104 results found
Chatterjee A, Strong G, Meinert E, et al., 2021, The use of video for patient information and education: A scoping review of the variability and effectiveness of interventions, PATIENT EDUCATION AND COUNSELING, Vol: 104, Pages: 2189-2199, ISSN: 0738-3991
de Pennington N, Mole G, Lim E, et al., 2021, Safety and acceptability of a natural language artificial intelligence assistant to deliver clinical follow-up to cataract surgery patients: proposal, JMIR Research Protocols, Vol: 10, ISSN: 1929-0748
Background:Due to an aging population, the demand for many services is exceeding the capacity of the clinical workforce. As a result, staff are facing a crisis of burnout from being pressured to deliver high-volume workloads, driving increasing costs for providers. Artificial intelligence (AI), in the form of conversational agents, presents a possible opportunity to enable efficiency in the delivery of care.Objective:This study aims to evaluate the effectiveness, usability, and acceptability of Dora agent: Ufonia’s autonomous voice conversational agent, an AI-enabled autonomous telemedicine call for the detection of postoperative cataract surgery patients who require further assessment. The objectives of this study are to establish Dora’s efficacy in comparison with an expert clinician, determine baseline sensitivity and specificity for the detection of true complications, evaluate patient acceptability, collect evidence for cost-effectiveness, and capture data to support further development and evaluation.Methods:Using an implementation science construct, the interdisciplinary study will be a mixed methods phase 1 pilot establishing interobserver reliability of the system, usability, and acceptability. This will be done using the following scales and frameworks: the system usability scale; assessment of Health Information Technology Interventions in Evidence-Based Medicine Evaluation Framework; the telehealth usability questionnaire; and the Non-Adoption, Abandonment, and Challenges to the Scale-up, Spread and Suitability framework.Results:The evaluation is expected to show that conversational technology can be used to conduct an accurate assessment and that it is acceptable to different populations with different backgrounds. In addition, the results will demonstrate how successfully the system can be delivered in organizations with different clinical pathways and how it can be integrated with their existing platforms.Conclusions:The project’s ke
Milne-Ives M, Neill S, Bayes N, et al., 2021, The impact of digital educational interventions to support parents caring for acutely ill children at home and factors that affect their use: systematic review protocol, JMIR Research Protocols, Vol: 10, ISSN: 1929-0748
Emergency and urgent care healthcare services are overburdened and the use of these services by acutely ill infants and children is increasing. A large proportion of these visits could be sufficiently addressed by other healthcare professionals. Uncertainty about the severity of a child’s symptoms is one of many factors that play a role in parents’ decisions to take their children to emergency services, demonstrating the need for improved support for health literacy. Digital interventions are a potential tool to improve parents’ knowledge, confidence, and self-efficacy at managing acute childhood illness. However, existing systematic reviews related to this topic need to be updated and expanded to provide a contemporary review of the impact, usability, and limitations of these solutions.
Milne-Ives M, Swancutt D, Burns L, et al., 2021, The effectiveness and usability of online, group-based interventions for people with severe obesity: Systematic review protocol, JMIR Research Protocols, Vol: 10, Pages: 1-7, ISSN: 1929-0748
Background: Globally, obesity is a growing crisis. Despite obesity being preventable, over a quarter of the United Kingdom adult population is currently considered clinically obese (typically Body Mass Index ≥35kg/m2). Access to treatment for people with severe obesity is limited by long wait times and local availability. Online and group-based interventions provide means of increasing the accessibility of obesity prevention and treatment services. However, there has been no prior review of the effectiveness of group-based interventions delivered online for people with severe obesity. Objective: The purpose of this systematic review protocol is to provide an evaluation of the effectiveness and usability of different types of online, group-based interventions for people with severe obesity. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and the Population, Intervention, Comparator, and Outcome frameworks were used to structure this review. The review will systematically search seven databases: Medline, Embase, the Cumulative Index of Nursing and Allied Health Literature, American Psychological Association PsycNet, Web of Science, the Cochrane Library, and the ProQuest Dissertations and Theses databases. Two authors will independently screen the titles and abstracts of identified articles, select studies for inclusion based on the eligibility criteria, and extract data into a standardized form. Any disagreements will be discussed and resolved by a third reviewer if necessary. Risk of bias will be assessed using the Cochrane Collaboration Risk of Bias tool and a descriptive analysis will be used to evaluate effectiveness and usability.Results: The systematic review has not yet been started. It is expected to be completed and submitted for publication by May 2021. Conclusions: This systematic review will summarize the effectiveness and usability of online, group-based interventions for people with obesity. It will identify
Surodina S, Lam C, Grbich S, et al., 2021, Machine Learning for Risk Group Identification and User Data Collection in a Herpes Simplex Virus Patient Registry: Algorithm Development and Validation Study, JMIRx Med, Vol: 2, Pages: e25560-e25560
