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Ghaempanah F, Moasses Ghafari B, Hesami D, Hossein Zadeh R, Noroozpoor R, Moodi Ghalibaf A, Hasanabadi P. Metaverse and its impact on medical education and health care system: A narrative review. Health Sci Rep 2024; 7:e70100. [PMID: 39323461 PMCID: PMC11422618 DOI: 10.1002/hsr2.70100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 08/27/2024] [Accepted: 09/06/2024] [Indexed: 09/27/2024] Open
Abstract
Background and Aims The metaverse has enormous potential in health care, continuously developing and offering innovative solutions by combining artificial intelligence (AI), augmented reality (AR)/virtual reality (VR), Internet of Medical Devices, and quantum computing technologies. In addition to using virtual platforms to help and boost medical education, familiarity with this platform is necessary to strengthen medical skills and communication with patients in medical sciences in the future. Methods We conducted a comprehensive search using keywords and their MeSH synonyms, including "metaverse," "medical education," and "health care," across PubMed, Scopus, and Web of Science. After screening the results, relevant articles were selected to inform the writing of this manuscript. Results The metaverse is shaping the future of medical sciences, offering new opportunities for health education, advocacy training, and patient outcome improvement. The combination of real and virtual worlds may advance international relations, facilitate data sharing, increase medical care speed, and reduce infectious diseases. The metaverse, despite its benefits, has some limitations. Only 37% of 15-24-year-olds have internet access, and AR/VR glasses are expensive and may cause eye discomfort. It is also a potential risk for medical students, who may need help understanding the limitations of simulations and develop unrealistic expectations. Considering the metaverse as a supplement to clinical practice, not a replacement for supervised training, is crucial. Ethical concerns, data security, privacy, and lack of instructions for education are also issues. However, providing information about the metaverse can increase health care workers' attribution to use it for patient examinations, students' education, and tests. Conclusion This paper explores the impact of the metaverse on medical science education and underscores the need to integrate the metaverse into all areas of medical sciences as a supplement to existing evidence.
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Affiliation(s)
- Faezeh Ghaempanah
- Student Committee of Medical Education Development, Education Development Center Kurdistan University of Medical Sciences Sanandaj Iran
- Medicine Faculty Kurdistan University of Medical Sciences Sanandaj Iran
- Student Research Committee Kurdistan University of Medical Sciences Sanandaj Iran
| | - Bahar Moasses Ghafari
- Medicine Faculty Kurdistan University of Medical Sciences Sanandaj Iran
- Nuclear Medicine Department Kurdistan University of Medical Sciences Sanandaj Iran
| | - Darya Hesami
- Student Committee of Medical Education Development, Education Development Center Kurdistan University of Medical Sciences Sanandaj Iran
- Student Research Committee Kurdistan University of Medical Sciences Sanandaj Iran
| | - Reza Hossein Zadeh
- Student Committee of Medical Education Development, Education Development Center Kurdistan University of Medical Sciences Sanandaj Iran
- Medicine Faculty Kurdistan University of Medical Sciences Sanandaj Iran
- Student Research Committee Kurdistan University of Medical Sciences Sanandaj Iran
| | - Rashin Noroozpoor
- Student Committee of Medical Education Development, Education Development Center Kurdistan University of Medical Sciences Sanandaj Iran
- Student Research Committee Kurdistan University of Medical Sciences Sanandaj Iran
| | - AmirAli Moodi Ghalibaf
- Student Committee of Medical Education Development, Education Development Center Birjand University of Medical Sciences Birjand Iran
- Student Research Committee Birjand University of Medical Sciences Birjand Iran
| | - Parsa Hasanabadi
- Student Committee of Medical Education Development, Education Development Center Kurdistan University of Medical Sciences Sanandaj Iran
- Medicine Faculty Kurdistan University of Medical Sciences Sanandaj Iran
- Student Research Committee Kurdistan University of Medical Sciences Sanandaj Iran
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Yao H, Liao Z, Zhang X, Zhang X, Li M, You L, Liu Y. A comprehensive survey of the clinical trial Landscape on digital therapeutics. Heliyon 2024; 10:e36115. [PMID: 39224386 PMCID: PMC11366857 DOI: 10.1016/j.heliyon.2024.e36115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024] Open
Abstract
Background Digital therapeutics (DTx) is an emerging and groundbreaking medical intervention that utilizes health software to treat or alleviate various diseases, disorders, conditions, or injuries. Although the potential of digital therapy is enormous, it is still in its nascent stage and faces multiple challenges and obstacles. The purpose of this study is to provide an overview of all DTx-related clinical trials in ClinicalTrials.gov and to promote the advancement of DTx. Methods Two reviewers and one expert evaluated data from all DTx clinical trials on ClinicalTrials.gov as of August 8, 2023. Trials utilizing digital therapeutics independently or in combination with traditional approaches were included. Incomplete trials and those lacking an evidence-based foundation were excluded. Basic information about product launches and primary outcome measures was extracted and analyzed. Results A total of 280 eligible trials were categorized into treating a disease (141, 50.4 %), managing a disease (120, 42.9 %), and improving a health function (19, 6.8 %). The focus was primarily on mental and behavioral disorders, neurological disorders, and endocrine, nutritional, and metabolic disorders. The number of trials has been increasing annually, yet trial design and conduct remain inconsistent. Randomized controlled trials (RCTs) accounted for 67.5 % of completed trials, and 36 trials (12.9 %) involved products already approved for marketing. Conclusions The growth in clinical studies on DTx underscores their potential in healthcare. However, challenges persist in standardization, regulation, and clinical efficacy. There is a need for a harmonized global classification of digital therapeutics and standardized clinical trial protocols to ensure efficacy and improve healthcare services.
