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Schinkel-Bielefeld N, Burke L, Holube I, Iankilevitch M, Jenstad LM, Lelic D, Naylor G, Singh G, Smeds K, von Gablenz P, Wolters F, Wu YH. Implementing Ecological Momentary Assessment in Audiological Research: Opportunities and Challenges. Am J Audiol 2024:1-26. [PMID: 38950171 DOI: 10.1044/2024_aja-23-00249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024] Open
Abstract
Ecological momentary assessment (EMA) is a way to evaluate experiences in everyday life. It is a powerful research tool but can be complex and challenging for beginners. Application of EMA in audiological research brings with it opportunities and challenges that differ from other research disciplines. This tutorial discusses important considerations when conducting EMA studies in hearing care. While more research is needed to develop specific guidelines for the various potential applications of EMA in hearing research, we hope this article can alert hearing researchers new to EMA to pitfalls when using EMA and help strengthen their study design. The current article elaborates study design details, such as choice of participants, representativeness of the study period for participants' lives, and balancing participant burden with data requirements. Mobile devices and sensors to collect objective data on the acoustic situation are reviewed alongside different possibilities for EMA setups ranging from online questionnaires paired with a timer to proprietary apps that also have access to parameters of a hearing device. In addition to considerations for survey design, a list of questionnaire items from previous studies is provided. For each item, an example and a list of references are given. EMA typically provides data sets that are rich but also challenging in that they are noisy, and there is often unequal amount of data between participants. After recommendations on how to check the data for compliance, reactivity, and careless responses, methods for statistical analysis on the individual level and on the group level are discussed including special methods for direct comparison of hearing device programs.
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Affiliation(s)
| | - Louise Burke
- School of Medicine, University of Nottingham, United Kingdom
| | - Inga Holube
- Institute of Hearing Technology and Audiology, Jade University of Applied Sciences, Oldenburg, Germany
- Cluster of Excellence Hearing4All, Oldenburg, Germany
| | - Maria Iankilevitch
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Lorienne M Jenstad
- School of Audiology and Speech Sciences, The University of British Columbia, Vancouver, Canada
| | | | - Graham Naylor
- School of Medicine, University of Nottingham, United Kingdom
- National Institute for Health and Care Research, Nottingham Biomedical Research Centre, United Kingdom
| | - Gurjit Singh
- Sonova Canada, Kitchener, Ontario, Canada
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- Department of Psychology, Toronto Metropolitan University, Ontario, Canada
| | | | - Petra von Gablenz
- Institute of Hearing Technology and Audiology, Jade University of Applied Sciences, Oldenburg, Germany
- Cluster of Excellence Hearing4All, Oldenburg, Germany
| | | | - Yu-Hsiang Wu
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
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Hudock NL, Hughes H, Shaheen N, Ramadan A, Parikh K, Anamika FNU, Jain R. Wearable health monitoring: wave of the future or waste of time? Glob Cardiol Sci Pract 2024; 2024:e202421. [PMID: 38983747 PMCID: PMC11230110 DOI: 10.21542/gcsp.2024.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/01/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Atrial fibrillation is responsible for over 400,000 hospitalizations in the United States (US) each year. This costs the US health system over 4 billion each year. New smartwatches can constantly monitor pulse, oxygen saturation, and even heart rhythm. The FDA has provided clearance for select smartwatches to detect arrhythmias, including atrial fibrillation. FINDINGS These devices are not currently widely implemented as diagnostic tools. In this review, we delve into the mechanism of how smartwatches work as healthcare tools and how they capture health data. Additionally, we analyze the reliability of the data collected by smartwatches and the accuracy of their sensors in monitoring health parameters. Moreover, we explore the accessibility of smartwatches as healthcare tools and their potential to promote self-care among individuals. Finally, we assess the outcomes of using smartwatches in healthcare, including the limited studies on the clinical effects and barriers to uptake by the community. CONCLUSION Although smartwatches are accurate for the detection of atrial fibrillation, they still face many hurdles, including access to aging populations and trust in the medical community.
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Affiliation(s)
| | | | - Nour Shaheen
- Faculty of Medicine Alexandria University, Al Attarin, Alexandria, Egypt
| | | | | | - FNU Anamika
- University College of Medical Sciences, New Delhi, India
| | - Rohit Jain
- Penn State College of Medicine, Hershey, PA, USA
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3
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Moorthy P, Weinert L, Schüttler C, Svensson L, Sedlmayr B, Müller J, Nagel T. Attributes, Methods, and Frameworks Used to Evaluate Wearables and Their Companion mHealth Apps: Scoping Review. JMIR Mhealth Uhealth 2024; 12:e52179. [PMID: 38578671 PMCID: PMC11031706 DOI: 10.2196/52179] [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: 08/25/2023] [Revised: 12/15/2023] [Accepted: 02/01/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Wearable devices, mobile technologies, and their combination have been accepted into clinical use to better assess the physical fitness and quality of life of patients and as preventive measures. Usability is pivotal for overcoming constraints and gaining users' acceptance of technology such as wearables and their companion mobile health (mHealth) apps. However, owing to limitations in design and evaluation, interactive wearables and mHealth apps have often been restricted from their full potential. OBJECTIVE This study aims to identify studies that have incorporated wearable devices and determine their frequency of use in conjunction with mHealth apps or their combination. Specifically, this study aims to understand the attributes and evaluation techniques used to evaluate usability in the health care domain for these technologies and their combinations. METHODS We conducted an extensive search across 4 electronic databases, spanning the last 30 years up to December 2021. Studies including the keywords "wearable devices," "mobile apps," "mHealth apps," "physiological data," "usability," "user experience," and "user evaluation" were considered for inclusion. A team of 5 reviewers screened the collected publications and charted the features based on the research questions. Subsequently, we categorized these characteristics following existing usability and wearable taxonomies. We applied a methodological framework for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. RESULTS A total of 382 reports were identified from the search strategy, and 68 articles were included. Most of the studies (57/68, 84%) involved the simultaneous use of wearables and connected mobile apps. Wrist-worn commercial consumer devices such as wristbands were the most prevalent, accounting for 66% (45/68) of the wearables identified in our review. Approximately half of the data from the medical domain (32/68, 47%) focused on studies involving participants with chronic illnesses or disorders. Overall, 29 usability attributes were identified, and 5 attributes were frequently used for evaluation: satisfaction (34/68, 50%), ease of use (27/68, 40%), user experience (16/68, 24%), perceived usefulness (18/68, 26%), and effectiveness (15/68, 22%). Only 10% (7/68) of the studies used a user- or human-centered design paradigm for usability evaluation. CONCLUSIONS Our scoping review identified the types and categories of wearable devices and mHealth apps, their frequency of use in studies, and their implementation in the medical context. In addition, we examined the usability evaluation of these technologies: methods, attributes, and frameworks. Within the array of available wearables and mHealth apps, health care providers encounter the challenge of selecting devices and companion apps that are effective, user-friendly, and compatible with user interactions. The current gap in usability and user experience in health care research limits our understanding of the strengths and limitations of wearable technologies and their companion apps. Additional research is necessary to overcome these limitations.
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Affiliation(s)
- Preetha Moorthy
- Department of Biomedical Informatics, Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lina Weinert
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
- Section for Oral Health, Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Christina Schüttler
- Medical Center for Information and Communication Technology, University Hospital Erlangen, Erlangen, Germany
| | - Laura Svensson
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Brita Sedlmayr
- Institute for Medical Informatics and Biometry, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Julia Müller
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Till Nagel
- Human Data Interaction Lab, Mannheim University of Applied Sciences, Mannheim, Germany
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4
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Olsen RJ, Hasan SS, Woo JJ, Nawabi DH, Ramkumar PN. The Fundamentals and Applications of Wearable Sensor Devices in Sports Medicine: A Scoping Review. Arthroscopy 2024:S0749-8063(24)00098-7. [PMID: 38331364 DOI: 10.1016/j.arthro.2024.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 01/28/2024] [Accepted: 01/30/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE To (1) characterize the various forms of wearable sensor devices (WSDs) and (2) review the peer-reviewed literature of applied wearable technology within sports medicine. METHODS A systematic search of PubMed and EMBASE databases, from inception through 2023, was conducted to identify eligible studies using WSDs within sports medicine. Data extraction was performed of study demographics and sensor specifications. Included studies were categorized by application: athletic training, rehabilitation, and research. RESULTS In total, 43 studies met criteria for inclusion in this review. Forms of WSDs include pedometers, accelerometers, encoders (consisting of magnetometers and gyroscopes), force sensors, global positioning system trackers, and inertial measurement units. Outcome metrics include step counts; gait, limb motion, and angular positioning; foot and skin pressure; change of direction and inclination, including analysis of both body parts and athletes on a field; displacement and velocity of body segments and joints; heart rate; plethysmography; sport-specific kinematics; range of motion, symmetry, and alignment; head impact; sleep; throwing biomechanics; and kinetic and spatiotemporal running metrics. WSDs are used in athletic training to assess sport-specific biomechanics and workload with a goal of injury prevention and training optimization, as well as for rehabilitation monitoring and research such as for risk predicting and aiding diagnosis. CONCLUSIONS WSDs enable real-time monitoring of human performance across a variety of implementations and settings, allowing collection of metrics otherwise not achievable. WSDs are powerful tools with multiple applications within athletic training, patient rehabilitation, and orthopaedic and sports medicine research. CLINICAL RELEVANCE Wearable technology may represent the missing link to quantitatively addressing return to play and previous performance. WSDs are commercially available and portable adjuncts that allow clinicians, trainers, and individual athletes to monitor biomechanical parameters, workload, and recovery status to better contextualize personalized training, injury risk, and rehabilitation.
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Affiliation(s)
- Reena J Olsen
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, U.S.A
| | | | - Joshua J Woo
- Brown University/The Warren Alpert School of Brown University, Providence, Rhode Island, U.S.A
| | - Danyal H Nawabi
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, U.S.A
| | - Prem N Ramkumar
- Long Beach Orthopedic Institute, Long Beach, California, U.S.A..
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Arnaert A, Sumbly P, da Costa D, Liu Y, Debe Z, Charbonneau S. Acceptance of the Apple Watch Series 6 for Telemonitoring of Older Adults With Chronic Obstructive Pulmonary Disease: Qualitative Descriptive Study Part 1. JMIR Aging 2023; 6:e41549. [PMID: 38147371 PMCID: PMC10777278 DOI: 10.2196/41549] [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: 07/29/2022] [Revised: 05/30/2023] [Accepted: 10/09/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND The Apple Watch is not a medical device per se; it is a smart wearable device that is increasingly being used for health monitoring. Evidence exists that the Apple Watch Series 6 can reliably measure blood oxygen saturation (SpO2) in patients with chronic obstructive pulmonary disease under controlled circumstances. OBJECTIVE This study aimed to better understand older adults' acceptance of the Watch as a part of telemonitoring, even with these advancements. METHODS This study conducted content analysis on data collected from 10 older adults with chronic obstructive pulmonary disease who consented to wear the Watch. RESULTS Using the Extended Unified Theory of Acceptance and Use of Technology model, results showed that participants experienced potential health benefits; however, the inability of the Watch to reliably measure SpO2 when in respiratory distress was concerning. Participants' level of tech savviness varied, which caused some fear and frustration at the start, yet all felt supported by family and would have explored more features if they owned the Watch. All agreed that the Watch is mainly a medical tool and not a gadget. CONCLUSIONS To conclude, although the Watch may enhance their physical health and well-being, results indicated that participants are more likely to accept the Watch if it ultimately proves to be useful when experiencing respiratory distress.
