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Digital Health 2023Lifestyle interventions are increasingly becoming an integrated part of nonalcoholic fatty liver disease (NAFLD) management. Electronic lifestyle interventions may be... (Review)
Review
OBJECTIVE
Lifestyle interventions are increasingly becoming an integrated part of nonalcoholic fatty liver disease (NAFLD) management. Electronic lifestyle interventions may be able to expand the access and utility of this approach. This study aimed to synthesize the evidence for the effects of electronic-based lifestyle interventions on weight, anthropometric, and liver enzyme measurements in patients with NAFLD.
METHODS
Medline, Scopus, and Web of Science were searched up to February 2023. Clinical trials investigating the effects of electronic lifestyle interventions on weight, body mass index (BMI), waist circumference (WC), and liver enzymes in NAFLD patients were reviewed. After reviewing full-text articles, seven clinical trials were included in the systematic review.
RESULTS
Two articles included telephone calls, one was based on text messaging, two studies were based on web-based lifestyle modifications, and two used mobile apps. Except for one, all other six studies indicated a significant impact on weight loss. BMI was reported in six of seven studies. Except for one, BMI was significantly reduced in the group receiving e-health. WC was reported in four studies, which indicated a significant reduction in the e-health intervention group. Alanine transaminase (ALT) was reported in all the included studies. Except for two, others demonstrated a significant improvement in ALT in the e-health intervention groups. As reported in four studies, Aspartate transaminase (AST) significantly decreased in the group receiving e-health interventions, except in one study.
CONCLUSIONS
The results support applying electronic lifestyle interventions in NAFLD patients to reduce weight, BMI, WC, AST, and ALT.
PubMed: 37529544
DOI: 10.1177/20552076231187597 -
NPJ Digital Medicine Feb 2024Psychological interventions can help reduce posttraumatic stress symptoms (PTSS) in youth, but many do not seek help. Internet- and mobile-based interventions (IMIs)... (Review)
Review
Psychological interventions can help reduce posttraumatic stress symptoms (PTSS) in youth, but many do not seek help. Internet- and mobile-based interventions (IMIs) show promise in expanding treatment options. However, the overall evidence on IMIs in reducing PTSS among youth remains unclear. This systematic review and meta-analysis investigated the efficacy of IMIs in PTSS reduction for youth exposed to traumatic events. A comprehensive literature search was conducted in January 2023 including non-randomized and randomized-controlled trials (RCT) investigating the effects of IMIs on PTSS in youth aged ≤25 years. Six studies were identified with five providing data for the meta-analysis. The majority of studies included youth with different types of trauma irrespective of PTSS severity at baseline (k = 5). We found a small within-group effect in reducing PTSS from baseline to post-treatment (g = -0.39, 95% CrI: -0.67 to -0.11, k = 5; n = 558; 9 comparisons). No effect emerged when comparing the effect of IMIs to control conditions (g = 0.04; 95%-CrI: -0.52 to 0.6, k = 3; n = 768; k = 3; 4 comparisons). Heterogeneity was low between and within studies. All studies showed at least some concerns in terms of risk of bias. Current evidence does not conclusively support the overall efficacy of IMIs in addressing youth PTSS. This review revealed a scarcity of studies investigating IMIs for youth exposed to traumatic events, with most being feasibility studies rather than adequately powered RCTs and lacking a trauma focus. This underscores the demand for more high-quality research.
PubMed: 38424186
DOI: 10.1038/s41746-024-01042-7 -
NPJ Digital Medicine Feb 2024Societies are exposed to major challenges at an increasing pace. This underscores the need for preventive measures such as resilience promotion that should be available... (Review)
Review
Societies are exposed to major challenges at an increasing pace. This underscores the need for preventive measures such as resilience promotion that should be available in time and without access barriers. Our systematic review summarizes evidence on digital resilience interventions, which have the potential to meet these demands. We searched five databases for randomized-controlled trials in non-clinical adult populations. Primary outcomes were mental distress, positive mental health, and resilience factors. Multilevel meta-analyses were performed to compare intervention and control groups at post-intervention and follow-up assessments. We identified 101 studies comprising 20,010 participants. Meta-analyses showed small favorable effects on mental distress, SMD = -0.24, 95% CI [-0.31, -0.18], positive mental health, SMD = 0.27, 95% CI [0.13, 0.40], and resilience factors, SMD = 0.31, 95% CI [0.21, 0.41]. Among middle-aged samples, older age was associated with more beneficial effects at follow-up, and effects were smaller for active control groups. Effects were comparable to those of face-to-face interventions and underline the potential of digital resilience interventions to prepare for future challenges.