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Affiliation(s)
- Han Yao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Zirui Liao
- National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, Shenzhen, Guangdong Province, 518112, China
| | - Xinyi Zhang
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Xiaoke Zhang
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Mengyu Li
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Lili You
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
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Rajendran A, Kella A, Narayanasamy D. The Revolution of Digital Therapeutics (DTx) in the Pharmaceutical Industry and Their Quality Impacts. Cureus 2024; 16:e66792. [PMID: 39268306 PMCID: PMC11392520 DOI: 10.7759/cureus.66792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 08/13/2024] [Indexed: 09/15/2024] Open
Abstract
An increasing number of developments and trends are driving the expansion of the digital therapeutics (DTx) market in the pharmaceutical industry. Digital therapeutics are therapies intended to treat, diagnose, and prevent diseases by using patient-directed clinically assessed software applications, which can optimize the effectiveness and delivery of healthcare. These digital innovations became important as the world changed, particularly during the coronavirus pandemic. Nowadays pharma companies are getting more comfortable with the idea of digital therapies. The majority of pharmaceutical companies are examining how to incorporate pharmaceuticals and digital therapies into their treatment regimens, leveraging digital tools to enhance patient outcomes and streamline healthcare delivery. A thorough overview of the most recent technological advancements in the creation of digital therapies shows particular technologies that are essential to the market's future growth. Moreover, the evaluation of digital therapeutics by clinical trial and real-world data is outlined. The critical quality attributes of DTx products and the challenges, including data management issues and regulatory obstacles, which make the creation, approval, and marketing of customized medicines more difficult, are covered in this review article. Overall, pharma companies are venturing into the world of digital therapeutics while acknowledging the limitations of the emerging field.
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Affiliation(s)
- Anuciya Rajendran
- Department of Pharmaceutical Quality Assurance, SRM College of Pharmacy, Faculty of Medicine and Health Science, SRM Institute of Science and Technology, Chengalpattu, IND
| | - Alekhya Kella
- Department of Pharmaceutical Quality Assurance, SRM College of Pharmacy, Faculty of Medicine and Health Science, SRM Institute of Science and Technology, Chengalpattu, IND
| | - Damodharan Narayanasamy
- Department of Pharmaceutical Quality Assurance, SRM College of Pharmacy, Faculty of Medicine and Health Science, SRM Institute of Science and Technology, Chengalpattu, IND
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Bonato M, Marmondi F, Mastropaolo C, Inzaghi C, Cerizza C, Galli L, Banfi G, Cinque P. A Digital Platform for Home-Based Exercise Prescription for Older People with Sarcopenia. SENSORS (BASEL, SWITZERLAND) 2024; 24:4788. [PMID: 39123834 PMCID: PMC11314642 DOI: 10.3390/s24154788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 07/12/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024]
Abstract
Digital therapeutics refers to smartphone applications, software, and wearable devices that provide digital solutions to improve healthcare delivery. We developed a digital platform to support the GYM (Grow Your Muscle) study, an ongoing 48-week randomized, controlled trial on reduction of sarcopenia through a home-based, app-monitored physical exercise intervention. The GYM platform consists of a smartphone application including the exercise program and video tutorials of body-weight exercises, a wearable device to monitor heart rate during training, and a website for downloading training data to remotely monitor the exercise. The aim of this paper is to describe the platform in detail and to discuss the technical issues emerging during the study and those related to usability of the smartphone application through a retrospective survey. The main technical issue concerned the API level 33 upgrade, which did not enable participants using the Android operating systems to use the wearable device. The survey revealed some problems with viewing the video tutorials and with internet or smartphone connection. On the other hand, the smartphone application was reported to be easy to use and helpful to guide home exercising. Despite the issues encountered during the study, this digital-supported physical exercise intervention could provide useful to improve muscle measures of sarcopenia.
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Affiliation(s)
- Matteo Bonato
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Giuseppe Colombo 71, 20133 Milan, Italy
- Laboratory of Movement and Sport Sciences (LaMSS), IRCCS Istituto Ortopedico Galeazzi, Via Cristina da Belgioioso 173, 20157 Milan, Italy; (C.I.); (G.B.)
| | - Federica Marmondi
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona 20, 20127 Milan, Italy; (F.M.); (C.C.); (L.G.); (P.C.)
| | | | - Cecilia Inzaghi
- Laboratory of Movement and Sport Sciences (LaMSS), IRCCS Istituto Ortopedico Galeazzi, Via Cristina da Belgioioso 173, 20157 Milan, Italy; (C.I.); (G.B.)
| | - Camilla Cerizza
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona 20, 20127 Milan, Italy; (F.M.); (C.C.); (L.G.); (P.C.)
| | - Laura Galli
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona 20, 20127 Milan, Italy; (F.M.); (C.C.); (L.G.); (P.C.)
| | - Giuseppe Banfi
- Laboratory of Movement and Sport Sciences (LaMSS), IRCCS Istituto Ortopedico Galeazzi, Via Cristina da Belgioioso 173, 20157 Milan, Italy; (C.I.); (G.B.)
| | - Paola Cinque
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona 20, 20127 Milan, Italy; (F.M.); (C.C.); (L.G.); (P.C.)
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Masanneck L, Stern AD. Tracing Digital Therapeutics Research Across Medical Specialties: Evidence from ClinicalTrials.gov. Clin Pharmacol Ther 2024; 116:177-185. [PMID: 38563641 DOI: 10.1002/cpt.3260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
Digital therapeutics (DTx), evidence-based software interventions for preventing, managing, or treating medical disorders, have rapidly evolved with healthcare's shift toward online, patient-centric solutions. This study scrutinizes DTx clinical trials from 2005 to 2022, analyzing their growth, funding, underlying medical specialties, and other R&D characteristics, using ClinicalTrials.gov data. Our analysis includes trials categorized via the ICD-11 system, covering active, recruiting, or completed studies and considering trials listing multiple conditions. In analyzing 5,889 registered DTx trials, we document a more than five-fold increase in such trials since 2011, and a compound annual growth rate of 22.82% since 2005. While most trials were single-center, the median number of study subjects increased in recent years, driven by larger interventional trials. The key disciplines driving this growth were psychiatry, neurology, oncology, and endocrinology. Mental health dominated DTx trials in recent years, led by neurocognitive disorders, substance abuse disorders, and mood disorders. Industry funding varied across disciplines and was particularly high in visual system diseases and dermatology. DTx trials have surged since 2005, accelerated by recent growth in mental health trials. These trends mirror developments toward remote healthcare delivery, amplified by digital health investments during the COVID-19 pandemic. Growing numbers of participants in DTx trials point to increased demand for more robust trials. However, because most trials are single-center and country-specific, more international cooperation and harmonized evaluation standards will be essential for DTx trials to become more efficient and provide validation across countries, health systems, and groups of individuals.
