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| 2. |
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| 3. |
- Blom, MC, et al.
(författare)
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Harmonization of the ICHOM Quality Measures to Enable Health Outcomes Measurement in Multimorbid Patients
- 2020
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Ingår i: Frontiers in digital health. - : Frontiers Media SA. - 2673-253X. ; 2, s. 606246-
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Tidskriftsartikel (refereegranskat)abstract
- Objectives:To update the sets of patient-centric outcomes measures (“standard-sets”) developed by the not-for-profit organization ICHOM to become more readily applicable in patients with multimorbidity and to facilitate their implementation in health information systems. To that end we set out to (i) harmonize measures previously defined separately for different conditions, (ii) create clinical information models from the measures, and (iii) restructure the annotation to make the sets machine-readable.Materials and Methods:First, we harmonized the semantic meaning of individual measures across all the 28 standard-sets published to date, in a harmonized measure repository. Second, measures corresponding to four conditions (Breast cancer, Cataracts, Inflammatory bowel disease and Heart failure) were expressed as logical models and mapped to reference terminologies in a pilot study.Results:The harmonization of semantic meaning resulted in a consolidation of measures used across the standard-sets by 15%, from 3,178 to 2,712. These were all converted into a machine-readable format. 61% of the measures in the 4 pilot sets were bound to existing concepts in either SNOMED CT or LOINC.Discussion:The harmonization of ICHOM measures across conditions is expected to increase the applicability of ICHOM standard-sets to multi-morbid patients, as well as facilitate their implementation in health information systems.Conclusion:Harmonizing the ICHOM measures and making them machine-readable is expected to expedite the global adoption of systematic and interoperable outcomes measurement. In turn, we hope that the improved transparency on health outcomes that follows will let health systems across the globe learn from each other to the ultimate benefit of patients.
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| 4. |
- Bäckström, Caroline A., et al.
(författare)
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Digital Tools as Parental Support : A Study Protocol Describing Prospective Development and Exploration of Two Digital Tools for Parents
- 2021
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Ingår i: Frontiers in Digital Health. - : Frontiers Media S.A.. - 2673-253X .- 2673-253X. ; 3, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Background: The access to digital tools for parents is increasing, and further exploration is needed to gain knowledge about parents' experiences in using such tools, for example, when preparing for childbirth and parenthood. This study protocol describes a prospective study that will explore serious games as digital tools for parental support, and both parents' and healthcare professionals' views will be included. The objectives of the prospective study are to explore two different serious games: (1) Childbirth Journey (Swedish: Förlossningsresan), relating to pregnancy, childbirth and parenthood; and (2) Interplay (Swedish: Samspel), relating to parental couple relationships and parenthood.Methods: An intervention study will be conducted. The study will include four different sub-studies (A–D) with both qualitative and quantitative methods and a longitudinal design. Both parents (A, B and D) and healthcare professionals (C) will be included, and data will be collected through interviews (A–C) and repeated web-based questionnaires (D). Data will be analysed using phenomenography and qualitative content analysis (A–C), and descriptive and analytical analyses will be performed for comparisons and associations (D).Discussion: The value of monitoring and reporting on developments and trends in digital innovation for public health has been stipulated by the World Health Organization. The prospective study will contribute further knowledge about multidisciplinary development of digital tools as professional support for parents, as well as knowledge about parents' and healthcare professionals' experiences using digital tools concerning pregnancy, labour, parenthood and parental couple relationships.Trial Registration: This study was retrospectively registered (02/10/2020) within the ISRCTN with ID: ISRCTN18017741. http://www.isrctn.com/ISRCTN18017741.
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| 5. |
- Bäckström, Caroline A., et al.
