Abstract:
BACKGROUND:Chronic obstructive pulmonary disease (COPD) is a progressive, chronic respiratory disease with a significant socioeconomic burden. Exacerbations, the sudden and sustained worsening of symptoms, can lead to hospitalization and reduce quality of life. Major limitations of previous telemonitoring interventions for COPD include low compliance, lack of consensus on what constitutes an exacerbation, limited numbers of patients, and short monitoring periods. We developed a telemonitoring system based on a digital health platform that was used to collect data from the 1-year EDGE (Self Management and Support Programme) COPD clinical trial aiming at daily monitoring in a heterogeneous group of patients with moderate to severe COPD. OBJECTIVE:The objectives of the study were as follows: first, to develop a systematic and reproducible approach to exacerbation identification and to track the progression of patient condition during remote monitoring; and second, to develop a robust algorithm able to predict COPD exacerbation, based on vital signs acquired from a pulse oximeter. METHODS:We used data from 110 patients, with a combined monitoring period of more than 35,000 days. We propose a finite-state machine-based approach for modeling COPD exacerbation to gain a deeper insight into COPD patient condition during home monitoring to take account of the time course of symptoms. A robust algorithm based on short-period trend analysis and logistic regression using vital signs derived from a pulse oximeter is also developed to predict exacerbations. RESULTS:On the basis of 27,260 sessions recorded during the clinical trial (average usage of 5.3 times per week for 12 months), there were 361 exacerbation events. There was considerable variation in the length of exacerbation events, with a mean length of 8.8 days. The mean value of oxygen saturation was lower, and both the pulse rate and respiratory rate were higher before an impending exacerbation episode, compared with stable periods. On the basis of the classifier developed in this work, prediction of COPD exacerbation episodes with 60%-80% sensitivity will result in 68%-36% specificity. CONCLUSIONS:All 3 vital signs acquired from a pulse oximeter (pulse rate, oxygen saturation, and respiratory rate) are predictive of COPD exacerbation events, with oxygen saturation being the most predictive, followed by respiratory rate and pulse rate. