227 hot topic(s) found with the query "Digital health"
International perspectives on measuring national digital public health system maturity through a multidisciplinary Delphi study
L Ma et al, NPJ Digital Medicine, April 12, 2024
(Posted: Apr 12, 2024 9AM)
From the abstract: "Unlocking the full potential of digital public health (DiPH) systems requires a comprehensive tool to assess their maturity. While the World Health Organization and the International Telecommunication Union released a toolkit in 2012 covering various aspects of digitalizing national healthcare systems, a holistic maturity assessment tool has been lacking ever since. To bridge this gap, we conducted a pioneering Delphi study, to which 54 experts from diverse continents and academic fields actively contributed to at least one of three rounds. 54 experts participated in developing and rating multidisciplinary quality indicators to measure the maturity of national digital public health systems. "
Improved measurement of disease progression in people living with early Parkinson's disease using digital health technologies.
Matthew D Czech et al. Commun Med (Lond) 2024 3 (1) 49
(Posted: Mar 18, 2024 9AM)
From the abstract: "Digital health technologies show promise for improving the measurement of Parkinson’s disease in clinical research and trials. However, it is not clear whether digital measures demonstrate enhanced sensitivity to disease progression compared to traditional measurement approaches. We develop a wearable sensor-based digital algorithm for deriving features of upper and lower-body bradykinesia and evaluate the sensitivity of digital measures to 1-year longitudinal progression using data from the WATCH-PD study, a multicenter, observational digital assessment study in participants with early, untreated Parkinson’s disease. "
Genetics Adviser: The development and usability testing of a new patient digital health application to support clinical genomic testing.
M CLausen et al, Genetics in Med Open, January 24, 2024
(Posted: Jan 23, 2024 8AM)
From the abstract: " Increasing demand for genomic testing coupled with genetics workforce shortages has placed unsustainable pressure on standard models of care. Digital tools can offer improved access, efficiency, and cost savings. We created a patient-facing digital health application to support genomic testing.
We developed the digital application through user-centered design, guided by an advisory board. We tested its usability and acceptability with patients, practitioners and members of the general public using mixed methods."
A digital health algorithm to guide antibiotic prescription in pediatric outpatient care: a cluster randomized controlled trial.
Rainer Tan et al. Nat Med 2023 12
(Posted: Dec 22, 2023 10AM)
From the abstract: "Excessive antibiotic use and antimicrobial resistance are major global public health threats. We developed ePOCT+, a digital clinical decision support algorithm in combination with C-reactive protein test, hemoglobin test, pulse oximeter and mentorship, to guide health-care providers in managing acutely sick children under 15?years old. To evaluate the impact of ePOCT+ compared to usual care, we conducted a cluster randomized controlled trial in primary care facilities. The use of ePOCT+ in intervention facilities resulted in a reduction in the coprimary outcome of antibiotic prescription compared to usual care (23.2% versus 70.1%, adjusted difference -46.4%, 95% confidence interval (CI) -57.6 to -35.2). "
Wearable Digital Health Technology
SH Friend et al, NEJM, November 29, 2023
(Posted: Nov 30, 2023 9AM)
From the article: " Increasingly, wearables are being used by medical professionals to provide clinical data on their patients and for their patients. This digital health technology (DHT) that is worn by patients and connected through mobile apps or personal digital assistants can be used for disease monitoring, diagnostics, alerts, or other clinical care services. "
Strengthening digital health equity by balancing techno-optimism and techno-skepticism through implementation science.
Jorge A Rodriguez et al. NPJ Digit Med 2023 11 (1) 203
(Posted: Nov 03, 2023 8AM)
From the abstract: " The promise that technology can revolutionize care by better connecting us to our patients, overcoming analog barriers to care, and addressing health disparities is grounded in “techno-optimism.” We advocate for organizational leaders to inform their digital health equity strategies with a balanced measure of “techno-skepticism”, grounded in implementation science, that can ensure alignment between health technology and health equity.
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Digital health tools in genomics: Advancing diversity, equity and inclusion
D Assamad et al, Public Health Genomics, November 2023
(Posted: Nov 02, 2023 9AM)
From the paper: "Patient-facing digital genomic tools are increasingly being used to facilitate the delivery of genetics services including patient intake, phenotyping, education, counseling, and result reporting. A recent systematic review found that digital tools improved the workflow of genetics providers and service efficiencies. Existing data on patient experiences also demonstrate high acceptance of pre-test digital tools across various contexts, with most
patients endorsing and expressing high levels of satisfaction with these tools. However, a closer examination of digital genomic tools reveals a concerning lack of consideration for diversity,
equity, and inclusion (DEI) principles in their design, evaluation, and implementation within health systems [ "
Prevalence and course of pregnancy symptoms using self-reported pregnancy app symptom tracker data
M Nissen et al, NPJ Digital Medicine, October 11, 2023
(Posted: Oct 11, 2023 4PM)
From the abstract: "We report real-world evidence from patient-reported outcomes that exceeds previous works: 1,549,186 tracked symptoms from 183,732 users of a smartphone pregnancy app symptom tracker are analyzed. The majority of users track symptoms on a single day. These data are generalizable to those users who use the tracker for at least 5 months. Week-by-week symptom report data are presented for each symptom. "
Does clinical research account for diversity in deploying digital health technologies?
NA Coss et al, NPJ Digital Medicine, October 10, 2023
(Posted: Oct 10, 2023 9AM)
From the abstract: "Digital health technologies (DHTs) should expand access to clinical research to represent the social determinants of health (SDoH) across the population. The frequency of reporting participant SDoH data in clinical publications is low and is not known for studies that utilize DHTs. We evaluated representation of 11 SDoH domains in 126 DHT-enabled clinical research publications and proposed a framework under which these domains could be captured and subsequently reported in future studies. "
Barriers and facilitators to utilizing digital health technologies by healthcare professionals
I Junior et al, NPJDigital Medicine, September 18, 2023
(Posted: Sep 18, 2023 11AM)
From the abstract: "High-quality evidence suggested that infrastructure and technical barriers (Relative Frequency Occurrence [RFO] 6.4% [95% CI 2.9–14.1]), psychological and personal issues (RFO 5.3% [95% CI 2.2–12.7]), and concerns of increasing working hours or workload (RFO 3.9% [95% CI 1.5–10.1]) were common concerns reported by HPs. Likewise, high-quality evidence supports that training/educational programs, multisector incentives, and the perception of technology effectiveness facilitate the adoption of digital technologies by HPs. "
Considerations for addressing bias in artificial intelligence for health equity
Abramoff MD, et al, NPJ Digital Medicine, September 12, 2023
(Posted: Sep 13, 2023 0PM)
From the abstract: "Health equity is a primary goal of healthcare stakeholders: patients and their advocacy groups, clinicians, other providers and their professional societies, bioethicists, payors and value based care organizations, regulatory agencies, legislators, and creators of artificial intelligence/machine learning (AI/ML)-enabled medical devices. Lack of equitable access to diagnosis and treatment may be improved through new digital health technologies, especially AI/ML, but these may also exacerbate disparities, depending on how bias is addressed. "
Cost effectiveness review of text messaging, smartphone application, and website interventions targeting T2DM or hypertension.
