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Huettemann R, Sevov B, Meister S, Fehring L. Understanding citizens' attitudes within user-centered digital health ecosystems: A sequential mixed method methodology including a web-survey. Digit Health 2024; 10:20552076241255929. [PMID: 39314816 PMCID: PMC11418335 DOI: 10.1177/20552076241255929] [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: 10/30/2023] [Accepted: 05/01/2024] [Indexed: 09/25/2024] Open
Abstract
Objective Transitioning from digital health applications to digital health ecosystems, leveraging the advances in technologies and informatics, could be the next revolution in digital health. This includes offering centralized access to various health services and improving citizens' well-being, delivery, clinical processes, and data management. However, a limited understanding of citizens may impede adaptation. Therefore, this study investigates citizens' attitudes within digital health ecosystems, differentiated by their characteristics, to support health service-providers and governmental policymakers in establishing user-centered solutions. Methods This study follows a three-step sequential mixed method methodology: (1) a literature review. (2) Qualitative thematic analyses based on semi-structured qualitative interviews. (3) Quantitative analyses based on a web-survey (descriptive statistics, one-way analysis of variances, Tukey-honestly, and Cohen's d tests). Results N = 15 citizens were interviewed and n = 1289 responded to the web-survey, to our knowledge the largest survey on this topic. Citizens desire a more convenient management of health services and data (M = 5.2, SD = 1.59). Services with peer-to-peer interactions (M = 3.7, SD = 1.81) and lower involvement of health professionals (M = 3.8, SD = 1.75) are less demanded. Data protection is critical (M = 6.2, SD = 1.23). Public payers are mandated as orchestrators (M = 4.3, SD = 1.99), while private companies receive lower acceptance (M = 3.0, SD = 1.42). Conclusions Health service-providers could follow a three-staged approach to establish digital health ecosystems: (1) Increasing the convenience for citizens by enabling online management of health services and data. (2) Extending the citizen-healthcare provider partnership through online interactions. (3) Fostering preventative behaviors and quicker recovery by personalizing health services and interactions. Governmental policymakers should integrate an electronic health record.
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Affiliation(s)
- Robin Huettemann
- Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Benedict Sevov
- Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Sven Meister
- Healthcare Informatics, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
- Department Healthcare, Fraunhofer Institute for Software and Systems Engineering ISST, Dortmund, Germany
| | - Leonard Fehring
- Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
- Gastroenterology, HELIOS University Hospital Wuppertal, University Witten/Herdecke, Wuppertal, Germany
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Dang T, Spathis D, Ghosh A, Mascolo C. Human-centred artificial intelligence for mobile health sensing: challenges and opportunities. ROYAL SOCIETY OPEN SCIENCE 2023; 10:230806. [PMID: 38026044 PMCID: PMC10646451 DOI: 10.1098/rsos.230806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023]
Abstract
Advances in wearable sensing and mobile computing have enabled the collection of health and well-being data outside of traditional laboratory and hospital settings, paving the way for a new era of mobile health. Meanwhile, artificial intelligence (AI) has made significant strides in various domains, demonstrating its potential to revolutionize healthcare. Devices can now diagnose diseases, predict heart irregularities and unlock the full potential of human cognition. However, the application of machine learning (ML) to mobile health sensing poses unique challenges due to noisy sensor measurements, high-dimensional data, sparse and irregular time series, heterogeneity in data, privacy concerns and resource constraints. Despite the recognition of the value of mobile sensing, leveraging these datasets has lagged behind other areas of ML. Furthermore, obtaining quality annotations and ground truth for such data is often expensive or impractical. While recent large-scale longitudinal studies have shown promise in leveraging wearable sensor data for health monitoring and prediction, they also introduce new challenges for data modelling. This paper explores the challenges and opportunities of human-centred AI for mobile health, focusing on key sensing modalities such as audio, location and activity tracking. We discuss the limitations of current approaches and propose potential solutions.
