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Journal of the American Medical... Jul 2024To examine whether comfort with the use of ChatGPT in society differs from comfort with other uses of AI in society and to identify whether this comfort and other...
OBJECTIVES
To examine whether comfort with the use of ChatGPT in society differs from comfort with other uses of AI in society and to identify whether this comfort and other patient characteristics such as trust, privacy concerns, respect, and tech-savviness are associated with expected benefit of the use of ChatGPT for improving health.
MATERIALS AND METHODS
We analyzed an original survey of U.S. adults using the NORC AmeriSpeak Panel (n = 1787). We conducted paired t-tests to assess differences in comfort with AI applications. We conducted weighted univariable regression and 2 weighted logistic regression models to identify predictors of expected benefit with and without accounting for trust in the health system.
RESULTS
Comfort with the use of ChatGPT in society is relatively low and different from other, common uses of AI. Comfort was highly associated with expecting benefit. Other statistically significant factors in multivariable analysis (not including system trust) included feeling respected and low privacy concerns. Females, younger adults, and those with higher levels of education were less likely to expect benefits in models with and without system trust, which was positively associated with expecting benefits (P = 1.6 × 10-11). Tech-savviness was not associated with the outcome.
DISCUSSION
Understanding the impact of large language models (LLMs) from the patient perspective is critical to ensuring that expectations align with performance as a form of calibrated trust that acknowledges the dynamic nature of trust.
CONCLUSION
Including measures of system trust in evaluating LLMs could capture a range of issues critical for ensuring patient acceptance of this technological innovation.
PubMed: 38960730
DOI: 10.1093/jamia/ocae164 -
Social Science & Medicine (1982) Jun 2024With the widespread prevalence of mobile devices, ecological momentary assessment (EMA) can be combined with geospatial data acquired through geographic techniques like... (Review)
Review
With the widespread prevalence of mobile devices, ecological momentary assessment (EMA) can be combined with geospatial data acquired through geographic techniques like global positioning system (GPS) and geographic information system. This technique enables the consideration of individuals' health and behavior outcomes of momentary exposures in spatial contexts, mostly referred to as "geographic ecological momentary assessment" or "geographically explicit EMA" (GEMA). However, the definition, scope, methods, and applications of GEMA remain unclear and unconsolidated. To fill this research gap, we conducted a systematic review to synthesize the methodological insights, identify common research interests and applications, and furnish recommendations for future GEMA studies. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines to systematically search peer-reviewed studies from six electronic databases in 2022. Screening and eligibility were conducted following inclusion criteria. The risk of bias assessment was performed, and narrative synthesis was presented for all studies. From the initial search of 957 publications, we identified 47 articles included in the review. In public health, GEMA was utilized to measure various outcomes, such as psychological health, physical and physiological health, substance use, social behavior, and physical activity. GEMA serves multiple research purposes: 1) enabling location-based EMA sampling, 2) quantifying participants' mobility patterns, 3) deriving exposure variables, 4) describing spatial patterns of outcome variables, and 5) performing data linkage or triangulation. GEMA has advanced traditional EMA sampling strategies and enabled location-based sampling by detecting location changes and specified geofences. Furthermore, advances in mobile technology have prompted considerations of additional sensor-based data in GEMA. Our results highlight the efficacy and feasibility of GEMA in public health research. Finally, we discuss sampling strategy, data privacy and confidentiality, measurement validity, mobile applications and technologies, and GPS accuracy and missing data in the context of current and future public health research that uses GEMA.
PubMed: 38959816
DOI: 10.1016/j.socscimed.2024.117075 -
Journal of Medical Internet Research Jul 2024The COVID-19 pandemic placed an additional mental health burden on individuals and families, resulting in widespread service access problems. Digital mental health... (Review)
Review
BACKGROUND
The COVID-19 pandemic placed an additional mental health burden on individuals and families, resulting in widespread service access problems. Digital mental health interventions suggest promise for improved accessibility. Recent reviews have shown emerging evidence for individual use and early evidence for multiusers. However, attrition rates remain high for digital mental health interventions, and additional complexities exist when engaging multiple family members together.