Ruben Willems et al. NPJ Digit Med 2023 8 (1) 150
(Posted: Aug 21, 2023 8AM)
Digital health interventions have been shown to be clinically-effective for type 2 diabetes mellitus (T2DM) and hypertension prevention and treatment. This study synthesizes and compares the cost-effectiveness of text-messaging, smartphone application, and websites. We found that digital interventions are cost-effective without substantial differences between the different delivery modes. Future health economic studies should increase transparency, conduct sufficient sensitivity analyses, and appraise the ICUR more critically in light of a reasoned willingness-to-pay threshold.
Pulse oximetry values from 33,080 participants in the Apple Heart & Movement Study
I Shapiro et al, NPJ Digital Medicine, July 27, 2023
(Posted: Jul 27, 2023 7AM)
Wearable devices that include pulse oximetry (SpO2) sensing afford the opportunity to capture oxygen saturation measurements from large cohorts under naturalistic conditions. We report here a cross-sectional analysis of 72 million SpO2 values collected from 33,080 individual participants in the Apple Heart and Movement Study, stratified by age, sex, body mass index (BMI), home altitude, and other demographic variables. Measurements aggregated by hour of day into 24-h SpO2 profiles exhibit similar circadian patterns for all demographic groups.
Just-in-Time Digital Health Interventions-Start of a New Era With Much More to Do.
Raman Khanna et al. JAMA Intern Med 2023 7
(Posted: Jul 19, 2023 1PM)
It is into this new era that just-in-time interventions (JITIs) were launched, integrating software in the form of DHTs with existing medical devices, including medication delivery devices and real-time contextual information to prompt users to take certain actions, or in some cases, to perform those actions directly.3 By becoming patient context-specific, JITIs increased their theoretical power.4 For example, JITIs may remind patients to take medications at the proper time, administer insulin from an implanted pump when the monitor indicates glucose levels are high, and discourage users from going into a corner store where they typically buy high-sugar food products. Do these JITIs actually work, however?
Digital health for aging populations.
Chuanrui Chen et al. Nat Med 2023 7 (7) 1623-1630
(Posted: Jul 19, 2023 7AM)
Growing life expectancy poses important societal challenges, placing an increasing burden on ever more strained health systems. Digital technologies offer tremendous potential for shifting from traditional medical routines to remote medicine and transforming our ability to manage health and independence in aging populations. In this Perspective, we summarize the current progress toward, and challenges and future opportunities of, harnessing digital technologies for effective geriatric care. Special attention is given to the role of wearables in assisting older adults to monitor their health and maintain independence at home.
Randomized-controlled trial assessing a digital care program versus conventional physiotherapy for chronic low back pain
D Cui et al, NPJ Digital Medicine, July 7, 2023
(Posted: Jul 10, 2023 8AM)
This randomized controlled trial (RCT) aims to compare the clinical outcomes of patients with CLBP following a digital intervention versus evidence-based in-person physiotherapy. Our results demonstrate that patient satisfaction and adherence were high and similar between groups, although a significantly lower dropout rate is observed in the digital group (11/70, 15.7% versus 24/70, 34.3% in the conventional group; P?=?0.019). Both groups experience significant improvements in disability (primary outcome), with no differences between groups in change from baseline,
Assessing statins use in a real-world primary care digital strategy: a cross-sectional analysis of a population-wide digital health approach
MJM Carrion et al, Lancet Regional Health, June 22, 2023
(Posted: Jun 26, 2023 8AM)
The digitization of the primary care system provides an opportunity to evaluate the current use of statins in secondary prevention populations (myocardial infarction or stroke). We conducted a cross-sectional study analysing anonymised data routinely collected by community health workers (CHW) between May 2016 and September 2021 to assess the proportion of self-reported statins use and associated factors. The analysis of a real-world database from a digitized primary care system, allowed us to identify a very low use of statins in secondary prevention patients, mostly influenced by socio-demographic factors and co-morbidities.
Rigorous and rapid evidence assessment in digital health with the evidence DEFINED framework
J Silberman et al, NPJ Digital Medicine, May 31, 2023
(Posted: May 31, 2023 7AM)
We propose a framework to assess Evidence in Digital health for EFfectiveness of INterventions with Evaluative Depth (Evidence DEFINED). Designed for real-world use, the Evidence DEFINED Quick Start Guide may help streamline DHI assessment. A checklist is provided summarizing high-priority evidence considerations in digital health. Evidence-to-recommendation guidelines are proposed, specifying degrees of adoption that may be appropriate for a range of evidence quality levels. Evidence DEFINED differs from prior frameworks in its inclusion of unique elements designed for rigor and speed.
Advancing heart failure research using machine learning
MA Mohammad, The Lancet Digital Health, June 2023
(Posted: May 25, 2023 8AM)
Machine learning has demonstrated significant potential in various medical research fields and has the potential to uncover intricate associations and the ability to identify subtypes of heart failure beyond those that are currently recognised, improve risk prediction, and ultimately pave the way for personalised medicine.
Wearable devices: underrepresentation in the ageing society
TW Guu et al, The Lancet Digital Health, June 2023
(Posted: May 25, 2023 8AM)
Wearable devices and smartphone applications could help health-care professionals gain insight into the spectrum of dementia conditions in a real-time, longitudinal, and more objective manner. Well validated devices and algorithms have the potential to assist in tracking cognitive and functional trajectories, monitoring social behaviour changes, preventing falls, and potentially relieving care-giver burden.
Digital health technology in clinical trials.
Mirja Mittermaier et al. NPJ Digit Med 2023 5 (1) 88
(Posted: May 19, 2023 10AM)
Digital health technologies (DHTs) have brought several significant improvements to clinical trials, enabling real-world data collection outside of the traditional clinical context and more patient-centered approaches. DHTs, such as wearables, allow the collection of unique personal data at home over a long period. But DHTs also bring challenges, such as digital endpoint harmonization and disadvantaging populations already experiencing the digital divide.
Children must co-design digital health research
The Lancet Digital Health editorial, April 2023
(Posted: Apr 09, 2023 7AM)
A recent umbrella review has shown promise in the use of digital health interventions to reduce risk behaviours in adolescents, including improving physical activity and diet. Digital health interventions have also been proven to reduce alcohol use in adolescents in long-term studies. However, the 2021 WHO framework on developing youth-centred digital health interventions highlights that digital health is not a silver bullet. So, can technology really improve health behaviour in children?
Evolving regulatory perspectives on digital health technologies for medicinal product development
S Colloud et al, NPJ Digital Medicine, March 29, 2023
(Posted: Mar 29, 2023 9AM)
This review is comprised of four case studies of DHTTs used throughout the lifecycle of medicinal products, starting from their development. These cases illustrate how the regulatory requirements of DHTTs used in medicines development are based on two European regulatory frameworks (medical device and the medicinal product regulations) and highlight the need for increased collaboration between various stakeholders, including regulators (medicines regulators and device bodies), pharmaceutical sponsors, manufacturers of devices and software, and academia.
Digital cognitive behavioral therapy for insomnia on depression and anxiety: a systematic review and meta-analysis
S Lee et al, NPJ Digital Medicine, March 25, 2023
(Posted: Mar 25, 2023 8AM)
Despite research into the development of digital cognitive behavioral therapy for insomnia (dCBT-I), research into the outcomes of dCBT-I on insomnia and the associated clinical conditions of depression and anxiety have been limited. The PubMed, PsycINFO (Ovid), Embase, and Cochrane databases were searched for randomized controlled trials (RCTs) on adult patients with insomnia also having reported measures of depressive or anxiety symptoms. We found that digital intervention for insomnia yielded significant effects on alleviating depressive and anxiety symptoms as well as insomnia symptoms. Specifically, the study demonstrated significant effects on the above symptoms when considering treatment adherence and implementing fully automated dCBT-I.
