–May 2019, were offered the SeamlessMD App, which was customized to meet requirements of the thoracic enhanced recovery pathway. The App guided patients through preoperative preparation, in-hospital recovery, and post-op discharge care with personalized reminders, task lists, education, progress tracking, and surveys. Results Fifty patients participated in the study (22.1%). Of the 50 patients, 20 (40%) patients completed the preoperative compliance survey, and 31 (62%) completed the hospital satisfaction survey. A total of 62 inpatient recovery checks were completed, identifying non-compliance with incentive spirometer use in 2 (3.2%) and patient worries about self-care after discharge in 18 (29%) instances. Postoperative health-checks were completed by 27 (54%) patients with a median of 3 [0–17] completed surveys per patient. Patient reported symptom scores up to 30 days after surgery, demonstrating a significant decrease maximum pain level (P=0.002) and anxiety scores (P<0.001). The App enabled health-checks improved confidence and decreased worries in over 80% of patients. Nine patients (40.9%) reported the health-checks helped avoid 1+ calls and 4 (18.2%) reported the App helped avoid 1+ visits to the hospital. Over 74% of patients reported the App was very or extremely useful in each of the preoperative, inpatient, and post-discharge settings. Conclusions A mobile device platform may serve as an effective mechanism to record perioperative PROs and satisfaction while facilitating patient-provider engagement in perioperative care.
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Affiliation(s)
- Peter J Kneuertz
- Division of Thoracic Surgery, Department of Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA
| | - Niveditha Jagadesh
- Division of Thoracic Surgery, Department of Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA
| | - Alicia Perkins
- Division of Thoracic Surgery, Department of Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA
| | - Morgan Fitzgerald
- Division of Thoracic Surgery, Department of Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA
| | - Susan D Moffatt-Bruce
- Division of Thoracic Surgery, Department of Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA
| | - Robert E Merritt
- Division of Thoracic Surgery, Department of Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA
| | - Desmond M D'Souza
- Division of Thoracic Surgery, Department of Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA
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Clinicians' User Experience of Telemedicine in Neurosurgery During COVID-19. World Neurosurg 2020; 146:e359-e367. [PMID: 33203534 DOI: 10.1016/j.wneu.2020.10.101] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/18/2020] [Accepted: 10/19/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Restricted access to hospitals due to the 2019 novel coronavirus disease (COVID-19) pandemic has significantly altered practice patterns for elective neurosurgical care. Particularly, telemedicine has become the primary modality of patient visits for nonemergent conditions. This study aimed to characterize user experiences of neurosurgeons and advanced practice providers focusing on perceived utility and barriers of telemedicine in management of elective neurosurgical patients during COVID-19. METHODS An online survey was sent to clinicians involved in neurosurgical care using telemedicine with questions focusing on frequency of utilization, duration of patient encounters, benefits of telemedicine, and barriers to current forms of remote patient visits. Survey responses were stratified by clinical position (neurosurgeon vs. advanced practice provider) and subspecialty focus (cranial vs. spinal neurosurgery). RESULTS The survey was completed by 14 of 17 eligible clinicians. Respondents included 10 neurosurgeons and 4 APPs with 57% specializing in cranial neurosurgery and 43% specializing in spinal neurosurgery. During the COVID-19 period, 78% of respondents used teleconference/video conference visits multiple times in a week, and 86% planned to continue using telemedicine after the pandemic. The most common barrier for telemedicine was the inability to perform a neurological examination, while the most common perceived benefit was increased convenience for patients. CONCLUSIONS During the COVID-19 period, telemedicine was heavily relied on to ensure the continuation of perioperative care for patients with elective neurosurgical pathologies. While clinicians identified numerous barriers for current telemedicine platforms, the use of telemedicine will likely continue, as it has provided unique benefits for patients, clinicians, and hospitals.