OBJECTIVE
As such, this scoping review aims to detail the reported evidence for digital mental health interventions designed for family use with a focus on the build and design characteristics that promote accessibility and engagement and enable cocompletion by families.
METHODS
A systematic literature search of MEDLINE, Embase, PsycINFO, Web of Science, and CINAHL databases was conducted for articles published in the English language from January 2002 to March 2024. Eligible records included empirical studies of digital platforms containing some elements designed for cocompletion by related people as well as some components intended to be completed without therapist engagement. Platforms were included in cases in which clinical evidence had been documented.
RESULTS
Of the 9527 papers reviewed, 85 (0.89%) met the eligibility criteria. A total of 24 unique platforms designed for co-use by related parties were identified. Relationships between participants included couples, parent-child dyads, family caregiver-care recipient dyads, and families. Common platform features included the delivery of content via structured interventions with no to minimal tailoring or personalization offered. Some interventions provided live contact with therapists. User engagement indicators and findings varied and included user experience, satisfaction, completion rates, and feasibility. Our findings are more remarkable for what was absent in the literature than what was present. Contrary to expectations, few studies reported any design and build characteristics that enabled coparticipation. No studies reported on platform features for enabling cocompletion or considerations for ensuring individual privacy and safety. None examined platform build or design characteristics as moderators of intervention effect, and none offered a formative evaluation of the platform itself.
CONCLUSIONS
In this early era of digital mental health platform design, this novel review demonstrates a striking absence of information about design elements associated with the successful engagement of multiple related users in any aspect of a therapeutic process. There remains a large gap in the literature detailing and evaluating platform design, highlighting a significant opportunity for future cross-disciplinary research. This review details the incentive for undertaking such research; suggests design considerations when building digital mental health platforms for use by families; and offers recommendations for future development, including platform co-design and formative evaluation.
Topics: Humans; COVID-19; Family; Mental Health Services; Telemedicine; Mental Health; SARS-CoV-2; Pandemics
PubMed: 38959030
DOI: 10.2196/49431 -
JMIR MHealth and UHealth Jul 2024Lifestyle behaviors including exercise, sleep, diet, stress, mental stimulation, and social interaction significantly impact the likelihood of developing dementia....
BACKGROUND
Lifestyle behaviors including exercise, sleep, diet, stress, mental stimulation, and social interaction significantly impact the likelihood of developing dementia. Mobile health (mHealth) apps have been valuable tools in addressing these lifestyle behaviors for general health and well-being, and there is growing recognition of their potential use for brain health and dementia prevention. Effective apps must be evidence-based and safeguard user data, addressing gaps in the current state of dementia-related mHealth apps.
OBJECTIVE
This study aims to describe the scope of available apps for dementia prevention and risk factors, highlighting gaps and suggesting a path forward for future development.
METHODS
A systematic search of mobile app stores, peer-reviewed literature, dementia and Alzheimer association websites, and browser searches was conducted from October 19, 2022, to November 2, 2022. A total of 1044 mHealth apps were retrieved. After screening, 152 apps met the inclusion criteria and were coded by paired, independent reviewers using an extraction framework. The framework was adapted from the Silberg scale, other scoping reviews of mHealth apps for similar populations, and background research on modifiable dementia risk factors. Coded elements included evidence-based and expert credibility, app features, lifestyle elements of focus, and privacy and security.
RESULTS
Of the 152 apps that met the final selection criteria, 88 (57.9%) addressed modifiable lifestyle behaviors associated with reducing dementia risk. However, many of these apps (59/152, 38.8%) only addressed one lifestyle behavior, with mental stimulation being the most frequently addressed. More than half (84/152, 55.2%) scored 2 points out of 9 on the Silberg scale, with a mean score of 2.4 (SD 1.0) points. Most of the 152 apps did not disclose essential information: 120 (78.9%) did not disclose expert consultation, 125 (82.2%) did not disclose evidence-based information, 146 (96.1%) did not disclose author credentials, and 134 (88.2%) did not disclose their information sources. In addition, 105 (69.2%) apps did not disclose adherence to data privacy and security practices.