Digital therapeutics from bench to bedside
C Wang et al, NPJ Digital Medicine, March 10, 2023
(Posted: Mar 10, 2023 3PM)
As a new therapeutic technique based on digital technology, the commercialization and clinical application of digital therapeutics (DTx) are increasing, and the demand for expansion to new clinical fields is remarkably high. However, the use of DTx as a general medical component is still ambiguous, and this ambiguity may be owing to a lack of consensus on a definition, in addition to insufficiencies in research and development, clinical trials, standardization of regulatory frameworks, and technological maturity.
A "one-size-fits-most" walking recognition method for smartphones, smartwatches, and wearable accelerometers.
Marcin Straczkiewicz et al. NPJ digital medicine 2023 2 (1) 29
(Posted: Feb 26, 2023 8AM)
We propose a walking recognition method for sub-second tri-axial accelerometer data, in which activity classification is based on the inherent features of walking: intensity, periodicity, and duration. We validate our method against 20 publicly available, annotated datasets on walking activity data collected at various body locations (thigh, waist, chest, arm, wrist). We demonstrate that our method can estimate walking periods with high sensitivity and specificity:
The role of patient-reported outcome measures in trials of artificial intelligence health technologies: a systematic evaluation of ClinicalTrials.gov records (1997–2022)
FJ Pierce et al., The Lancet Digital Health, February 2023
(Posted: Feb 23, 2023 9AM)
The search identified 2958 trials, of which 627 were included in the analysis. 152 (24%) of the included trials used one or more PROM, visual analogue scale, patient-reported experience measure, or usability measure as a trial endpoint. The type of AI health technologies used by these trials included AI-enabled smart devices, clinical decision support systems, and chatbots. The number of clinical trials of AI health technologies registered on ClinicalTrials.gov and the proportion of trials that used PROMs increased from registry inception to 2022.
Digital health interventions for non-communicable disease management in primary health care in low-and middle-income countries
S Xiong et al, NPJ Digital Medicine, February 1, 2023
(Posted: Feb 01, 2023 6AM)
Of 8866 results, 52 met eligibility criteria (31 reviews, 21 trials). Benchmarked against World Health Organization’s digital health classifications, only 14 out of 28 digital health intervention categories are found, suggesting critical under-use and lagging innovation. Digital health interventions’ effectiveness vary across outcomes: clinical (mixed), behavioral (positively inclined), and service implementation outcomes (clear effectiveness).
The evolution of digital health technologies in cardiovascular disease research
CZ Zwack et al, NPJ Digital Medicine, January 3, 2023
(Posted: Jan 04, 2023 6AM)
A recent emergence of research activities in digital technology in cardiovascular rehabilitation (CR), out-of-hospital cardiac arrest (OHCA), and arrythmia research was also demonstrated. Conversely, wearable technologies, activity tracking and electronic medical records research are now past their peak of reported research activity. With increasing amounts of novel technologies becoming available and more patients taking part in remote health care monitoring, further evaluation and research into digital technologies is needed.
DIGItal Health Literacy after COVID-19 Outbreak among Frail and Non-Frail Cardiology Patients: The DIGI-COVID Study
M Vitolo et al, J Per Med, December 31, 2020
(Posted: Dec 31, 2022 7AM)
A total of 300 patients were enrolled (36.3% females, median age 75 (66–84)) and stratified according to frailty status as robust (EFS = 5; 70.7%), pre-frail (EFS 6–7; 15.7%), and frail (EFS = 8; 13.7%). Frail and pre-frail patients used digital tools less frequently and accessed the Internet less frequently compared to robust patients. In the logistic regression analysis, frail patients were significantly associated with the non-use of the Internet (adjusted odds ratio 2.58, 95% CI 1.92–5.61) compared to robust and pre-frail patients. Digital health literacy decreased as the level of frailty increased in all the digital domains examined.
Factors associated with long-term use of digital devices in the electronic Framingham Heart Study
CH Pathiravasan et al, NPJ Digital Medicine, December 27, 2022
(Posted: Dec 27, 2022 0PM)
Long-term use of digital devices is critical for successful clinical or research use, but digital health studies are challenged by a rapid drop-off in participation. A nested e-cohort (eFHS) is embedded in the Framingham Heart Study and uses three system components: a new smartphone app, a digital blood pressure (BP) cuff, and a smartwatch. This study aims to identify factors associated with the use of individual eFHS system components over 1-year.
Digital health tools to support parents with parent-infant sleep and mental well-being
HL Ball et al, NPJ Digital Medicine, December 21, 2022
(Posted: Dec 21, 2022 8AM)
Digital technology has been developed to support parents in the following four ways: (1) providing digital information on infant sleep, (2) offering targeted support for night-time care, (3) managing infant sleep and (4) monitoring infant sleep and safety. Evidence on the effectiveness of these strategies is varied and there are concerns regarding the reliability of information, use of personal data, commercial exploitation of parents, and the effects of replacing caregiver presence with digital technology.
Editorial: Digitalization for precision healthcare
F Cascini et al, Front Public Health, December 2022
(Posted: Dec 21, 2022 8AM)
The creation of digital infrastructure and technologies to collect, analyse and connect electronic health and life-science data supports—now more than ever—the growth of precision healthcare. However, the current adoption of digital health tools and infrastructures is geographically variable and often missing an assessment, as shown in a systematic review of the cost-effectiveness of digital interventions. This lacking approach to the digitalisation of the health sector has the effect of wasting resources with no improvement in care.
Digital health technology-specific risks for medical malpractice liability
SP Rowland et al, NPJ Digital Medicine, October 20, 2022
(Posted: Oct 20, 2022 6AM)
Medical professionals are increasingly required to use digital technologies as part of care delivery and this may represent a risk for medical error and subsequent malpractice liability. For example, if there is a medical error, should the error be attributed to the clinician or the artificial intelligence-based clinical decision-making system? In this article, we identify and discuss digital health technology-specific risks for malpractice liability and offer practical advice for the mitigation of malpractice risk.
HIV Prevention: Digital Health Interventions to Improve Adherence to HIV Pre-Exposure Prophylaxis
The Community Guide, October 2022
(Posted: Oct 13, 2022 6AM)
The Community Preventive Services Task Force (CPSTF) recommends digital health interventions to increase adherence to HIV pre-exposure prophylaxis (PrEP). Systematic review evidence shows interventions improve both daily-use pill taking and retention in PrEP care. This improves health for population groups who are not infected with HIV and engage in behaviors that may increase their chances of getting HIV.
Translational gaps and opportunities for medical wearables in digital health.
Xu Shuai et al. Science translational medicine 2022 10 (666) eabn6036
(Posted: Oct 13, 2022 6AM)
Medical grade wearables—noninvasive, on-body sensors operating with clinical accuracy—will play an increasingly central role in medicine by providing continuous, cost-effective measurement and interpretation of physiological data relevant to patient status and disease trajectory, both inside and outside of established health care settings. Here, we review current digital health technologies and highlight critical gaps to clinical translation and adoption.