(författare)
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Healthcare professionals' perceptions of a digital parental support, Childbirth Journey, constructed as a serious game—An intervention study
- 2023
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Ingår i: Frontiers in Digital Health. - : Frontiers Media S.A.. - 2673-253X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Globally, the digital sources developed and available in antenatal care differ, and infrastructure challenges may impede the further development of such sources. Challenges accompanying digital developments can include the commonly occurring high workload, which affects healthcare professionals' ability to acquire professional knowledge about how to best support parents in using digital sources. Including healthcare professionals in the development process of digital sources may increase the likelihood that such sources will be adopted and employed by these professionals in their future care work. Therefore, the present research explored healthcare professionals' perceptions of the digital support intervention Childbirth Journey, which was constructed as a serious game for expectant parents. Methods: Data were collected through semi-structured focus-group interviews with 11 midwives at antenatal, labour and postnatal clinics as well as with child healthcare nurses. Prior to the interviews, all participants were provided the intervention, Childbirth Journey, which is a serious game in a mobile application format consisting of two distinct parts: (1) a story-driven game and (2) a Knowledge Portal. The data were analysed using phenomenographic methods. Results: The perceptions of Childbirth Journey by healthcare professionals, midwives and child healthcare nurses are presented in four descriptive categories: extended professional support, trustworthy contents, diversity or individuality, and both appealing and in need of development. Conclusions: Current study revealed that Childbirth Journey may be utilised as a digital support for parents, allowing healthcare professionals to offer a digital solution as a complementary support to standard, face-to-face meetings with caregivers. However, the research results also revealed that some elements of Childbirth Journey must be improved, thereby representing a main contribution of this study: insights into how to better develop digital tools under the umbrella of health care. Thus, we conclude that in order to create sustainable and safe digital care solutions that function as trustworthy professional supports instead of technical products that risk harming users, the perspectives of both patients and healthcare professionals should be considered in the exploration and development of these solutions.
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| 6. |
- Bäckström, Caroline, et al.
(författare)
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Parents' Perceptions About Future Digital Parental Support—A Phenomenographic Interview Study
- 2021
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Ingår i: Frontiers in Digital Health. - : Frontiers Media S.A.. - 2673-253X .- 2673-253X. ; 3, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Parents use digital sources (such as the internet or online forums and applications) during pregnancy and after childbirth to receive informative support. Research shows that there is further need for innovation development in digital parental support despite informative support available in digital form.Purpose: To explore parents' perceptions of future digital parental support concerning pregnancy and the first 18 months of parenthood.Method: A phenomenographic interview study with an inductive approach including 15 semi-structured interviews was conducted.Results: The analysis process resulted in three descriptive categories: Opportunities for virtual and in-person meetings, Individualized digital parental support, and Professional knowledge and trustworthiness concerning future digital parental support.Conclusion: The results broaden the knowledge about how future digital parental support can be designed to facilitate the functional, interactive, and critical digital health literacy of new and would-be parents. To succeed, healthcare organizations should allow healthcare professionals to assume an active role in developing digital parental support, both as health educators (i.e., providing parents with knowledge) and facilitators (i.e., facilitating parents' use of digital parental support). However, parents perceived that future digital parental support should complement standard care instead of replacing in-person meetings with healthcare professionals.
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| 7. |
- Hamidi, Farzaneh, et al.
(författare)
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Identifying potential circulating miRNA biomarkers for the diagnosis and prediction of ovarian cancer using machine-learning approach : application of Boruta
- 2023
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Ingår i: FRONTIERS IN DIGITAL HEALTH. - : Frontiers Media S.A.. - 2673-253X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: In gynecologic oncology, ovarian cancer is a great clinical challenge. Because of the lack of typical symptoms and effective biomarkers for noninvasive screening, most patients develop advanced-stage ovarian cancer by the time of diagnosis. MicroRNAs (miRNAs) are a type of non-coding RNA molecule that has been linked to human cancers. Specifying diagnostic biomarkers to determine non-cancer and cancer samples is difficult.Methods: By using Boruta, a novel random forest-based feature selection in the machine-learning techniques, we aimed to identify biomarkers associated with ovarian cancer using cancerous and non-cancer samples from the Gene Expression Omnibus (GEO) database: GSE106817. In this study, we used two independent GEO data sets as external validation, including GSE113486 and GSE113740. We utilized five state-of-the-art machine-learning algorithms for classification: logistic regression, random forest, decision trees, artificial neural networks, and XGBoost.Results: Four models discovered in GSE113486 had an AUC of 100%, three in GSE113740 with AUC of over 94%, and four in GSE113486 with AUC of over 94%. We identified 10 miRNAs to distinguish ovarian cancer cases from normal controls: hsa-miR-1290, hsa-miR-1233-5p, hsa-miR-1914-5p, hsa-miR-1469, hsa-miR-4675, hsa-miR-1228-5p, hsa-miR-3184-5p, hsa-miR-6784-5p, hsa-miR-6800-5p, and hsa-miR-5100. Our findings suggest that miRNAs could be used as possible biomarkers for ovarian cancer screening, for possible intervention.
