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Yokomizo R, Nakamura A, Sato M, Nasu R, Hine M, Urayama KY, Kishi H, Sago H, Okamoto A, Umezawa A. O-187 Smartphone application improves fertility treatment-related literacy: A large-scale surveillance and randomized controlled trial in Japan. Hum Reprod 2021. [DOI: 10.1093/humrep/deab127.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Can providing quality-assured fertility-related information via a smartphone application improve fertility- and treatment-related literacy among smartphone application users?
Summary answer
Provision of quality-assured fertility-related information via a smartphone application contributed to enhancing fertility- and treatment-related literacy among the smartphone application users.
What is known already
For infertility patients, the interpretation of examination results may be overly complicated and complex, and patients may have difficulty in making sense of their own fertility problems. Accessing and learning about fertility-related information using the Internet via smartphone is reasonable; however, the information does not always reflect evidence-based recommendations and low-quality information may lead to adverse effects on users; thus, innovative methods to provide both accessible and high-quality information are desired.
Study design, size, duration
We performed a randomized control-group pretest posttest study and 4,137 smartphone application users were invited to participate between June 18 and 25, 2020. Participants’ fertility treatment-related literacy were assessed with a pretest that comprised of 28 questions and participants were allocated with stratified randomization to either intervention or control group. The intervention comprised a one-week smartphone application-based provision of information on fertility- and treatment-related information and the control group received general information about women’s healthcare.
Participants/materials, setting, methods
The 3,765 participants (91.0 %) who responded were randomly allocated into either the intervention group (N = 1883) or the control group (N = 1882). Characteristics of participants appeared similar between the groups reflecting that the randomization was successful in producing a balance in baseline characteristics. Effectiveness of intervention was assessed using pretest-posttest analysis. Ethical approval was obtained from the Institutional Review Board of the National Center for Child Health and Development of Japan (approval number: 2019-184).
Main results and the role of chance
The posttest was completed by 659 participants (17.5%), and finally 207 participants in the intervention group and 222 participants in the control group were available for pretest-posttest analysis. Demographic characteristics of these participants appeared similar between the groups. In comparing the demographic characteristics of participants who did and did not complete the posttest, there were significant differences between the two groups in age, overall test score, proportion living with a partner, and action for pregnancy. For the posttest, the overall mean test scores were significantly higher in the intervention group compared to the control group (P = 0.0082). Interestingly, we also observed that posttest scores were significantly improved compared to pretest scores in both the intervention group and control group (P < 0.001). When examining by specific test question, the proportion answering correctly appeared to generally increase at posttest compared to pretest for intervention (P < 0.001) and control (P < 0.001) groups. There was over 10% improvement in 7 questions, and particularly, over 20% improvement for a question about clinical significance of anti-Müllerian hormone. Furthermore, directly comparing the difference in posttest versus pretest scores between the two groups showed, on average, greater improvements in the intervention group than the control group (P < 0.001).
Limitations, reasons for caution
As the intervention was educational material, it was not possible to blind participants to intervention group assignment. We were not able to monitor the participants when completing the tests; thus, whether they accessed other resources could not be addressed.
Wider implications of the findings
Providing information through a smartphone application can be considered acceptable since retrieving information through a smartphone application is in line with the current modern day lifestyle. A smartphone application may offer alternatives such as chatbots and movie-based learning, and they have the potential to increase the effectiveness.
Trial registration number
UMIN Clinical Trials Registry number UMIN000040721.