CONCLUSIONS
There is an opportunity for mHealth apps to support individuals in engaging in behaviors linked to reducing dementia risk. While there is a market for these products, there is a lack of dementia-related apps focused on multiple lifestyle behaviors. Gaps in the rigor of app development regarding evidence base, credibility, and adherence to data privacy and security standards must be addressed. Following established and validated guidelines will be necessary for dementia-related apps to be effective and advance successfully.
Topics: Humans; Mobile Applications; Dementia; Alzheimer Disease; Telemedicine
PubMed: 38959029
DOI: 10.2196/50186 -
Frontiers in Artificial Intelligence 2024The release of GPT-4 has garnered widespread attention across various fields, signaling the impending widespread adoption and application of Large Language Models... (Review)
Review
The release of GPT-4 has garnered widespread attention across various fields, signaling the impending widespread adoption and application of Large Language Models (LLMs). However, previous research has predominantly focused on the technical principles of ChatGPT and its social impact, overlooking its effects on human-computer interaction and user psychology. This paper explores the multifaceted impacts of ChatGPT on human-computer interaction, psychology, and society through a literature review. The author investigates ChatGPT's technical foundation, including its Transformer architecture and RLHF (Reinforcement Learning from Human Feedback) process, enabling it to generate human-like responses. In terms of human-computer interaction, the author studies the significant improvements GPT models bring to conversational interfaces. The analysis extends to psychological impacts, weighing the potential of ChatGPT to mimic human empathy and support learning against the risks of reduced interpersonal connections. In the commercial and social domains, the paper discusses the applications of ChatGPT in customer service and social services, highlighting the improvements in efficiency and challenges such as privacy issues. Finally, the author offers predictions and recommendations for ChatGPT's future development directions and its impact on social relationships.
PubMed: 38957452
DOI: 10.3389/frai.2024.1418869 -
Ghana Medical Journal Mar 2024Infertility remains a global challenge, with assisted reproductive technology (ART) progressively gaining relevance in developing countries, including Ghana. However,...
OBJECTIVE
Infertility remains a global challenge, with assisted reproductive technology (ART) progressively gaining relevance in developing countries, including Ghana. However, associated ethico-legal challenges have not received the needed policy attention. This study explored the legal and ethical challenges of ART practice in Ghana.
DESIGN
The study employed an exploratory phenomenological approach to examine ART in Ghana, focusing on ethics and law governing this practice.
PARTICIPANTS
Respondents were ART practitioners, managers, facility owners, representatives of surrogacy/gamete donor agencies, and regulatory body representatives.
METHODS
A semi-structured interview guide was used to collect data.The in-depth interviews were audiotaped, and responses transcribed for analysis through coding, followed by generation of themes and sub-themes, supported with direct quotes.
RESULTS
It emerged that there are no ethical and legal frameworks for ART practice in Ghana, and this adversely affects ART practice. Ethical challenges identified border on informed consent, clients' privacy and clinical data protection, gamete donation issues, multiple gestations, single parenting, and social and religious issues. The legal challenges identified include the non-existence of a legal regime for regulating ART practice and the absence of a professional body with clear-cut guidelines on ART practice. In the absence of legal and ethical frameworks in Ghana, practitioners intimated they do comply with internationally accepted principles and general ethics in medical practice.
CONCLUSION
There are no regulations on ART in Ghana. Legal and ethical guidelines are essential to the provision of safe and successful ART practices to protect providers and users. Governmental efforts to regulate Ghana need to be prioritized.
FUNDING
This study had no external funding support. It was funded privately from researchers' contributions.