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Jibb LA, Khan JS, Seth P, Lalloo C, Mulrooney L, Nicholson K, Nowak DA, Kaur H, Chee-A-Tow A, Foster J, Stinson JN. Electronic Data Capture Versus Conventional Data Collection Methods in Clinical Pain Studies: Systematic Review and Meta-Analysis. J Med Internet Res 2020; 22:e16480. [PMID: 32348259 PMCID: PMC7351264 DOI: 10.2196/16480] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/21/2020] [Accepted: 03/22/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The most commonly used means to assess pain is by patient self-reported questionnaires. These questionnaires have traditionally been completed using paper-and-pencil, telephone, or in-person methods, which may limit the validity of the collected data. Electronic data capture methods represent a potential way to validly, reliably, and feasibly collect pain-related data from patients in both clinical and research settings. OBJECTIVE The aim of this study was to conduct a systematic review and meta-analysis to compare electronic and conventional pain-related data collection methods with respect to pain score equivalence, data completeness, ease of use, efficiency, and acceptability between methods. METHODS We searched the Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE), and Cochrane Central Register of Controlled Trials (CENTRAL) from database inception until November 2019. We included all peer-reviewed studies that compared electronic (any modality) and conventional (paper-, telephone-, or in-person-based) data capture methods for patient-reported pain data on one of the following outcomes: pain score equivalence, data completeness, ease of use, efficiency, and acceptability. We used random effects models to combine score equivalence data across studies that reported correlations or measures of agreement between electronic and conventional pain assessment methods. RESULTS A total of 53 unique studies were included in this systematic review, of which 21 were included in the meta-analysis. Overall, the pain scores reported electronically were congruent with those reported using conventional modalities, with the majority of studies (36/44, 82%) that reported on pain scores demonstrating this relationship. The weighted summary correlation coefficient of pain score equivalence from our meta-analysis was 0.92 (95% CI 0.88-0.95). Studies on data completeness, patient- or provider-reported ease of use, and efficiency generally indicated that electronic data capture methods were equivalent or superior to conventional methods. Most (19/23, 83%) studies that directly surveyed patients reported that the electronic format was the preferred data collection method. CONCLUSIONS Electronic pain-related data capture methods are comparable with conventional methods in terms of score equivalence, data completeness, ease, efficiency, and acceptability and, if the appropriate psychometric evaluations are in place, are a feasible means to collect pain data in clinical and research settings.
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Affiliation(s)
- Lindsay A Jibb
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - James S Khan
- Department of Anesthesia, Mount Sinai Hospital, Toronto, ON, Canada
- Department of Anesthesia, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Puneet Seth
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Chitra Lalloo
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Lauren Mulrooney
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Kathryn Nicholson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Dominik A Nowak
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Harneel Kaur
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | - Joel Foster
- Office of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jennifer N Stinson
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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Choi Y, Kim CH, Rhee JM, Kuo CC, Lee U, Park SB, Lee CH, Yang SH, Kim KT, Chung CK. Longitudinal clinical outcomes after full-endoscopic lumbar discectomy for recurrent disc herniation after open discectomy. J Clin Neurosci 2020; 72:124-129. [PMID: 31948880 DOI: 10.1016/j.jocn.2019.12.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 12/20/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Full-endoscopic lumbar discectomy (FELD) is a minimally invasive surgical option for recurrent lumbar disc herniation (LDH). Nonetheless, patients' clinical outcomes may be poorer after surgery for recurrent LDH than for primary LDH. Therefore, we compared patients' longitudinal clinical outcomes after FELD for recurrent LDH or primary LDH. METHODS The medical records of patients who underwent FELD for primary LDH (group A) or recurrent LDH (group B) were retrospectively reviewed. The inclusion criteria were: 1) single-level LDH or recurrent LDH at L4-5 or L5-S1, 2) age ≤60 years, 3) previous open discectomy (group B), and 4) ≥6 months of follow-up. In total, 244 patients (group A, 211; group B, 33) were included. Clinical outcomes (Oswestry Disability Index [ODI]; visual analogue pain score for the back and leg [VAS-B] and [VAS-L]) over 24 months of follow-up were compared between groups with a linear mixed-effects model. RESULTS All clinical outcomes significantly improved from pre-operation to 3 months postoperatively (p < 0.01), and the improvement was maintained for 24 months postoperatively in both groups. The clinical outcomes of groups A and B were not significantly different during 24 months follow-up (ODI, p = 0.94; VAS-B, p = 0.11; and VAS-L, p = 0.48). The reoperation rate was 3.3% in group A and 3.0% in group B, but the overall complication rate was higher in group B (9.8%) than in group A (6.6%). CONCLUSION The longitudinal clinical outcomes after FELD for recurrent LDH may not be poor as feared. However, the higher complication rate in patients undergoing FELD for recurrent LDH should be noted.