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| 8. |
- Ingvar, M., et al.
(författare)
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On the Annotation of Health Care Pathways to Allow the Application of Care-Plans That Generate Data for Multiple Purposes
- 2021
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Ingår i: Frontiers in Digital Health. - : Frontiers Media SA. - 2673-253X. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Procedural interoperability in health care requires information support and monitoring of a common work practice. Our aim was to devise an information model for a complete annotation of actions in clinical pathways that allow use of multiple plans concomitantly as several partial processes underlie any composite clinical process. Materials and Methods: The development of the information model was based on the integration of a defined protocol for clinical interoperability in the care of patients with chronic obstructive pulmonary disease and an observational study protocol for cohort characterization at the group level. In the clinical process patient reported outcome measures were included. Results: The clinical protocol and the observation study protocol were developed on the clinical level and a single plan definition was developed by merging of the protocols. The information model and a common data model that had been developed for care pathways was successfully implemented and data for the medical records and the observational study could be extracted independently. The interprofessional process support improved the communication between the stakeholders (health care professionals, clinical scientists and providers). Discussion: We successfully merged the processes and had a functionally successful pilot demonstrating a seamless appearance for the health care professionals, while at the same time it was possible to generate data that could serve quality registries and clinical research. The adopted data model was initially tested and hereby published to the public domain. Conclusion: The use of a patient centered information model and data annotation focused on the care pathway simplifies the annotation of data for different purposes and supports sharing of knowledge along the patient care path.
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| 9. |
- Jingili, Nuru, et al.
(författare)
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A systematic review on the efficacy of virtual reality and gamification interventions for managing anxiety and depression
- 2023
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Ingår i: Frontiers in Digital Health. - : Frontiers Media S.A.. - 2673-253X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- This systematic review aims to assess the effectiveness of virtual reality (VR) and gamification interventions in addressing anxiety and depression. The review also seeks to identify gaps in the current VR treatment landscape and provide guidelines for future research and development. A systematic literature search was conducted using Scopus, Web of Science, and PubMed databases, focusing on studies that utilized VR and gamification technology to address anxiety and depression disorders. A total of 2,664 studies were initially identified, 15 of those studies fulfilled the inclusion criteria for this systematic review. The efficacy of VR in addressing anxiety and depression was evident across all included studies. However, the diversity among VR interventions highlights the need for further investigation. It is advised to incorporate more diverse participant samples and larger cohorts and explore a broader spectrum of therapeutic approaches within VR interventions for addressing anxiety and depression to enhance the credibility of future research. Additionally, conducting studies in varying socioeconomic contexts would contribute to a more comprehensive understanding of their real-world applicability.
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| 10. |
- Leijon, Arne, et al.
(författare)
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Bayesian analysis of Ecological Momentary Assessment (EMA) data collected in adults before and after hearing rehabilitation
- 2023
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Ingår i: Frontiers in Digital Health. - : Frontiers Media SA. - 2673-253X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents a new Bayesian method for analyzing Ecological Momentary Assessment (EMA) data and applies this method in a re-analysis of data from a previous EMA study. The analysis method has been implemented as a freely available Python package EmaCalc, RRID:SCR 022943. The analysis model can use EMA input data including nominal categories in one or more situation dimensions, and ordinal ratings of several perceptual attributes. The analysis uses a variant of ordinal regression to estimate the statistical relation between these variables. The Bayesian method has no requirements related to the number of participants or the number of assessments by each participant. Instead, the method automatically includes measures of the statistical credibility of all analysis results, for the given amount of data. For the previously collected EMA data, the analysis results demonstrate how the new tool can handle heavily skewed, scarce, and clustered data that were collected on ordinal scales, and present results on interval scales. The new method revealed results for the population mean that were similar to those obtained in the previous analysis by an advanced regression model. The Bayesian approach automatically estimated the inter-individual variability in the population, based on the study sample, and could show some statistically credible intervention results also for an unseen random individual in the population. Such results may be interesting, for example, if the EMA methodology is used by a hearing-aid manufacturer in a study to predict the success of a new signal-processing method among future potential customers.