<jats:sec> <jats:title>Background</jats:title> <jats:p>Researching people with herpes simplex virus (HSV) is challenging because of poor data quality, low user engagement, and concerns around stigma and anonymity.</jats:p> </jats:sec> <jats:sec> <jats:title>Objective</jats:title> <jats:p>This project aimed to improve data collection for a real-world HSV registry by identifying predictors of HSV infection and selecting a limited number of relevant questions to ask new registry users to determine their level of HSV infection risk.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>The US National Health and Nutrition Examination Survey (NHANES, 2015-2016) database includes the confirmed HSV type 1 and type 2 (HSV-1 and HSV-2, respectively) status of American participants (14-49 years) and a wealth of demographic and health-related data. The questionnaires and data sets from this survey were used to form two data sets: one for HSV-1 and one for HSV-2. These data sets were used to train and test a model that used a random forest algorithm (devised using Python) to minimize the number of anonymous lifestyle-based questions needed to identify risk groups for HSV.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>The model selected a reduced number of questions from the NHANES questionnaire that predicted HSV infection risk with high accuracy scores of 0.91 and 0.96 and high recall scores of 0.88 and 0.98 for the HSV-1 and HSV-2 data sets, respectively. The number of questions was reduced from 150 to an average of 40, depending on age and gender. The model, therefore, provided high predictability of risk of infection with minimal required input.</jats:p>
Surodina S, Lam C, Grbich S, et al., 2021, Authors’ Response to Peer Reviews of “Machine Learning for Risk Group Identification and User Data Collection in a Herpes Simplex Virus Patient Registry: Algorithm Development and Validation Study”, JMIRx Med, Vol: 2, Pages: e28917-e28917
Milne-Ives M, Lam C, Rehman N, et al., 2021, Distributed ledger infrastructure to verify adverse event reporting (DeLIVER): proposal for a proof-of-concept study, JMIR Research Protocols, Vol: 10, ISSN: 1929-0748
Background: Adverse drug event reporting is critical for ensuring patient safety; however, numbers of reports have been declining. There is a need for a more user-friendly reporting system and for a means of verifying reports that have been filed. Objectives: This project has two main objectives: 1) to identify the perceived benefits and barriers in the current reporting of adverse events by patients and healthcare providers and 2) to develop a distributed ledger infrastructure and user interface to collect and collate adverse event reports to create a comprehensive and interoperable database.Methods: A review of the literature will be conducted to identify the strengths and limitations of the current UK adverse event reporting system (the Yellow Card System). If insufficient information is found in this review, a survey will be created to collect data from system users. The results of these investigations will be incorporated into the development of a mobile and web app for adverse event reporting. A digital infrastructure will be built using distributed ledger technology to provide a means of linking reports with existing pharmaceutical tracking systems. Results: The key outputs of this project will be the development of a digital infrastructure including the backend distributed ledger system and the app-based user interface.Conclusions: This infrastructure is expected to improve the accuracy and efficiency of adverse event reporting systems by enabling the monitoring of specific medicines or medical devices over their life course while protecting patients’ personal health data.
Lam C, Meinert E, Yang A, et al., 2021, Comparison between centralized and decentralized supply chains of autologous chimeric antigen receptor T-cell therapies: a UK case study based on discrete event simulation., Cytotherapy, Vol: 23, Pages: 433-451
BACKGROUND AIMS: Decentralized, or distributed, manufacturing that takes place close to the point of care has been a manufacturing paradigm of heightened interest within the cell therapy domain because of the product's being living cell material as well as the need for a highly monitored and temperature-controlled supply chain that has the potential to benefit from close proximity between manufacturing and application. METHODS: To compare the operational feasibility and cost implications of manufacturing autologous chimeric antigen receptor T (CAR T)-cell products between centralized and decentralized schemes, a discrete event simulation model was built using ExtendSIM 9 for simulating the patient-to-patient supply chain, from the collection of patient cells to the final administration of CAR T therapy in hospitals. Simulations were carried out for hypothetical systems in the UK using three demand levels-low (100 patients per annum), anticipated (200 patients per annum) and high (500 patients per annum)-to assess resource allocation, cost per treatment and system resilience to demand changes and to quantify the risks of mix-ups within the supply chain for the delivery of CAR T treatments. RESULTS: The simulation results show that although centralized manufacturing offers better economies of scale, individual facilities in a decentralized system can spread facility costs across a greater number of treatments and better utilize resources at high demand levels (annual demand of 500 patients), allowing for an overall more comparable cost per treatment. In general, raw material and consumable costs have been shown to be one of the greatest cost drivers, and genetic modification-associated costs have been shown to account for over one third of raw material and consumable costs. Turnaround time per treatment for the decentralized scheme is shown to be consistently lower than its centralized counterpart, as there is no need for product freeze-thaw, packaging and transportat
Meinert E, Eerens J, Banks C, et al., 2021, Exploring the Cost of eLearning in Health Professions Education: Scoping Review., JMIR Med Educ, Vol: 7, ISSN: 2369-3762