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Affiliation(s)
- Antonia Arnaert
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Pia Sumbly
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Daniel da Costa
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Yuxin Liu
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Zoumanan Debe
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Sylvain Charbonneau
- Academic Affairs, Teaching and Research Directorate, Montreal West Island Integrated University Health and Social Service Centre, Montreal, QC, Canada
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6
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Mayer S, Kohn B, Fotteler M, Özkan S, Denkinger M. [Functionality and everyday suitability of commercially wristwear products for frail older people - a comparative product testing]. MMW Fortschr Med 2023; 165:3-10. [PMID: 38062322 DOI: 10.1007/s15006-023-3107-5] [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] [Indexed: 12/18/2023]
Abstract
BACKGROUND AND AIM There is a wide range of smartwatches and emergency watches on the market that are specifically designed for older people. The products are freely available, which is why there is an urgent need for information about the reliability and functionality of the products among potential users, but also health professionals and decision-makers. As part of a systematic product comparison test, the functionality and quality of seven smartwatches were investigated. METHOD Four watches for seniors, one watch for adults and two watches for children, but with comparable functionalities, were included in the test. For the test, real-life situations were simulated and, in addition to emergency calls, GPS tracking, fall detection and geofencing, the battery life, call quality, stability/robustness of the products and service/support were evaluated. From the total number of points, a grade was determined based on the German school grading system (1 = very good to 6 = insufficient). RESULTS All smartwatches evaluated were rated at least "3-satisfactory". The two best-rated watches received a score of 1.8. The differences were particularly evident in the emergency call functionality, battery life, precision of the tracking function, and service/support. The call quality, with one exception, and the stability/robustness were consistently rated as "1-very good". Three watches in the test were able to detect falls with variable results. CONCLUSION The functionality and usability of the tested products differed considerably. A focus on a few main functions can even provide added value for older, frail people. Continuous comparative testing of products for this target group with new and updated products is desirable.
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Affiliation(s)
- Sarah Mayer
- Institut für Geriatrische Forschung der Universität Ulm, AGAPLESION Bethesda Klinik Ulm gGmbH, Zollernring 26, 89073, Ulm, Deutschland
| | - Brigitte Kohn
- Geriatrisches Zentrum Ulm, AGAPLESION Bethesda Ulm, Zollernring 26, 89073, Ulm, Deutschland
| | - Marina Fotteler
- Geriatrisches Zentrum Ulm, AGAPLESION Bethesda Ulm, Zollernring 26, 89073, Ulm, Deutschland
| | - Seda Özkan
- Geriatrisches Zentrum Ulm, AGAPLESION Bethesda Ulm, Zollernring 26, 89073, Ulm, Deutschland
| | - Michael Denkinger
- Institut für Geriatrische Forschung der Universität Ulm, AGAPLESION Bethesda Klinik Ulm gGmbH, Zollernring 26, 89073, Ulm, Deutschland.
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Ding EY, Tran KV, Lessard D, Wang Z, Han D, Mohagheghian F, Mensah Otabil E, Noorishirazi K, Mehawej J, Filippaios A, Naeem S, Gottbrecht MF, Fitzgibbons TP, Saczynski JS, Barton B, Chon K, McManus DD. Accuracy, Usability, and Adherence of Smartwatches for Atrial Fibrillation Detection in Older Adults After Stroke: Randomized Controlled Trial. JMIR Cardio 2023; 7:e45137. [PMID: 38015598 DOI: 10.2196/45137] [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: 12/16/2022] [Revised: 05/31/2023] [Accepted: 06/19/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is a common cause of stroke, and timely diagnosis is critical for secondary prevention. Little is known about smartwatches for AF detection among stroke survivors. We aimed to examine accuracy, usability, and adherence to a smartwatch-based AF monitoring system designed by older stroke survivors and their caregivers. OBJECTIVE This study aims to examine the feasibility of smartwatches for AF detection in older stroke survivors. METHODS Pulsewatch is a randomized controlled trial (RCT) in which stroke survivors received either a smartwatch-smartphone dyad for AF detection (Pulsewatch system) plus an electrocardiogram patch or the patch alone for 14 days to assess the accuracy and usability of the system (phase 1). Participants were subsequently rerandomized to potentially 30 additional days of system use to examine adherence to watch wear (phase 2). Participants were aged 50 years or older, had survived an ischemic stroke, and had no major contraindications to oral anticoagulants. The accuracy for AF detection was determined by comparing it to cardiologist-overread electrocardiogram patch, and the usability was assessed with the System Usability Scale (SUS). Adherence was operationalized as daily watch wear time over the 30-day monitoring period. RESULTS A total of 120 participants were enrolled (mean age 65 years; 50/120, 41% female; 106/120, 88% White). The Pulsewatch system demonstrated 92.9% (95% CI 85.3%-97.4%) accuracy for AF detection. Mean usability score was 65 out of 100, and on average, participants wore the watch for 21.2 (SD 8.3) of the 30 days. CONCLUSIONS Our findings demonstrate that a smartwatch system designed by and for stroke survivors is a viable option for long-term arrhythmia detection among older adults at risk for AF, though it may benefit from strategies to enhance adherence to watch wear. TRIAL REGISTRATION ClinicalTrials.gov NCT03761394; https://clinicaltrials.gov/study/NCT03761394. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1016/j.cvdhj.2021.07.002.
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Affiliation(s)
- Eric Y Ding
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Khanh-Van Tran
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Darleen Lessard
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Ziyue Wang
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Dong Han
- Department of Bioengineering, University of Connecticut, Storrs, CT, United States
| | - Fahimeh Mohagheghian
- Department of Bioengineering, University of Connecticut, Storrs, CT, United States
| | - Edith Mensah Otabil
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Kamran Noorishirazi
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Jordy Mehawej
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Andreas Filippaios
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Syed Naeem
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Matthew F Gottbrecht
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Timothy P Fitzgibbons
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Jane S Saczynski
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston, MA, United States
| | - Bruce Barton
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Ki Chon
- Department of Bioengineering, University of Connecticut, Storrs, CT, United States
| | - David D McManus
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
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Masoumian Hosseini M, Masoumian Hosseini ST, Qayumi K, Hosseinzadeh S, Sajadi Tabar SS. Smartwatches in healthcare medicine: assistance and monitoring; a scoping review. BMC Med Inform Decis Mak 2023; 23:248. [PMID: 37924029 PMCID: PMC10625201 DOI: 10.1186/s12911-023-02350-w] [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] [Accepted: 10/22/2023] [Indexed: 11/06/2023] Open
Abstract
Smartwatches have become increasingly popular in recent times because of their capacity to track different health indicators, including heart rate, patterns of sleep, and physical movements. This scoping review aims to explore the utilisation of smartwatches within the healthcare sector. According to Arksey and O'Malley's methodology, an organised search was performed in PubMed/Medline, Scopus, Embase, Web of Science, ERIC and Google Scholar. In our search strategy, 761 articles were returned. The exclusion/inclusion criteria were applied. Finally, 35 articles were selected for extracting data. These included six studies on stress monitoring, six on movement disorders, three on sleep tracking, three on blood pressure, two on heart disease, six on covid pandemic, three on safety and six on validation. The use of smartwatches has been found to be effective in diagnosing the symptoms of various diseases. In particular, smartwatches have shown promise in detecting heart diseases, movement disorders, and even early signs of COVID-19. Nevertheless, it should be emphasised that there is an ongoing discussion concerning the reliability of smartwatch diagnoses within healthcare systems. Despite the potential advantages offered by utilising smartwatches for disease detection, it is imperative to approach their data interpretation with prudence. The discrepancies in detection between smartwatches and their algorithms have important implications for healthcare use. The accuracy and reliability of the algorithms used are crucial, as well as high accuracy in detecting changes in health status by the smartwatches themselves. This calls for the development of medical watches and the creation of AI-hospital assistants. These assistants will be designed to help with patient monitoring, appointment scheduling, and medication management tasks. They can educate patients and answer common questions, freeing healthcare providers to focus on more complex tasks.
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Affiliation(s)
- Mohsen Masoumian Hosseini
- Department of E-Learning in Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
- CyberPatient Research Affiliate, Interactive Health International, Department of the surgery, University of British Columbia, Vancouver, Canada
| | - Seyedeh Toktam Masoumian Hosseini
- CyberPatient Research Affiliate, Interactive Health International, Department of the surgery, University of British Columbia, Vancouver, Canada.
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
| | - Karim Qayumi
- Professor at Department of Surgery, University of British Columbia, Vancouver, Canada
| | - Shahriar Hosseinzadeh
- CyberPatient Research Coordinator, Interactive Health International, Department of Surgery, University of British Columbia, Vancouver, Canada
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Kurtz SM, Higgs GB, Chen Z, Koshut WJ, Tarazi JM, Sherman AE, McLean SG, Mont MA. Patient Perceptions of Wearable and Smartphone Technologies for Remote Outcome Monitoring in Total Knee Arthroplasties. J Knee Surg 2023; 36:1253-1258. [PMID: 36049771 DOI: 10.1055/s-0042-1755378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
While there is enthusiasm for wearables and smartphone technologies in evaluating clinical outcomes among clinicians, less is known about the willingness of patients who have osteoarthritis (OA) to consent for remote outcome monitoring. We developed an Institutional Review Board-approved questionnaire to assess patient perceptions of remote monitoring technologies in a high-volume orthopaedic clinical center. Fifty total knee arthroplasty (TKA) patients (56% female; mean age: 61 years, range: 23-89) and fifty nonoperative OA knee patients (54% female; mean age: 58 years, range: 25-89) routinely consulted in the clinic as part of their OA treatment and consented to participate in the study. Patient perceptions were compared using Pearson's chi-square analyses with a significance threshold of p < 0.05. We found that TKA patients were more receptive to the use of smartphone apps (84 vs. 60%, p = 0.008) and wearable sensors (80 vs. 48%, p < 0.001) and learning to use custom wearables (72 vs. 38%, p = 0.002) than nonoperative OA knee patients as part of their treatment. Likewise, the majority of TKA patients were willing to use the global positioning system in their postoperative technology (54 vs. 18%, p < 0.001), especially if they were only active during certain circumstances (62 vs. 24%, p < 0.001). TKA patients also expressed willingness to have their body movement (68%), balance (70%), sleep (76%), and cardiac output (80%) tracked using remote technologies. Overall, we found that TKA patients were highly receptive to using wearable technology in their treatments, whereas nonoperative OA knee patients were generally unreceptive. Our study challenges the concept that current wearable technology approaches will be generally effective as a tool to remotely monitor all patients across the OA severity landscape.