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Affiliation(s)
- Ting Dang
- University of Cambridge, Cambridge, UK
- Nokia Bell Labs, Cambridge, UK
| | - Dimitris Spathis
- University of Cambridge, Cambridge, UK
- Nokia Bell Labs, Cambridge, UK
| | - Abhirup Ghosh
- University of Cambridge, Cambridge, UK
- University of Birmingham, Birmingham, UK
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Gasteiger N, Dowding D, Norman G, McGarrigle L, Eost-Telling C, Jones D, Vercell A, Ali SM, O'Connor S. Conducting a systematic review and evaluation of commercially available mobile applications (apps) on a health-related topic: the TECH approach and a step-by-step methodological guide. BMJ Open 2023; 13:e073283. [PMID: 37308269 PMCID: PMC10277147 DOI: 10.1136/bmjopen-2023-073283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/25/2023] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVES To provide an overview of the methodological considerations for conducting commercial smartphone health app reviews (mHealth reviews), with the aim of systematising the process and supporting high-quality evaluations of mHealth apps. DESIGN Synthesis of our research team's experiences of conducting and publishing various reviews of mHealth apps available on app stores and hand-searching the top medical informatics journals (eg, The Lancet Digital Health, npj Digital Medicine, Journal of Biomedical Informatics and the Journal of the American Medical Informatics Association) over the last five years (2018-2022) to identify other app reviews to contribute to the discussion of this method and supporting framework for developing a research (review) question and determining the eligibility criteria. RESULTS We present seven steps to support rigour in conducting reviews of health apps available on the app market: (1) writing a research question or aims, (2) conducting scoping searches and developing the protocol, (3) determining the eligibility criteria using the TECH framework, (4) conducting the final search and screening of health apps, (5) data extraction, (6) quality, functionality and other assessments and (7) analysis and synthesis of findings. We introduce the novel TECH approach to developing review questions and the eligibility criteria, which considers the Target user, Evaluation focus, Connectedness and the Health domain. Patient and public involvement and engagement opportunities are acknowledged, including co-developing the protocol and undertaking quality or usability assessments. CONCLUSION Commercial mHealth app reviews can provide important insights into the health app market, including the availability of apps and their quality and functionality. We have outlined seven key steps for conducting rigorous health app reviews in addition to the TECH acronym, which can support researchers in writing research questions and determining the eligibility criteria. Future work will include a collaborative effort to develop reporting guidelines and a quality appraisal tool to ensure transparency and quality in systematic app reviews.
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Affiliation(s)
- Norina Gasteiger
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
- Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, UK
| | - Dawn Dowding
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
| | - Gill Norman
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
| | - Lisa McGarrigle
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - Charlotte Eost-Telling
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
| | - Debra Jones
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
| | - Amy Vercell
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - Syed Mustafa Ali
- Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, UK
| | - Siobhan O'Connor
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
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Alon N, Torous J. Current challenges for evaluating mobile health applications. J Am Med Inform Assoc 2022; 30:617-624. [PMID: 36484621 PMCID: PMC9933055 DOI: 10.1093/jamia/ocac244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/22/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
As mobile health applications continue to proliferate without clear regulation, the need for app evaluation frameworks to offer guidance to patients and clinicians also expands. However, this expanding number of app evaluation frameworks itself can be a source of confusion and often contradictory recommendations. In pursuit of better frameworks that offer innovation for app evaluation, we present 4 challenges that app evaluation frameworks must overcome as well as examples from our own experience toward overcoming them. The recommendations are applicable to all health apps from any field of medicine, although we use examples from mental health as they are illustrative.