PubMed: 38332030
DOI: 10.1038/s41746-024-01017-8 -
NPJ Digital Medicine Jul 2023Digital health, including telemedicine, has increased access to abortion care. The convenience, flexibility of appointment times, and ensured privacy to abortion users... (Review)
Review
Digital health, including telemedicine, has increased access to abortion care. The convenience, flexibility of appointment times, and ensured privacy to abortion users may make abortion services via telemedicine preferable. This scoping review systematically mapped studies conducted on abortion services via telemedicine, including their effectiveness and acceptability for abortion users and providers. All published papers included abortion services via telemedicine in the United States were considered. Articles were searched in PubMed, CINAHL, and Google Scholar databases in September 2022. The findings were synthesized narratively, and the PRISMA-ScR guidelines were used to report this study. Out of 757 retrieved articles, 33 articles were selected based on the inclusion criteria. These studies were published between 2011 and 2022, with 24 published in the last 3 years. The study found that telemedicine increased access to abortion care in the United States, especially for people in remote areas or those worried about stigma from in-person visits. The effectiveness of abortion services via telemedicine was comparable to in-clinic visits, with 6% or fewer abortions requiring surgical intervention. Both care providers and abortion seekers expressed positive perceptions of telemedicine-based abortion services. However, abortion users reported mixed emotions, with some preferring in-person visits. The most common reasons for choosing telemedicine included the distance to the abortion clinic, convenience, privacy, cost, flexibility of appointment times, and state laws imposing waiting periods or restrictive policies. Telemedicine offered a preferable option for abortion seekers and providers. The feasibility of accessing abortion services via telemedicine in low-resource settings needs further investigation.
PubMed: 37438435
DOI: 10.1038/s41746-023-00871-2 -
Digital Health 2024The integration of advanced technologies, including three-dimensional (3D) imaging modalities and virtual simulations, has significantly influenced contemporary... (Review)
Review
AIM
The integration of advanced technologies, including three-dimensional (3D) imaging modalities and virtual simulations, has significantly influenced contemporary approaches to preoperative planning in implant dentistry. Through a meticulous analysis of relevant studies, this review synthesizes findings related to accuracy outcomes in implant placement facilitated by 3D imaging in virtual patients.
METHODS
A comprehensive literature search was conducted across relevant databases to identify relevant studies published to date. The inclusion criteria were studies utilizing 3D imaging techniques, virtual patients, and those focusing on the accuracy of dental implant planning and surgical placement. The selected studies were critically appraised for their methodological quality.
RESULTS
After a rigorous analysis, 21 relevant articles were included out of 3021 articles. This study demonstrates the versatility and applicability of these technologies in both and settings. Integrating Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM), cone bean computed tomography (CBCT), and advanced 3D reconstruction methodologies showcases a trend toward enhanced precision in implant planning and placement. Notably, the evaluation parameters varied, encompassing distances, discrepancies, and deviations in the implant placement. The ongoing integration of systems such as dynamic navigation systems, augmented reality, and sophisticated software platforms shows a promising trajectory for the continued refinement of virtual reality applications in dental implantology, providing valuable insights for future research and clinical implementation. Moreover, using stereolithographic surgical guides, virtual planning with CBCT data, and 3D-printed templates consistently demonstrates enhanced precision in dental implant placement compared to traditional methods.
CONCLUSION
The synthesis of the available evidence underscores the substantial positive impact of 3D imaging techniques and virtual patients on dental implant planning and surgical placement accuracy. Utilizing these technologies contributes to a more personalized and precise approach that enhances overall treatment outcomes. Future research directions and potential refinements to the application of these technologies in clinical practice should be discussed.
PubMed: 38726220
DOI: 10.1177/20552076241253550 -
Digital Health 2024Electronic patient-reported outcome (ePRO) systems hold promise for revolutionizing communication between cancer patients and healthcare providers across various care... (Review)
Review
OBJECTIVE
Electronic patient-reported outcome (ePRO) systems hold promise for revolutionizing communication between cancer patients and healthcare providers across various care settings. This systematic review explores the multifaceted landscape of ePROs in cancer care, encompassing their advantages, disadvantages, potential risks, and opportunities for improvement.