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Affiliation(s)
- Steven M Kurtz
- Department of Biomedical Engineering, Exponent, Inc., Philadelphia, Pennyslvania
- Implant Research Core, Drexel University, Philadelphia, Pennyslvania
| | - Genymphas B Higgs
- Department of Biomedical Engineering, Exponent, Inc., Menlo Park, California
| | - Zhongming Chen
- Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
- Department of Orthopaedics, Northwell Health-Lenox Hill Hospital, New York, New York
| | - William J Koshut
- Department of Biomedical Engineering, Exponent, Inc., Menlo Park, California
| | - John M Tarazi
- Department of Orthopaedics, Northwell Health-Huntington Hospital, Huntington, New York
- Donald and Barbara Zucker School of Medicine at Hofstra, Northwell, Hempstead, New York, New York
| | - Alain E Sherman
- Department of Orthopaedics, Northwell Health-Lenox Hill Hospital, New York, New York
| | - Scott G McLean
- Department of Biomedical Engineering, Exponent, Inc., Menlo Park, California
| | - Michael A Mont
- Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
- Department of Orthopaedics, Northwell Health-Lenox Hill Hospital, New York, New York
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10
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Alpert JM, Sharma B, Cenko E, Zapata R, Karnati Y, Fillingim RB, Gill TM, Marsiske M, Ranka S, Manini T. Identifying barriers and facilitators for using a smartwatch to monitor health among older adults. EDUCATIONAL GERONTOLOGY 2023; 50:282-295. [PMID: 38737621 PMCID: PMC11081104 DOI: 10.1080/03601277.2023.2260970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Smartwatches are a type of wearable device that enable continuous monitoring of an individual's activities and critical health metrics. As the number of older adults age 65+ continues to grow in the U.S., so does their usage of smartwatches, making it necessary to understand the real-world uptake and use of these devices to monitor health. In this study, older adults with a relatively high level of education and digital skills were provided with a smartwatch equipped with a mobile application (ROAMM) that was worn for a median of 14 days. Usability surveys were distributed, and a qualitative analysis was performed about participants' experience using the smartwatch and ROAMM application. Constructs from the Technology Acceptance Model and Consolidated Framework for Implementation Research were incorporated into in-depth interviews, which were recorded and transcribed. Data were analyzed using the constant comparative method. Interviews among 30 older adults revealed the following main themes: 1) familiarization with the device and adoption and acceptance, 2) factors encouraging usage, such as a doctor's endorsement or the appeal of tracking one's health, and 3) barriers to usage, such as insufficient education and training and the desire for additional functionality. Overall, participants found the smartwatch easy to use and were likely to continue using the device in a long-term study. Data generated from smartwatches have the potential to engage individuals about their health and could inspire them to participate more actively during clinical encounters.
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Affiliation(s)
- Jordan M. Alpert
- Internal Medicine and Geriatrics, Cleveland Clinic, Cleveland, OH, USA
| | - Bhakti Sharma
- College of Journalism and Communications, University of Florida, Gainesville, FL, USA
| | - Erta Cenko
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Ruben Zapata
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Yashaswi Karnati
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Roger B. Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Thomas M. Gill
- Department of Medicine, Yale University, New Haven, CT, USA
| | - Michael Marsiske
- Department of Clinical and Health Psychology in the College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Sanjay Ranka
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Todd Manini
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
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11
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Overton M, Swain N, Falling C, Gwynne-Jones D, Fillingim R, Mani R. Experiences and Perceptions of Using Smartphone Ecological Momentary Assessment for Reporting Knee Osteoarthritis Pain and Symptoms. Clin J Pain 2023; 39:442-451. [PMID: 37335088 DOI: 10.1097/ajp.0000000000001138] [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: 12/26/2022] [Accepted: 06/07/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Knee osteoarthritis (OA) is a prevalent, painful, and disabling musculoskeletal condition. One method that could more accurately monitor the pain associated with knee OA is ecological momentary assessment (EMA) using a smartphone. OBJECTIVES The aim of this study was to explore participant experiences and perceptions of using smartphone EMA as a way of communicating knee OA pain and symptoms following participating in a 2-week smartphone EMA study. MATERIALS AND METHODS Using a maximum variation sampling method, participants were invited to share their thoughts and opinions in semistructured focus group interviews. Interviews were recorded and transcribed verbatim before thematic analysis using the general inductive approach. RESULTS A total of 20 participants participated in 6 focus groups. Three themes and 7 subthemes were identified from the data. Identified themes included: user experience of smartphone EMA, data quality of smartphone EMA, and practical aspects of smartphone EMA. DISCUSSION Overall, smartphone EMA was deemed as being an acceptable method for monitoring pain and symptoms associated with knee OA. These findings will assist researchers in designing future EMA studies alongside clinicians implementing smartphone EMA into practice. PERSPECTIVE This study highlights that smartphone EMA is an acceptable method for capturing pain-related symptoms and experiences of those expereiencing knee OA. Future EMA studies should ensure design features are considered that reduce missing data and limit the responder burden to improve data quality.
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Affiliation(s)
- Mark Overton
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago
| | - Nicola Swain
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago
| | - Carrie Falling
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago
| | - David Gwynne-Jones
- Department of Surgical Sciences, Otago School of Medicine, University of Otago, Dunedin, New Zealand
| | - Roger Fillingim
- Department of Community Dentistry and Behavioural Science, Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL
| | - Ramakrishnan Mani
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago
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12
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Plachta-Danielzik S, Grasskemper L, Schmidt K, Schreiber S, Bokemeyer B. Health Status, Quality of Life, Psychosocial Well-being, and Wearables Data of Patients With Active Ulcerative Colitis Receiving Filgotinib Therapy (FilgoColitis Study): Protocol for a Real-world Observational Study. JMIR Res Protoc 2023; 12:e42574. [PMID: 37155235 DOI: 10.2196/42574] [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: 09/12/2022] [Revised: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Filgotinib was approved in Germany for treating patients with moderate to severe active ulcerative colitis in November 2021. It represents a preferential Janus kinase 1 inhibitor. The FilgoColitis study began recruiting immediately after approval and aims to assess filgotinib effectiveness under real-world conditions with a particular focus on patient-reported outcomes (PROs). The novelty of the study design is the optional inclusion of 2 innovative wearables, which could provide a new layer of patient-derived data. OBJECTIVE The study investigates quality of life (QoL) and psychosocial well-being of patients with active ulcerative colitis during long-term exposure to filgotinib. PROs related to QoL and psychometric profiles (fatigue and depression) are collected alongside with disease activity symptom scores. We aim to evaluate physical activity patterns collected by wearables as an addition to traditional PROs, patient-reported health status, and QoL in different phases of disease activity. METHODS This is a prospective, single-arm, multicentric, noninterventional, observational study with a sample size of 250 patients. QoL is assessed with validated questionnaires: the Short Inflammatory Bowel Disease Questionnaire (sIBDQ) for the disease-specific QoL, the EQ-5D for the general QoL, and the fatigue questionnaire (Inflammatory Bowel Disease-Fatigue [IBD-F]). Physical activity data are collected from patients using wearables (SENS motion leg sensor [accelerometry] and smartwatch, GARMIN vívosmart 4). RESULTS The enrollment started in December 2021 and was still open at the date of submission. After 6 months of study initiation, 69 patients were enrolled. The study is expected to be completed in June 2026. CONCLUSIONS Real-world data for novel drugs are important to assess effectiveness outside of highly selected populations represented by randomized controlled trials. We examine whether patients' QoL and other PROs can be supplemented with physical activity patterns measured objectively. Use of wearables with newly defined outcomes represents an additional observational tool for monitoring disease activity in patients with inflammatory bowel disease. TRIAL REGISTRATION German Clinical Trials Register DRKS00027327; https://drks.de/search/en/trial/DRKS00027327. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42574.
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Affiliation(s)
| | | | | | - Stefan Schreiber
- Clinic of General Internal Medicine I, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Bernd Bokemeyer
- Department Medicine I, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
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13
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Hasan F, Mudey A, Joshi A. Role of Internet of Things (IoT), Artificial Intelligence and Machine Learning in Musculoskeletal Pain: A Scoping Review. Cureus 2023; 15:e37352. [PMID: 37182066 PMCID: PMC10170184 DOI: 10.7759/cureus.37352] [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: 01/25/2023] [Accepted: 04/09/2023] [Indexed: 05/16/2023] Open
Abstract
Artificial intelligence (AI), Internet of Things (IoT), and machine learning (ML) have considerably increased in numerous critical medical sectors and significantly impacted our daily lives. Digital health interventions support cost-effective, accessible, and preferred interventions that meet time and resource constraints for large patient populations. Musculoskeletal conditions significantly impact society, the economy, and people's life. Adults with chronic neck and back pain are frequently the victims, rendering them physically unable to move. They often experience discomfort, necessitating them to take over-the-counter medications or painkilling gels. Technologies driven by AI have been suggested as an alternative approach to improve adherence to exercise therapy, which in turn helps patients undertake exercises every day to relieve pain associated with the musculoskeletal system. Even though there are many computer-aided evaluations available for physiotherapy rehabilitation, current approaches to computer-aided performance and monitoring lack flexibility and robustness. A thorough literature search was conducted using key databases like PubMed and Google Scholar, as well as Medical Subject Headings (MeSH) terms and related keywords. This research aimed to determine if AI-operated digital health therapies that use cutting-edge IoT, brain imaging, and ML technologies are beneficial in lowering pain and enhancing functional impairment in patients with musculoskeletal diseases. The secondary goal was to ascertain whether solutions driven by machine learning or artificial intelligence can improve exercise compliance and be viewed as a lifestyle choice.
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Affiliation(s)
- Fatima Hasan
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Abhay Mudey
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Abhishek Joshi
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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14
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Kurtz SM, Higgs GB, Chen Z, Koshut WJ, Tarazi JM, Sherman AE, McLean SG, Mont MA. Patient Perceptions of Wearable and Smartphone Technologies for Remote Outcome Monitoring in Patients Who Have Hip Osteoarthritis or Arthroplasties. J Arthroplasty 2022; 37:S488-S492.e2. [PMID: 35277311 DOI: 10.1016/j.arth.2022.02.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/21/2022] [Accepted: 02/08/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Although there is interest in wearables and smartphone technologies for remote outcome monitoring, little is known regarding the willingness of hip osteoarthritis (OA) and/or total hip arthroplasty (THA) patients to authorize and adhere to such treatment. METHODS We developed an Institutional Review Board-approved questionnaire to evaluate patient perceptions of remote monitoring technologies in a high-volume orthopedic center. Forty-seven THA patients (60% female; mean age: 66 years) and 50 nonoperative OA hip patients (52% female; mean age: 63 years) participated. Patient perceptions were compared using Pearson's chi-squared analyses. RESULTS THA patients were similarly interested in the use of smartphone apps (91% vs 94%, P = .695) in comparison to nonoperative hip OA patients. THA patients were more receptive to using wearable sensors (94% vs 44%, P < .001) relative to their nonoperative counterparts. THA patients also expressed stronger interest in learning to use custom wearables (87% vs 32%, P < .001) vs nonoperative patients. Likewise, the majority of THA patients were willing to use Global Positioning System technology (74% vs 26%, P < .001). THA patients also expressed willingness to have their body movement (89%), balance (89%), sleep (87%), and cardiac output (91%) tracked using remote technology. CONCLUSION Overall, we found that THA patients were highly receptive to using wearable technology in their treatments. Nonoperative OA hip patients were generally unreceptive to using smart technologies, with the exception of smartphone applications. This information may be useful as utilization of these technologies for patient care continues to evolve.