BACKGROUND: Existing research on the costs associated with the design and deployment of eLearning in health professions education is limited. The relative costs of these learning platforms to those of face-to-face learning are also not well understood. The lack of predefined costing models used for eLearning cost data capture has made it difficult to complete cost evaluation. OBJECTIVE: The key aim of this scoping review was to explore the state of evidence concerning cost capture within eLearning in health professions education. The review explores the available data to define cost calculations related to eLearning. METHODS: The scoping review was performed using a search strategy with Medical Subject Heading terms and related keywords centered on eLearning and cost calculation with a population scope of health professionals in all countries. The search was limited to articles published in English. No restriction was placed on literature publication date. RESULTS: In total, 7344 articles were returned from the original search of the literature. Of these, 232 were relevant to associated keywords or abstract references following screening. Full-text review resulted in 168 studies being excluded. Of these, 61 studies were excluded because they were unrelated to eLearning and focused on general education. In addition, 103 studies were excluded because of lack of detailed information regarding costs; these studies referred to cost in ways either indicating cost favorability or unfavorability, but without data to support findings. Finally, 4 studies were excluded because of limited cost data that were insufficient for analysis. In total, 42 studies provided data and analysis of the impact of cost and value in health professions education. The most common data source was total cost of training (n=29). Other sources included cost per learner, referring to the cost for individual students (n=13). The population most frequently cited was medical students (n=15), although 12
Milne-Ives M, Meinert E, 2021, Digital technologies for monitoring and improving treatment adherence in children and adolescents with asthma: A scoping review of randomised controlled trials, Publisher: Cold Spring Harbor Laboratory
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Inadequate paediatric asthma care has resulted in potentially avoidable unplanned hospital admissions and morbidity. A wide variety of digital technologies have been developed to help monitor and support treatment adherence for children and adolescents with asthma. However, existing reviews need to be updated and expanded to provide an overview of the current state of research around these technologies and how they are being integrated into existing healthcare services and care pathways.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>The purpose of this scoping review is to provide an overview of the current research landscape and knowledge gaps regarding the use of digital technologies to support the care of children and adolescents with asthma.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The review was structured according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and Population, Intervention, Comparator, Outcome, and Study (PICOS) frameworks. Five databases (PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, EMBASE, and PsycINFO) were systematically searched for studies published in English from 2014 on. One reviewer screened references, selected studies for inclusion based on the eligibility criteria, and extracted the data, which were synthesised in a descriptive analysis.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A wide variety in study characteristics - including the number and age of participants, study duration, and type of digital intervention - was identified. There was mixed evidence for the effectiveness of the interventions; 6 of the 9 studies
Milne-Ives M, Lam C, Meinert E, 2021, Digital technologies for monitoring and improving treatment adherence in children and adolescents with asthma: A scoping review of randomised controlled trials, JMIR Public Health and Surveillance, ISSN: 2369-2960
Background: Inadequate paediatric asthma care has resulted in potentially avoidable unplanned hospital admissions and morbidity. A wide variety of digital technologies have been developed to help monitor and support treatment adherence for children and adolescents with asthma. However, existing reviews need to be updated and expanded to provide an overview of the current state of research around these technologies and how they are being integrated into existing healthcare services and care pathways. Objective: The purpose of this scoping review is to provide an overview of the current research landscape and knowledge gaps regarding the use of digital technologies to support the care of children and adolescents with asthma. Methods: The review was structured according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and Population, Intervention, Comparator, Outcome, and Study (PICOS) frameworks. Five databases (PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, EMBASE, and PsycINFO) were systematically searched for studies published in English from 2014 on. Two reviewers independently screened the references and selected studies for inclusion based on the eligibility criteria. Data was systematically extracted per research questions, which were synthesised in a descriptive analysis.Results: A wide variety in study characteristics - including the number and age of participants, study duration, and type of digital intervention - was identified. There was mixed evidence for the effectiveness of the interventions; 7 of the 10 studies that evaluated treatment adherence found improvements, but the evidence was inconsistent for asthma control (6/9 reported improvement or maintenance, but only one was significantly different between groups) and health outcome variables (5/9 found no evidence of effectiveness). The 6 studies that examined patient perceptions and assessment