A deep learning model for detection of Alzheimer's disease based on retinal photographs: a retrospective, multicentre case-control study
CY Cheung et al, The Lancet Digital Health, September 30, 2022
(Posted: Oct 03, 2022 6AM)
12?949 retinal photographs from 648 patients with Alzheimer's disease and 3240 people without the disease were used to train, validate, and test the deep learning model. In the internal validation dataset, the deep learning model had 83·6% (SD 2·5) accuracy, 93·2% (SD 2·2) sensitivity, 82·0% (SD 3·1) specificity, and an area under the receiver operating characteristic curve (AUROC) of 0·93 (0·01) for detecting Alzheimer's disease-dementia.
Artificial intelligence for detection of Alzheimer's disease: demonstration of real-world value is required to bridge the translational gap
CR Marshall et al, The Lancet Digital Health, September 30, 2022
(Posted: Oct 03, 2022 6AM)
The wide availability of retinal photography could, in principle, support detection of Alzheimer's disease at population level, allowing earlier access to support and treatment. This raises important questions that have yet to be resolved around what constitutes a timely diagnosis of Alzheimer's disease, and how effectively earlier detection improves quality of life, prognosis, and future health-care resource requirements.
Health digital twins as tools for precision medicine: Considerations for computation, implementation, and regulation
KP Venkatesh et al, NPJ Digital Medicine, Sepetmber 22, 2022
(Posted: Sep 23, 2022 7AM)
Health digital twins are defined as virtual representations (“digital twin”) of patients (“physical twin”) that are generated from multimodal patient data, population data, and real-time updates on patient and environmental variables. With appropriate use, HDTs can model random perturbations on the digital twin to gain insight into the expected behavior of the physical twin—offering groundbreaking applications in precision medicine, clinical trials, and public health.
The health digital twin to tackle cardiovascular disease—a review of an emerging interdisciplinary field
G Coorey et al, NPJ Digital Medicine, August 26, 2022
(Posted: Aug 26, 2022 8AM)
Potential benefits of precision medicine in cardiovascular disease (CVD) include more accurate phenotyping of individual patients with the same condition or presentation, using multiple clinical, imaging, molecular and other variables to guide diagnosis and treatment. An approach to realizing this potential is the digital twin concept, whereby a virtual representation of a patient is constructed and receives real-time updates of a range of data variables in order to predict disease and optimize treatment selection for the real-life patient.
Regulatory considerations to keep pace with innovation in digital health products
J Torous et al, NPJ Digital Medicine, August 19, 2022
(Posted: Aug 19, 2022 11AM)
Current regulatory pathways were developed for traditional (hardware) medical devices and offer a useful structure, but the evolution of digital devices requires concomitant innovation in regulatory approaches to maximize the potential benefits of these emerging technologies. A number of specific adaptations could strengthen current regulatory oversight while promoting ongoing innovation.
The diagnostic and triage accuracy of digital and online symptom checker tools: a systematic review
W Wallace et al, NPJ Digital Medicine, August 18, 2022
(Posted: Aug 18, 2022 1PM)
Researchers evaluated the accuracy of symptom checkers using a variety of medical conditions, including ophthalmological conditions, inflammatory arthritides and HIV. The diagnostic accuracy of the primary diagnosis was low across included studies (range: 19–37.9%) and varied between individual symptom checkers, despite consistent symptom data input. Triage accuracy (range: 48.8–90.1%) was typically higher than diagnostic accuracy. Overall, the diagnostic and triage accuracy of symptom checkers are variable and of low accuracy.
A framework for digital health equity
S Richardson, NPJ Digital Medicine, August 18, 2022
(Posted: Aug 18, 2022 1PM)
We present a comprehensive Framework for Digital Health Equity, detailing key digital determinants of health (DDoH), to support the work of digital health tool creators in industry, health systems operations, and academia. The rapid digitization of healthcare may widen health disparities if solutions are not developed with these determinants in mind. We examine DDoHs at the individual, interpersonal, community, and societal levels, and discuss the importance of a root cause, multi-level approach.
A systems approach towards remote health-monitoring in older adults: Introducing a zero-interaction digital exhaust
N Shutz et al, NPJ Digital Medicine, August 16, 2022
(Posted: Aug 16, 2022 10AM)
We introduce and describe a zero-interaction digital exhaust: a set of 1268 digital measures that cover large parts of a person’s activity, behavior and physiology. Making this approach more inclusive of older adults, we base this set entirely on contactless, zero-interaction sensing technologies. Applying the resulting digital exhaust to real-world data, we then demonstrate the possibility to create multiple ageing relevant digital clinical outcome assessments. Paired with modern machine learning, we find these assessments to be surprisingly powerful and often on-par with mobile approaches
The cost-effectiveness of digital health interventions: A systematic review of the literature
A Gentili et al, Front Public Health, August 2022
(Posted: Aug 11, 2022 7AM)
The studies were heterogeneous by country (mostly conducted in upper and upper-middle income countries), type of eHealth intervention, method of implementation, and reporting perspectives. The qualitative analysis identified the economic and effectiveness evaluation of six different types of interventions: (1) seventeen studies on new video-monitoring service systems; (2) five studies on text messaging interventions; (3) five studies on web platforms and digital health portals; (4) two studies on telephone support; (5) three studies on new mobile phone-based systems and applications; and (6) three studies on digital technologies and innovations.
The Need for Electronic Health Records to Support Delivery of Behavioral Health Preventive Services.
Huffstetler Alison N et al. JAMA 2022 8
(Posted: Aug 06, 2022 8AM)
To accomplish digital health goals, it is essential to adhere to 3 key principles. First, digital health systems need to make it easy for clinicians to deliver national guidelines and quality recommendations. Second, digital health systems need to make information actionable for clinicians and patients. Third, digital health systems need to be easy to use; they should be intuitive for users, easily accessible, and not require complex workflows to enter and retrieve data.
Remote COVID-19 Assessment in Primary Care (RECAP) risk prediction tool: derivation and real-world validation studies
AE Gonzales et al, The Lancet Digital Health, July 28, 2022
(Posted: Jul 31, 2022 7AM)
Accurate assessment of COVID-19 severity in the community is essential for patient care and requires COVID-19-specific risk prediction scores adequately validated in a community setting. We aimed to develop and validate two COVID-19-specific risk prediction scores. Remote COVID-19 Assessment in Primary Care-General Practice score (RECAP-GP; without peripheral oxygen saturation [SpO2]) and RECAP-oxygen saturation score (RECAP-O2; with SpO2). RECAP was a prospective cohort study that used multivariable logistic regression. Data on signs and symptoms (predictors) of disease were collected from community-based patients with suspected COVID-19 via primary care electronic health records and linked with secondary data on hospital admission (outcome) within 28 days of symptom onset.
A Systematic Scoping Review of Digital Health Technologies During COVID-19: A New Normal in Primary Health Care Delivery
C Ndayshimie et al, Research Square, July 19, 2022
(Posted: Jul 20, 2022 7AM)
A total of 46 studies were included in the final synthesis: 40 articles; one book; two book chapters; one working paper; and two technical reports. These studies scrutinized various aspects of DHTs, entailing 19 types of DHTs with 20 areas of use that can be compressed into five bigger PHC functions: general PHC service delivery (teleconsultations, e-diagnosis, e-prescription, etc.); behaviour promotion and digital health literacy (e.g., combating vaccine hesitancy); surveillance functions; vaccination and drugs; and enhancing system decision-making for proper follow-up of ongoing PHC interventions during COVID-19.