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Affiliation(s)
- Steven M Kurtz
- Exponent Inc., Philadelphia, PA; Implant Research Core, Drexel University, Philadelphia, PA
| | | | - Zhongming Chen
- Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD; Department of Orthopaedics, Northwell Health-Lenox Hill Hospital, New York, NY
| | | | - John M Tarazi
- Department of Orthopaedics, Northwell Health-Huntington Hospital, Huntington, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead New York, NY
| | - Alain E Sherman
- Department of Orthopaedics, Northwell Health-Lenox Hill Hospital, New York, NY
| | | | - Michael A Mont
- Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD; Department of Orthopaedics, Northwell Health-Lenox Hill Hospital, New York, NY
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15
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Ding EY, CastañedaAvila M, Tran KV, Mehawej J, Filippaios A, Paul T, Otabil EM, Noorishirazi K, Han D, Saczynski JS, Barton B, Mazor KM, Chon K, McManus DD. Usability of a smartwatch for atrial fibrillation detection in older adults after stroke. CARDIOVASCULAR DIGITAL HEALTH JOURNAL 2022; 3:126-135. [PMID: 35720675 PMCID: PMC9204791 DOI: 10.1016/j.cvdhj.2022.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Smartwatches can be used for atrial fibrillation (AF) detection, but little is known about how older adults at risk for AF perceive their usability. Methods We employed a mixed-methods study design using data from the ongoing Pulsewatch study, a randomized clinical trial (NCT03761394) examining the accuracy of a smartwatch-smartphone app dyad (Samsung/Android) compared to usual care with a patch monitor (Cardea SOLO™ ECG System) for detection of AF among older stroke survivors. To be eligible to participate in Pulsewatch, participants needed to be at least 50 years of age, have had an ischemic stroke, and have no major contraindications to anticoagulation therapy should AF be detected. After 14 days of use, usability was measured by the System Usability Scale (SUS) and investigator-generated questions. Qualitative interviews were conducted, transcribed, and coded via thematic analysis. Results Ninety participants in the Pulsewatch trial were randomized to use a smartwatch-smartphone app dyad for 14 days (average age: 65 years, 41% female, 87% White), and 46% found it to be highly usable (SUS ≥68). In quantitative surveys, participants who used an assistive device (eg, wheelchair) and those with history of anxiety or depression were more likely to report anxiety associated with watch use. In qualitative interviews, study participants reported wanting a streamlined system that was more focused on rhythm monitoring and a smartwatch with a longer battery life. In-person training and support greatly improved their experience, and participants overwhelmingly preferred use of a smartwatch over traditional cardiac monitoring owing to its comfort, appearance, and convenience. Conclusion Older adults at high risk for AF who were randomized to use a smartwatch-app dyad for AF monitoring over 14 days found it to be usable for AF detection and preferred their use to the use of a patch monitor. However, participants reported that a simpler device interface and longer smartwatch battery life would increase the system's usability.
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Affiliation(s)
- Eric Y. Ding
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
- Address reprint requests and correspondence: Mr Eric Y. Ding, University of Massachusetts Chan Medical School, 55 N Lake Ave, Worcester, MA 01655.
| | - Maira CastañedaAvila
- Department of Population and Quantitative Health Sciences at the University of Massachusetts Medical School, Worcester, Massachusetts
| | - Khanh-Van Tran
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Jordy Mehawej
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Andreas Filippaios
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Tenes Paul
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Edith Mensah Otabil
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Kamran Noorishirazi
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Dong Han
- Department of Biomedical Engineering, University of Connecticut, Storrs, Connecticut
| | - Jane S. Saczynski
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston, Massachusetts
| | - Bruce Barton
- Department of Population and Quantitative Health Sciences at the University of Massachusetts Medical School, Worcester, Massachusetts
| | - Kathleen M. Mazor
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Ki Chon
- Department of Biomedical Engineering, University of Connecticut, Storrs, Connecticut
| | - David D. McManus
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
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16
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LeBaron V, Alam R, Bennett R, Blackhall L, Gordon K, Hayes J, Homdee N, Jones R, Lichti K, Martinez Y, Mohammadi S, Ogunjirin E, Patel N, Lach J. Deploying the Behavioral and Environmental Sensing and Intervention for Cancer (BESI-C) smart health system to support patients and family caregivers in managing pain: A feasibility and acceptability study. (Preprint). JMIR Cancer 2022; 8:e36879. [PMID: 35943791 PMCID: PMC9399893 DOI: 10.2196/36879] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 01/03/2023] Open
Abstract
Background Distressing cancer pain remains a serious symptom management issue for patients and family caregivers, particularly within home settings. Technology can support home-based cancer symptom management but must consider the experience of patients and family caregivers, as well as the broader environmental context. Objective This study aimed to test the feasibility and acceptability of a smart health sensing system—Behavioral and Environmental Sensing and Intervention for Cancer (BESI-C)—that was designed to support the monitoring and management of cancer pain in the home setting. Methods Dyads of patients with cancer and their primary family caregivers were recruited from an outpatient palliative care clinic at an academic medical center. BESI-C was deployed in each dyad home for approximately 2 weeks. Data were collected via environmental sensors to assess the home context (eg, light and temperature); Bluetooth beacons to help localize dyad positions; and smart watches worn by both patients and caregivers, equipped with heart rate monitors, accelerometers, and a custom app to deliver ecological momentary assessments (EMAs). EMAs enabled dyads to record and characterize pain events from both their own and their partners’ perspectives. Sensor data streams were integrated to describe and explore the context of cancer pain events. Feasibility was assessed both technically and procedurally. Acceptability was assessed using postdeployment surveys and structured interviews with participants. Results Overall, 5 deployments (n=10 participants; 5 patient and family caregiver dyads) were completed, and 283 unique pain events were recorded. Using our “BESI-C Performance Scoring Instrument,” the overall technical feasibility score for deployments was 86.4 out of 100. Procedural feasibility challenges included the rurality of dyads, smart watch battery life and EMA reliability, and the length of time required for deployment installation. Postdeployment acceptability Likert surveys (1=strongly disagree; 5=strongly agree) found that dyads disagreed that BESI-C was a burden (1.7 out of 5) or compromised their privacy (1.9 out of 5) and agreed that the system collected helpful information to better manage cancer pain (4.6 out of 5). Participants also expressed an interest in seeing their own individual data (4.4 out of 5) and strongly agreed that it is important that data collected by BESI-C are shared with their respective partners (4.8 out of 5) and health care providers (4.8 out of 5). Qualitative feedback from participants suggested that BESI-C positively improved patient-caregiver communication regarding pain management. Importantly, we demonstrated proof of concept that seriously ill patients with cancer and their caregivers will mark pain events in real time using a smart watch. Conclusions It is feasible to deploy BESI-C, and dyads find the system acceptable. By leveraging human-centered design and the integration of heterogenous environmental, physiological, and behavioral data, the BESI-C system offers an innovative approach to monitor cancer pain, mitigate the escalation of pain and distress, and improve symptom management self-efficacy. International Registered Report Identifier (IRRID) RR2-10.2196/16178
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Affiliation(s)
- Virginia LeBaron
- University of Virginia School of Nursing, Charlottesville, VA, United States
| | - Ridwan Alam
- Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Rachel Bennett
- University of Virginia School of Nursing, Charlottesville, VA, United States
| | - Leslie Blackhall
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Kate Gordon
- Virginia Commonwealth University Health, Richmond, VA, United States
| | - James Hayes
- Trident Systems, Inc, Fairfax, VA, United States
| | - Nutta Homdee
- Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand
| | - Randy Jones
- University of Virginia School of Nursing, Charlottesville, VA, United States
| | - Kathleen Lichti
- University of Virginia School of Nursing, Charlottesville, VA, United States
| | - Yudel Martinez
- University of Virginia School of Engineering & Applied Science, Charlottesville, VA, United States
| | - Sahar Mohammadi
- Penn Medicine, University of Pennsylvania Health System, Philadelphia, PA, United States
| | - Emmanuel Ogunjirin
- University of Virginia School of Engineering & Applied Science, Charlottesville, VA, United States
| | - Nyota Patel
- University of Virginia School of Engineering & Applied Science, Charlottesville, VA, United States
| | - John Lach
- The George Washington University School of Engineering & Applied Science, Washington, DC, United States
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17
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Badal VD, Lee EE, Daly R, Parrish EM, Kim HC, Jeste DV, Depp CA. Dynamics of Loneliness Among Older Adults During the COVID-19 Pandemic: Pilot Study of Ecological Momentary Assessment With Network Analysis. Front Digit Health 2022; 4:814179. [PMID: 35199099 PMCID: PMC8859335 DOI: 10.3389/fdgth.2022.814179] [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: 11/12/2021] [Accepted: 01/05/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic has had potentially severe psychological implications for older adults, including those in retirement communities, due to restricted social interactions, but the day-to-day experience of loneliness has received limited study. We sought to investigate sequential association, if any, between loneliness, activity, and affect. METHODS We used ecological momentary assessment (EMA) with dynamic network analysis to investigate the affective and behavioral concomitants of loneliness in 22 residents of an independent living sector of a continuing care retirement community (mean age 80.2; range 68-93 years). RESULTS Participants completed mean 83.9% of EMA surveys (SD = 16.1%). EMA ratings of loneliness were moderately correlated with UCLA loneliness scale scores. Network models showed that loneliness was contemporaneously associated with negative affect (worried, anxious, restless, irritable). Negative (but not happy or positive) mood tended to be followed by loneliness and then by exercise or outdoor physical activity. Negative affect had significant and high inertia (stability). CONCLUSIONS The data suggest that EMA is feasible and acceptable to older adults. EMA-assessed loneliness was moderately associated with scale-assessed loneliness. Network models in these independent living older adults indicated strong links between negative affect and loneliness, but feelings of loneliness were followed by outdoor activity, suggesting adaptive behavior among relatively healthy adults.
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Affiliation(s)
- Varsha D Badal
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States.,Department of Psychiatry, Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, San Diego, CA, United States
| | - Ellen E Lee
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States.,Department of Psychiatry, Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, San Diego, CA, United States.,Desert-Pacific Mental Illness Research Education and Clinical Center, Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
| | - Rebecca Daly
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States.,Department of Psychiatry, Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, San Diego, CA, United States
| | - Emma M Parrish
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States
| | - Ho-Cheol Kim
- AI and Cognitive Software, International Business Machines (IBM) Research-Almaden, San Jose, CA, United States
| | - Dilip V Jeste
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States.,Department of Psychiatry, Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, San Diego, CA, United States.,Department of Neurosciences, University of California, San Diego, San Diego, CA, United States
| | - Colin A Depp
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States.,Department of Psychiatry, Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, San Diego, CA, United States.,Veterans Affairs (VA) San Diego Healthcare System, La Jolla, CA, United States
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18
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Cudejko T, Button K, Willott J, Al-Amri M. Applications of Wearable Technology in a Real-Life Setting in People with Knee Osteoarthritis: A Systematic Scoping Review. J Clin Med 2021; 10:5645. [PMID: 34884347 PMCID: PMC8658504 DOI: 10.3390/jcm10235645] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 12/12/2022] Open
Abstract
With the growing number of people affected by osteoarthritis, wearable technology may enable the provision of care outside a traditional clinical setting and thus transform how healthcare is delivered for this patient group. Here, we mapped the available empirical evidence on the utilization of wearable technology in a real-world setting in people with knee osteoarthritis. From an analysis of 68 studies, we found that the use of accelerometers for physical activity assessment is the most prevalent mode of use of wearable technology in this population. We identify low technical complexity and cost, ability to connect with a healthcare professional, and consistency in the analysis of the data as the most critical facilitators for the feasibility of using wearable technology in a real-world setting. To fully realize the clinical potential of wearable technology for people with knee osteoarthritis, this review highlights the need for more research employing wearables for information sharing and treatment, increased inter-study consistency through standardization and improved reporting, and increased representation of vulnerable populations.
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Affiliation(s)
- Tomasz Cudejko
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, College House, King George V Drive East, Heath Park, Cardiff CF14 4EP, UK; (K.B.); (J.W.); (M.A.-A.)