Meinert E, Reeves S, Eerens J, et al., 2020, Exploring the cost of eLearning within the field of health professions education: Scoping Review, JMIR Medical Education, ISSN: 2369-3762
Background: Existing research on the costs associated for design and deploying eLearning in health professions education is limited. The way in which these learning platforms compare in cost to face-to-face learning is also not well understood. The lack of pre-defined costing models used for eLearning cost data capture has made it difficult to complete cost evaluation.Objective: The key aim of this scoping review is to explore the state of evidence concerning cost capture within eLearning in health professions education. The review explores what data exists to define cost calculations related to eLearning.Methods: Scoping review using a search strategy of MeSH terms and related keywords centered on eLearning and cost calculation with a population scope of health professionals in all countries. The search was limited to English language studies. No restriction was placed on literature publication date. Results: In total, 7344 articles were returned from the original search of the literature. Of these, 232 were relevant to associated keywords or abstract references following screening. Full-text review resulted in 168 studies being excluded. Of these, sixty-one studies were excluded because they were unrelated to eLearning and focused on general education. One-hundred and three studies were excluded because of lack of detailed information regarding costs. These studies referred to cost in ways either indicating cost favorability or unfavorability, but without data to support findings. Finally, four studies were excluded because of limited cost data insufficient for analysis. In total, 42 studies provide data and analysis of the impact of cost and value in health professions education. The most common data source was total cost of training (n=29). Other sources included cost per learner; meaning the cost per individual student (n=13). The population most frequently cited was medical students (n=15), although a group of articles focused on multiple populations (n=12). A
Lam C, van Velthoven M, Meinert E, 2020, Developing a blockchain-based supply chain system for advanced therapies: study protocol, JMIR Research Protocols, Vol: 9, Pages: 1-6, ISSN: 1929-0748
Advanced therapies, including cell and gene therapies, have shown therapeutic promise in curing life-threatening diseases such as leukaemia and lymphoma. However, they can be complicated and expensive to deliver due to their sensitivity to environment, troublesome tissue, cell, or genetic material sourcing and complicated regulatory requirements.
Milne-Ives M, de Cock C, Lim E, et al., 2020, The effectiveness of artificial intelligence conversational agents in healthcare: a systematic review, Journal of Medical Internet Research, Vol: 22, ISSN: 1438-8871
Background: High demand on healthcare services and the growing capability of artificial intelligence has led to the development of conversational agents designed to support a variety of health-related activities - including behaviour change, treatment support, health monitoring, training, triage, and screening support. Automation of these tasks could free clinicians to focus on more complex work and increase accessibility to healthcare services for the general public. An overarching assessment of the acceptability, usability, and effectiveness of these agents in healthcare is needed to collate the evidence so that future development can target areas for improvement and potential for sustainable adoption. Objective: This systematic review aimed to assess the effectiveness and usability of conversational agents in healthcare and identify the elements that users like and dislike, to inform future research and development of these agents. Methods: PubMed, Medline (Ovid), EMBASE, CINAHL, Web of Science, and ACM Digital Library were systematically searched for articles published since 2008 that evaluated unconstrained natural language processing conversational agents used in healthcare. Endnote (version X9; Clarivate Analytics) reference management software was used for initial screening, then full-text screening was conducted by one reviewer. Data was extracted and risk of bias was assessed by one reviewer and validated by another. Results: A total of 31 studies were selected and included a variety of conversational agents - 14 chatbots (two of which were voice chatbots), 6 embodied conversational agents, 3 each of interactive voice response calls, virtual patients, and speech recognition screening systems, as well as one contextual question answering agent and one voice recognition triage system. Overall, the evidence reported was mostly positive or mixed. Usability and satisfaction performed well (27/30 and 26/31) and positive or mixed effectiveness was found in three
Milne-Ives M, Lam C, Van Velthoven M, et al., 2020, Mobile fitness and weight management apps: an evaluation protocol, JMIR Research Protocols, Vol: 9, Pages: 1-5, ISSN: 1929-0748
Obesity is a large contributing factor for many non-communicable diseases and is a growing problem worldwide. Many mobile apps have been developed to help users improve their fitness and weight management behaviours. However, the speed at which apps are created and updated means that it is important to periodically assess their quality.
Milne-Ives M, Lam C, van Velthoven M, et al., 2020, The impact of Brexit on the UK pharmaceutical supply chain: a scoping review protocol, JMIR Research Protocols, Vol: 9, Pages: 1-6, ISSN: 1929-0748
The continuing uncertainty around Brexit has caused concern in the pharmaceutical industry and among healthcare professionals and patients. The exact consequences of Brexit on the UK pharmaceutical supply chain will depend on whether a deal is reached and what it entails, but it is likely to be affected by the withdrawal of the UK from the EU. Regulatory issues and delays in supply have the potential to seriously negatively affect the ability of UK residents to receive an adequate and timely supply of necessary medicines.