METHODS
In our systematic review, we conducted a rigorous search in Scopus, Web of Science, and PubMed, employing comprehensive medical subject heading terms for ePRO and cancer, with no date limitations up to 2024. Studies were critically appraised and thematically analyzed based on inclusion and exclusion criteria, including considerations of advantages, disadvantages, opportunities, and threats.
FINDINGS
Analyzing 85 articles revealed 69 themes categorized into four key areas. Advantages ( = 14) were dominated by themes like "improved quality of life and care." Disadvantages ( = 26) included "limited access and technical issues." Security concerns and lack of technical skills were prominent threats ( = 10). Opportunities ( = 19) highlighted advancements in symptom management and potential solutions for technical challenges.
CONCLUSION
This review emphasizes the crucial role of continuous exploration, integration, and innovation in ePRO systems for optimizing patient outcomes in cancer care. Beyond traditional clinical settings, ePROs hold promise for applications in survivorship, palliative care, and remote monitoring. By addressing existing limitations and capitalizing on opportunities, ePROs can empower patients, enhance communication, and ultimately improve care delivery across the entire cancer care spectrum.
PubMed: 38812853
DOI: 10.1177/20552076241257146 -
Digital Health 2023Due to the large volume of online health information, while quality remains dubious, understanding the usage of artificial intelligence to evaluate health information... (Review)
Review
BACKGROUND
Due to the large volume of online health information, while quality remains dubious, understanding the usage of artificial intelligence to evaluate health information and surpass human-level performance is crucial. However, the existing studies still need a comprehensive review highlighting the vital machine, and Deep learning techniques for the automatic health information evaluation process.
OBJECTIVE
Therefore, this study outlines the most recent developments and the current state of the art regarding evaluating the quality of online health information on web pages and specifies the direction of future research.
METHODS
In this article, a systematic literature is conducted according to the PRISMA statement in eight online databases PubMed, Science Direct, Scopus, ACM, Springer Link, Wiley Online Library, Emerald Insight, and Web of Science to identify all empirical studies that use machine and deep learning models for evaluating the online health information quality. Furthermore, the selected techniques are compared based on their characteristics, such as health quality criteria, quality measurement tools, algorithm type, and achieved performance.
RESULTS
The included papers evaluate health information on web pages using over 100 quality criteria. The results show no universal quality dimensions used by health professionals and machine or deep learning practitioners while evaluating health information quality. In addition, the metrics used to assess the model performance are not the same as those used to evaluate human performance.
CONCLUSIONS
This systemic review offers a novel perspective in approaching the health information quality in web pages that can be used by machine and deep learning practitioners to tackle the problem more effectively.
PubMed: 38025112
DOI: 10.1177/20552076231212296 -
Frontiers in Aging Neuroscience 2023Diagnostic classification systems and guidelines posit distinguishing patterns of impairment in Alzheimer's (AD) and vascular dementia (VaD). In our study, we aim to...
INTRODUCTION
Diagnostic classification systems and guidelines posit distinguishing patterns of impairment in Alzheimer's (AD) and vascular dementia (VaD). In our study, we aim to identify which diagnostic instruments distinguish them.
METHODS
We searched PubMed and PsychInfo for empirical studies published until December 2020, which investigated differences in cognitive, behavioral, psychiatric, and functional measures in patients older than 64 years and reported information on VaD subtype, age, education, dementia severity, and proportion of women. We systematically reviewed these studies and conducted Bayesian hierarchical meta-regressions to quantify the evidence for differences using the Bayes factor (BF). The risk of bias was assessed using the Newcastle-Ottawa-Scale and funnel plots.
RESULTS
We identified 122 studies with 17,850 AD and 5,247 VaD patients. Methodological limitations of the included studies are low comparability of patient groups and an untransparent patient selection process. In the digit span backward task, AD patients were nine times more probable (BF = 9.38) to outperform VaD patients ( = 0.33, 95% = 0.12, 0.52). In the phonemic fluency task, AD patients outperformed subcortical VaD (sVaD) patients ( = 0.51, 95% = 0.22, 0.77, BF = 42.36). VaD patients, in contrast, outperformed AD patients in verbal ( = -0.61, 95% = -0.97, -0.26, BF = 22.71) and visual ( = -0.85, 95% = -1.29, -0.32, BF = 13.67) delayed recall. We found the greatest difference in verbal memory, showing that sVaD patients outperform AD patients ( = -0.64, 95% = -0.88, -0.36, BF = 72.97). Finally, AD patients performed worse than sVaD patients in recognition memory tasks ( = -0.76, 95% = -1.26, -0.26, BF = 11.50).