Topics: Humans; Ghana; Reproductive Techniques, Assisted; Female; Informed Consent; Male; Interviews as Topic; Pregnancy; Infertility; Qualitative Research
PubMed: 38957285
DOI: 10.4314/gmj.v58i1.11 -
The Lancet Regional Health. Southeast... Aug 2024Telemedicine is a promising solution to the challenges of delivering equitable and quality primary healthcare, especially in LMICs. This review evaluated peer-reviewed... (Review)
Review
Telemedicine is a promising solution to the challenges of delivering equitable and quality primary healthcare, especially in LMICs. This review evaluated peer-reviewed literature on telehealth interventions in Indian primary care published from Jan 1, 2011 to Dec 31, 2021, from PubMed, Scopus, TRIP, Google Scholar, Indian Kanoon, and Cochrane database The majority of Indian studies focus on key health issues like maternal and child health, mental health, diabetes, infectious diseases, and hypertension, mainly through patient education, monitoring, and diagnostics. Yet, there's a lack of research on telemedicine's cost-effectiveness, communication among providers, and the role of leadership in its quality and accessibility. The current research has gaps, including small sample sizes and inconsistent methodologies, which hamper the evaluation of telemedicine's effectiveness. India's varied healthcare landscape, technological limitations, and social factors further challenge telemedicine's adoption. Despite regulatory efforts, issues like the digital divide and data privacy persist. Addressing these challenges with a context-aware, technologically driven approach is crucial for enhancing healthcare through telemedicine in India.
PubMed: 38957222
DOI: 10.1016/j.lansea.2024.100431 -
BMC Women's Health Jul 2024This qualitative study aims to assess perspectives of clinicians and clinic staff on mail-order pharmacy dispensing for medication abortion.
BACKGROUND
This qualitative study aims to assess perspectives of clinicians and clinic staff on mail-order pharmacy dispensing for medication abortion.
METHODS
Participants included clinicians and staff involved in implementing a mail-order dispensing model for medication abortion at eleven clinics in seven states as part of a prospective cohort study, which began in January 2020 (before the FDA removed the in-person dispensing requirement for mifepristone). From June 2021 to July 2022, we invited participants at the participating clinics, including six primary care and five abortion clinics, to complete a semi-structured video interview about their experiences. We then conducted qualitative thematic analysis of interview data, summarizing themes related to perceived benefits and concerns about the mail-order model, perceived patient interest, and potential barriers to larger-scale implementation.
RESULTS
We conducted 24 interviews in total with clinicians (13 physicians and one nurse practitioner) and clinic staff (n = 10). Participants highlighted perceived benefits of the mail-order model, including its potential to expand abortion services into primary care, increase patient autonomy and privacy, and to normalize abortion services. They also highlighted key logistical, clinical, and feasibility concerns about the mail-order model, and specific challenges related to integrating abortion into primary care.
CONCLUSION
Clinicians and clinic staff working in primary care and abortion clinics were optimistic that mail-order dispensing of medication abortion can improve the ability of some providers to provide abortion and enable more patients to access services. The feasibility of mail-order pharmacy dispensing of medication abortion following the Supreme Court Dobbs decision is to be determined.
TRIAL REGISTRATION
Registry: Clinicaltrials.gov.
TRIAL REGISTRATION NUMBER
NCT03913104. Date of registration: first submitted on April 3, 2019 and first posted on April 12, 2019.
Topics: Humans; Abortion, Induced; Female; Qualitative Research; Primary Health Care; Postal Service; Attitude of Health Personnel; Pregnancy; Prospective Studies; Adult; Male; United States; Middle Aged; Abortifacient Agents
PubMed: 38956609
DOI: 10.1186/s12905-024-03202-z -
BMC Psychiatry Jul 2024Patients' online record access (ORA) enables patients to read and use their health data through online digital solutions. One such solution, patient-accessible...
BACKGROUND
Patients' online record access (ORA) enables patients to read and use their health data through online digital solutions. One such solution, patient-accessible electronic health records (PAEHRs) have been implemented in Estonia, Finland, Norway, and Sweden. While accumulated research has pointed to many potential benefits of ORA, its application in mental healthcare (MHC) continues to be contested. The present study aimed to describe MHC users' overall experiences with national PAEHR services.