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Affiliation(s)
- Yunhee Choi
- Medical Research Collaborating Center, Seoul National University Hospital, 101 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea
| | - Chi Heon Kim
- Department of Neurosurgery, Seoul National University College of Medicine, 103 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea; Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea; Clinical Research Institute, Seoul National University Hospital, 101 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea; Department of Orthopaedic Surgery and Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA.
| | - John M Rhee
- Department of Orthopaedic Surgery and Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Calvin C Kuo
- Regional Spine Surgery Department, Kaiser Permanente, 3600 Broadway, Suite 15, Oakland, CA 94611, USA
| | - Urim Lee
- Human Brain Function Laboratory, Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea
| | - Sung Bae Park
- Department of Neurosurgery, Seoul National University College of Medicine, 103 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea; Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea; Clinical Research Institute, Seoul National University Hospital, 101 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea; Department of Neurosurgery, Seoul National University Boramae Hospital, Borame Medical Center 20, Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, South Korea
| | - Chang-Hyun Lee
- Department of Neurosurgery, Seoul National University College of Medicine, 103 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea; Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea; Clinical Research Institute, Seoul National University Hospital, 101 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea
| | - Seung Heon Yang
- Department of Neurosurgery, Seoul National University College of Medicine, 103 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea; Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea; Clinical Research Institute, Seoul National University Hospital, 101 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea
| | - Kyoung-Tae Kim
- Department of Neurosurgery, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, South Korea; Department of Neurosurgery, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, South Korea
| | - Chun Kee Chung
- Department of Neurosurgery, Seoul National University College of Medicine, 103 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea; Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea; Clinical Research Institute, Seoul National University Hospital, 101 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea; Human Brain Function Laboratory, Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea; Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, South Korea
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Najm A, Gossec L, Weill C, Benoist D, Berenbaum F, Nikiphorou E. Mobile Health Apps for Self-Management of Rheumatic and Musculoskeletal Diseases: Systematic Literature Review. JMIR Mhealth Uhealth 2019; 7:e14730. [PMID: 31769758 PMCID: PMC6904900 DOI: 10.2196/14730] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/26/2019] [Accepted: 07/30/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Although the increasing availability of mobile health (mHealth) apps may enable people with rheumatic and musculoskeletal diseases (RMDs) to better self-manage their health, there is a general lack of evidence on ways to ensure appropriate development and evaluation of apps. OBJECTIVE This study aimed to obtain an overview on existing mHealth apps for self-management in patients with RMDs, focusing on content and development methods. METHODS A search was performed up to December 2017 across 5 databases. For each publication relevant to an app for RMDs, information on the disease, purpose, content, and development strategies was extracted and qualitatively assessed. RESULTS Of 562 abstracts, 32 were included in the analysis. Of these 32 abstracts, 11 (34%) referred to an app linked to a connected device. Most of the apps targeted rheumatoid arthritis (11/32, 34%). The top three aspects addressed by the apps were pain (23/32, 71%), fatigue (15/32, 47%), and physical activity (15/32, 47%). The development process of the apps was described in 84% (27/32) of the articles and was of low to moderate quality in most of the cases. Despite most of the articles having been published within the past two years, only 5 apps were still commercially available at the time of our search. Moreover, only very few studies showed improvement of RMD outcome measures. CONCLUSIONS The development process of most apps was of low or moderate quality in many studies. Owing to the increasing RMD patients' willingness to use mHealth apps for self-management, optimal standards and quality assurance of new apps are mandatory.
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Affiliation(s)
- Aurélie Najm
- Department of Rheumatology, Nantes University Hospital, Nantes, France.,INSERM UMR 1238, Nantes University of Medicine, Nantes, France
| | - Laure Gossec
- INSERM UMR S1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France.,Rheumatology department, Pitié Salpêtrière Hospital, AP-HP, Paris, France
| | - Catherine Weill
- Bibliothèque interuniversitaire de Santé, Paris Descartes University, Paris, France
| | - David Benoist
- Bibliothèque interuniversitaire de Santé, Paris Descartes University, Paris, France
| | - Francis Berenbaum
- Department of rheumatology, Sorbonne Université, INSERM CRSA Saint-Antoine, AP-HP, Saint Antoine Hospital, Paris, France
| | - Elena Nikiphorou
- Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences & Medicine, King's College London, Paris, France
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Khan JS, Jibb LA, Busse JW, Gilron I, Choi S, Paul JE, McGillion M, Mackey S, Buckley DN, Lee SF, Devereaux PJ. Electronic Versus Traditional Data Collection: A Multicenter Randomized Controlled Perioperative Pain Trial. Can J Pain 2019; 3:16-25. [PMID: 35005415 PMCID: PMC8730625 DOI: 10.1080/24740527.2019.1587584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background: Electronic data collection is increasingly available as a means to collect pain-related clinical trial data; however, effectiveness and costs relative to traditional data collection are uncertain. Aims: The aim of this study was to evaluate data quality, protocol adherence, satisfaction, and resource requirements of electronic data collection (i.e., Internet-based electronic submission) compared to traditional data collection methods (i.e., paper-based diaries and telephone interviews) in a perioperative factorial randomized controlled trial. Methods: This study was an open-label two-arm parallel randomized controlled trial. Women (18-75 years) undergoing breast cancer surgery were allocated to either electronic or traditional data collection and completed pain-related questionnaires at baseline, postoperative period, and 3-month follow-up (NCT02240199). Results: We acquired outcome data at all time points from 78 randomized patients, 38 in the electronic group and 40 in the traditional group. The number of data queries (e.g., erroneously entered data) per patient was higher in the electronic data group (4.92 [SD = 4.67] vs. 1.88 [SD = 1.51]; P < 0.001). No between-group differences were observed for compliance with medications, data completeness, loss to follow-up, or patient or research assistant satisfaction. More research assistant time per patient was spent collecting data in the traditional group (42.6 min [SD = 12.8] vs. 9.92 min [SD = 7.6]; P < 0.001); however, costs per patient were higher in the electronic group ($176.85 [SD = 2.90] vs. $16.33 [SD = 4.90]; P < 0.001). Conclusion: Electronic data collection is feasible for perioperative pain clinical trials. Additional trials, including different surgical populations, are needed to confirm our findings and optimize use of electronic data capture methods.
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Affiliation(s)
- James S. Khan
- Department of Anesthesia, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada,CONTACT James S. Khan Department of Anesthesia, University of Toronto, 12th Floor, 123 Edward Street, Toronto, ONM5G 1E2, Canada
| | - Lindsay A. Jibb
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada,Evidence-to-Practice Program, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Jason W. Busse
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada,Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada,The Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, Ontario, Canada
| | - Ian Gilron
- Department of Anesthesiology & Perioperative Medicine, Queen’s University, Kingston, Ontario, Canada
| | - Stephen Choi
- Department of Anesthesia, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada,Department of Anesthesia, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - James E. Paul
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
| | - Michael McGillion
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada,School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sean Mackey
- Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Palo Alto, CA, USA
| | - D. Norman Buckley
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada,Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Shun Fu Lee
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - P. J. Devereaux
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada,Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada,Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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10
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Lee U, Kim CH, Kuo CC, Choi Y, Park SB, Yang SH, Lee CH, Kim KT, Chung CK. Does Preservation of Ligamentum Flavum in Percutaneous Endoscopic Lumbar Interlaminar Discectomy Improve Clinical Outcomes? Neurospine 2019; 16:113-119. [PMID: 30943713 PMCID: PMC6449832 DOI: 10.14245/ns.1938008.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/11/2019] [Indexed: 12/11/2022] Open
Abstract
Objective Ligamentum flavum (LF) is an important anatomical structure for prevention of postoperative adhesions, but the opening of LF is necessary for percutaneous endoscopic lumbar interlaminar discectomy (PEID). Although the defect in LF is small with conventional PEID, the defect could be minimized with LF splitting technique. The objective of this study was to compare clinical outcomes of PEID with opening of LF versus splitting of LF.
Methods A retrospective study was performed for patients underwent PEID for L5–S1. PEID with the opening of LF (open-group) was performed for 55 patients and with splitting of LF (split-group) was performed for 34 patients. The defect of LF in Open-group was 3–5 mm, but the defect was negligible in split-group because the split LF was reapproximated by its elasticity. Clinical outcomes were evaluated with Korean version of the Oswestry Disability Index (K-ODI) and visual analogue pain scores for back (VASB) and leg (VASL). The changes of clinical outcomes during postoperative 24 months between groups were evaluated with linear mixed-effects model.
Results The clinical outcomes were similar between groups for K-ODI (p=0.98), VASB (p=0.52), and VASL (p=0.59). Each outcome demonstrated significant improvement from preoperative baseline throughout the postoperative 24 months (p<0.05). Complications included recurrence in 4 patients and dural tear in 1 in open-group (9.1%), and residual disc herniation in 2 patients and transient weakness in 1 in split-group (8.8%).
Conclusion Splitting versus opening LF in PEID may be left to the surgeon’s discretion. The potential risks and benefits of LF handling should be considered when performing this surgical technique in PEID.
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Affiliation(s)
- Urim Lee
- Human Brain Function Laboratory, Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
| | - Chi Heon Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.,Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.,Clinical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Calvin C Kuo
- Regional Spine Surgery Department, Kaiser Permanente, Oakland, CA, USA
| | - Yunhee Choi
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea
| | - Sung Bae Park
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.,Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.,Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.,Department of Neurosurgery, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea
| | - Seung Heon Yang
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.,Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.,Clinical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Chang-Hyun Lee
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.,Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.,Clinical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Kyoung-Tae Kim
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea.,Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Chun Kee Chung
- Human Brain Function Laboratory, Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.,Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.,Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.,Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.,Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Korea
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11
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Digital Phenotyping in Patients with Spine Disease: A Novel Approach to Quantifying Mobility and Quality of Life. World Neurosurg 2019; 126:e241-e249. [PMID: 30797933 DOI: 10.1016/j.wneu.2019.01.297] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 01/29/2019] [Accepted: 01/31/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To identify trends in mobility and daily pain levels among a cohort of patients with clinically diagnosed spine disease. METHODS Participants with spine disease were enrolled from a general neurosurgical clinic and installed a smartphone application (Beiwe) designed for digital phenotyping to their personal smartphone. This application collected passive meta-data on a minute-to-minute basis, including global positioning system (GPS), WiFi, accelerometer, text and telephone logs, and screen on and off time. The application also administered daily visual analog scale pain surveys. A linear mixed model framework was used to test for associations between self-reported pain and mobility and sociability from the passively collected data. RESULTS A total of 105 patients were enrolled, with a median follow-up time of 94.5 days; 55 patients underwent a surgical intervention during the follow-up period. The weekly pain survey response rate was 73.2%. By the end of follow-up, the mean change in pain for all patients was -1.3 points (4.96 at the start of follow-up to 3.66 by the end of follow-up). Increased pain was significantly associated with reduced patient mobility as measured using 3 daily GPS summary statistics (i.e., average flight length, maximum diameter travelled, total distance travelled). CONCLUSIONS Patients with spine disease who reported greater pain had reduced mobility, as measured by the passively collected smartphone GPS data. Smartphone-based digital phenotyping appears to be a promising and scalable approach to assess mobility and quality of life of patients with spine disease.
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12
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Postoperative Changes in Moderate to Severe Nonspecific Low Back Pain After Cervical Myelopathy Surgery. World Neurosurg 2018; 116:e429-e435. [DOI: 10.1016/j.wneu.2018.04.224] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/29/2018] [Accepted: 04/30/2018] [Indexed: 11/21/2022]
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13
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Choi YH, Kwon SW, Moon JH, Kim CH, Chung CK, Park SB, Heo W. Lateral Lumbar Interbody Fusion and in Situ Screw Fixation for Rostral Adjacent Segment Stenosis of the Lumbar Spine. J Korean Neurosurg Soc 2017; 60:755-762. [PMID: 29142637 PMCID: PMC5678063 DOI: 10.3340/jkns.2017.0606.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/09/2017] [Accepted: 08/21/2017] [Indexed: 11/27/2022] Open
Abstract
Objective The purpose of this study is to describe the detailed surgical technique and short-term clinical and radiological outcomes of lateral lumbar interbody fusion (LLIF) and in situ lateral screw fixation using a conventional minimally invasive screw fixation system (MISF) for revision surgery to treat rostral lumbar adjacent segment disease. Methods The medical and radiological records were retrospectively reviewed. The surgery was indicated in 10 consecutive patients with rostral adjacent segment stenosis and instability. After the insertion of the interbody cage, lateral screws were inserted into the cranial and caudal vertebra using the MISF through the same LLIF trajectory. The radiological and clinical outcomes were assessed preoperatively and at 1, 3, 6, and 12 months postoperatively. Results The median follow-up period was 13 months (range, 3–48 months). Transient sensory changes in the left anterior thigh occurred in 3 patients, and 1 patient experienced subjective weakness; however, these symptoms normalized within 1 week. Back and leg pain were significantly improved (p<0.05). In the radiological analysis, both the segmental angle at the operated segment and anterior disc height were significantly increased. At 6 months postoperatively, solid bony fusion was confirmed in 7 patients. Subsidence and mechanical failure did not occur in any patients. Conclusion This study demonstrates that LLIF and in situ lateral screw fixation may be an alternative surgical option for rostral lumbar adjacent segment disease.
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Affiliation(s)
- Young Hoon Choi
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
| | - Shin Won Kwon
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
| | - Jung Hyeon Moon
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.,Department of Neurosurgery, The Armed Forces Capital Hospital, Seongnam, Korea
| | - Chi Heon Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.,Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.,Clinical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Chun Kee Chung
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.,Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.,Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.,Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Korea
| | - Sung Bae Park
- Department of Neurosurgery, Seoul National University Boramae Hospital, Seoul, Korea
| | - Won Heo
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.,Department of Neurosurgery, Gyeongsang National University Changwon Hospital, Changwon, Korea
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14
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Algattas H, Cohen J, Agarwal N, Hamilton DK. Trends in the use of patient-reported outcome instruments in neurosurgical adult thoracolumbar deformity and degenerative disease literature. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2017; 8:103-107. [PMID: 28694592 PMCID: PMC5490342 DOI: 10.4103/jcvjs.jcvjs_29_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective: Shifting national healthcare trends place increased emphasis on patient-centered care and value-based outcomes, and thus, patient-reported outcome instruments (PROIs) are often used. We sought to characterize the trends in PROI use over the past decade with regard to thoracolumbar degenerative spine disease and spinal deformity in major neurosurgical journals. Methods: Articles were screened for PROI use through a PubMed search among five major neurosurgical journals from 2006 to 2016. Articles focusing on adult thoracolumbar deformity and degenerative disease were selected with stringent criteria to further characterize PROI use. Results: A total of 29 different PROIs were used among 102 articles identified from 2006 to 2016 using our search strategy. Journal of Neurosurgery: Spine contained the most articles utilizing PROIs with 35.3% of all articles meeting search criteria. The most frequently used PROIs were Oswestry Disability Index, visual analog scale, and the European Quality of Life Five-dimension questionnaire used in 79.4%, 59.8%, and 29.4% of articles, respectively. Linear regression identified a significant increase in the number of articles employing PROIs from 2006 to 2016 (Y = 1.85, R2= 0.77, P < 0.01). The total number of PROIs per article was relatively stagnant over time and did not significantly change (Y = 0.03, R2= 0.05, P = 0.51). Conclusions: PROI use as an outcome tool in the adult thoracolumbar disease literature has increased during the past decade, which may be an indicative of PROI use to define patient expectations. This may also represent a trend toward PROI use as a surrogate measure of value-based care.
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Affiliation(s)
- Hanna Algattas
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, USA
| | - Jonathan Cohen
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, USA
| | - Nitin Agarwal
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, USA
| | - D Kojo Hamilton
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, USA
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