Meinert E, Rahman E, Potter A, et al., 2020, Usability of the mobile digital health ‘NoObesity’ app for families and healthcare professionals: a feasibility study, JMIR Research Protocols, Vol: 9, Pages: 1-10, ISSN: 1929-0748
Background: Almost a quarter or more than a fifth of children in the United Kingdom (UK) are overweight or obese by the time they start school. The UK Department of Health and Social Care has updated national policy for combating childhood obesity in 2018, with critical outcomes centred on sugar and caloric consumption reduction. Health Education England has developed two digital apps for families with children up to 15 and for their associated health care professionals (HCPs) to provide a digital learning resource and tool aimed at encouraging healthy lifestyles to prevent obesity.Objective: This feasibility study assesses Health Education England’s NoObesity app usability and acceptability to undertake activities to improve families’ diet and physical activity. The purpose of the study is to evaluate the app’s influence on self-efficacy and goal setting and to determine what can be learned to improve its design for future studies, should there be evidence of adoption and sustainability. Methods: The study population will include 20-40 families and their linked health care professionals. Recognising issues related to digital access associated with socioeconomic status (SES) and impact on information technology (IT) use, study recruitment will be regionally focused on a low SES area. The study will last nine-months; three months intervention period and six months follow up. The evaluation of feasibility, acceptability, and usability will be conducted using the following scales and theoretical frameworks: 1. The system usability scale; 2. The Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework; 3. Bandura’s model of health promotion; and 4. The Nonadoption, Abandonment, and Challenges to the Scale-up, Spread, and Suitability (NASSS) framework. App use will be captured and quantitatively analysed for net use patterns (e.g. number of screens viewed, number of logins, cumulative minutes using the app, number of plans made
Surodina S, Lam C, Grbich S, et al., 2020, Requirements Engineering of a Herpes Simplex Virus Patient Registry: Alpha Phase
<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background</jats:bold> Collecting data from people with herpes simplex virus is challenging because of poor data quality, low user engagement, and concerns around stigma and anonymity. This project aimed to improve data collection for a real-world HSV registry by identifying predictors of HSV infection and selecting a limited number of relevant questions to ask new registry users in order to determine the HSV infection risk group. <jats:bold>Methods</jats:bold>. The US National Health and Nutrition Examination Survey (NHANES, 2015-16) database has confirmed HSV1 and HSV2 status of American participants (14-49 years) as well as a wealth of demographic and health-related data. Two datasets – for HSV1 and HSV2 – were formed using this database, and an anonymous lifestyle-data based questionnaire with a Random Forest algorithm was devised using Python. The algorithm was optimised to reduce the number of questions and to identify risk groups for HSV. Data was split into subsets to train and test the model. <jats:bold>Results </jats:bold>The model selected a reduced number of questions from the NHANES questionnaire that predicted HSV infection risk with high accuracy scores of 0.91 and 0.96 and high recall scores of 0.88 and 0.98 for HSV1 and HSV2 datasets, respectively. The number of questions was reduced from 150 to an average of 40, depending on age and gender, that together provides high predictability of the infection <jats:bold>Conclusions</jats:bold> This machine-learning algorithm for risk identification of people infected with HSV can be used in a real-world evidence registry to collect relevant lifestyle data. A current limitation is the absence of real user data and integration with electronic medical records that would enable model learning and improvement. Future work will explore model adjustments, anonymisation options, e
de Cock C, van Velthoven M, Milne-Ives M, et al., 2020, Use of apps to promote childhood vaccination: a systematic review, JMIR mHealth and uHealth, Vol: 8, ISSN: 2291-5222
Vaccination is a critical step to reducing child mortality; however, vaccination rates have declined in many countries in recent years. This decrease has been associated with an increase in outbreaks of vaccine-preventable diseases. The potential for leveraging mobile platforms to promote vaccination coverage has been investigated in the development of numerous mobile apps. Whilst many are available for public use, there is little robust evaluation of these applications.