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Affiliation(s)
- R Yokomizo
- National Center for Child Health and Development Research Institute, Center for Regenerative Medicine, Tokyo, Japan
- The Jikei University School of Medicine, Department of Obstetrics and Gynecology, Tokyo, Japan
- National Center for Child Health and Development, Center for Maternal-Fetal- Neonatal and Reproductive Medicine, Tokyo, Japan
| | - A Nakamura
- MTI Ltd., Department of Healthcare Business, Tokyo, Japan
| | - M Sato
- MTI Ltd., Department of Healthcare Business, Tokyo, Japan
| | - R Nasu
- MTI Ltd., Department of Healthcare Business, Tokyo, Japan
| | - M Hine
- MTI Ltd., Department of Healthcare Business, Tokyo, Japan
| | - K Y Urayama
- National Center for Child Health and Development, Department of Social Medicine, Tokyo, Japan
- St. Luke’s International University, Graduate School of Public Health, Tokyo, Japan
| | - H Kishi
- The Jikei University School of Medicine, Department of Obstetrics and Gynecology, Tokyo, Japan
| | - H Sago
- National Center for Child Health and Development, Center for Maternal-Fetal- Neonatal and Reproductive Medicine, Tokyo, Japan
| | - A Okamoto
- The Jikei University School of Medicine, Department of Obstetrics and Gynecology, Tokyo, Japan
| | - A Umezawa
- National Center for Child Health and Development Research Institute, Center for Regenerative Medicine, Tokyo, Japan
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Cozen W, Timofeeva MN, Li D, Diepstra A, Hazelett D, Delahaye-Sourdeix M, Edlund CK, Franke L, Rostgaard K, Van Den Berg DJ, Cortessis VK, Smedby KE, Glaser SL, Westra HJ, Robison LL, Mack TM, Ghesquieres H, Hwang AE, Nieters A, de Sanjose S, Lightfoot T, Becker N, Maynadie M, Foretova L, Roman E, Benavente Y, Rand KA, Nathwani BN, Glimelius B, Staines A, Boffetta P, Link BK, Kiemeney L, Ansell SM, Bhatia S, Strong LC, Galan P, Vatten L, Habermann TM, Duell EJ, Lake A, Veenstra RN, Visser L, Liu Y, Urayama KY, Montgomery D, Gaborieau V, Weiss LM, Byrnes G, Lathrop M, Cocco P, Best T, Skol AD, Adami HO, Melbye M, Cerhan JR, Gallagher A, Taylor GM, Slager SL, Brennan P, Coetzee GA, Conti DV, Onel K, Jarrett RF, Hjalgrim H, van den Berg A, McKay JD. A meta-analysis of Hodgkin lymphoma reveals 19p13.3 TCF3 as a novel susceptibility locus. Nat Commun 2014; 5:3856. [PMID: 24920014 PMCID: PMC4055950 DOI: 10.1038/ncomms4856] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 04/11/2014] [Indexed: 12/20/2022] Open
Abstract
Recent genome-wide association studies (GWAS) of Hodgkin lymphoma (HL) have identified associations with genetic variation at both HLA and non-HLA loci; however, much of heritable HL susceptibility remains unexplained. Here we perform a meta-analysis of three HL GWAS totaling 1,816 cases and 7,877 controls followed by replication in an independent set of 1,281 cases and 3,218 controls to find novel risk loci. We identify a novel variant at 19p13.3 associated with HL (rs1860661; odds ratio (OR)=0.81, 95% confidence interval (95% CI) = 0.76-0.86, P(combined) = 3.5 × 10(-10)), located in intron 2 of TCF3 (also known as E2A), a regulator of B- and T-cell lineage commitment known to be involved in HL pathogenesis. This meta-analysis also notes associations between previously published loci at 2p16, 5q31, 6p31, 8q24 and 10p14 and HL subtypes. We conclude that our data suggest a link between the 19p13.3 locus, including TCF3, and HL risk.
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Affiliation(s)
- W Cozen
- 1] USC Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California 90089-9175, USA [2]
| | - M N Timofeeva
- 1] International Agency for Research on Cancer (IARC), 69372 Lyon, France [2] Institute of Genetics and Molecular Medicine, University of Edinburgh, EH4 2XU Edinburgh, UK [3]
| | | | - A Diepstra
- 1] University of Groningen, University Medical Centre Groningen, 9700 RB Groningen, The Netherlands [2]
| | - D Hazelett
- 1] USC Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California 90089-9175, USA [2]
| | - M Delahaye-Sourdeix
- 1] International Agency for Research on Cancer (IARC), 69372 Lyon, France [2]
| | - C K Edlund
- USC Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California 90089-9175, USA
| | - L Franke
- University of Groningen, University Medical Centre Groningen, 9700 RB Groningen, The Netherlands
| | - K Rostgaard
- Statens Serum Institut, DK-2300 Copenhagen, Denmark
| | - D J Van Den Berg
- USC Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California 90089-9175, USA
| | - V K Cortessis
- USC Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California 90089-9175, USA
| | - K E Smedby
- Karolinska Institutet and Karolinska University Hospital, S-221 00 Stockholm, Sweden
| | - S L Glaser
- Cancer Prevention Institute of California, Fremont, California 94538, USA
| | - H-J Westra