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19
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Shah N, Costello K, Mehta A, Kumar D. Applications of Digital Health Technologies in Knee Osteoarthritis: A Narrative Review (Preprint). JMIR Rehabil Assist Technol 2021; 9:e33489. [PMID: 35675102 PMCID: PMC9218886 DOI: 10.2196/33489] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/12/2022] [Accepted: 05/06/2022] [Indexed: 12/23/2022] Open
Abstract
Background With the increasing adoption of high-speed internet and mobile technologies by older adults, digital health is a promising modality to enhance clinical care for people with knee osteoarthritis (KOA), including those with knee replacement (KR). Objective This study aimed to summarize the current use, cost-effectiveness, and patient and clinician perspectives of digital health for intervention delivery in KOA and KR. Methods In this narrative review, search terms such as mobile health, smartphone, mobile application, mobile technology, ehealth, text message, internet, knee osteoarthritis, total knee arthroplasty, and knee replacement were used in the PubMed and Embase databases between October 2018 and February 2021. The search was limited to original articles published in the English language within the past 10 years. In total, 91 studies were included. Results Digital health technologies such as websites, mobile apps, telephone calls, SMS text messaging, social media, videoconferencing, and custom multi-technology systems have been used to deliver interventions in KOA and KR populations. Overall, there was significant heterogeneity in the types and applications of digital health used in these populations. Digital patient education improved disease-related knowledge, especially when used as an adjunct to traditional methods of patient education for both KOA and KR. Digital health that incorporated person-specific motivational messages, biofeedback, or patient monitoring was more successful at improving physical activity than self-directed digital interventions for both KOA and KR. Many digital exercise interventions were found to be as effective as in-person physical therapy for people with KOA. Many digital exercise interventions for KR incorporated both in-person and web-based treatments (blended format), communication with clinicians, and multi-technology systems and were successful in improving knee range of motion and self-reported symptoms and reducing the length of hospital stays. All digital interventions that incorporated cognitive behavioral therapy or similar psychological interventions showed significant improvements in knee pain, function, and psychological health when compared with no treatment or traditional treatments for both KOA and KR. Although limited in number, studies have indicated that digital health may be cost-effective for these populations, especially when travel costs are considered. Finally, although patients with KOA and KR and clinicians had positive views on digital health, concerns related to privacy and security and concerns related to logistics and training were raised by patients and clinicians, respectively. Conclusions For people with KOA and KR, many studies found digital health to be as effective as traditional treatments for patient education, physical activity, and exercise interventions. All digital interventions that incorporated cognitive behavioral therapy or similar psychological treatments were reported to result in significant improvements in patients with KOA and KR when compared with no treatment or traditional treatments. Overall, technologies that were blended and incorporated communication with clinicians, as well as biofeedback or patient monitoring, showed favorable outcomes.
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Affiliation(s)
- Nirali Shah
- Department of Physical Therapy and Athletic Training, Boston University, Boston, MA, United States
| | - Kerry Costello
- Department of Physical Therapy and Athletic Training, Boston University, Boston, MA, United States
| | - Akshat Mehta
- Department of Physical Therapy and Athletic Training, Boston University, Boston, MA, United States
| | - Deepak Kumar
- Department of Physical Therapy and Athletic Training, Boston University, Boston, MA, United States
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20
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Study Protocol Modeling Evoked Pain in Older African Americans With Knee Osteoarthritis. Nurs Res 2021; 70:391-398. [PMID: 33951704 DOI: 10.1097/nnr.0000000000000520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND African American (AA) older adults with knee osteoarthritis experience more severe chronic pain and advanced physical disability. One of the most prominent stimuli that provokes knee pain is movement. Research suggests that, compared to Whites, AAs report significantly higher movement-evoked pain (MEP) in the knee. However, little is known about the biopsychosocial-behavioral mechanisms underlying MEP. OBJECTIVES The aim of the study was to present a study protocol to (a) characterize the biopsychosocial-behavioral mechanisms that predict MEP in AAs with knee osteoarthritis and (b) develop a targeted, mechanism-based self-management intervention to reduce MEP and maximize movement. METHODS An observational, mixed-methods cohort study will enroll 90 AA/Black adults (ages 55-90 years) to understand intraindividual and interindividual effects on MEP. Participants will complete assessments of MEP, function and gait, biopsychosocial-behavioral questionnaires, quantitative sensory testing, and 7-day ecological momentary assessments of pain and related symptoms. For the qualitative phase, focus groups will be conducted to co-construct a mechanism-based pain self-management intervention. RESULTS We will develop phenotypes of MEP based on biopsychosocial-behavioral predictors and correlate measures of MEP with function. Our central hypothesis is that higher levels of MEP will predict lower self-reported function and poorer performance on functional tasks and that multiple biopsychosocial and behavioral factors will be associated with MEP and function. Predictors may serve as risk or protective factors for MEP and physical function. In targeting the biopsychosocial-behavioral mechanisms of MEP, we anticipate that older AAs may request that intervention components include culturally tailored self-management education, movement/physical activity training, treatment decision-making skills, coaching, spirituality, and social/kinship support. CONCLUSION Osteoarthritis is now the single most common cause of disability, mobility limitations, and persistent pain in older adults-especially AA older adults. To our knowledge, this will be the first study to systematically phenotype MEP in an older racial minority population with knee osteoarthritis and will be relevant for reducing knee pain and improving function.
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Rouzaud Laborde C, Cenko E, Mardini MT, Nerella S, Kheirkhahan M, Ranka S, Fillingim RB, Corbett DB, Weber E, Rashidi P, Manini T. Satisfaction, Usability, and Compliance With the Use of Smartwatches for Ecological Momentary Assessment of Knee Osteoarthritis Symptoms in Older Adults: Usability Study. JMIR Aging 2021; 4:e24553. [PMID: 34259638 PMCID: PMC8319786 DOI: 10.2196/24553] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/12/2021] [Accepted: 04/22/2021] [Indexed: 01/17/2023] Open
Abstract
Background Smartwatches enable physicians to monitor symptoms in patients with knee osteoarthritis, their behavior, and their environment. Older adults experience fluctuations in their pain and related symptoms (mood, fatigue, and sleep quality) that smartwatches are ideally suited to capture remotely in a convenient manner. Objective The aim of this study was to evaluate satisfaction, usability, and compliance using the real-time, online assessment and mobility monitoring (ROAMM) mobile app designed for smartwatches for individuals with knee osteoarthritis. Methods Participants (N=28; mean age 73.2, SD 5.5 years; 70% female) with reported knee osteoarthritis were asked to wear a smartwatch with the ROAMM app installed. They were prompted to report their prior night’s sleep quality in the morning, followed by ecological momentary assessments (EMAs) of their pain, fatigue, mood, and activity in the morning, afternoon, and evening. Satisfaction, comfort, and usability were evaluated using a standardized questionnaire. Compliance with regard to answering EMAs was calculated after excluding time when the watch was not being worn for technical reasons (eg, while charging). Results A majority of participants reported that the text displayed was large enough to read (22/26, 85%), and all participants found it easy to enter ratings using the smartwatch. Approximately half of the participants found the smartwatch to be comfortable (14/26, 54%) and would consider wearing it as their personal watch (11/24, 46%). Most participants were satisfied with its battery charging system (20/26, 77%). A majority of participants (19/26, 73%) expressed their willingness to use the ROAMM app for a 1-year research study. The overall EMA compliance rate was 83% (2505/3036 responses). The compliance rate was lower among those not regularly wearing a wristwatch (10/26, 88% vs 16/26, 71%) and among those who found the text too small to read (4/26, 86% vs 22/26, 60%). Conclusions Older adults with knee osteoarthritis positively rated the ROAMM smartwatch app and were generally satisfied with the device. The high compliance rates coupled with the willingness to participate in a long-term study suggest that the ROAMM app is a viable approach to remotely collecting health symptoms and behaviors for both research and clinical endeavors.
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Affiliation(s)
- Charlotte Rouzaud Laborde
- Department of Pharmacy, University of Toulouse, Toulouse, France.,Department of Aging and Geriatric research, University of Florida, Gainesville, FL, United States
| | - Erta Cenko
- Department of Epidemiology, University of Florida, Gainesville, FL, United States
| | - Mamoun T Mardini
- Department of Aging and Geriatric research, University of Florida, Gainesville, FL, United States.,Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Subhash Nerella
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | | | - Sanjay Ranka
- Department of Computer and Information Science and Engineering, University of Florida, Gainesville, FL, United States
| | - Roger B Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
| | - Duane B Corbett
- Department of Aging and Geriatric research, University of Florida, Gainesville, FL, United States
| | - Eric Weber
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
| | - Parisa Rashidi
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Todd Manini
- Department of Aging and Geriatric research, University of Florida, Gainesville, FL, United States
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22
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Rampioni M, Moșoi AA, Rossi L, Moraru SA, Rosenberg D, Stara V. A Qualitative Study toward Technologies for Active and Healthy Aging: A Thematic Analysis of Perspectives among Primary, Secondary, and Tertiary End Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147489. [PMID: 34299940 PMCID: PMC8308090 DOI: 10.3390/ijerph18147489] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 12/23/2022]
Abstract
It is expected that, by 2050, people aged over 60 in 65 nations will constitute 30% of the total population. Healthy aging is at the top of the world political agenda as a possible means for hindering the collapse of care systems. How can ICT/sensing technology meet older people's needs for active and healthy aging? This qualitative study carried out in Italy and Romania in 2020 involved 30 participants: older adults, caregivers, and stakeholders. Based on a user-centered design approach, this study aimed to understand which requirements of ICT/sensing technologies could match people's needs of active and healthy aging. Findings highlighted that ICT/sensing technology needs to focus on six major themes: (1) learnability, (2) security, (3) independence, empowerment, and coaching values, (4) social isolation, (5) impact of habit, culture, and education variables, and (6) personalized solutions. These themes are consistent with the Active Aging framework and the factors that influence perceived usefulness and potential benefits among older adults. Consequently, this study shows how well-known, but still unresolved, issues affect the field of information and communication technologies (ICTs) to promote active and healthy aging. This suggests that the reinforcement of the public health system, especially considering the pandemic effect, requires a concrete and formidable effort from an interdisciplinary research network.
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Affiliation(s)
- Margherita Rampioni
- IRCCS INRCA—National Institute of Health and Science on Ageing, Innovative Models for Ageing Care and Technology, via S. Margherita 5, 60124 Ancona, Italy; (M.R.); (L.R.)
| | - Adrian Alexandru Moșoi
- Department of Psychology, Education and Teacher Training, Transilvania University of Brasov, B-dul Eroilor 29, 500036 Brașov, Romania;
| | - Lorena Rossi
- IRCCS INRCA—National Institute of Health and Science on Ageing, Innovative Models for Ageing Care and Technology, via S. Margherita 5, 60124 Ancona, Italy; (M.R.); (L.R.)
| | - Sorin-Aurel Moraru
- Department of Automatics and Information Technology, Transilvania University of Brasov, B-dul Eroilor 29, 500036 Brașov, Romania; (S.-A.M.); (D.R.)
| | - Dan Rosenberg
- Department of Automatics and Information Technology, Transilvania University of Brasov, B-dul Eroilor 29, 500036 Brașov, Romania; (S.-A.M.); (D.R.)
| | - Vera Stara
- IRCCS INRCA—National Institute of Health and Science on Ageing, Innovative Models for Ageing Care and Technology, via S. Margherita 5, 60124 Ancona, Italy; (M.R.); (L.R.)
- Correspondence:
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23
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Lee HJ. Digital therapeutics in pain medicine. Korean J Pain 2021; 34:247-249. [PMID: 34193631 PMCID: PMC8255155 DOI: 10.3344/kjp.2021.34.3.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- Ho-Jin Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea
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24
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Patient Engagement Technologies in Orthopaedics: What They Are, What They Offer, and Impact. J Am Acad Orthop Surg 2021; 29:e584-e592. [PMID: 33826580 DOI: 10.5435/jaaos-d-20-00585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 12/06/2020] [Indexed: 02/01/2023] Open
Abstract
The modern era is an increasingly digital and connected world. Most of the Americans now use a smartphone irrespective of age or income level. As smartphone technologies become ubiquitous, there is tremendous interest and growth in mobile health applications. One segment of these new technologies are the so-called patient engagement platforms. These technologies present a host of features that may improve care. This article provides an introduction to this growing technology sector, offers insight into what they may offer patients and surgeons, and discusses how to evaluate various platforms.
