Electronic Follow-Up of Developing World Cleft Patients: A Digital Dream?

WeChat assisted electronic symptom measurement for patients with adenomyosis

PURPOSE

Symptom assessment is central to appropriate adenomyosis management. Using a WeChat mini-program-based portal, we aimed to establish a valid symptom assessment scale of adenomyosis (AM-SAS) to precisely and timely identify needs of symptom management and ultimately, to alert disease recurrence.

METHODS

A combination of intensive interviews of patients with adenomyosis and natural language processing on WeChat clinician-patient group communication was used to generate a pool of symptom items-related to adenomyosis. An expert panel shortened the list to form the provisional AM-SAS. The AM-SAS was built in a Wechat mini-programmer and sent to patients to exam the psychotically validity and clinical applicability through classic test theory and item response theory.

RESULTS

Total 338 patients with adenomyosis (29 for interview, 179 for development, and 130 for external validation) and 86 gynecologists were included. The over 90% compliance to the WeChat-based symptom evaluate. The AM-SAS demonstrated the uni-dimensionality through Rasch analysis, good internal consistency (all Cronbach's alphas above 0.8), and test-retest reliability (intraclass correlation coefficients ranging from 0.65 to 0.84). Differences symptom severity score between patients in the anemic and normal hemoglobin groups (3.04 ± 3.17 vs. 5.68 ± 3.41, P < 0.001). In external validation, AM-SAS successfully detected differences in symptom burden and physical status between those with or without relapse.

CONCLUSION

Electronic PRO-based AM-SAS is a valuable instrument for monitoring AM-related symptoms. As an outcome measure of multiple symptoms in clinical trials, the AM-SAS may identify patients who need extensive care after discharge and capture significant beneficial changes of patients may have been overlooked.

TRIAL REGISTRATION

This trial was approved by the institutional review board of the Chongqing Medical University and three participating hospitals (Medical Ethics Committee of Nanchong Central Hospital, Medical Ethics Committee of Affiliated Hospital of Southwest Medical University, and Medical Ethics Committee of Haifu Hospital) and registered in the Chinese Clinical Trial Registry (registration number ChiCTR2000038590), date of registration was 26/10/2020.

Legal issues in digital oral health: a scoping review

BACKGROUND

This scoping review aims to systematically and critically describe the numerous legal challenges brought about by the utilization of digital oral health in the delivery of oral healthcare.

METHODS

A systematic search was conducted. The following electronic databases were reviewed from inception up to March 2023: MEDLINE, Embase, Scopus, and LILACS. The search included any scientific document and paper in English, Spanish, or Portuguese on legal issues raised using digital health in oral healthcare delivery. Two reviewers conducted the selection process and data extraction. Legal issues raised concerning the adoption of digital health technology were analysed using the modified Mars' framework.

RESULTS

Seventeen studies were included. Most of the documents identified and covered generic aspects of delivering digital oral healthcare (n = 11) without explicitly referring to any dental specialty. The most mentioned legal issues were data security (n = 15); liability and malpractice (n = 14); consent (n = 12); and confidentiality (n = 12). To a lower extent, patient-practitioner relationship (n = 11); and license and jurisdiction (n = 11) were also covered. These were followed by privacy of information (n = 10); adequacy of records (n = 9); and e-referrals (n = 8). On the other hand, fewer studies commented on social media use (n = 3), authentication (n = 2); or e-prescriptions (n = 2). Before implementing any digital health solution, practitioners need to be aware of the many legal issues that the introduction of these technologies involves, be clear where the responsibility lies, and apply extreme caution in following national guidelines. Current literature concentrates on a few well-known legal issues. Issues around authentication, use of social media, and e-prescriptions received less attention.

The use of mobile devices in oculoplastic and oral and maxillofacial surgery: A systematic review

BACKGROUND

The use of smartphones in the United States has more than doubled since 2011. Mobile phone applications have versatile functions in ophthalmology, otolaryngology, and plastic surgery, such as increasing patient engagement in treatment, decreasing no-shows to appointments, and providing patient education. They also provide practical advantages to the clinician, including supplementing an otoscope, laryngoscope, or ophthalmoscope. Their use in oral and maxillofacial surgery (OMFS) and oculoplastic surgery has shown effectiveness for a variety of applications, such as for photography and medical reference. Research suggests that smartphones may improve clinical outcomes and efficiency.

OBJECTIVE

The goal of this study is to provide a comprehensive and up-to-date systematic review of the available literature investigating mobile phone use in oculoplastic surgery and OMFS.

METHODS

A query of terms relevant to oculoplastic surgery and OMFS was conducted using the databases PubMed, CINAHL, Web of Science, and PsychINFO to identify studies meeting inclusion criteria that investigated the implementation, efficacy, and outcomes of mobile device use in oculoplastic surgery and OMFS. A qualitative summary and discussion of the literature was subsequently synthesized.

RESULTS

Out of a total of 289 articles reviewed, 171 were removed due to duplication across the four databases. Of the 118 studies remaining, 19 of them were included within the final qualitative review after screening the abstracts and full text for relevance. The articles were published between 2005 and 2020 from 7 different countries. Review of the relevant articles showed three settings in which mobile devices were used: communication between providers, communication between providers and patients, and as surgical supplementation. The literature review included use of mobile device photography for quality improvement, visual representation of procedures for patient education, and improved communication amongst providers and patients in the setting of oculoplastics and OMFS.

CONCLUSION

Mobile device use has become ubiquitous across cultures worldwide. The literature suggests that mobile phone use in oculoplastic surgery and OMFS may improve clinical practice in multiple settings. However, further investigation is necessary to quantify the clinical benefits of mobile device use in oculoplastic and oral and maxillofacial surgery.

Telemedicine as an Alternative Way to Provide Multidisciplinary Cleft Care During the COVID-19 Pandemic

The current coronavirus pandemic is changing the way healthcare professionals provide services to patients. Healthcare professionals are required to provide quality care while reducing the risk of viral transmission. This pandemic has disrupted the timely multidisciplinary team care for patients with clefts across the globe. Thus, telemedicine has been recognized and accepted by various medical and dental specialists as a viable alternative to face-to-face consultation. In addition, telemedicine incorporating a digital workflow in cleft management will further reduce the risk of viral transmission and enhance the quality of treatment being provided to these patients.