Meinert E, Milne-Ives M, Surodina S, et al., 2020, Agile requirements engineering and software planning for a digital health platform to engage the effects of isolation caused by social distancing: A Case study and feasibility study protocol, JMIR Public Health and Surveillance, Vol: 6, ISSN: 2369-2960
BackgroundSocial distancing measures have been put in place to reduce social interaction to slow transmission of coronavirus (COVID-19). For older people, self-isolation presents particular challenges for mental health and social relationships. As time progresses, continued social distancing could have a compounding impact on these concerns.ObjectiveThis project aims to provide a tool for older people, their families, and peers to improve their wellbeing and health during and after regulated social distancing. Firstly, we will evaluate the tool’s feasibility, acceptability, and usability to encourage positive nutrition, enhance physical activity, and enable virtual interaction during social-distancing. Secondly, we will be implementing the app to provide an online community to assist families and peer groups in maintaining contact with older people using goal setting. Anonymised data from the app will be aggregated with other real-world data sources to develop a machine-learning algorithm to improve COVID-19 patient identification and track for real-time use by health systems.MethodsDevelopment of this project is occurring at the time of publication, and therefore a case study design was selected to provide a systematic means of capturing software engineering in progress. To mitigate potential issues of non-adoption of the proposed intervention, the system was designed using the non-adoption, abandonment, scale-up, spread and sustainability (NASSS) framework. The application development framework utilised is based on Agile methods. The evaluation of the solution’s acceptability and usability shall be conducted as a feasibility study to analyse factors impacting the solution’s use, adoption and uptake.Results Making use of a pre-existing software framework for health behaviour change, a proof of concept was developed, and multi-stage application development and deployment for the solution created. Grant submissions to fund the project and study exec
Milne-Ives M, van Velthoven M, Meinert E, 2020, Mobile apps for real-world evidence in health care, Journal of the American Medical Informatics Association, Vol: 27, Pages: 976-980, ISSN: 1067-5027
The use of real-world evidence for health care research and evaluation is growing. Mobile health apps have often-overlooked potential to contribute valuable real-world data that are not captured by other sources and could provide data that are more cost-effective and generalizable than can randomized controlled trials. However, there are several challenges that must be overcome to realize the potential value of patient-used mobile health app real-world data, including data quality, motivation for long-term use, privacy and security, methods of analysis, and standardization and integration. Addressing these challenges will increase the value of data from mobile health apps to inform real-world evidence and improve patient empowerment, clinical management, disease research, and treatment development.
Lam C, Meinert E, Yang A, et al., 2020, Tackling the unique challenges of capacity planning for autologous cell therapies, Publisher: ELSEVIER SCI LTD, Pages: S148-S149, ISSN: 1465-3249
Alturkistani A, Lam C, Foley K, et al., 2020, Massive Open Online Course (MOOC) evaluation methods: A systematic review, Journal of Medical Internet Research, Vol: 22, Pages: 1-14, ISSN: 1438-8871
Background: Massive open online courses (MOOCs) have the potential for broad education impact due to many learners undertaking these courses. Despite their reach, there is a lack of knowledge about which methods are used for evaluating these courses.Objective: This review aims to identify current MOOC evaluation methods in order to inform future study designs.Methods: We systematically searched the following databases: (1) SCOPUS; (2) Education Resources Information Center (ERIC); (3) IEEE Xplore; (4) Medline/PubMed; (5) Web of Science; (6) British Education Index and (7) Google Scholar search engine for studies from January 2008 until October 2018. Two reviewers independently screened abstracts and titles of the studies. Published studies in English that evaluated MOOCs were included. The study design of the evaluations, the underlying motivation for the evaluation studies, data collection and data analysis methods were quantitatively and qualitatively analyzed. The quality of the included studies was appraised using the Cochrane Collaboration Risk of Bias Tool for RCTs, the NIH - National Heart, Lung and Blood Institute quality assessment tool for cohort observational studies, and for “Before-After (Pre-Post) Studies With No Control Group”.Results: The initial search resulted in 3275 studies, and 33 eligible studies were included in this review. Studies mostly had a cross-sectional design evaluating one version of a MOOC. We found that studies mostly had a learner-focused, teaching-focused or platform-focused motivation to evaluate the MOOC. The most used data collection methods were surveys, learning management system data and quiz grades and the most used data analysis methods were descriptive and inferential statistics. The methods for evaluating the outcomes of these courses were diverse and unstructured. Most studies with cross-sectional design had a low-quality assessment, whereas randomized controlled trials and quasi-experimental studies receiv
Lam C, van Velthoven M, Meinert E, 2020, Application of “Internet of Things” in cell-based therapy delivery: a systematic review protocol, JMIR Research Protocols, Vol: 9, Pages: 1-6, ISSN: 1929-0748
Internet of Things (IoT) or Industry 4.0, represents a ‘smart’ shift to more interconnected manufacturing processes where individual entities within the supply chain communicate with each other in order to achieve greater flexibility and responsiveness in manufacturing and leaner manufacturing to reduce cost of production. IoT has proven itself instrumental in driving leaner manufacturing and more efficient systems in other industries such as transportation and logistics. While cell-based therapeutic products hold the promise of transforming various diseases, the delivery of these products is complex and challenging. This review aims to understand the applicability of IoT in cell-based product supply chain and delivery.