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25
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Cesario A, D’Oria M, Calvani R, Picca A, Pietragalla A, Lorusso D, Daniele G, Lohmeyer FM, Boldrini L, Valentini V, Bernabei R, Auffray C, Scambia G. The Role of Artificial Intelligence in Managing Multimorbidity and Cancer. J Pers Med 2021; 11:jpm11040314. [PMID: 33921621 PMCID: PMC8074144 DOI: 10.3390/jpm11040314] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 02/07/2023] Open
Abstract
Traditional healthcare paradigms rely on the disease-centered approach aiming at reducing human nature by discovering specific drivers and biomarkers that cause the advent and progression of diseases. This reductive approach is not always suitable to understand and manage complex conditions, such as multimorbidity and cancer. Multimorbidity requires considering heterogeneous data to tailor preventing and targeting interventions. Personalized Medicine represents an innovative approach to address the care needs of multimorbid patients considering relevant patient characteristics, such as lifestyle and individual preferences, in opposition to the more traditional “one-size-fits-all” strategy focused on interventions designed at the population level. Integration of omic (e.g., genomics) and non-strictly medical (e.g., lifestyle, the exposome) data is necessary to understand patients’ complexity. Artificial Intelligence can help integrate and manage heterogeneous data through advanced machine learning and bioinformatics algorithms to define the best treatment for each patient with multimorbidity and cancer. The experience of an Italian research hospital, leader in the field of oncology, may help to understand the multifaceted issue of managing multimorbidity and cancer in the framework of Personalized Medicine.
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Affiliation(s)
- Alfredo Cesario
- Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (A.C.); (A.P.); (D.L.); (G.D.); (F.M.L.); (G.S.)
| | - Marika D’Oria
- Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (A.C.); (A.P.); (D.L.); (G.D.); (F.M.L.); (G.S.)
- Correspondence:
| | - Riccardo Calvani
- Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.C.); (A.P.); (R.B.)
| | - Anna Picca
- Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.C.); (A.P.); (R.B.)
| | - Antonella Pietragalla
- Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (A.C.); (A.P.); (D.L.); (G.D.); (F.M.L.); (G.S.)
- Gynecological Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Domenica Lorusso
- Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (A.C.); (A.P.); (D.L.); (G.D.); (F.M.L.); (G.S.)
- Gynecological Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Life Sciences and Public Health, Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gennaro Daniele
- Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (A.C.); (A.P.); (D.L.); (G.D.); (F.M.L.); (G.S.)
| | - Franziska Michaela Lohmeyer
- Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (A.C.); (A.P.); (D.L.); (G.D.); (F.M.L.); (G.S.)
| | - Luca Boldrini
- Radiation Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (L.B.); (V.V.)
| | - Vincenzo Valentini
- Radiation Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (L.B.); (V.V.)
| | - Roberto Bernabei
- Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.C.); (A.P.); (R.B.)
| | - Charles Auffray
- European Institute for Systems Biology and Medicine (EISBM), 69390 Vourles, France;
| | - Giovanni Scambia
- Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (A.C.); (A.P.); (D.L.); (G.D.); (F.M.L.); (G.S.)
- Gynecological Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Life Sciences and Public Health, Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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26
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Johnson AJ, Palit S, Terry EL, Thompson OJ, Powell-Roach K, Dyal BW, Ansell M, Booker SQ. Managing osteoarthritis pain with smart technology: a narrative review. Rheumatol Adv Pract 2021; 5:rkab021. [PMID: 33928214 PMCID: PMC8068316 DOI: 10.1093/rap/rkab021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/26/2021] [Indexed: 12/23/2022] Open
Abstract
Osteoarthritis (OA) is a highly prevalent musculoskeletal condition worldwide. More than 300 million individuals are affected by OA, and pain is the most common and challenging symptom to manage. Although many new advances have led to improved OA-related pain management, smart technology offers additional opportunities to enhance symptom management. This narrative review identifies and describes the current literature focused on smart technology for pain management in individuals with OA. In collaboration with a health sciences librarian, an interdisciplinary team of clinician-scientists searched multiple databases (e.g. PubMed, CINAHL and Embase), which generated 394 citations for review. After inclusion criteria were met, data were extracted from eight studies reporting on varied smart technologies, including mobile health, wearables and eHealth tools to measure or manage pain. Our review highlights the dearth of research in this crucial area, the implications for clinical practice and technology development, and future research needs.
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Affiliation(s)
- Alisa J Johnson
- Pain Research and Intervention Center of Excellence, Department of Community Dentistry and Behavioral Science, College of Dentistry
| | - Shreela Palit
- Pain Research and Intervention Center of Excellence, Department of Community Dentistry and Behavioral Science, College of Dentistry
| | - Ellen L Terry
- Pain Research and Intervention Center of Excellence, Department of Community Dentistry and Behavioral Science, College of Dentistry
| | - Osheeca J Thompson
- Pain Research and Intervention Center of Excellence, Department of Community Dentistry and Behavioral Science, College of Dentistry
| | - Keesha Powell-Roach
- Pain Research and Intervention Center of Excellence, Department of Community Dentistry and Behavioral Science, College of Dentistry
| | - Brenda W Dyal
- Department of Biobehavioral Nursing Science, College of Nursing
| | - Margaret Ansell
- George A. Smathers Libraries, Health Science Center Libraries, University of Florida, Gainesville, FL, USA
| | - Staja Q Booker
- Pain Research and Intervention Center of Excellence, Department of Community Dentistry and Behavioral Science, College of Dentistry
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27
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Mardini MT, Nerella S, Kheirkhahan M, Ranka S, Fillingim RB, Hu Y, Corbett DB, Cenko E, Weber E, Rashidi P, Manini TM. The Temporal Relationship Between Ecological Pain and Life-Space Mobility in Older Adults With Knee Osteoarthritis: A Smartwatch-Based Demonstration Study. JMIR Mhealth Uhealth 2021; 9:e19609. [PMID: 33439135 PMCID: PMC7840291 DOI: 10.2196/19609] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 09/18/2020] [Accepted: 10/20/2020] [Indexed: 11/30/2022] Open
Abstract
Background Older adults who experience pain are more likely to reduce their community and life-space mobility (ie, the usual range of places in an environment in which a person engages). However, there is significant day-to-day variability in pain experiences that offer unique insights into the consequences on life-space mobility, which are not well understood. This variability is complex and cannot be captured with traditional recall-based pain surveys. As a solution, ecological momentary assessments record repeated pain experiences throughout the day in the natural environment. Objective The aim of this study was to examine the temporal association between ecological momentary assessments of pain and GPS metrics in older adults with symptomatic knee osteoarthritis by using a smartwatch platform called Real-time Online Assessment and Mobility Monitor. Methods Participants (n=19, mean 73.1 years, SD 4.8; female: 13/19, 68%; male: 6/19, 32%) wore a smartwatch for a mean period of 13.16 days (SD 2.94). Participants were prompted in their natural environment about their pain intensity (range 0-10) at random time windows in the morning, afternoon, and evening. GPS coordinates were collected at 15-minute intervals and aggregated each day into excursion, ellipsoid, clustering, and trip frequency features. Pain intensity ratings were averaged across time windows for each day. A random effects model was used to investigate the within and between-person effects. Results The daily mean pain intensities reported by participants ranged between 0 and 8 with 40% reporting intensities ≥2. The within-person associations between pain intensity and GPS features were more likely to be statistically significant than those observed between persons. Within-person pain intensity was significantly associated with excursion size, and others (excursion span, total distance, and ellipse major axis) showed a statistical trend (excursion span: P=.08; total distance: P=.07; ellipse major axis: P=.07). Each point increase in the mean pain intensity was associated with a 3.06 km decrease in excursion size, 2.89 km decrease in excursion span, 5.71 km decrease total distance travelled per day, 31.4 km2 decrease in ellipse area, 0.47 km decrease ellipse minor axis, and 3.64 km decrease in ellipse major axis. While not statistically significant, the point estimates for number of clusters (P=.73), frequency of trips (P=.81), and homestay (P=.15) were positively associated with pain intensity, and entropy (P=.99) was negatively associated with pain intensity. Conclusions In this demonstration study, higher intensity knee pain in older adults was associated with lower life-space mobility. Results demonstrate that a custom-designed smartwatch platform is effective at simultaneously collecting rich information about ecological pain and life-space mobility. Such smart tools are expected to be important for remote health interventions that harness the variability in pain symptoms while understanding their impact on life-space mobility.
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Affiliation(s)
- Mamoun T Mardini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States.,Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, United States
| | - Subhash Nerella
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | | | - Sanjay Ranka
- Department of Computer and Information Science and Engineering, University of Florida, Gainesville, FL, United States
| | - Roger B Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
| | - Yujie Hu
- Department of Geography, University of Florida, Gainesville, FL, United States
| | - Duane B Corbett
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States
| | - Erta Cenko
- Department of Epidemiology, University of Florida, Gainesville, FL, United States
| | - Eric Weber
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
| | - Parisa Rashidi
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Todd M Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States
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28
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Laitner MH, Erickson LC, Ortman E. Understanding the Impact of Sex and Gender in Osteoarthritis: Assessing Research Gaps and Unmet Needs. J Womens Health (Larchmt) 2020; 30:634-641. [PMID: 33325792 DOI: 10.1089/jwh.2020.8828] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Osteoarthritis (OA) affects more than 300 million individuals globally, with higher prevalence in women than in men. In addition, OA affects women and men differently, with women demonstrating both increased disease severity and disability. The Society for Women's Health Research (SWHR) convened an interdisciplinary group of expert researchers and clinicians for a roundtable meeting to review the current state of the science on OA and to identify knowledge gaps in the scientific literature, especially as they relate to the topics of sex and gender. The current review summarizes discussions from the roundtable and prioritizes areas of need that warrant further attention in OA research, diagnosis, care, and education. Improvements in basic and clinical research, clinical practice, patient education, and policy are needed to allow for better understanding as to the pathogenesis of sex- and gender-related disparities in OA.
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Affiliation(s)
- Melissa H Laitner
- The Society for Women's Health Research, Washington, District of Columbia, USA
| | | | - Emily Ortman
- The Society for Women's Health Research, Washington, District of Columbia, USA
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29
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Anton SD, Cruz-Almeida Y, Singh A, Alpert J, Bensadon B, Cabrera M, Clark DJ, Ebner NC, Esser KA, Fillingim RB, Goicolea SM, Han SM, Kallas H, Johnson A, Leeuwenburgh C, Liu AC, Manini TM, Marsiske M, Moore F, Qiu P, Mankowski RT, Mardini M, McLaren C, Ranka S, Rashidi P, Saini S, Sibille KT, Someya S, Wohlgemuth S, Tucker C, Xiao R, Pahor M. Innovations in Geroscience to enhance mobility in older adults. Exp Gerontol 2020; 142:111123. [PMID: 33191210 PMCID: PMC7581361 DOI: 10.1016/j.exger.2020.111123] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 02/07/2023]
Abstract
Aging is the primary risk factor for functional decline; thus, understanding and preventing disability among older adults has emerged as an important public health challenge of the 21st century. The science of gerontology - or geroscience - has the practical purpose of "adding life to the years." The overall goal of geroscience is to increase healthspan, which refers to extending the portion of the lifespan in which the individual experiences enjoyment, satisfaction, and wellness. An important facet of this goal is preserving mobility, defined as the ability to move independently. Despite this clear purpose, this has proven to be a challenging endeavor as mobility and function in later life are influenced by a complex interaction of factors across multiple domains. Moreover, findings over the past decade have highlighted the complexity of walking and how targeting multiple systems, including the brain and sensory organs, as well as the environment in which a person lives, can have a dramatic effect on an older person's mobility and function. For these reasons, behavioral interventions that incorporate complex walking tasks and other activities of daily living appear to be especially helpful for improving mobility function. Other pharmaceutical interventions, such as oxytocin, and complementary and alternative interventions, such as massage therapy, may enhance physical function both through direct effects on biological mechanisms related to mobility, as well as indirectly through modulation of cognitive and socioemotional processes. Thus, the purpose of the present review is to describe evolving interventional approaches to enhance mobility and maintain healthspan in the growing population of older adults in the United States and countries throughout the world. Such interventions are likely to be greatly assisted by technological advances and the widespread adoption of virtual communications during and after the COVID-19 era.