A systematic review of healthcare provider-targeted mobile applications for non-communicable diseases in low- and middle-income countries
P Geldsetzer et al, NPJ Digital Medicine, July 19, 2022
(Posted: Jul 19, 2022 7AM)
Cardiology was the most common clinical domain of the technologies evaluated, with 89 publications. mHealth innovations were predominantly developed using Apple’s iOS operating system. Cost data were provided in only 50 studies, but most technologies for which this information was available cost less than 20 USD. Only 24 innovations targeted the ten NCDs responsible for the greatest number of disability-adjusted life years lost globally. Most publications evaluated products created in high-income countries. Reported mHealth technologies are well-developed, but their implementation in LMICs faces operating system incompatibility and a relative neglect of NCDs causing the greatest disease burden.
Development of a multiomics model for identification of predictive biomarkers for COVID-19 severity: a retrospective cohort study
SK Byeon et al, The Lancet Digital Health, July 11, 2022
(Posted: Jul 14, 2022 6AM)
We quantified 1463 cytokines and circulatory proteins, along with 902 lipids and 1018 metabolites. By developing a machine-learning-based prediction model, a set of 102 biomarkers, which predicted severe and clinical COVID-19 outcomes better than the traditional set of cytokines, were discovered. These predictive biomarkers included several novel cytokines and other proteins, lipids, and metabolites.
The Promise of Digital Health: Then, Now, and the Future
A Abernathy et al, National Academy of Medicine discussion paper, June 27, 2022
(Posted: Jun 27, 2022 11AM)
Over the past several decades, the development and accelerated advancement of digital technology has prompted change across virtually all aspects of human endeavor. The positive and negative effects of these changes have been and will remain the focus of active speculation, including the implications for human health. Application of mechanical and digital recording and capture of physical status, experiences, and narratives have set the stage for revolutionary progress in individual health and medical management, population-wide health strategies, and integrated real-time generation of new knowledge and insights.
UK National Screening Committee's approach to reviewing evidence on artificial intelligence in breast cancer screening
S Taylor-Phillips et al, The Lancet Digital Health, July, 2022
(Posted: Jun 22, 2022 11AM)
When considering cancer detection, AI test sensitivity alone is not sufficiently informative, and additional information on the spectrum of disease detected and interval cancers is crucial to better understand the benefits and harms of screening. Although large retrospective studies might provide useful evidence by directly comparing test accuracy and spectrum of disease detected between different AI systems and by population subgroup, most retrospective studies are biased due to differential verification (ie, the use of different reference standards to verify the target condition among study participants).
Smartphone apps in the COVID-19 pandemic
JA Pandit et al, Nature Biotechnology, June 20,2022
(Posted: Jun 20, 2022 6PM)
Smartphone apps, given accessibility in the time of physical distancing, were widely used for tracking, tracing and educating the public about COVID-19. Despite limitations, such as concerns around data privacy, data security, digital health illiteracy and structural inequities, there is ample evidence that apps are beneficial for understanding outbreak epidemiology, individual screening and contact tracing. While there were successes and failures in each category, outbreak epidemiology and individual screening were substantially enhanced by the reach of smartphone apps and accessory wearables.
Watching Parkinson’s disease with wrist-based sensors
JA Diao et al, NPJ Digital Medicine, June 13, 2022
(Posted: Jun 13, 2022 7AM)
Parkinson’s disease (PD) lacks sensitive, objective, and reliable measures for disease progression and response. This presents a challenge for clinical trials given the multifaceted and fluctuating nature of PD symptoms. Innovations in digital health and wearable sensors promise to more precisely measure aspects of patient function and well-being. Beyond research trials, digital biomarkers and clinical outcome assessments may someday support clinician-initiated or closed-loop treatment adjustments.
COVID-19 trajectories among 57 million adults in England: a cohort study using electronic health records
JH Thygesen et al, The Lancet Digital Health, June 8, 2022
(Posted: Jun 09, 2022 10AM)
Updatable estimates of COVID-19 onset, progression, and trajectories underpin pandemic mitigation efforts. To identify and characterise disease trajectories, we aimed to define and validate ten COVID-19 phenotypes from nationwide linked electronic health records (EHR) using an extensible framework.
In this cohort study, we used eight linked National Health Service (NHS) datasets for people in England alive on Jan 23, 2020. Data on COVID-19 testing, vaccination, primary and secondary care records, and death registrations were collected until Nov 30, 2021. We defined ten COVID-19 phenotypes reflecting clinically relevant stages of disease severity and encompassing five categories: positive SARS-CoV-2 test, primary care diagnosis, hospital admission, ventilation modality (four phenotypes), and death (three phenotypes).
Key components of successful digital remote monitoring in oncology.
Wells Mary et al. Nature medicine 2022 6
(Posted: Jun 07, 2022 8AM)
Although digital interventions are not new to the oncology field, the COVID-19 pandemic has accelerated the wide adoption of technological solutions for remote monitoring4. This has created an urgent need for high-quality evidence to support the implementation of remote monitoring for patients with cancer. In this issue of Nature Medicine, a new study reports the findings of the first randomized controlled trial of a digital remote monitoring intervention (CAPRI) for patients receiving oral anti-cancer therapy.
Digital Health Applications in Oncology: An Opportunity to Seize.
Parikh Ravi B et al. Journal of the National Cancer Institute 2022 5
(Posted: Jun 05, 2022 7AM)
This article summarizes the current state of digital health technologies in medical practice and strategies to improve clinical utility and integration. These recommendations, with calls to action for clinicians, health systems, technology innovators, and policymakers, will facilitate efficient yet safe integration of digital health technologies into cancer care.
Multinational landscape of health app policy: toward regulatory consensus on digital health
JA Diao et al, NPJ Digital Medicine, May 11, 2022
(Posted: May 11, 2022 7AM)
Due to its enormous capacity for benefit, harm, and cost, health care is among the most tightly regulated industries in the world. But with the rise of smartphones, an explosion of direct-to-consumer mobile health applications has challenged the role of centralized gatekeepers. As interest in health apps continue to climb, national regulatory bodies have turned their attention toward strategies to protect consumers from apps that mine and sell health data, recommend unsafe practices, or simply do not work as advertised.
Wearable fitness tracker use in federally qualified health center patients: strategies to improve the health of all of us using digital health devices
M Holko et al, NPJ Digital Medicine, April 25, 2022
(Posted: Apr 25, 2022 7AM)
As the use of connected devices rises, an understanding of how digital health technologies can be used for equitable healthcare across diverse communities is needed. We surveyed 1007 adult patients at six Federally Qualified Health Centers that are a part of the All of Us Consortium regarding wearable fitness trackers. Findings indicate the majority interest in having fitness trackers. Barriers included cost and lack of information, revealing that broad digital health device adoption requires education, investment, and high-touch methods.