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| 11. |
- Maus, Benjamin, et al.
(författare)
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Privacy Personas for IoT-Based Health Research : A Privacy Calculus Approach
- 2021
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Ingår i: Frontiers in Digital Health. - : Frontiers Media S.A.. - 2673-253X. ; 3, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- The reliance on data donation from citizens as a driver for research, known as citizen science, has accelerated during the Sars-Cov-2 pandemic. An important enabler of this is Internet of Things (IoT) devices, such as mobile phones and wearable devices, that allow continuous data collection and convenient sharing. However, potentially sensitive health data raises privacy and security concerns for citizens, which research institutions and industries must consider. In e-commerce or social network studies of citizen science, a privacy calculus related to user perceptions is commonly developed, capturing the information disclosure intent of the participants. In this study, we develop a privacy calculus model adapted for IoT-based health research using citizen science for user engagement and data collection. Based on an online survey with 85 participants, we make use of the privacy calculus to analyse the respondents' perceptions. The emerging privacy personas are clustered and compared with previous research, resulting in three distinct personas which can be used by designers and technologists who are responsible for developing suitable forms of data collection. These are the 1) Citizen Science Optimist, the 2) Selective Data Donor, and the 3) Health Data Controller. Together with our privacy calculus for citizen science based digital health research, the three privacy personas are the main contributions of this study.
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| 12. |
- Rahman Jabin, MD Shafiqur, et al.
(författare)
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Characterizing patient details-related challenges from health information technology-related incident reports from Swedish healthcare
- 2024
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Ingår i: Frontiers in Digital Health. - : Frontiers Media S.A.. - 2673-253X. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Despite many benefits offered by Health Information Technology (HIT) systems, new technology brings new and unforeseen risks to healthcare quality and patient safety if they're not properly planned, designed, implemented, and managed. This study examined health information technology-related (HIT) incidents to identify patient details-related issues, their association with contributing factors, and outcomes. Methods: Sources of information comprised retrospectively collected incident reports (n=95) using two sampling methods, i.e., purposive and snowball sampling. The incident reports were analyzed using both the inductive method (thematic analysis) and the deductive approach using an existing framework, i.e., the International Classification for Patient Safety. Results: The studies identified 90 incidents with 120 patient details-related issues—categorized as either information-related (48%) or documentation-related (52%) problems; around two-thirds of the 120 issues were characterized by human factors. Of the total sample, 87 contributing factors were identified, of which "medical device/system" (45%) and "documentation" (20%) were the most common contributing factors. Of 90 incidents, more than half (59%) comprised patient-related outcomes—patient inconvenience (47%) and patient harm (12%) and the remaining 41% (n=37) included staff or organization-related outcomes. Discussion: More than half of the incidents resulted in patient-related outcomes, namely patient inconvenience and patient harm, including disease risks, severe health deterioration, injury, and even patient death. Incidents associated with patient details can cause deleterious effects; therefore, characterizing them should be a routine part of clinical practice to improve the constantly changing healthcare system.