- University of Groningen, University Medical Centre Groningen, 9700 RB Groningen, The Netherlands
| | - L L Robison
- St Jude Children's Hospital, Cordova, Tennessee 38105, USA
| | - T M Mack
- USC Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California 90089-9175, USA
| | - H Ghesquieres
- Centre Léon Bérard, UMR CNRS 5239-Université Lyon 1, 69008 Lyon, France
| | - A E Hwang
- USC Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California 90089-9175, USA
| | - A Nieters
- University Medical Centre Freiburg, D-79085 Freiburg, Germany
| | - S de Sanjose
- IDIBELL Institut Català d'Oncologia, 8907 Barcelona, Spain
| | | | - N Becker
- German Cancer Research Centre, D-69120 Heidelberg, Germany
| | - M Maynadie
- CHU de Dijon, EA 4184, University of Burgundy, 21070 Dijon, France
| | - L Foretova
- Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic
| | - E Roman
- University of York, YO10 5DD York, UK
| | - Y Benavente
- IDIBELL Institut Català d'Oncologia, 8907 Barcelona, Spain
| | - K A Rand
- USC Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California 90089-9175, USA
| | - B N Nathwani
- City of Hope National Medical Center, Duarte, California 91010, USA
| | | | - A Staines
- School of Nursing and Human Sciences, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - P Boffetta
- Icahn School of Medicine at Mount Sinai, New York City, New York 10029-6574, USA
| | - B K Link
- University of Iowa College of Medicine, Iowa City, Iowa 52242, USA
| | - L Kiemeney
- Radboud University Nijmegen Medical Centre, 6500HB Nijmegen, The Netherlands
| | - S M Ansell
- Mayo Clinic, Rochester, Minnesota 55905, USA
| | - S Bhatia
- City of Hope National Medical Center, Duarte, California 91010, USA
| | - L C Strong
- MD Anderson Cancer Center, University of Texas, Houston, Texas 77030, USA
| | - P Galan
- INSERM U557 (UMR Inserm; INRA; CNAM, Université Paris 13), 93017 Paris, France
| | - L Vatten
- Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
| | | | - E J Duell
- IDIBELL Institut Català d'Oncologia, 8907 Barcelona, Spain
| | - A Lake
- MRC University of Glasgow Centre for Virus Research, Garscube Estate, University of Glasgow, G12 8QQ Glasgow, Scotland, UK
| | - R N Veenstra
- University of Groningen, University Medical Centre Groningen, 9700 RB Groningen, The Netherlands
| | - L Visser
- University of Groningen, University Medical Centre Groningen, 9700 RB Groningen, The Netherlands
| | - Y Liu
- University of Groningen, University Medical Centre Groningen, 9700 RB Groningen, The Netherlands
| | - K Y Urayama
- Department of Human Genetics and Disease Diversity, Tokyo Medical and Dental University, Tokyo 104-0044, Japan
| | - D Montgomery
- MRC University of Glasgow Centre for Virus Research, Garscube Estate, University of Glasgow, G12 8QQ Glasgow, Scotland, UK
| | - V Gaborieau
- International Agency for Research on Cancer (IARC), 69372 Lyon, France
| | - L M Weiss
- Clarient Pathology Services, Aliso Viejo, California 92656, USA
| | - G Byrnes
- International Agency for Research on Cancer (IARC), 69372 Lyon, France
| | - M Lathrop
- Genome Quebec, Montreal, Canada H3A 0G1
| | - P Cocco
- Institute of Occupational Health, University of Cagliari, Monserrato, 09042 Cagliari, Italy
| | - T Best
- The University of Chicago, Chicago, Illinois 60637-5415, USA
| | - A D Skol
- The University of Chicago, Chicago, Illinois 60637-5415, USA
| | - H-O Adami
- 1] Karolinska Institutet and Karolinska University Hospital, S-221 00 Stockholm, Sweden [2] Harvard University School of Public Health, Boston, Massachusetts 02115, USA
| | - M Melbye
- Statens Serum Institut, DK-2300 Copenhagen, Denmark
| | - J R Cerhan
- Mayo Clinic, Rochester, Minnesota 55905, USA
| | - A Gallagher
- MRC University of Glasgow Centre for Virus Research, Garscube Estate, University of Glasgow, G12 8QQ Glasgow, Scotland, UK
| | - G M Taylor
- School of Cancer Sciences, University of Manchester, St Mary's Hospital, M13 0JH Manchester, UK
| | - S L Slager
- Mayo Clinic, Rochester, Minnesota 55905, USA
| | - P Brennan
- International Agency for Research on Cancer (IARC), 69372 Lyon, France
| | - G A Coetzee
- USC Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California 90089-9175, USA
| | - D V Conti
- USC Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California 90089-9175, USA
| | - K Onel
- 1] The University of Chicago, Chicago, Illinois 60637-5415, USA [2]
| | - R F Jarrett
- 1] MRC University of Glasgow Centre for Virus Research, Garscube Estate, University of Glasgow, G12 8QQ Glasgow, Scotland, UK [2]
| | - H Hjalgrim
- 1] Statens Serum Institut, DK-2300 Copenhagen, Denmark [2]
| | - A van den Berg
- 1] University of Groningen, University Medical Centre Groningen, 9700 RB Groningen, The Netherlands [2]
| | - J D McKay
- 1] International Agency for Research on Cancer (IARC), 69372 Lyon, France [2]
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