CONCLUSION
Our findings show inferior performance of AD in episodic memory and superior performance in working memory. We found little support for other differences proposed by diagnostic systems and diagnostic guidelines. The utility of cognitive, behavioral, psychiatric, and functional measures in differential diagnosis is limited and should be complemented by other information. Finally, we identify research areas and avenues, which could significantly improve the diagnostic value of cognitive measures.
PubMed: 38020767
DOI: 10.3389/fnagi.2023.1267434 -
NPJ Digital Medicine May 2024Ensuring diagnostic performance of artificial intelligence (AI) before introduction into clinical practice is essential. Growing numbers of studies using AI for digital... (Review)
Review
Ensuring diagnostic performance of artificial intelligence (AI) before introduction into clinical practice is essential. Growing numbers of studies using AI for digital pathology have been reported over recent years. The aim of this work is to examine the diagnostic accuracy of AI in digital pathology images for any disease. This systematic review and meta-analysis included diagnostic accuracy studies using any type of AI applied to whole slide images (WSIs) for any disease. The reference standard was diagnosis by histopathological assessment and/or immunohistochemistry. Searches were conducted in PubMed, EMBASE and CENTRAL in June 2022. Risk of bias and concerns of applicability were assessed using the QUADAS-2 tool. Data extraction was conducted by two investigators and meta-analysis was performed using a bivariate random effects model, with additional subgroup analyses also performed. Of 2976 identified studies, 100 were included in the review and 48 in the meta-analysis. Studies were from a range of countries, including over 152,000 whole slide images (WSIs), representing many diseases. These studies reported a mean sensitivity of 96.3% (CI 94.1-97.7) and mean specificity of 93.3% (CI 90.5-95.4). There was heterogeneity in study design and 99% of studies identified for inclusion had at least one area at high or unclear risk of bias or applicability concerns. Details on selection of cases, division of model development and validation data and raw performance data were frequently ambiguous or missing. AI is reported as having high diagnostic accuracy in the reported areas but requires more rigorous evaluation of its performance.
PubMed: 38704465
DOI: 10.1038/s41746-024-01106-8 -
NPJ Digital Medicine Mar 2024The effects of technology-supported behavior change interventions for reducing sodium intake on health outcomes in adults are inconclusive. Effective intervention... (Review)
Review
The effects of technology-supported behavior change interventions for reducing sodium intake on health outcomes in adults are inconclusive. Effective intervention characteristics associated with sodium reduction have yet to be identified. A systematic review and meta-analysis were conducted, searching randomized controlled trials (RCTs) published between January 2000 and April 2023 across 5 databases (PROSPERO: CRD42022357905). Meta-analyses using random-effects models were performed on 24-h urinary sodium (24HUNa), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Subgroup analysis and meta-regression of 24HUNa were performed to identify effective intervention characteristics. Eighteen RCTs involving 3505 participants (51.5% female, mean age 51.6 years) were included. Technology-supported behavior change interventions for reducing sodium intake significantly reduced 24HUNa (mean difference [MD] -0.39 gm/24 h, 95% confidence interval [CI] -0.50 to -0.27; I = 24%), SBP (MD -2.67 mmHg, 95% CI -4.06 to -1.29; I = 40%), and DBP (MD -1.39 mmHg, 95% CI -2.31 to -0.48; I = 31%), compared to control conditions. Interventions delivered more frequently (≤weekly) were associated with a significantly larger effect size in 24HUNa reduction compared to less frequent interventions (>weekly). Other intervention characteristics, such as intervention delivery via instant messaging and participant-family dyad involvement, were associated with larger, albeit non-significant, effect sizes in 24HUNa reduction when compared to other subgroups. Technology-supported behavior change interventions aimed at reducing sodium intake were effective in reducing 24HUNa, SBP, and DBP at post-intervention. Effective intervention characteristics identified in this review should be considered to develop sodium intake reduction interventions and tested in future trials, particularly for its long-term effects.
PubMed: 38499729
DOI: 10.1038/s41746-024-01067-y