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| 13. |
- Rahman Jabin, MD Shafiqur
(författare)
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Operational disruption in healthcare associated with software functionality issue due to software security patching : a case report
- 2024
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Ingår i: Frontiers in Digital Health. - : Frontiers Media S.A.. - 2673-253X. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Despite many benefits, the extensive deployment of Health Information Technology (HIT) systems by healthcare organizations has encountered many challenges, particularly in the field of telemetry concerning patient monitoring and its operational workflow. These challenges can add more layers of complexity when an unplanned software security patching is performed, affecting patient monitoring and causing disruption in daily clinical operations. This study is a reflection on what happened associated with software security patching and why it happened through the lens of an incident report to develop potential preventive and corrective strategies using qualitative analyses—inductive and deductive approaches. There is a need for such analyses to identify the underlying mechanism behind such issues since very limited research has been conducted on the study of software patching. The incident was classified as a “software functionality” issue, and the consequence was an “incident with a noticeable consequence but no patient harm”, and the contributing factor was a software update, i.e., software security patching. This report describes how insufficient planning of software patching, lack of training for healthcare professionals, contingency planning on unplanned system disruption, and HIT system configuration can compromise healthcare quality and cause risks to patient safety. We propose 15 preventive and corrective strategies grouped under four key areas based on the system approach and social-technical aspects of the patching process. The key areas are (i) preparing, developing, and deploying patches; (ii) training the frontline operators; (iii) ensuring contingency planning; and (iv) establishing configuration and communication between systems. These strategies are expected to minimize the risk of HIT-related incidents, enhance software security patch management in healthcare organizations, and improve patient safety. However, further discussion should be continued about general HIT problems connected to software security patching.
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| 14. |
- Skoglund, Martin, 1981-, et al.
(författare)
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Activity Tracking Using Ear-Level Accelerometers
- 2021
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Ingår i: Frontiers in digital health. - : Frontiers Media S.A.. - 2673-253X. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: By means of adding more sensor technology, modern hearing aids (HAs) strive to become better, more personalized, and self-adaptive devices that can handle environmental changes and cope with the day-to-day fitness of the users. The latest HA technology available in the market already combines sound analysis with motion activity classification based on accelerometers to adjust settings. While there is a lot of research in activity tracking using accelerometers in sports applications and consumer electronics, there is not yet much in hearing research. Objective: This study investigates the feasibility of activity tracking with ear-level accelerometers and how it compares to waist-mounted accelerometers, which is a more common measurement location. Method: The activity classification methods in this study are based on supervised learning. The experimental set up consisted of 21 subjects, equipped with two XSens MTw Awinda at ear-level and one at waist-level, performing nine different activities. Results: The highest accuracy on our experimental data as obtained with the combination of Bagging and Classification tree techniques. The total accuracy over all activities and users was 84% (ear-level), 90% (waist-level), and 91% (ear-level + waist-level). Most prominently, the classes, namely, standing, jogging, laying (on one side), laying (face-down), and walking all have an accuracy of above 90%. Furthermore, estimated ear-level step-detection accuracy was 95% in walking and 90% in jogging. Conclusion: It is demonstrated that several activities can be classified, using ear-level accelerometers, with an accuracy that is on par with waist-level. It is indicated that step-detection accuracy is comparable to a high-performance wrist device. These findings are encouraging for the development of activity applications in hearing healthcare.
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| 15. |
- Wallden, Mats, et al.
(författare)
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Evaluation of 6 years of eHealth data in the alcohol use disorder field indicates improved efficacy of care
- 2024
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Ingår i: Frontiers in Digital Health. - : Frontiers Media S.A.. - 2673-253X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPredictive eHealth tools will change the field of medicine, however long-term data is scarce. Here, we report findings on data collected over 6 years with an AI-based eHealth system for supporting the treatment of alcohol use disorder.MethodsSince the deployment of Previct Alcohol, structured data has been archived in a data warehouse, currently comprising 505,641 patient days. The frequencies of relapse and caregiver-patient messaging over time was studied. The effects of both introducing an AI-driven relapse prediction tool and the COVID-19 pandemic were analyzed.ResultsThe relapse frequency per patient day among Previct Alcohol users was 0.28 in 2016, 0.22 in 2020 and 0.25 in 2022 with no drastic change during COVID-19. When a relapse was predicted, the actual occurrence of relapse in the days immediately after was found to be above average. Additionally, there was a noticeable increase in caregiver interactions following these predictions. When caregivers were not informed of these predictions, the risk of relapse was found to be higher compared to when the prediction tool was actively being used. The prediction tool decreased the relapse risk by 9% for relapses that were of short duration and by 18% for relapses that lasted more than 3 days.ConclusionsThe eHealth system Previct Alcohol allows for high resolution measurements, enabling precise identifications of relapse patterns and follow up on individual and population-based alcohol use disorder treatment. eHealth relapse prediction aids the caregiver to act timely, which reduces, delays, and shortens relapses.