The performance of wearable sensors in the detection of SARS-CoV-2 infection: a systematic review
M Mitratza et al, Lancet Digital Health, May 2022
(Posted: Apr 22, 2022 1PM)
Of 3196 records identified and screened, 12 articles and 12 study protocols were analysed. Most included articles had a moderate risk of bias, as per the National Institute of Health Quality Assessment Tool for Observational and Cross-Sectional Studies. The accuracy of algorithmic models to detect SARS-CoV-2 infection varied greatly (area under the curve 0·52–0·92). An algorithm's ability to detect presymptomatic infection varied greatly (from 20% to 88% of cases), from 14 days to 1 day before symptom onset. Increased heart rate was most frequently associated with SARS-CoV-2 infection, along with increased skin temperature and respiratory rate. All 12 protocols described prospective studies that had yet to be completed or to publish their results, including two randomised controlled trials. The evidence surrounding wearable devices in the early detection of SARS-CoV-2 infection is still in an early stage.
The medical algorithmic audit
X Liu et al, Lancet Digital Health, April 2022
(Posted: Apr 10, 2022 3PM)
We propose a medical algorithmic audit framework that guides the auditor through a process of considering potential algorithmic errors in the context of a clinical task, mapping the components that might contribute to the occurrence of errors, and anticipating their potential consequences. We suggest several approaches for testing algorithmic errors, including exploratory error analysis, subgroup testing, and adversarial testing, and provide examples from our own work and previous studies. The medical algorithmic audit is a tool that can be used to better understand the weaknesses of an artificial intelligence system and put in place mechanisms to mitigate their impact.
Validation and algorithmic audit of a deep learning system for the detection of proximal femoral fractures in patients in the emergency department: a diagnostic accuracy study
LO Rayner et al, Lancet Digital Health, April 5, 2022
(Posted: Apr 07, 2022 10AM)
Digital biomarkers: Convergence of digital health technologies and biomarkers
D Vasudevan et al, NPJ Digital Medicine, March 25, 2022
(Posted: Mar 26, 2022 3PM)
Increasing digitization across the healthcare continuum has revolutionized medical research, diagnostics, and therapeutics. This digitization has led to rapid advancements in the development and adoption of Digital Health Technologies (DHT) by the healthcare ecosystem. With the proliferation of DHTs, the term ‘digital biomarker’ has been increasingly used to describe a broad array of measurements. Our objectives are to align the meaning of ‘digital biomarker’ with established biomarker terminology and to highlight opportunities to enable consistency in evidence generation and evaluation, improving the assessment of scientific evidence for future digital biomarkers.
Culturally adapting internet- and mobile-based health promotion interventions might not be worth the effort: a systematic review and meta-analysis
S Balci et al, NPJ Digital Medicine, March 23, 2022
(Posted: Mar 24, 2022 8AM)
Out of 9438 records, 13 randomized controlled trials (RCT) investigating culturally adapted health promotion IMI addressing healthy eating, physical activity, alcohol consumption, sexual health behavior, and smoking cessation included. From the included studies 10,747 participants were eligible. Culturally adapted IMI proved to be non-superior over active control conditions in short- (g?=?0.10, [95% CI -0.19 to 0.40]) and long-term (g?=?0.20, [95% CI -0.11 to 0.51]) in promoting health behavior. However, culturally adapted IMI for physical activity (k?=?3, N?=?296) compared to active controls yielded a beneficial effect in long-term (g?=?0.48, [95%CI 0.25 to 0.71]).
Smartphone applications for informal caregivers of chronically ill patients: a scoping review
MG Marguarido et al, NPJ Digital Medicine, March 21, 2022
(Posted: Mar 21, 2022 7AM)
36 articles were included, encompassing 26 applications. Of these, smartphone applications were designed for use only by caregivers (n?=?15), with a few applications also intended to be used with patients (n?=?5), healthcare providers (n?=?4), or all three roles (n?=?2). Most applications targeted a single chronic condition (n?=?25), with Alzheimer’s and other dementia being the most common (n?=?18). Only one application was designed for management of multiple chronic conditions. Long-term evaluation methods are needed to continually assess the impact of applications on a range of process and health outcomes, such as usability, caregiver burden, and quality of life.
Health app policy: international comparison of nine countries’ approaches
A Essen et al, NPJ Digital Medicine, March 18, 2022
(Posted: Mar 18, 2022 7AM)
We found that most approaches aim for centralized pipelines for health app approvals, although some countries are adding decentralized elements. While the countries studied are taking diverse paths, there is nevertheless broad, international convergence in terms of requirements in the areas of transparency, health content, interoperability, and privacy and security. The sheer number of apps on the market in most countries represents a challenge for clinicians and patients. Our analyses of the relevant policies identified challenges in areas such as reimbursement, safety, and privacy.
Diagnostic accuracy of mercurial versus digital blood pressure measurement devices: a systematic review and meta-analysis
M Muniyandi et al, Scientific Reports, March 1, 2022
(Posted: Mar 02, 2022 7AM)
The digital blood pressure monitoring has a moderate level of accuracy and the device can correctly distinguish hypertension with a pooled estimate sensitivity of 65.7% and specificity of 95.9%. After removing one study, which had very low sensitivity and very high specificity, the pooled sensitivity estimate was 79%, and the specificity was 91%. The meta-analysis of DOR suggests that the digital blood pressure monitor had moderate accuracy with a mercury sphygmomanometer. This will provide the clinician and patients with accurate information on blood pressure with which diagnostic and treatment decisions could be made.
Preventing Digital Overdiagnosis.
Capurro Daniel et al. JAMA 2022 1
(Posted: Jan 22, 2022 2PM)
The accelerated adoption of digital technologies in people’s lives is creating unique opportunities to leverage routinely collected digital data and machine learning models to diagnose diseases before they become symptomatic. Like traditional tests, digital screening will likely generate cases of overdiagnosis and thereby harm some patients. Digital screening tests (such as detecting mood or sleep disorders from smartphone use patterns) are being developed faster than the ability to assess their value. The additional risks and benefits of these digital tests are not only a function of their accuracy; and it is important that such approaches be validated prospectively.
Digital health tools for the passive monitoring of depression: a systematic review of methods
V de Angel et al, NPJ Digital Medicine, January 10, 2022
(Posted: Jan 11, 2022 8AM)
The literature is characterized by small sample sizes, short follow-up duration and great variability in the quality of reporting, limiting the interpretability of pooled results. Bivariate analyses show consistency in statistically significant associations between depression and digital features from sleep, physical activity, location, and phone use data. Machine learning models found the predictive value of aggregated features. Given the pitfalls in the combined literature, these results should be taken purely as a starting point for hypothesis generation.
Management of cardiovascular disease using an mHealth tool: a randomized clinical trial
SH Kang e al, NPJ Digital Medicine, December 3, 2021
(Posted: Dec 05, 2021 3PM)
This randomized controlled, single-center, open-label trial tested the impact of a mobile health (mHealth) service tool optimized for ASCVD patient care. Patients with clinical ASCVD were enrolled and randomly assigned to the intervention or control group. Participants in the intervention group were provided with a smartphone application named HEART4U, while a dedicated interface integrated into the electronic healthcare record system was provided to the treating physicians
Sports related concussion: an emerging era in digital sports technology
D Powell et al, NPJ Digital Medicine, December 2, 2021
(Posted: Dec 03, 2021 11AM)
We provide insights into sports-related concussion (SRC) clinical assessment methods and the translational utility of digital approaches, with a focus on off-field digital techniques to detect key SRC metrics/biomarkers. We also provide insights and recommendations to the common benefits and challenges facing digital approaches as they aim to transition from novel technologies to an efficient, valid, reliable, and integrated clinical assessment tool for SRC.