METHODS
The study analysed the MHC-part of the NORDeHEALTH 2022 Patient Survey, a large-scale multi-country survey. The survey consisted of 45 questions, including demographic variables and questions related to users' experiences with ORA. We focused on the questions concerning positive experiences (benefits), negative experiences (errors, omissions, offence), and breaches of security and privacy. Participants were included in this analysis if they reported receiving mental healthcare within the past two years. Descriptive statistics were used to summarise data, and percentages were calculated on available data.
RESULTS
6,157 respondents were included. In line with previous research, almost half (45%) reported very positive experiences with ORA. A majority in each country also reported improved trust (at least 69%) and communication (at least 71%) with healthcare providers. One-third (29.5%) reported very negative experiences with ORA. In total, half of the respondents (47.9%) found errors and a third (35.5%) found omissions in their medical documentation. One-third (34.8%) of all respondents also reported being offended by the content. When errors or omissions were identified, about half (46.5%) reported that they took no action. There seems to be differences in how patients experience errors, omissions, and missing information between the countries. A small proportion reported instances where family or others demanded access to their records (3.1%), and about one in ten (10.7%) noted that unauthorised individuals had seen their health information.
CONCLUSIONS
Overall, MHC patients reported more positive experiences than negative, but a large portion of respondents reported problems with the content of the PAEHR. Further research on best practice in implementation of ORA in MHC is therefore needed, to ensure that all patients may reap the benefits while limiting potential negative consequences.
Topics: Humans; Electronic Health Records; Male; Female; Adult; Middle Aged; Estonia; Norway; Finland; Mental Health Services; Sweden; Surveys and Questionnaires; Young Adult; Aged; Patient Access to Records; Adolescent
PubMed: 38956493
DOI: 10.1186/s12888-024-05916-8 -
International Journal of Gynecological... Jul 2024To investigate the prevalence and patterns of social media use among gynecologic oncologists for professional and academic purposes.
OBJECTIVE
To investigate the prevalence and patterns of social media use among gynecologic oncologists for professional and academic purposes.
METHODS
A prospective online survey between November and December 2022 targeted gynecologic oncology practitioners (gynecologic oncologists, surgical oncologists, medical oncologists, radiation/clinical oncologists, and onco-pathologists/pathologists). The survey, distributed via various social media platforms, included 40 questions to capture qualitative and quantitative data on social media use.
RESULTS
Of 131 respondents from 32 countries, 106 (80.9%) were gynecologic oncologists and affiliated with academic institutions (84.7%). Facebook (n=110, 83.9%), Twitter (n= 108, 82.4%), and Instagram (n=100, 76.3%) were the most used platforms. Respondents used social media to stay updated (n=101, 77.1%), network (n=97, 74%), learn about conferences and webinars (n=97, 74%), and engage in academic discussions (n=84, 64.1%). Following the COVID-19 pandemic, 100/129 (77.5%) reported increased social media use. However, only 32 (24.4%) used it to connect with patients, and concerns were raised about privacy and the need for separate professional and personal accounts. A quarter of respondents hesitated to share their opinions on social media due to the fear of controversy, with 26 (20%) experiencing cyberbullying, yet 120/130 (92.3%) believed it enabled junior professionals to express their views. Concerns about differentiating valid content, information reliability, and the professional perception of sourcing knowledge from social media were noted. Gender, age, specialty, and income level influenced patterns of social media use, with variations in preferences for platforms, content engagement, and purposes, highlighting a complex landscape of social media interaction among gynecologic oncologists.
CONCLUSION
While the use of social media among gynecologic oncologists is prevalent, particularly for academic and professional development, challenges such as cyberbullying, privacy concerns, and the need for formal training in social media navigation persist. Tailored training programs and guidelines could enhance social media's effective and ethical use in this field, promoting a safe environment for professional expression and engagement.
PubMed: 38955373
DOI: 10.1136/ijgc-2024-005573