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Affiliation(s)
- Stephen D Anton
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Yenisel Cruz-Almeida
- University of Florida, Department of Community Dentistry and Behavioral Science, 1329 SW Archer Road, Gainesville, FL 32610, United States.
| | - Arashdeep Singh
- University of Florida, Department of Pharmacodynamics, College of Pharmacy, 1345 Center Drive, Gainesville, FL 32610, United States.
| | - Jordan Alpert
- University of Florida, College of Journalism and Communications, Gainesville, FL 32610, United States.
| | - Benjamin Bensadon
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Melanie Cabrera
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - David J Clark
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Natalie C Ebner
- University of Florida, Department of Psychology, 945 Center Drive, Gainesville, FL 32611, United States.
| | - Karyn A Esser
- University of Florida, Department of Physiology and Functional Genomics, 1345 Center Drive, Gainesville, FL, United States.
| | - Roger B Fillingim
- University of Florida, Department of Community Dentistry and Behavioral Science, 1329 SW Archer Road, Gainesville, FL 32610, United States.
| | - Soamy Montesino Goicolea
- University of Florida, Department of Community Dentistry and Behavioral Science, 1329 SW Archer Road, Gainesville, FL 32610, United States.
| | - Sung Min Han
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Henrique Kallas
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Alisa Johnson
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Christiaan Leeuwenburgh
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Andrew C Liu
- University of Florida, Department of Physiology and Functional Genomics, 1345 Center Drive, Gainesville, FL, United States.
| | - Todd M Manini
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Michael Marsiske
- University of Florida, Department of Clinical & Health Psychology, 1225 Center Drive, Gainesville, FL 32610, United States.
| | - Frederick Moore
- University of Florida, Department of Surgery, Gainesville, FL 32610, United States.
| | - Peihua Qiu
- University of Florida, Department of Biostatistics, Gainesville, FL 32611, United States.
| | - Robert T Mankowski
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Mamoun Mardini
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Christian McLaren
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Sanjay Ranka
- University of Florida, Department of Computer & Information Science & Engineering, Gainesville, FL 32611, United States.
| | - Parisa Rashidi
- University of Florida, Department of Biomedical Engineering. P.O. Box 116131. Gainesville, FL 32610, United States.
| | - Sunil Saini
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Kimberly T Sibille
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Shinichi Someya
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Stephanie Wohlgemuth
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Carolyn Tucker
- University of Florida, Department of Psychology, 945 Center Drive, Gainesville, FL 32611, United States.
| | - Rui Xiao
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Marco Pahor
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
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Coombs LA, Ellington L, Fagerlin A, Mooney K. Age Is Not a Barrier: Older Adults With Cancer Derive Similar Benefit in a Randomized Controlled Trial of a Remote Symptom Monitoring Intervention Compared With Younger Adults. Cancer Control 2020; 27:1073274820968878. [PMID: 33153313 PMCID: PMC7791468 DOI: 10.1177/1073274820968878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
This study investigated a remote symptom monitoring intervention to examine if
older participants with cancer received a similar magnitude of benefit compared
with younger adults with cancer. We analyzed a longitudinal symptom monitoring
intervention for 358 participants beginning a new course of chemotherapy
treatment in community and academic oncology practices. The study design was a
randomized control trial; participants were randomized to the intervention or
usual care, the intervention was delivered during daily automated coaching.
Older adults with moderate and severe symptoms derived similar benefit as those
adults younger than 60 years of age, adherence to the study protocol which
involved daily calls was high. There was no significant difference between the 2
age categories; on average, older adult participants made 88% of expected daily
calls and younger adult participants made 90% of expected daily calls. Our
results challenge the perception that older adults are unwilling or unable to
use a technological tool such as interactive voice response and suggest that
patient utilization may be guided by other factors, such as ease of use and
perceived benefit from the intervention.
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Affiliation(s)
- Lorinda A Coombs
- School of Nursing, University of North Carolina at Chapel Hill, NC USA.,Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Lee Ellington
- University of Utah College of Nursing, Salt Lake City, UT, USA.,Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Angela Fagerlin
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Kathi Mooney
- University of Utah College of Nursing, Salt Lake City, UT, USA.,Huntsman Cancer Institute, Salt Lake City, UT, USA
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Alpert JM, Kota NSP, Ranka S, Mendoza TV, Solberg LM, Rashidi P, Manini TM. A Simulated Graphical Interface for Integrating Patient-Generated Health Data From Smartwatches With Electronic Health Records: Usability Study. JMIR Hum Factors 2020; 7:e19769. [PMID: 33124988 PMCID: PMC7665942 DOI: 10.2196/19769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/19/2020] [Accepted: 08/26/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Wearable technology, such as smartwatches, can capture valuable patient-generated data and help inform patient care. Electronic health records provide logical and practical platforms for including such data, but it is necessary to evaluate the way the data are presented and visualized. OBJECTIVE The aim of this study is to evaluate a graphical interface that displays patients' health data from smartwatches, mimicking the integration within the environment of electronic health records. METHODS A total of 12 health care professionals evaluated a simulated interface using a usability scale questionnaire, testing the clarity of the interface, colors, usefulness of information, navigation, and readability of text. RESULTS The interface was positively received, with 14 out of the 16 questions generating a score of 5 or greater among at least 75% of participants (9/12). On an 8-point Likert scale, the highest rated features of the interface were quick turnaround times (mean score 7.1), readability of the text (mean score 6.8), and use of terminology/abbreviations (mean score 6.75). CONCLUSIONS Collaborating with health care professionals to develop and refine a graphical interface for visualizing patients' health data from smartwatches revealed that the key elements of the interface were acceptable. The implementation of such data from smartwatches and other mobile devices within electronic health records should consider the opinions of key stakeholders as the development of this platform progresses.
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Affiliation(s)
- Jordan M Alpert
- Department of Advertising, College of Journalism and Communications, University of Florida, Gainesville, FL, United States
| | - Naga S Prabhakar Kota
- Department of Computer & Information Science & Engineering, University of Florida, Gainesville, FL, United States
| | - Sanjay Ranka
- Department of Computer & Information Science & Engineering, University of Florida, Gainesville, FL, United States
| | - Tonatiuh V Mendoza
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, United States
| | - Laurence M Solberg
- College of Nursing, University of Florida, Gainesville, FL, United States
- Geriatrics Research, Education and Clinical Center (GRECC), Veterans Health Administration, NF/SG VHS, Gainesville, FL, United States
| | - Parisa Rashidi
- Department of Computer & Information Science & Engineering, University of Florida, Gainesville, FL, United States
- J Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Todd M Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States
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Perlmutter A, Benchoufi M, Ravaud P, Tran VT. Identification of Patient Perceptions That Can Affect the Uptake of Interventions Using Biometric Monitoring Devices: Systematic Review of Randomized Controlled Trials. J Med Internet Res 2020; 22:e18986. [PMID: 32915153 PMCID: PMC7519434 DOI: 10.2196/18986] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/23/2020] [Accepted: 07/26/2020] [Indexed: 12/24/2022] Open
Abstract
Background Biometric monitoring devices (BMDs) are wearable or environmental trackers and devices with embedded sensors that
can remotely collect high-frequency objective data on patients’ physiological, biological, behavioral, and environmental
contexts (for example, fitness trackers with accelerometer). The real-world effectiveness of interventions using biometric monitoring devices depends on patients’ perceptions of these interventions. Objective We aimed to systematically review whether and how recent randomized controlled trials (RCTs) evaluating interventions using BMDs assessed patients’ perceptions toward the intervention. Methods We systematically searched PubMed (MEDLINE) from January 1, 2017, to December 31, 2018, for RCTs evaluating interventions using BMDs. Two independent investigators extracted the following information: (1) whether the RCT collected information on patient perceptions toward the intervention using BMDs and (2) if so, what precisely was collected, based on items from questionnaires used and/or themes and subthemes identified from qualitative assessments. The two investigators then synthesized their findings in a schema of patient perceptions of interventions using BMDs. Results A total of 58 RCTs including 10,071 participants were included in the review (the median number of randomized participants was 60, IQR 37-133). BMDs used in interventions were accelerometers/pedometers (n=35, 60%), electrochemical biosensors (eg, continuous glucose monitoring; n=18, 31%), or ecological momentary assessment devices (eg, carbon monoxide monitors for smoking cessation; n=5, 9%). Overall, 26 (45%) trials collected information on patient perceptions toward the intervention using BMDs and allowed the identification of 76 unique aspects of patient perceptions that could affect the uptake of these interventions (eg, relevance of the information provided, alarm burden, privacy and data handling, impact on health outcomes, independence, interference with daily life). Patient perceptions were unevenly collected in trials. For example, only 5% (n=3) of trials assessed how patients felt about privacy and data handling aspects of the intervention using BMDs. Conclusions Our review showed that less than half of RCTs evaluating interventions using BMDs assessed patients’ perceptions toward interventions using BMDs. Trials that did assess perceptions often only assessed a fraction of them. This limits the extrapolation of the results of these RCTs to the real world. We thus provide a comprehensive schema of aspects of patient perceptions that may affect the uptake of interventions using BMDs and which should be considered in future trials. Trial Registration PROSPERO CRD42018115522; https://tinyurl.com/y5h8fjgx
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Affiliation(s)
- Alexander Perlmutter
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.,School of Global Public Health, New York University, New York, NY, United States
| | - Mehdi Benchoufi
- UMR1153 (METHODS team), Centre de Recherche en Epidemiologie et StatistiqueS, Institut national de la santé et de la recherche médicale, Paris, France
| | - Philippe Ravaud
- UMR1153 (METHODS team), Centre de Recherche en Epidemiologie et StatistiqueS, Institut national de la santé et de la recherche médicale, Paris, France
| | - Viet-Thi Tran
- UMR1153 (METHODS team), Centre de Recherche en Epidemiologie et StatistiqueS, Institut national de la santé et de la recherche médicale, Paris, France
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Lortz J, Simanovski J, Kuether T, Kreitschmann-Andermahr I, Ullrich G, Steinmetz M, Rammos C, Jánosi RA, Moebus S, Rassaf T, Paldán K. Needs and Requirements in the Designing of Mobile Interventions for Patients With Peripheral Arterial Disease: Questionnaire Study. JMIR Form Res 2020; 4:e15669. [PMID: 32663154 PMCID: PMC7435621 DOI: 10.2196/15669] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 11/11/2019] [Accepted: 03/29/2020] [Indexed: 12/24/2022] Open
Abstract
Background The development of mobile interventions for noncommunicable diseases has increased in recent years. However, there is a dearth of apps for patients with peripheral arterial disease (PAD), who frequently have an impaired ability to walk. Objective Using a patient-centered approach for the development of mobile interventions, we aim to describe the needs and requirements of patients with PAD regarding the overall care situation and the use of mobile interventions to perform supervised exercise therapy (SET). Methods A questionnaire survey was conducted in addition to a clinical examination at the vascular outpatient clinic of the West-German Heart and Vascular Center of the University Clinic Essen in Germany. Patients with diagnosed PAD were asked to answer questions on sociodemographic characteristics, PAD-related need for support, satisfaction with their health care situation, smartphone and app use, and requirements for the design of mobile interventions to support SET. Results Overall, a need for better support of patients with diagnosed PAD was identified. In total, 59.2% (n=180) expressed their desire for more support for their disease. Patients (n=304) had a mean age of 67 years and half of them (n=157, 51.6%) were smartphone users. We noted an interest in smartphone-supported SET, even for people who did not currently use a smartphone. “Information,” “feedback,” “choosing goals,” and “interaction with physicians and therapists” were rated the most relevant components of a potential app. Conclusions A need for the support of patients with PAD was determined. This was particularly evident with regard to disease literacy and the performance of SET. Based on a detailed description of patient characteristics, proposals for the design of mobile interventions adapted to the needs and requirements of patients can be derived.