Digital transformation could increase the burden of treatment on patients
FS Mair et al, BMJ, November 25, 2021
(Posted: Nov 26, 2021 10AM)
Digital health has the potential to reduce the burden of treatment for some. The ability to tele-consult (via telephone or video) can reduce the number of visits to health professionals. Attending clinic or hospital appointments is time consuming, can be stressful, and may entail considerable expense and effort. The distance a person must travel, availability and affordability of transportation, building accessibility, and whether the appointment requires the person to negotiate time off work or childcare, can all influence the perceived burden of treatment associated with attending appointments. Reducing these visits through teleconsulting can lessen the burden of treatment for those with busy home or work lives, for those for whom accessing transportation is difficult or expensive, or those with disabilities (visible or invisible). However, teleconsulting via video requires access to fast broadband and wi-fi in the home and assumes that people can use these systems
Bias and privacy in AI's cough-based COVID-19 recognition
HB Espinoza et al, Lancet Digital Health, December 2021
(Posted: Nov 25, 2021 9AM)
Mobile devices and wearable technology for measuring patient outcomes after surgery: a systematic review
SR Knight et al, NPJ Digital Medicine, November 12, 2021
(Posted: Nov 13, 2021 6AM)
6969 articles were screened, with 44 articles included. The majority (n?=?34) described small prospective study designs, with a high risk of bias demonstrated. Reporting standards were suboptimal across all domains, particularly in relation to data security, prior patient engagement and cost analysis. Despite the potential of digital health interventions to improve postoperative patient care, current progress is severely restricted by limitations in methodological reporting.
Evaluating the reliability of mobility metrics from aggregated mobile phone data as proxies for SARS-CoV-2 transmission in the USA: a population-based study
N Kishore et al, The Lancet Digital Health, November 2, 2021
(Posted: Nov 03, 2021 10AM)
In this population-based study, we collected epidemiological data on COVID-19 cases and deaths, as well as human mobility metrics collated by advertisement technology that was derived from global positioning systems, from 1396 counties across the USA that had at least 100 laboratory-confirmed cases of COVID-19.We show that the reproduction number is most strongly associated with mobility proxies for change in the travel into counties (0·757 [95% CI 0·689 to 0·857]), but this relationship primarily holds for counties in the three most urban categories as defined by the NCHS. This relationship weakens considerably after the initial 15 weeks of the epidemic (0·442 [-0·492 to -0·392]), consistent with the emergence of more complex local policies and behaviors, including masking.
Focusing on Digital Health Equity
CR Lyles et al, JAMA, October 22, 2021
(Posted: Oct 22, 2021 1PM)
The pandemic provided examples of troubling barriers to digital health access, such as low uptake of video visits among underserved populations2 and disproportionate barriers to access to online vaccination appointments for communities most affected by the pandemic. These gaps reflect both structural deficiencies within the digital infrastructure in the US as well as a lack of attention to equity within the development and implementation of digital platforms and solutions. Achieving digital health equity entails not only ensuring access to digital infrastructure but also designing digital health solutions with the broad range of end users in mind.
A systematic review of smartphone-based human activity recognition methods for health research
M Strackiewiz et al, NPJ Digital Medicine
(Posted: Oct 19, 2021 6AM)
We identified 108 articles and described the various approaches used for data acquisition, data preprocessing, feature extraction, and activity classification, identifying the most common practices, and their alternatives. We conclude that smartphones are well-suited for HAR research in the health sciences. For population-level impact, future studies should focus on improving the quality of collected data, address missing data, incorporate more diverse participants and activities, relax requirements about phone placement, provide more complete documentation on study participants, and share the source code of the implemented methods and algorithms.
Blockchain applications in health care for COVID-19 and beyond: a systematic review
WY Ng et al, Lancet Digital Health, October 2021
(Posted: Oct 17, 2021 6PM)
The COVID-19 pandemic has had a substantial and global impact on health care, and has greatly accelerated the adoption of digital technology. One of these emerging digital technologies, blockchain, has unique characteristics (eg, immutability, decentralization, and transparency) that can be useful in multiple domains (eg, management of electronic medical records and access rights, and mobile health). We conducted a systematic review of COVID-19-related and non-COVID-19-related applications of blockchain in health care.
Walking on common ground: a cross-disciplinary scoping review on the clinical utility of digital mobility outcomes
A Polhemus et al, NPJ Digital Medicine, October 14, 2021
(Posted: Oct 16, 2021 7AM)
Gait speed, step length, cadence, step time and step count exhibited consistent evidence of validity and responsiveness in multiple conditions, although the evidence was inconsistent or lacking for other DMOs. If DMOs are to be adopted as mainstream tools, further work is needed to establish their predictive validity, responsiveness, and ecological validity. Cross-disciplinary efforts to align methodology and validate DMOs may facilitate their adoption into clinical practice.
Development features and study characteristics of mobile health apps in the management of chronic conditions: a systematic review of randomised trials
M Cucchiniello et al, NPJ Digital Medicine, October 5, 2021
(Posted: Oct 05, 2021 6AM)
We identified 69 studies on diabetes (n?=?29), cardiovascular diseases (n?=?13), chronic respiratory diseases (n?=?13), cancer (n?=?10) or their combinations (n?=?4). The apps rarely adopted developmental factors in the design stage, with only around one-third of studies reporting user or healthcare professional engagement. Findings were not significant for the majority of studies across all CD, with most RCTs revealing a high risk of bias.
Cultural adaptation: a framework for addressing an often-overlooked dimension of digital health accessibility
JS Marwaha et al, NPJ Digital Medicine, October 1, 2021
(Posted: Oct 01, 2021 6AM)
Relatively little is known about how to make digital health tools accessible to different populations from a cultural standpoint. Alignment with cultural values and communication styles may affect these tools’ ability to diagnose and treat various conditions. In this Editorial, we highlight the findings of recent work to make digital tools for mental health more culturally accessible, and propose ways to advance this area of study.
Mobile health technology for diverse populations: challenges and opportunities
JA Diao et al, NPJ Digital Medicine, September 6, 2021
(Posted: Sep 06, 2021 7AM)
Nearly half of US adults have hypertension, and three in four cases are not well-controlled. Due to structural barriers, underserved communities face greater burdens of disease, less consistent management, and worse outcomes. Mobile technology presents an opportunity to reduce financial, geographic, and workforce barriers, but little data currently support its use in populations with digital disparities. A recent article systematically reviews the literature to quantify outcomes for these populations and provide a roadmap toward more inclusive mobile health strategies.
Health Literacy in the Digital Age: Applications to Genomics
Slide presentation, CDC webinar, June 2021
(Posted: Sep 04, 2021 8AM)
With the recent COVID-19 pandemic, patients are turning more to online information sources and telehealth services to address their healthcare needs. Digital health literacy plays an increasingly important role in understanding information and in patient-provider communication. This has implications across disease prevention and the healthcare continuum including the field of genetics.
Paying for Digital Health Care - Problems with the Fee-for-Service System.
Adler-Milstein Julia et al. The New England journal of medicine 2021 8 (10) 871-873
(Posted: Sep 02, 2021 8AM)
Although billing for more units of (digital) care will increase clinical revenue, such a shift could have substantial negative consequences. Administrative costs will increase because of the increased number of bills submitted and, more important, because of complex billing requirements and related documentation.