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Affiliation(s)
- Lars Masanneck
- Department of Neurology, Medical Faculty University Hospital Düsseldorf, Düsseldorf, Germany
- Digital Health Cluster, Hasso-Plattner Institute, Potsdam, Germany
| | - Ariel D Stern
- Digital Health Cluster, Hasso-Plattner Institute, Potsdam, Germany
- Technology and Operations Management Unit, Harvard Business School, Boston, Massachusetts, USA
- Harvard-MIT Center for Regulatory Science, Boston, Massachusetts, USA
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6
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Schmidt L, Pawlitzki M, Renard BY, Meuth SG, Masanneck L. The three-year evolution of Germany's Digital Therapeutics reimbursement program and its path forward. NPJ Digit Med 2024; 7:139. [PMID: 38789620 PMCID: PMC11126413 DOI: 10.1038/s41746-024-01137-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
The 2019 German Digital Healthcare Act introduced the Digital Health Application program, known in German as 'Digitale Gesundheitsanwendungen' (DiGA). The program has established a pioneering model for integrating Digital Therapeutics (DTx) into a healthcare system with scalable and effective reimbursement strategies. To date, the continuous upward trend enabled by this framework has resulted in more than 374,000 DiGA prescriptions, increasingly cementing its role in the German healthcare system. This perspective provides a synthesis of the DiGA program's evolution since its inception three years ago, highlighting trends regarding prescriptions and pricing as well as criticisms and identified shortcomings. It further discusses forthcoming legislative amendments, including the anticipated integration of higher-risk medical devices, which have the potential to significantly transform the program. Despite encountering challenges related to effectiveness, evidence requirements, and integration within the healthcare system, the DiGA program continues to evolve and serves as a seminal example for the integration of DTx, offering valuable insights for healthcare systems globally.
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Affiliation(s)
- Linea Schmidt
- Hasso Plattner Institute, Digital Engineering Faculty, University of Potsdam, Potsdam, Germany
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Windreich Dept. of Artificial Intelligence & Human Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Marc Pawlitzki
- Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Bernhard Y Renard
- Hasso Plattner Institute, Digital Engineering Faculty, University of Potsdam, Potsdam, Germany
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Windreich Dept. of Artificial Intelligence & Human Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sven G Meuth
- Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Lars Masanneck
- Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
- German Society of Digital Medicine e.V. (DGDM), Berlin, Germany.
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Liu C, Zhou R, Shi J. How to Enhance Adherence in Patients with Nonalcoholic Fatty Liver Disease: A Thought-Provoking Issue. J Med Internet Res 2024; 26:e59208. [PMID: 38743941 PMCID: PMC11134234 DOI: 10.2196/59208] [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: 04/05/2024] [Accepted: 04/27/2024] [Indexed: 05/16/2024] Open
Affiliation(s)
- Chunlan Liu
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Run Zhou
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Junping Shi
- Department of Infectious Disease and Hepatology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory of Medical Epigenetics, Hangzhou, China
- Institute of Hepatology and Metabolic Disease, Hangzhou Normal University, Hangzhou, China
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Masanneck L, Pawlitzki MG, Meuth SG. [Digital medicine in neurological research-Between hype and evidence]. DER NERVENARZT 2024; 95:230-235. [PMID: 38095660 DOI: 10.1007/s00115-023-01581-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 03/06/2024]
Abstract
BACKGROUND The rapid advancement of digital medicine and health technologies in neurology offers both significant potential and challenges. This article outlines fundamental aspects of digital medicine related to neurological research and highlights application examples of digital technologies in neurological research. AIM To provide a comprehensive overview of current digital developments in neurology and their impact on neurological research. MATERIAL AND METHODS In this narrative review articles from various sources and references related to digital medicine and health technologies in neurology were compiled and analyzed. RESULTS AND DISCUSSION The data presented indicate that digital health technologies and digital therapeutics have the potential to decisively shape neurological care and research; however, it is emphasized that a critical evaluation and evidence-based approach to these technologies are essential to determine their actual value in neurology.
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Affiliation(s)
- Lars Masanneck
- Klinik für Neurologie, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland.
- Hasso-Plattner-Institut, Potsdam, Deutschland.
| | - Marc G Pawlitzki
- Klinik für Neurologie, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Sven G Meuth
- Klinik für Neurologie, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland.
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Hong W. Advances and Opportunities of Mobile Health in the Postpandemic Era: Smartphonization of Wearable Devices and Wearable Deviceization of Smartphones. JMIR Mhealth Uhealth 2024; 12:e48803. [PMID: 38252596 PMCID: PMC10823426 DOI: 10.2196/48803] [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: 05/07/2023] [Revised: 11/08/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
Mobile health (mHealth) with continuous real-time monitoring is leading the era of digital medical convergence. Wearable devices and smartphones optimized as personalized health management platforms enable disease prediction, prevention, diagnosis, and even treatment. Ubiquitous and accessible medical services offered through mHealth strengthen universal health coverage to facilitate service use without discrimination. This viewpoint investigates the latest trends in mHealth technology, which are comprehensive in terms of form factors and detection targets according to body attachment location and type. Insights and breakthroughs from the perspective of mHealth sensing through a new form factor and sensor-integrated display overcome the problems of existing mHealth by proposing a solution of smartphonization of wearable devices and the wearable deviceization of smartphones. This approach maximizes the infinite potential of stagnant mHealth technology and will present a new milestone leading to the popularization of mHealth. In the postpandemic era, innovative mHealth solutions through the smartphonization of wearable devices and the wearable deviceization of smartphones could become the standard for a new paradigm in the field of digital medicine.
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Affiliation(s)
- Wonki Hong
- Department of Digital Healthcare, Daejeon University, Daejeon, Republic of Korea
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Hu P, Hu L, Wang F, Mei J. Editorial: Computing and artificial intelligence in digital therapeutics. Front Med (Lausanne) 2024; 10:1330686. [PMID: 38249985 PMCID: PMC10796466 DOI: 10.3389/fmed.2023.1330686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024] Open
Affiliation(s)
- Pengwei Hu
- The Xinjiang Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Ürümqi, China
| | - Lun Hu
- The Xinjiang Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Ürümqi, China
| | - Fei Wang
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Jing Mei
- Ping An Technology, Shenzhen, China
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Yang E. Implications of immersive technologies in healthcare sector and its built environment. FRONTIERS IN MEDICAL TECHNOLOGY 2023; 5:1184925. [PMID: 37799269 PMCID: PMC10548380 DOI: 10.3389/fmedt.2023.1184925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 09/04/2023] [Indexed: 10/07/2023] Open
Abstract
Objectives This research focuses on how built environment experts can contribute to the MXR-enabled digital innovation as part of the multidisciplinary team effort to ensure post-pandemic resilience in healthcare built environment. The goal of this research is to help healthcare providers, built environment experts, and policy makers respectively: (1) Advocate the benefits of MXR for innovating health and social care; (2) Spark debate across networks of expertise to create health-promoting environment; and (3) Understand the overriding priorities in making effective pathways to the implementation of MXR. Methods To highlight the novelty of this research, the study relies on two qualitative methodologies: exploratory literature review and semi-structured interviews. Based on the evaluation of prior works and cross-national case studies, hypotheses are formulated from three arenas: (1) Cross-sectional Initiatives for Post-pandemic Resilience; (2) Interoperability and Usability of Next-gen Medicines; and (3) Metaverse and New Forms of Value in Future Healthcare Ecosystems. To verify those hypotheses, empirical findings are derived from in-depth interviews with nine key informants. Results The main findings are summarized under the following three themes: (1) Synergism between Architecture and Technology; (2) Patient Empowerment and Staff Support; and (3) Scalable Health and Wellbeing in Non-hospital and Therapeutic Settings. Firstly, both built environment and healthcare sectors can benefit from the various capabilities of MXR through cross-sectional initiatives, evidence-based practices, and participatory approaches. Secondly, a confluence of knowledge and methods of HCI and HBI can increase the interoperability and usability of MXR for the patient-centered and value-based healthcare models. Thirdly, the MXR-enabled technological regime will largely affect the new forms of value in healthcare premises by fostering more decentralized, preventive, and therapeutic characteristics in the future healthcare ecosystems. Conclusion Whether it's virtual or physical, our healthcare systems have placed great emphasis on the rigor of evidence-based approach linking health outcome to a clinical environment. Henceforth, built environment experts should seek closer ties with the MXR ecosystems for the co-production of scalable health and wellbeing in non-hospital and therapeutic settings. Ultimately, this is to improve resource efficiency in the healthcare sector while considering the transition of health resources towards in silico status by increasing the implementation of MXR.
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Affiliation(s)
- Eunsil Yang
- Healthcare Facilities, Bartlett School of Sustainable Construction, University College London, London, United Kingdom
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Coughlin LN, Salino S, Jennings C, Lacek M, Townsend W, Koffarnus MN, Bonar EE. A systematic review of remotely delivered contingency management treatment for substance use. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 147:208977. [PMID: 36804352 PMCID: PMC10936237 DOI: 10.1016/j.josat.2023.208977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 11/23/2022] [Accepted: 02/05/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Substance use and related consequences (e.g., impaired driving, injuries, disease transmission) continue to be major public health concerns. Contingency management (CM) is a highly effective treatment for substance use disorders. Yet CM remains vastly underutilized, in large part due to implementation barriers to in-person delivery. If feasible and effective, remote delivery of CM may reduce barriers at both the clinic- and patient-level, thus increasing reach and access to effective care. Here, we summarize data from a systematic review of studies reporting remote delivery of CM for substance use treatment. METHODS We conducted a systematic review, reported according to PRISMA guidelines. The study team identified a total of 4358 articles after deduplication. Following title and abstract screening, full-text screening, and reference tracking, 39 studies met the eligibility criteria. We evaluated the methodological quality of the included studies using the Effective Public Health Practice Project Quality tool. RESULTS Of 39 articles included in the review, most (n = 26) targeted cigarette smoking, with others focusing on alcohol (n = 9) or other substance use or targeting multiple substances (n = 4). Most remotely delivered CM studies focused on abstinence (n = 29), with others targeting substance use reduction (n = 2), intervention engagement (n = 5), and both abstinence and intervention engagement (n = 3). CM was associated with better outcomes (either abstinence, use reduction, or engagement), with increasingly more remotely delivered CM studies published in more recent years. Studies ranged from moderate to strong quality, with the majority (57.5 %) of studies being strong quality. CONCLUSIONS Consistent with in-person CM, remotely delivered CM focusing on abstinence or use reduction from substances or engagement in substance use treatment services improves outcomes at the end of treatment compared to control conditions. Moreover, remotely delivered CM is feasible across a variety of digital delivery platforms (e.g., web, mobile, and wearable), with acceptability and reduced clinic and patient burden as technological advancements streamline monitoring and reinforcer delivery.
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Affiliation(s)
- Lara N Coughlin
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Injury Prevention Center, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Sarah Salino
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Claudia Jennings
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Madelyn Lacek
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Whitney Townsend
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI 48109, USA
| | - Mikhail N Koffarnus
- Department of Family and Community Medicine, University of Kentucky, Lexington, KY 40506, USA
| | - Erin E Bonar
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Injury Prevention Center, University of Michigan, Ann Arbor, MI 48109, USA
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13
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Xu J, Cai H, Wu Z, Li X, Tian C, Ao Z, Niu VC, Xiao X, Jiang L, Khodoun M, Rothenberg M, Mackie K, Chen J, Lee LP, Guo F. Acoustic metamaterials-driven transdermal drug delivery for rapid and on-demand management of acute disease. Nat Commun 2023; 14:869. [PMID: 36797284 PMCID: PMC9935629 DOI: 10.1038/s41467-023-36581-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/06/2023] [Indexed: 02/18/2023] Open
Abstract
Transdermal drug delivery provides convenient and pain-free self-administration for personalized therapy. However, challenges remain in treating acute diseases mainly due to their inability to timely administrate therapeutics and precisely regulate pharmacokinetics within a short time window. Here we report the development of active acoustic metamaterials-driven transdermal drug delivery for rapid and on-demand acute disease management. Through the integration of active acoustic metamaterials, a compact therapeutic patch is integrated for penetration of skin stratum corneum and active percutaneous transport of therapeutics with precise control of dose and rate over time. Moreover, the patch device quantitatively regulates the dosage and release kinetics of therapeutics and achieves better delivery performance in vivo than through subcutaneous injection. As a proof-of-concept application, we show our method can reverse life-threatening acute allergic reactions in a female mouse model of anaphylaxis via a multi-burst delivery of epinephrine, showing better efficacy than a fixed dosage injection of epinephrine, which is the current gold standard 'self-injectable epinephrine' strategy. This innovative method may provide a promising means to manage acute disease for personalized medicine.
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Affiliation(s)
- Junhua Xu
- Department of Intelligent Systems Engineering, Indiana University, Bloomington, IN, 47405, USA
- Biopharmaceutical Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Hongwei Cai
- Department of Intelligent Systems Engineering, Indiana University, Bloomington, IN, 47405, USA
| | - Zhuhao Wu
- Department of Intelligent Systems Engineering, Indiana University, Bloomington, IN, 47405, USA
| | - Xiang Li
- Department of Intelligent Systems Engineering, Indiana University, Bloomington, IN, 47405, USA
| | - Chunhui Tian
- Department of Intelligent Systems Engineering, Indiana University, Bloomington, IN, 47405, USA
| | - Zheng Ao
- Department of Intelligent Systems Engineering, Indiana University, Bloomington, IN, 47405, USA
| | - Vivian C Niu
- Department of Intelligent Systems Engineering, Indiana University, Bloomington, IN, 47405, USA
- Bloomington High School South, Bloomington, IN, 47401, USA
| | - Xiao Xiao
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Lei Jiang
- Department of Intelligent Systems Engineering, Indiana University, Bloomington, IN, 47405, USA
| | - Marat Khodoun
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, 45229, USA
| | - Marc Rothenberg
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, 45229, USA
| | - Ken Mackie
- Gill Center for Biomolecular Science, and Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, 47405, USA
| | - Jun Chen
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
| | - Luke P Lee
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
- Department of Bioengineering, Department of Electrical Engineering and Computer Science, University of California at Berkeley, Berkeley, CA, 94720, USA.
- Institute of Quantum Biophysics, Department of Biophysics, Sungkyunkwan University, Suwon, Korea.
| | - Feng Guo
- Department of Intelligent Systems Engineering, Indiana University, Bloomington, IN, 47405, USA.
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14
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Ono M, Iwasaki K. Comprehensive Analysis of Clinical Studies and Regulations of Therapeutic Applications in the United States and Japan. Ther Innov Regul Sci 2023; 57:86-99. [PMID: 36070067 PMCID: PMC9755089 DOI: 10.1007/s43441-022-00442-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 07/25/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Digital therapeutics (DTx), the provision of treatment through mobile devices such as smartphones, have attracted great interest as a new medical modality. However, the number of authorized therapeutic applications in the US and Japan is low. Understanding the obstacles in obtaining regulatory authorizations will be the key in promoting timely development of therapeutic applications. Thus, we conducted a comprehensive analysis of the clinical study designs of therapeutic applications authorized in the US and Japan. METHODS Data on authorized therapeutic applications and the regulations involved were collated from the databases of the Food and Drug Administration (USA), Ministry of Health, Labour and Welfare (Japan), and Pharmaceuticals and Medical Devices Agency (Japan). RESULTS Most therapeutic applications authorized targeted neuropsychiatric disorders and used cognitive behavioral therapy (CBT)-based treatments. All the involved clinical trials were randomized-controlled studies. Various types of controls-such as standard care, sham application, digital control, and therapies delivered by healthcare providers-were used. Both subjective and objective indices were acceptable as the primary endpoints. Long-term efficacy was evaluated, and all adverse events were assessed comprehensively. The setting up of controls and the need to study long-term efficacy depend heavily on the applications functionality and the target disease characteristics. CONCLUSIONS This study reveals the points to be considered in planning clinical studies and regulatory strategies for authorizing therapeutic applications. Therapeutic applications can provide new therapy and have potential to solve unmet clinical needs. Our findings shed a light on efficient development and rapid commercialization of therapeutic applications.
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Affiliation(s)
- Mao Ono
- Cooperative Major in Advanced Biomedical Sciences, Joint Graduate School of Tokyo Women’s Medical University and Waseda University, Waseda University, 2-2 Wakamatsucho, Shinjuku, Tokyo 162-8480 Japan
| | - Kiyotaka Iwasaki
- Cooperative Major in Advanced Biomedical Sciences, Joint Graduate School of Tokyo Women’s Medical University and Waseda University, Waseda University, 2-2 Wakamatsucho, Shinjuku, Tokyo 162-8480 Japan ,Department of Modern Mechanical Engineering, School of Creative Science and Engineering, Waseda University, Tokyo, 169-8555 Japan ,Department of Integrative Bioscience and Biomedical Engineering, Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, 162-8480 Japan ,Institute for Medical Regulatory Science, Waseda University, Tokyo, 162-8480 Japan
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15
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Qiu CS, Majeed A, Khan S, Watson M. Transforming health through the metaverse. J R Soc Med 2022; 115:484-486. [PMID: 36480946 PMCID: PMC9747900 DOI: 10.1177/01410768221144763] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Connor S Qiu
- School of Public Health, Imperial College London, London SW7 2AZ, UK,Connor S Qiu.
| | - Azeem Majeed
- School of Public Health, Imperial College London, London SW7 2AZ, UK
| | - Sadhia Khan
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London W2 1NY, UK
| | - Mando Watson
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London W2 1NY, UK
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16
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Eccleston C, Fisher E, Liikkanen S, Sarapohja T, Stenfors C, Jääskeläinen SK, Rice AS, Mattila L, Blom T, Bratty JR. A prospective, double-blind, pilot, randomized, controlled trial of an "embodied" virtual reality intervention for adults with low back pain. Pain 2022; 163:1700-1715. [PMID: 35324507 PMCID: PMC9393796 DOI: 10.1097/j.pain.0000000000002617] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/28/2022] [Accepted: 02/13/2022] [Indexed: 11/25/2022]
Abstract
ABSTRACT Adults with chronic low back pain, disability, moderate-to-severe pain, and high fear of movement and reinjury were recruited into a trial of a novel, automated, digital therapeutics, virtual reality, psychological intervention for pain (DTxP). We conducted a 3-arm, prospective, double-blind, pilot, randomized, controlled trial comparing DTxP with a sham placebo comparator and an open-label standard care. Participants were enrolled for 6 to 8 weeks, after which, the standard care control arm were rerandomized to receive either the DTxP or sham placebo. Forty-two participants completed assessments at baseline, immediately posttreatment (6-8 weeks), 9-week, and 5-month follow-up. We found that participants in the DTxP group reported greater reductions in fear of movement and better global impression of change when compared with sham placebo and standard care post treatment. No other group differences were noted at posttreatment or follow-up. When compared with baseline, participants in the DTxP group reported lower disability at 5-month follow-up, lower pain interference and fear of movement post treatment and follow-up, and lower pain intensity at posttreatment. The sham placebo group also reported lower disability and fear of movement at 5-month follow-up compared with baseline. Standard care did not report any significant changes. There were a number of adverse events, with one participant reporting a serious adverse event in the sham placebo, which was not related to treatment. No substantial changes in medications were noted, and participants in the DTxP group reported positive gaming experiences.
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Affiliation(s)
- Christopher Eccleston
- Department for Health, Centre for Pain Research, University of Bath, Bath, United Kingdom
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Emma Fisher
- Department for Health, Centre for Pain Research, University of Bath, Bath, United Kingdom
- Cochrane Pain, Palliative, and Supportive Care Review Groups, Oxford University Hospitals, Oxford, United Kingdom
| | | | | | | | - Satu K. Jääskeläinen
- Department of Clinical Neurophysiology, Turku University Hospital and University of Turku, Turku, Finland
| | - Andrew S.C. Rice
- Department of Surgery and Cancer, Pain Research, Faculty of Medicine, Imperial College, London, United Kingdom
| | | | - Taru Blom
- Orion Corporation Orion Pharma, R&D, Espoo, Finland
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17
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Sunyaev A, Fürstenau D, Davison E. Call for Papers, Issue 3/2024. BUSINESS & INFORMATION SYSTEMS ENGINEERING 2022. [DOI: 10.1007/s12599-022-00763-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Zhang Z, Zheng X, An K, He Y, Wang T, Zhou R, Zheng Q, Nuo M, Liang J, Lei J. Current Status of the Health Information Technology Industry in China from the China Hospital Information Network Conference: Cross-sectional Study of Participating Companies. JMIR Med Inform 2022; 10:e33600. [PMID: 35014959 PMCID: PMC8790697 DOI: 10.2196/33600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/09/2021] [Accepted: 11/14/2021] [Indexed: 11/20/2022] Open
Abstract
Background The China Hospital Information Network Conference (CHINC) is one of the most influential academic and technical exchange activities in medical informatics and medical informatization in China. It collects frontier ideas in medical information and has an important reference value for the analysis of China's medical information industry development. Objective This study summarizes the current situation and future development of China's medical information industry and provides a future reference for China and abroad in the future by analyzing the characteristics of CHINC exhibitors in 2021. Methods The list of enterprises and participating keywords were obtained from the official website of CHINC. Basic characteristics of the enterprises, industrial fields, applied technologies, company concepts, and other information were collected from the TianYanCha website and the VBDATA company library. Descriptive analysis was used to analyze the collected data, and we summarized the future development directions. Results A total of 205 enterprises officially participated in the exhibition. Most of the enterprises were newly founded, of which 61.9% (127/205) were founded in the past 10 years. The majority of these enterprises were from first-tier cities, and 79.02% (162/205) were from Beijing, Zhejiang, Guangdong, Shanghai, and Jiangsu Provinces. The median registered capital is 16.67 million RMB (about US $2.61 million), and there are 35 (72.2%) enterprises with a registered capital of more than 100 million RMB (about US $15.68 million), 17 (8.3%) of which are already listed. A total of 126 enterprises were found in the VBDATA company library, of which 39 (30.9%) are information technology vendors and 57 (45.2%) are application technology vendors. In addition, 16 of the 57 (28%) use artificial intelligence technology. Smart medicine and internet hospitals were the focus of the enterprises participating in this conference. Conclusions China's tertiary hospital informatization has basically completed the construction of the primary stage. The average grade of hospital electronic medical records exceeds grade 3, and 78.13% of the provinces have reached grade 3 or above. The characteristics are as follows: On the one hand, China's medical information industry is focusing on the construction of smart hospitals, including intelligent systems supporting doctors' scientific research, diagnosis-related group intelligent operation systems, and office automation systems supporting hospital management, single-disease clinical decision support systems assisting doctors' clinical care, and intelligent internet of things for logistics. On the other hand, the construction of a compact county medical community is becoming a new focus of enterprises under the guidance of practical needs and national policies to improve the quality of grassroots health services. In addition, whole-course management and digital therapy will also become a new hotspot in the future.
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Affiliation(s)
- Zhongan Zhang
- Department of Information Center, Affiliated Qingdao Central Hospital, Qingdao University, Qingdao, China
| | - Xu Zheng
- Peking University Third Hospital, Beijing, China.,Center for Medical Informatics, Health Science Center, Peking University, Beijing, China
| | - Kai An
- Peking University Third Hospital, Beijing, China.,Center for Medical Informatics, Health Science Center, Peking University, Beijing, China
| | - Yunfan He
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Tong Wang
- Department of Medical Informatics, School of Public Health, Jilin University, Changchun, China
| | - Ruizhu Zhou
- Department of Applied Mathematics, Northwestern Polytechnical University, Xian, China
| | - Qilin Zheng
- Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Mingfu Nuo
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China
| | - Jun Liang
- Information Technology Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jianbo Lei
- Center for Medical Informatics, Health Science Center, Peking University, Beijing, China.,Institute of Medical Technology, Health Science Center, Peking University, Beijing, China.,School of Medical Informatics and Engineering, Southwest Medical University, Luzhou, China
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19
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Lee YS, Choi SE, Hahm J, Kim MJ, Bae HS, Yi K, Lim HT, Hyon JY. Digital Therapeutics: Exploring the Possibilities of Digital Intervention for Myopia. Front Digit Health 2021; 3:710644. [PMID: 34713181 PMCID: PMC8521975 DOI: 10.3389/fdgth.2021.710644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/03/2021] [Indexed: 11/23/2022] Open
Abstract
Pediatric myopia is increasing globally and has become a major public health issue. However, the mechanism of pediatric myopia is still poorly understood, and there is no effective treatment to prevent its progression. Based on results from animal and clinical studies, certain neuronal–humoral factors (NHFs), such as IGF-1, dopamine, and cortisol may be involved in the progression of pediatric myopia. Digital therapeutics uses evidence-based software as therapeutic interventions and it has the potential to offer innovative treatment strategies for pediatric myopia beyond conventional treatment methods. In this perspective article, we introduce digital therapeutics SAT-001, a software algorithm that modulates the level of NHFs to reduce the progression of pediatric myopia. The proposed mechanism is based on a theoretical hypothesis derived from scientific research and clinical studies and will be further confirmed by evidence generated from clinical studies involving pediatric myopia.
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Affiliation(s)
| | | | - Jarang Hahm
- S-Alpha Therapeutics, Inc., Seoul, South Korea
| | - Myoung Joon Kim
- S-Alpha Therapeutics, Inc., Seoul, South Korea.,Renew Seoul Eye Center, Seoul, South Korea
| | | | - Kayoung Yi
- Department of Ophthalmology, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea
| | - Hyun Taek Lim
- Department of Ophthalmology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea
| | - Joon Young Hyon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul University Bundang Hospital, Seongnam, South Korea
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20
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Anguera JA, Schachtner JN, Simon AJ, Volponi J, Javed S, Gallen CL, Gazzaley A. Long-term maintenance of multitasking abilities following video game training in older adults. Neurobiol Aging 2021; 103:22-30. [PMID: 33789209 DOI: 10.1016/j.neurobiolaging.2021.02.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 11/18/2022]
Abstract
The use of cognitive interventions to remediate deficient cognitive functions, or to enhance or preserve intact cognitive abilities, has been explored for some time, especially in older adults. However, few studies have investigated the long-term persistence of any positive benefits, with none examining whether changes in functional brain activity persist several years later. Here, we assessed whether enhanced cognitive abilities and potential underlying neural changes attained via the use of a custom-made video game (NeuroRacer) played by older adults (60-85 years old) continued to be elevated beyond control participants 6 years later. The NeuroRacer group continued to show reduced multitasking costs beyond control participants, with a neural signature of cognitive control, midline frontal theta power, also continuing to show heightened activity. However, previously evidenced performance benefits that had extended to untrained cognitive control abilities (i.e., enhanced sustained attention and working memory) did not persist, highlighting sustainability limitations. These findings continue to demonstrate the robust plasticity of the prefrontal cognitive control system in the aging brain, a potential neural mechanism underlying enhanced performance over time, and the possible long-term impact that digital therapeutics can have.
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Affiliation(s)
- Joaquin A Anguera
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Neuroscape Center, University of California, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, CA, USA.
| | - Jessica N Schachtner
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Neuroscape Center, University of California, San Francisco, CA, USA
| | - Alexander J Simon
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Neuroscape Center, University of California, San Francisco, CA, USA
| | - Joshua Volponi
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Neuroscape Center, University of California, San Francisco, CA, USA
| | - Samirah Javed
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Neuroscape Center, University of California, San Francisco, CA, USA
| | - Courtney L Gallen
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Neuroscape Center, University of California, San Francisco, CA, USA
| | - Adam Gazzaley
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Neuroscape Center, University of California, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, CA, USA; Department of Physiology, University of California, San Francisco, CA, USA
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21
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Patel NA, Butte AJ. Characteristics and challenges of the clinical pipeline of digital therapeutics. NPJ Digit Med 2020; 3:159. [PMID: 33311567 PMCID: PMC7733514 DOI: 10.1038/s41746-020-00370-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 11/12/2020] [Indexed: 11/25/2022] Open
Abstract
In this Comment, we characterize the current pipeline of digital therapeutics and offer a clinical perspective into the advantages, challenges, and barriers to implementation of this treatment modality for patient care, which we hope will inform future regulatory policy, prescribing decisions, and scope of real-world evidence collection.
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Affiliation(s)
- Nisarg A Patel
- Department of Oral and Maxillofacial Surgery, University of California San Francisco, San Francisco, CA, USA.
- Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, CA, USA.
| | - Atul J Butte
- Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, CA, USA
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22
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Crotty BH, Somai M. The Bugs In the Virtual Clinic: Confronting Telemedicine’s Challenges Through Empathy and Support (Preprint). J Particip Med 2020; 14:e25688. [PMID: 35452399 PMCID: PMC9077509 DOI: 10.2196/25688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/28/2020] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
Although telemedicine has been an important conduit for clinical care during the COVID-19 pandemic, not all patients have been able to meaningfully participate in this mode of health care provision. Challenges with accessing telemedicine using consumer technology can interfere with the ability of patients and clinicians to meaningfully connect and lead to significant investments in time by clinicians and their staff. In this narrative case, we identify issues related to patients’ use of technology, make comparisons between telehealth adoption and the deployment of electronic health records, and propose that building intuitive and supported digital care experiences for patients is required to make virtual care sustainable.
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Affiliation(s)
- Bradley H Crotty
- Inception Labs, Collaborative for Healthcare Delivery Science, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Melek Somai
- Inception Labs, Collaborative for Healthcare Delivery Science, Medical College of Wisconsin, Milwaukee, WI, United States
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23
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Mois G, Fortuna KL. Visioning the Future of Gerontological Digital Social Work. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2020; 63:412-427. [PMID: 32478644 PMCID: PMC8120642 DOI: 10.1080/01634372.2020.1772436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 05/18/2020] [Accepted: 05/18/2020] [Indexed: 05/22/2023]
Abstract
Gerontological Social Work education has been substantially altered by the advancement of today's digital technologies, influencing both the training and tools required to ensure student success in social work research, policy, and practice. The goal of this paper is to present the state of the science on gerontological digital social work education, identify implications for emerging technologies, and define areas for social work student competencies and proficiencies to advance the field of gerontological digital social work. This paper underlines the role of gerontological digital social work education in preparing future researchers, practitioners, and policymakers when engaging in Digital Therapeutic Teams. We provide insightful considerations pertaining to emerging technologies which present unique opportunities for innovation. Furthermore, this paper presents training and education opportunities for social work education in preparing future gerontologist practitioners, researchers, and policymakers to engage in multidisciplinary team efforts and leverage digital technologies and digital therapeutics.
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Affiliation(s)
- George Mois
- School of Social Work, University of Georgia, Athens, GA, USA
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24
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van de Graaf DL, Schoonman GG, Habibović M, Pauws SC. Towards eHealth to support the health journey of headache patients: a scoping review. J Neurol 2020; 268:3646-3665. [PMID: 32529582 PMCID: PMC8463346 DOI: 10.1007/s00415-020-09981-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 11/28/2022]
Abstract
Objective The aim of this study is to (1) review the digital health tools that have been used in headache studies, and (2) discuss the effectivity and reliability of these tools. Background Many headache patients travel a long and troublesome journey from first symptoms until a meaningful care plan. eHealth, mHealth, and digital therapeutic modalities have been advocated as the way forward to improve patient care. Method Online databases PubMed, Cinahl, and PsycINFO were searched using a predefined search query. A data extraction form was used to gather relevant data elements from the selected papers. Results A total of 39 studies were selected. The studies included 94,127 participants. The majority of studies focused on diaries (N = 27 out of 39). Digital (cognitive) behavioral therapy were also quite common (N = 7 out of 39). Other digital health tool categories were tele-consultations, telemonitoring and patient portals. Conclusion Many digital health tools for headache patients regarding diaries and behavioral/therapeutical treatment are described in scientific research with limited information on effectivity and reliability. Scientific knowledge with regard to other categories such as tele-consultations, patient portals, telemonitoring including medication adherence, online information resources, wearable, symptom checkers, digital peer support is still scarce or missing.
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Affiliation(s)
| | - Guus G Schoonman
- Department of Neurology, Elizabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Mirela Habibović
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Cardiology, Elizabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Steffen C Pauws
- TiCC-Tilburg University, Tilburg, The Netherlands.,Philips Research, Healthcare, Eindhoven, The Netherlands
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25
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Dang A, Arora D, Rane P. Role of digital therapeutics and the changing future of healthcare. J Family Med Prim Care 2020; 9:2207-2213. [PMID: 32754475 PMCID: PMC7380804 DOI: 10.4103/jfmpc.jfmpc_105_20] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/12/2020] [Accepted: 03/23/2020] [Indexed: 11/21/2022] Open
Abstract
With healthcare becoming digital, patients today are more empowered than ever before. As a result, digital health solutions have become the need of the hour to keep up with an increasing number of empowered patients participating in their own treatment decisions. Digital health encompasses various platforms and systems that apply technological solutions to enhance healthcare delivery. Digital therapeutics (DTx) is one such category of digital health solutions that provides evidence-based software-driven therapeutic interventions for the prevention and management of a medical disorder or disease. This review aims to provide a comprehensive overview of DTx, its functions and applications in healthcare, and associated regulatory aspects, among others.
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Affiliation(s)
- Amit Dang
- Founder and CEO, KYT Adhere, Founder and CEO, MarksMan Healthcare Communications, Hyderabad, Telangana, India
| | - Dimple Arora
- Co-Founder, KYT Adhere, Co-Founder, MarksMan Healthcare Communications, Hyderabad, Telangana, India
| | - Pawan Rane
- Co-Founder, KYT Adhere, Head and Neck Oncosurgeon, Healthway Hospital, Goa, India
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26
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Hirsch MC, Ronicke S, Krusche M, Wagner AD. Rare diseases 2030: how augmented AI will support diagnosis and treatment of rare diseases in the future. Ann Rheum Dis 2020; 79:740-743. [PMID: 32209541 PMCID: PMC7286047 DOI: 10.1136/annrheumdis-2020-217125] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 02/28/2020] [Accepted: 03/03/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Martin Christian Hirsch
- Institute for AI in Medicine, University Hospital of Giessen and Marburg, Marburg, Germany.,Ada Health GmbH, Berlin, Germany
| | - Simon Ronicke
- Ada Health GmbH, Berlin, Germany.,Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Martin Krusche
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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