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Affiliation(s)
- Julia Lortz
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Jan Simanovski
- Centre for Urban Epidemiology, Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Tabea Kuether
- Centre of Competence Personal Analytics at the University of Duisburg-Essen, Department of Engineering Sciences, University of Duisburg-Essen, Duisburg, Germany
| | | | - Greta Ullrich
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Christos Rammos
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Rolf Alexander Jánosi
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Susanne Moebus
- Centre for Urban Epidemiology, Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Katrin Paldán
- Centre for Urban Epidemiology, Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany.,Centre of Competence Personal Analytics at the University of Duisburg-Essen, Department of Engineering Sciences, University of Duisburg-Essen, Duisburg, Germany
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Digital Orthopaedics: A Glimpse Into the Future in the Midst of a Pandemic. J Arthroplasty 2020; 35:S68-S73. [PMID: 32416956 PMCID: PMC7175889 DOI: 10.1016/j.arth.2020.04.048] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The response to COVID-19 catalyzed the adoption and integration of digital health tools into the health care delivery model for musculoskeletal patients. The change, suspension, or relaxation of Medicare and federal guidelines enabled the rapid implementation of these technologies. The expansion of payment models for virtual care facilitated its rapid adoption. The authors aim to provide several examples of digital health solutions utilized to manage orthopedic patients during the pandemic and discuss what features of these technologies are likely to continue to provide value to patients and clinicians following its resolution. CONCLUSION The widespread adoption of new technologies enabling providers to care for patients remotely has the potential to permanently change the expectations of all stakeholders about the way care is provided in orthopedics. The new era of Digital Orthopaedics will see a gradual and nondisruptive integration of technologies that support the patient's journey through the successful management of their musculoskeletal disease.
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Metal-on-Metal Total Hip Revisions: Pearls and Pitfalls. J Arthroplasty 2020; 35:S68-S72. [PMID: 32081501 DOI: 10.1016/j.arth.2020.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND At the turn of the 21st century, there was a re-emergence of metal-on-metal (MoM) articulation with 35% of all total hip arthroplasty implants having MoM articulation. Approximately 10 years after its peak use, MoM articulation began to decrease dramatically as revisions became more apparent because of adverse reaction to metal debris. Today, there are surveillance guidelines and reconstructive clinical pearls a surgeon should recognize. METHODS This article gives a literature-based overview of clinical pearls and discusses how to avoid pitfalls when performing revision of a metal-on-metal total hip arthroplasty. RESULTS Patients with MoM can be risk-stratified based on symptom, implant, and testing variables. Those patients who are symptomatic and/or develop adverse reaction to metal debris with local tissue destruction will require a revision. The revision of MoM can be challenging due to bone and soft tissue destruction. Constraint may be needed in cases of abductor deficiency. CONCLUSION Although MoM implants for THA have declined significantly, surgeons are still faced with the revision burden from a decade of high use. Risk stratification tools are available to aid in revision decision making, and the surgeon should be prepared to address the challenges these revisions present.
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Carr DJ, Adia AC, Wray TB, Celio MA, Pérez AE, Monti PM. Using the Internet to access key populations in ecological momentary assessment research: Comparing adherence, reactivity, and erratic responding across those enrolled remotely versus in-person. Psychol Assess 2020; 32:768-779. [PMID: 32437190 DOI: 10.1037/pas0000847] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Ecological momentary assessment (EMA) is a set of longitudinal methods that researchers can use to understand complex processes (e.g., health, behavior, emotion) in "high resolution." Although technology has made EMA data collection easier, concerns remain about the consistency and quality of data collected from participants who are enrolled and followed online. In this study, we used EMA data from a larger study on HIV-risk behavior among men who have sex with men (MSM) to explore whether several indicators of data consistency/quality differed across those who elected to enroll in-person and those enrolled online. One hundred MSM (age 18-54) completed a 30-day EMA study. Forty-five of these participants chose to enroll online. There were no statistically significant differences in response rates for any survey type (e.g., daily diary [DD], experience sampling [ES], event-contingent [EC]) across participants who enrolled in-person versus online. DD and ES survey response rates were consistent across the study and did not differ between groups. EC response rates fell sharply across the study, but this pattern was also consistent across groups. Participants' responses on the DD were generally consistent with a poststudy follow-up Timeline Followback (TLFB) with some underreporting on the TLFB, but this pattern was consistent across both groups. In this sample of well-educated, mostly White MSM recruited from urban areas, EMA data collected from participants followed online was as consistent, reliable, and valid as data collected from participants followed in-person. These findings yield important insights about best practices for EMA studies with cautions regarding generalizability. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Alpert JM, Manini T, Roberts M, Kota NSP, Mendoza TV, Solberg LM, Rashidi P. Secondary care provider attitudes towards patient generated health data from smartwatches. NPJ Digit Med 2020; 3:27. [PMID: 32140569 PMCID: PMC7054258 DOI: 10.1038/s41746-020-0236-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/24/2020] [Indexed: 01/07/2023] Open
Abstract
Wearable devices, like smartwatches, are increasingly used for tracking physical activity, community mobility, and monitoring symptoms. Data generated from smartwatches (PGHD_SW) is a form of patient-generated health data, which can benefit providers by supplying frequent temporal information about patients. The goal of this study was to understand providers' perceptions towards PGHD_SW adoption and its integration with electronic medical records. In-depth, semi-structured qualitative interviews were conducted with 12 providers from internal medicine, family medicine, geriatric medicine, nursing, surgery, rehabilitation, and anesthesiology. Diffusion of Innovations was used as a framework to develop questions and guide data analysis. The constant comparative method was utilized to formulate salient themes from the interviews. Four main themes emerged: (1) PGHD_SW is perceived as a relative advantage; (2) data are viewed as compatible with current practices; (3) barriers to overcome to effectively use PGHD_SW; (4) assessments from viewing sample data. Overall, PGHD_SW was valued because it enabled access to information about patients that were traditionally unattainable. It also can initiate discussions between patients and providers. Providers consider PGHD_SW important, but data preferences varied by specialty. The successful adoption of PGHD_SW will depend on tailoring data, frequencies of reports, and visualization preferences to correspond with the demands of providers.
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Affiliation(s)
- Jordan M. Alpert
- Department of Advertising, College of Journalism and Communications, University of Florida, Gainesville, FL USA
| | - Todd Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL USA
| | - Megan Roberts
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL USA
| | - Naga S. Prabhakar Kota
- Computer & Information Science & Engineering, University of Florida, Gainesville, FL USA
| | - Tonatiuh V. Mendoza
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL USA
| | - Laurence M. Solberg
- Veterans Health Administration, NF/SG VHS, Geriatrics Research, Education and Clinical Center (GRECC), Gainesville, FL USA
- College of Nursing, University of Florida, Gainesville, FL USA
| | - Parisa Rashidi
- Computer & Information Science & Engineering, University of Florida, Gainesville, FL USA
- J. Crayton Pruitt Family Department of Biomedical Engineering (BME), University of Florida, Gainesville, FL USA
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Escalona-Marfil C, Coda A, Ruiz-Moreno J, Riu-Gispert LM, Gironès X. Validation of an Electronic Visual Analog Scale mHealth Tool for Acute Pain Assessment: Prospective Cross-Sectional Study. J Med Internet Res 2020; 22:e13468. [PMID: 32049063 PMCID: PMC7055746 DOI: 10.2196/13468] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 10/30/2019] [Accepted: 11/29/2019] [Indexed: 12/21/2022] Open
Abstract
Background Accurate measurement of pain is required to improve its management and in research. The visual analog scale (VAS) on paper format has been shown to be an accurate, valid, reliable, and reproducible way to measure pain intensity. However, some limitations should be considered, some of which can be implemented with the introduction of an electronic VAS version, suitable to be used both in a tablet and a smartphone. Objective This study aimed to validate a new method of recording pain level by comparing the traditional paper VAS with the pain level module on the newly designed Interactive Clinics app. Methods A prospective observational cross-sectional study was designed. The sample consisted of 102 participants aged 18 to 65 years. A Force Dial FDK 20 algometer (Wagner Instruments) was employed to induce mild pressure symptoms on the participants’ thumbs. Pain was measured using a paper VAS (10 cm line) and the app. Results Intermethod reliability estimated by ICC(3,1) was 0.86 with a 95% confidence interval of 0.81 to 0.90, indicating good reliability. Intramethod reliability estimated by ICCa(3,1) was 0.86 with a 95% confidence interval of 0.81 to 0.90, also indicating good reliability. Bland-Altman analysis showed a difference of 0.175 (0.49), and limits of agreement ranged from –0.79 to 1.14. Conclusions The pain level module on the app is highly reliable and interchangeable with the paper VAS version. This tool could potentially help clinicians and researchers precisely assess pain in a simple, economic way with the use of a ubiquitous technology.
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Affiliation(s)
- Carles Escalona-Marfil
- Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya, Manresa, Spain.,University School of Health and Sport, University of Girona, Salt (Girona), Spain
| | - Andrea Coda
- School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre for Health Behaviour, Hunter Medical Research Institute, The University of Newcastle, Callaghan, Australia
| | | | - Lluís Miquel Riu-Gispert
- Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya, Manresa, Spain
| | - Xavier Gironès
- Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya, Manresa, Spain
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Naranjo-Hernández D, Reina-Tosina J, Roa LM. Sensor Technologies to Manage the Physiological Traits of Chronic Pain: A Review. SENSORS (BASEL, SWITZERLAND) 2020; 20:E365. [PMID: 31936420 PMCID: PMC7014460 DOI: 10.3390/s20020365] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/03/2020] [Accepted: 01/05/2020] [Indexed: 12/15/2022]
Abstract
Non-oncologic chronic pain is a common high-morbidity impairment worldwide and acknowledged as a condition with significant incidence on quality of life. Pain intensity is largely perceived as a subjective experience, what makes challenging its objective measurement. However, the physiological traces of pain make possible its correlation with vital signs, such as heart rate variability, skin conductance, electromyogram, etc., or health performance metrics derived from daily activity monitoring or facial expressions, which can be acquired with diverse sensor technologies and multisensory approaches. As the assessment and management of pain are essential issues for a wide range of clinical disorders and treatments, this paper reviews different sensor-based approaches applied to the objective evaluation of non-oncological chronic pain. The space of available technologies and resources aimed at pain assessment represent a diversified set of alternatives that can be exploited to address the multidimensional nature of pain.
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Affiliation(s)
- David Naranjo-Hernández
- Biomedical Engineering Group, University of Seville, 41092 Seville, Spain; (J.R.-T.); (L.M.R.)
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Argüello Prada EJ. The Internet of Things (IoT) in pain assessment and management: An overview. INFORMATICS IN MEDICINE UNLOCKED 2020. [DOI: 10.1016/j.imu.2020.100298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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