Lam C, Milne-Ives M, van Velthoven M, et al., 2020, IoT-enabled technologies for weight management in children and young people: a systematic review protocol, JMIR Research Protocols, Vol: 9, Pages: 1-7, ISSN: 1929-0748
Background:Childhood obesity is a serious global issue, leading to greater medical spending in obesity-related diseases such as cardiovascular diseases and diabetes. There is a need for healthcare services that link health behaviour, such as diet and physical activity, to risk factors and provides better advice and feedback to users, which Internet of Things-enabled technologies could facilitate.Objective:The objective of the systematic review will be to identify available Internet of Things-enabled technologies for weight management of children and young people (users below the age of 18). Also it will aim to understand the use, effectiveness and feasibility of these technologies.Methods:We will search Medline, PubMed, Web of Science, Scopus, ProQuest Central and the IEEE Xplore Digital Library for studies published after 2010 using a combination of keywords and subject headings related to health activity tracking, youth and Internet of Things. In addition, a Google search to identify grey literature will be conducted. Two authors will independently screen the titles and abstracts identified from the search and accept or reject the studies according to the study inclusion criteria. Any discrepancies will then be discussed and resolved. The quality of the included studies will be assessed using the Critical Appraisal Skills Programme (CASP) checklists. Data from included studies will be extracted into a predesigned form to identify the types of devices or apps, Internet of Things applications and health outcomes related to weight management.Results:A preliminary search on Medline returned 484 results. The full systematic review will be conducted within the next 12 months and the publication of the final review and meta-analysis is expected at the beginning of the year 2020.Conclusions:The effectiveness and feasibility of physical activity trackers and consumer wearables for different patient groups have been well reviewed but there are currently no published reviews
Milne-Ives M, Lam C, De Cock C, et al., 2020, Mobile apps for health behaviour change in physical activity, diet, drug and alcohol use, and mental health: a systematic review, JMIR mHealth and uHealth, Vol: 8, Pages: 1-16, ISSN: 2291-5222
Background: With a growing focus on patient interaction with health management, mobile apps are increasingly used to deliver behavioural health interventions. The large variation in these mobile health apps - their target patient group, health behaviour, and behavioural change strategies - has resulted in a large but incohesive body of literature.Objective: The purpose of this systematic review was to assess the effectiveness of mobile apps at improving health behaviours and outcomes, and to examine the inclusion and effectiveness of Behaviour Change Techniques in mobile health apps.Methods: Medline, EMBASE, CINAHL, and Web of Science were systematically searched for articles published between 2014 and 2019 that evaluated mobile apps for health behaviour change. Two authors independently screened and selected studies according to the eligibility criteria. Data was extracted and risk of bias assessed by one reviewer and validated by a second reviewer.Results: 52 randomized controlled trials met the inclusion criteria and were included in analysis - 37 studies focused on physical activity, diet, or a combination of both, 11 on drug and alcohol use, and 4 on mental health. Participant perceptions were generally positive - only one app was rated as less helpful and satisfactory than the control - and the studies that measured engagement and usability found relatively high study completion rates (mean = 83.3%, n = 18) and ease of use ratings (3 significantly better than control, 9/15 rated >70%) . However, there was little evidence of changed behaviour or health outcomes.Conclusions: There was not strong evidence found to support the effectiveness of mobile apps at improving health behaviours or outcomes because few studies found significant differences between the app and control groups. Further research is needed to identify the behaviour change techniques that are most effective at promoting behaviour change. Improved reporting is necessary to accurately evaluate t
van Velthoven M, Lam C, de Cock C, et al., 2020, Development of an innovative real world evidence registry for the herpes simplex Virus: a case study, JMIR Dermatology, Vol: 3, Pages: 1-10, ISSN: 2562-0959
Background: Infection with the Herpes Simplex Virus is common but is not well understood and stigmatised. Whilst a considerable number of people experience mild to severe physical symptoms after infection, only one sub-effective drug is available for treatment. A registry collecting real world data reported by people with the Herpes Simplex Virus could help them manage their condition, facilitate research into a vaccine, better treatment, and the impact of herpes on other conditions.Objective: This paper reports on the development a registry to collect real world data reported by people with the Herpes Simplex Virus.Methods: A case study design was selected to support a systematic means of observing the subject of investigation. The case study followed seven stages: plan, design, prepare, collect, analyse, create and share. We carried out semi-structured interviews with experts, thematically analysed the findings and built use cases. These will be used to generate detailed models of how a real world evidence registry might look, feel, and operate for different users.Results: We found the following key themes in the interviews: 1) stigma and anonymity; 2) selection bias; 3) understanding treatment and outcome gaps; 4) lifestyle factors; 5) individualised vs population-level; and 6) severe complications of herpes simplex virus. We developed use cases for different types of patients, members of the public, researchers and clinicians for a herpes simplex virus registry.Conclusions: This case study showed insights for the development of an appropriate registry to collect real world data reported by people with the Herpes Simplex Virus. Further research is needed on developing and testing the registry with different users and evaluate its feasibility and effectiveness of collecting data to support symptom management, and the development of vaccines and better treatment.