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| 16. |
- Yeo, LL, et al.
(författare)
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The Role of Carbon Dioxide in the Rat Acute Stroke Penumbra
- 2021
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Ingår i: Frontiers in digital health. - : Frontiers Media SA. - 2673-253X. ; 3, s. 824334-
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Tidskriftsartikel (refereegranskat)abstract
- The vasodilatory response to inhaled CO2 occurs in the acute stroke ischemic penumbra and may be a potential therapeutic modality.MethodsTwenty-two Sprague-Dawley rats were subjected to 90-min occlusion of the M2 segment of the middle cerebral artery (M2CAO) by endovascular technique. The animals were administered different C02 concentrations and scanned serially with 9.4 T MRI. Infarct tissue was determined by diffusion-weighted imaging (DWI) and hypoperfused tissue was determined by arterial spin labeling (PWI).Results4 animals were administered room air (RA)+ 6% CO2 (group 1), 6 animals RA+12% CO2 (Group 2) and 4 animals only RA (group 3). In the rats with CO2 administered (groups 1 and 2), the DWI lesion to cerebral hypoperfusion volume ratio (SD) at pre-CO2 administration, was 0.145(0.168), which increased to 0.708(0.731) during CO2 administration and reduced to 0.533(0.527) post-CO2 administration. In 9 of 10 rats the hypoperfused volume decreased when CO2 was administered. When CO2 was stopped the hypoperfused volume became larger again. Administration of RA+12% CO2 (Group 2) decreased the volume of CBF hypoperfusion significantly compared to the control group (95%CI: 0.084 ± 0.0213, p = 0.004).ConclusionInhaled CO2 appears to reduce the size of the hypoperfused tissue volume during acute stroke and may be a potential modality for treatment of acute ischemic stroke. These findings will nonetheless need to be validated in a larger cohort in other centers.
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| 17. |
- Zemp, DD, et al.
(författare)
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A blended e-health intervention for improving functional capacity in elderly patients on haemodialysis: A feasibility study
- 2022
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Ingår i: Frontiers in digital health. - : Frontiers Media SA. - 2673-253X. ; 4, s. 1054932-
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Tidskriftsartikel (refereegranskat)abstract
- Physical exercise showed to be beneficial for frail older adults on haemodialysis (HD). However, there are several obstacles hindering the regular practice of exercise, such as transportation difficulties, lack of time, fatigue and comorbidities. E-health in this regard has many potential advantages and could be useful for motivating HD patients to increase their level of physical activity. The aim of this study was to evaluate the feasibility of a blended e-health intervention for elderly HD patients who individually exercise at home while under remote supervision of a physiotherapist.Material and methodsPatients over 60 years of age with sufficient cognitive and motoric resources to perform a simple physical test battery and to use a tablet-computer were recruited from four HD outpatient facilities. Following baseline assessment at home, the participants were visited by a physiotherapist (PT). The PT set an individual exercise programme and explained how to use the web-based interface. During the 12 weeks of training, the PTs remotely supervised the patients' progress. At 12 weeks follow-up a second assessment took place.ResultsTwenty-two patients were recruited to participate in the study. Seven patients dropped out of the blended programme and 15 patients concluded the programme. The average training frequency of the 15 participants concluding the study was 1.5 times a week [range 0.2–5.8]. The duration of a training session was between 20 and 40 min. The usability of the system was deemed positive. Regarding the efficacy of the intervention, no significant improvement of any measured parameter was found, and effect sizes were small to medium.ConclusionA blended e-health intervention supported by a web-based application for exercising at home under remote supervision of a PT is feasible in a HD population including older patients. However, before planning a randomized controlled trial, strategies to increase the recruitment rate and the adherence to such a blended intervention should be further developed, e.g., to improve the recruitment procedures and lower the expectable drop-out rate. Furthermore, the dosage of the blended programme should be adapted to the patients' physical performance levels in future trials.The study was registered on the website clinicaltrials.gov with ID NCT04076488.