Effect of a Mobile App on Prehospital Medication Errors During Simulated Pediatric Resuscitation
A Randomized Clinical Trial
JN Siebert et al, JAMA Network Open, August 30, 2021
(Posted: Aug 31, 2021 8AM)
In this multicenter, simulation-based, randomized clinical trial including 150 advanced paramedics in 14 emergency medical services centers and 600 drug preparations, the proportion of medication errors committed during sequential preparation of 4 intravenous emergency drugs in prehospital settings was significantly decreased with the use of the app in absolute terms by 66.5%.
The effect of population mobility on COVID-19 incidence in 314 Latin American cities: a longitudinal ecological study with mobile phone location data
JL Kephart et al, Lancet Digital Health, August 26, 2021
(Posted: Aug 27, 2021 6AM)
In this longitudinal ecological study, we compiled aggregated mobile phone location data, daily confirmed COVID-19 cases, and features of urban and social environments to analyze population mobility and COVID-19 incidence at the subcity level among cities with more than 100?000 inhabitants in Argentina, Brazil, Colombia, Guatemala, and Mexico. Reduced population movement within a subcity area is associated with a subsequent decrease in COVID-19 incidence among residents of that subcity area.
Cultural adaptation of internet- and mobile-based interventions for mental disorders: a systematic review
K Spanhel et al, NPJ Digital Medicine, August 25, 2021
(Posted: Aug 26, 2021 7AM)
Providing accessible and effective healthcare solutions for people living in low- and middle-income countries, migrants, and indigenous people is central to reduce the global mental health treatment gap. Internet- and mobile-based interventions (IMI) are considered scalable psychological interventions to reduce the burden of mental disorders and are culturally adapted for implementation in these target groups.
The potential use of digital health technologies in the African context: a systematic review of evidence from Ethiopia
T Manyazewal et al, NPJ Digital Medicine, August 17, 2021
(Posted: Aug 17, 2021 7AM)
Digital health: how to govern during a never-ending data tsunami
DS Muntz, NPJ Digital Medicine, August 10, 2021
(Posted: Aug 10, 2021 3PM)
Good data governance requires principles1 to help guide people who produce and consume data. The three primary activities of a good data governance process are communication, coordination, and most importantly, collaboration. These 3Cs are force multipliers. Harnessing the power of a tsunami requires strong principles-based governance.
Early detection of COVID-19 in the UK using self-reported symptoms: a large-scale, prospective, epidemiological surveillance study
LS Canas et al, Lancet Digital Health, July 29, 2021
(Posted: Jul 30, 2021 6AM)
In this large-scale, prospective, epidemiological surveillance study, we used prospective, observational, longitudinal, self-reported data from participants in the UK on 19 symptoms over 3 days after symptoms onset and COVID-19 PCR test results extracted from the COVID-19 Symptom Study mobile phone app.Our results suggest that a hierarchical Gaussian process model is effective in predicting SARS-CoV-2 infection when earlier symptoms are considered. This study represents a novel effort to identify and refer individuals for COVID-19 testing, enabling a more efficient allocation of medical resources during crucial stages of a pandemic.
Power to the people
Editorial, Lancet Digital Health, July 2021
(Posted: Jul 29, 2021 8AM)
Artificial intelligence (AI) for health is a rapidly evolving field, with many potential benefits and risks, but governing bodies are struggling to keep pace. This lag is further fuelled by a lack of comprehensive international guidance on how to ensure AI for health complies with ethical norms and human rights standards. To address this gap, WHO has published guidance on the ethics and governance of AI for health.
Anosmia, ageusia, and other COVID-19-like symptoms in association with a positive SARS-CoV-2 test, across six national digital surveillance platforms: an observational study
CH Sudre et al, Lancet Digital Health, July 2021
(Posted: Jul 27, 2021 11AM)
Despite differences in syndromic surveillance methods, access to and timing of SARS-CoV-2 testing, and disease prevalence, anosmia or ageusia were consistently the strongest predictors of COVID-19 infection across all platforms over time. The odds of a positive COVID-19 test was nearly 17 times higher among individuals with anosmia or ageusia than those without these symptoms. Fever and respiratory symptoms (shortness of breath and cough) also ranked highly in their association with test positivity. This large, collaborative analysis showed that anosmia–ageusia, fever, shortness of breath, and cough are suitable empirical signals of ongoing COVID-19 transmission.
Bridging the Digital Divide in Healthcare to Improve Access to Care
ASTHO, July 2021
(Posted: Jul 24, 2021 7AM)
The Federal Communications Commission reports that 19 million Americans still lack access to highspeed internet. As telehealth becomes more accessible due to increased federal funding investments and lifted policy restrictions catalyzed by the COVID-19 pandemic, the disparities in access to technology used for telehealth (i.e., smartphones, laptops) and high-speed broadband remain. This digital divide in healthcare remains a challenge, creating a growing a division between communities who have access to digital health technologies and efficient broadband resources versus those who experience limited access due to socioeconomic, geographic, and financial barriers.
Mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses
EC Khoong et al, NPJ Digital Medicine, July 22, 2021
(Posted: Jul 23, 2021 7AM)
Mobile health (mHealth) technologies improve hypertension outcomes, but it is unknown if this benefit applies to all populations. This review aimed to describe the impact of mHealth interventions on blood pressure outcomes in populations with disparities in digital health use.
The new platforms of health care
ER Dorsey, NPJ Digital Health
(Posted: Jul 16, 2021 7AM)
Mobile app validation: a digital health scorecard approach
R Sedhom et al, NPJ Digital Medicine, July 14, 2021
(Posted: Jul 16, 2021 7AM)
We investigated the pragmatic application of a previously described framework for digital health validation, the Digital Health Scorecard, in a cohort of 22 popular mobile health oncology apps. The apps evaluated using this framework performed poorly, scoring 49.4% across all evaluation criteria as a group.
The powers and perils of using digital data to understand human behaviour
Nature Editorial, July 2021
(Posted: Jul 05, 2021 11AM)
During the course of the coronavirus pandemic alone, researchers have been able to access millions of mobile-phone records to study how people’s movement changed during the pandemic and the impact of those changes on how SARS-CoV-2 spread. They have been able to access anonymized credit-card purchase histories to study how people are spending money during the pandemic — information which is then used to understand how COVID-19 is affecting various sectors of the economy.
Race representation matters in cancer care
Lancet Digital Health, June 2021
(Posted: Jun 26, 2021 7AM)
Without reporting how representative existing datasets are, we cannot understand if potentially lifesaving technologies for cancer screening and diagnosis are built for use by everyone. In response, the National Institutes of Health launched the All of Us initiative in 2015 with ambitious goals to collect genomic data from one million people, with a focus on recruiting minority ethnic volunteers. However, there continues to be a paucity of data from non-White populations, widening the gap between those who already benefit and those who do not.
‘It’s hard to know what’s trustworthy’: A new research effort aims to vet digital health data from wearables
K Palmer, Stat News, June 22, 2021
(Posted: Jun 23, 2021 8AM)
Digital health: balancing innovation and cybersecurity
Lancet Respiratory Medicine editorial, June 16, 2021
(Posted: Jun 17, 2021 9AM)
Digital health is an area of medicine that has seen huge acceleration and investment globally over the past decade—even more so during the COVID-19 pandemic, when reliance on digital and telehealth has been essential. With this growth in digital health, however, comes concern surrounding the use of digital patient data and the associated risks of cybersecurity breaches.