Fawcett E, van Velthoven M, Brindley D, et al., 2020, Long-term weight management using wearable technology in overweight and obese adults: A systematic review, JMIR mHealth and uHealth, Vol: 8, Pages: 1-10, ISSN: 2291-5222
Background:Whilst there are many wearable devices available to help people losing weight and decrease the rising obesity prevalence, their effectiveness in long-term weight management has not been established.Objective:To systematically review the literature on using wearable technology for long-term weight loss in overweight and obese adults.Methods:We searched the following databases: Medline, Embase, Compendex - ScienceDirect, Cochrane Central, and Scopus. Studies were included that took measurements over a period of ≥1 year (long-term) and had adult participants with a BMI > 24. Two reviewers screened titles and abstracts and assessed selected full text papers for eligibility. Risk of bias assessment was done through the following tools appropriate for different study types: The Cochrane Risk of Bias Tool, ROBINS-I, AMSTAR, ‘6 Questions to Trigger Critical Thinking’. The results of the studies are provided in a narrative summary. Results: We included five intervention studies: four randomised controlled trials, and one non-randomized study. Also, we used insights from six systematic reviews, four commentary papers and a dissertation. The interventions delivered by wearable devices did not show a benefit over comparator interventions, but overweight and obese participants still lost weight over time. The included intervention studies were likely to suffer from bias. There was a range of conclusions between the included studies, due to differences in their objectives, methods, and results. Therefore, it was not possible to conduct a meta-analysis. Conclusions:This review showed some evidence that wearable devices can improve long-term physical activity and weight loss outcomes, but there was not enough evidence to show a benefit over comparator methods. A major issue is the challenge to separate the effect of decreasing use of wearable devices over time from the effect of the wearable devices on outcomes. Consistency in study methods is needed i
de Cock C, Milne-Ives M, van Velthoven M, et al., 2020, Effectiveness of conversational agents (virtual assistants) in healthcare: protocol for a systematic review, JMIR Research Protocols, Vol: 9, Pages: 1-6, ISSN: 1929-0748
Background:Conversational agents have evolved in recent decades to become multimodal, multifunctional platforms that have the potential to automate a diverse range of health-related activities, supporting the general public, patients and physicians. Multiple studies have reported the development of these agents and recent systematic reviews have described the scope of use of conversational agents in healthcare. However, there is little focus on the effectiveness of these systems, thus the viability and applicability of these systems is unclear.Objective:The objective of this systematic review is to assess the effectiveness of conversational agents in healthcare and to identify limitations, adverse events and areas for future investigation of these agents.Methods:The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols will be used to structure this protocol. The focus of the systematic review is guided by a population, intervention, comparator, and outcome framework . A systematic search of PubMed (Medline), EMBASE, CINAHL, and Web of Science will be conducted. Two authors will independently screen the titles and abstracts of identified references and select studies according to the eligibility criteria. Any discrepancies will then be discussed and resolved. Two reviewers will extract and validate data, respectively, from included studies into a standardised form and conduct quality appraisal.Results:At the time of writing, we have begun a preliminary literature search and piloting of the study selection process.Conclusions:This systematic review aims to clarify the effectiveness, limitations and future applications of conversational agents in healthcare. Our findings may be used to inform future development of conversational agents and further the personalisation of care.
Van Velthoven M, Milne-Ives M, de Cock C, et al., 2020, Use of apps to promote childhood vaccination: a systematic review protocol, JMIR Research Protocols, Vol: 9, Pages: 1-6, ISSN: 1929-0748
Background:The decline in the uptake of routine childhood vaccinations has resulted in outbreaks of vaccine-preventable diseases. Vaccination apps can be used as a tool to promote immunization through the provision of reminders, dissemination of information, peer-support and feedback.Objective:The aim of this review is to systematically review the evidence on the use of apps to support childhood vaccination uptake, information storage and record sharing. Methods:We will identify relevant papers by searching electronic databases: PubMed, EMBASE (Ovid), Cochrane Central Register of Controlled Trials, ERIC and ClinicalTrials.gov. We will review the reference lists of those studies that we include to identify relevant additional papers not initially identified using our search strategy. In addition to the use of electronic databases, we will search for grey literature on the topic. The search strategy will include only terms relating to or describing the intervention, which is app use. As almost all titles and abstracts are in English, 100% of these will be reviewed, but retrieval will be confined to those in the English language. We will record the search outcome on a specifically designed record sheet. Two reviewers will select observational and intervention studies, appraise the quality of the studies and extract the relevant data.
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