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Affiliation(s)
- Noy Alon
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - John Torous
- Corresponding Author: John Torous, MD, MBI, Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA;
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Scherer J, Youssef Y, Dittrich F, Albrecht UV, Tsitsilonis S, Jung J, Pförringer D, Landgraeber S, Beck S, Back DA. Proposal of a New Rating Concept for Digital Health Applications in Orthopedics and Traumatology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14952. [PMID: 36429670 PMCID: PMC9690508 DOI: 10.3390/ijerph192214952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/29/2022] [Accepted: 11/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Health-related mobile applications (apps) are rapidly increasing in number. There is an urgent need for assessment tools and algorithms that allow the usability and content criteria of these applications to be objectively assessed. The aim of this work was to establish and validate a concept for orthopedic societies to rate health apps to set a quality standard for their safe use. METHODS An objective rating concept was created, consisting of nine quality criteria. A self-declaration sheet for app manufacturers was designed. Manufacturers completed the self-declaration, and the app was examined by independent internal reviewers. The pilot validation and analysis were performed on two independent health applications. An algorithm for orthopedic societies was created based on the experiences in this study flow. RESULTS "Sprunggelenks-App" was approved by the reviewers with 45 (98%) fulfilled criteria and one (2%) unfulfilled criterion. "Therapie-App" was approved, with 28 (61%) met criteria, 6 (13%) unfulfilled criteria and 12 (26%) criteria that could not be assessed. The self-declaration completed by the app manufacturer is recommended, followed by a legal and technical rating performed by an external institution. When rated positive, the societies' internal review using independent raters can be performed. In case of a positive rating, a visual certification can be granted to the manufacturer for a certain time frame. CONCLUSION An objective rating algorithm is proposed for the assessment of digital health applications. This can help societies to improve the quality assessment, quality assurance and patient safety of those apps. The proposed concept must be further validated for inter-rater consistency and reliability.
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Affiliation(s)
- Julian Scherer
- Department of Traumatology, University Hospital Zurich, Raemistr. 100, 8091 Zürich, Switzerland
| | - Yasmin Youssef
- Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Liebigstr. 20, 04103 Leipzig, Germany
| | - Florian Dittrich
- Joint Centre Bergisch Land, Department for Orthopaedics, Sana Fabricius Clinic Remscheid, Brüderstraße 65, 42853 Remscheid, Germany
- Department of Orthopedics and Orthopedic Surgery, Universität des Saarlandes-Campus Homburg, Kirrberger Straße, 66421 Homburg, Germany
| | - Urs-Vito Albrecht
- Medizinische Fakultät OWL, AG 4-Digitale Medizin, Universität Bielefeld, 33501 Bielefeld, Germany
| | - Serafeim Tsitsilonis
- Center for Musculoskeletal Surgery, Charité–Universitätsmedizin Berlin, Augustenburger Pl. 1, 13353 Berlin, Germany
| | - Jochen Jung
- ATOS Klinik Heidelberg, Department of Orthopaedic Surgery, Bismarckstr. 9-15, 69115 Heidelberg, Germany
| | - Dominik Pförringer
- Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Clinic and Policlinic for Trauma Surgery, Ismaninger Str. 22, 81675 Munich, Germany
| | - Stefan Landgraeber
- Department of Orthopedics and Orthopedic Surgery, Universität des Saarlandes-Campus Homburg, Kirrberger Straße, 66421 Homburg, Germany
| | - Sascha Beck
- Clinic for Orthopaedics and Trauma Surgery, Sportsclinic Hellersen, Paulmannshöher Str. 17, 58515 Lüdenscheid, Germany
| | - David A. Back
- Bundeswehr Hospital Berlin, Department for Traumatology and Orthopedics, Scharnhorststr. 13, 10115 Berlin, Germany
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Bakken S. Climate change, security, privacy, and data sharing: Important areas for advocacy and informatics solutions. J Am Med Inform Assoc 2021; 28:2072-2073. [PMID: 34536285 DOI: 10.1093/jamia/ocab188] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Suzanne Bakken
- School of Nursing, Department of Biomedical Informatics, and Data Science Institute, Columbia University, New York, New York, USA
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