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| 18. |
- Zetterström, Andreas, et al.
(författare)
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The Clinical Course of Alcohol Use Disorder Depicted by Digital Biomarkers
- 2021
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Ingår i: Frontiers in Digital Health. - : Frontiers Media S.A.. - 2673-253X. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Aims: This study introduces new digital biomarkers to be used as precise, objective tools to measure and describe the clinical course of patients with alcohol use disorder (AUD).Methods: An algorithm is outlined for the calculation of a new digital biomarker, the recovery and exacerbation index (REI), which describes the current trend in a patient's clinical course of AUD. A threshold applied to the REI identifies the starting point and the length of an exacerbation event (EE). The disease patterns and periodicity are described by the number, length, and distance between EEs. The algorithms were tested on data from patients from previous clinical trials (n = 51) and clinical practice (n = 1,717).Results: Our study indicates that the digital biomarker-based description of the clinical course of AUD might be superior to the traditional self-reported relapse/remission concept and conventional biomarkers due to higher data quality (alcohol measured) and time resolution. We found that EEs and the REI introduce distinct tools to identify qualitative and quantitative differences in drinking patterns (drinks per drinking day, phosphatidyl ethanol levels, weekday and holiday patterns) and effect of treatment time.Conclusions: This study indicates that the disease state-level, trend and periodicity-can be mathematically described and visualized with digital biomarkers, thereby improving knowledge about the clinical course of AUD and enabling clinical decision-making and adaptive care. The algorithms provide a basis for machine-learning-driven research that might also be applied for other disorders where daily data are available from digital health systems.
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| 19. |
- Öhman, Fredrik, et al.
(författare)
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Unsupervised mobile app-based cognitive testing in a population-based study of older adults born 1944
- 2022
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Ingår i: Frontiers in Digital Health. - : Frontiers Media SA. - 2673-253X. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mobile app-based tools have the potential to yield rapid, cost-effective, and sensitive measures for detecting dementia-related cognitive impairment in clinical and research settings. At the same time, there is a substantial need to validate these tools in real-life settings. The primary aim of this study was thus to evaluate the feasibility, validity, and reliability of mobile app-based tasks for assessing cognitive function in a population-based sample of older adults. Method: A total of 172 non-demented (Clinical Dementia Rating 0 and 0.5) older participants (aged 76–77) completed two mobile app-based memory tasks—the Mnemonic Discrimination Task for Objects and Scenes (MDT-OS) and the long-term (24h) delayed Object-In-Room Recall Task (ORR-LDR). To determine the validity of the tasks for measuring relevant cognitive functions in this population, we assessed relationships with conventional cognitive tests. In addition, psychometric properties, including test-retest reliability, and the participants’ self-rated experience with mobile app-based cognitive tasks were assessed. Result: MDT-OS and ORR-LDR were weakly-to-moderately correlated with the Preclinical Alzheimer's Cognitive Composite (PACC5) (r = 0.3–0.44, p <.001) and with several other measures of episodic memory, processing speed, and executive function. Test-retest reliability was poor–to-moderate for one single session but improved to moderate–to-good when using the average of two sessions. We observed no significant floor or ceiling effects nor effects of education or gender on task performance. Contextual factors such as distractions and screen size did not significantly affect task performance. Most participants deemed the tasks interesting, but many rated them as highly challenging. While several participants reported distractions during tasks, most could concentrate well. However, there were difficulties in completing delayed recall tasks on time in this unsupervised and remote setting. Conclusion: Our study proves the feasibility of mobile app-based cognitive assessments in a community sample of older adults, demonstrating its validity in relation to conventional cognitive measures and its reliability for repeated measurements over time. To further strengthen study adherence, future studies should implement additional measures to improve task completion on time.
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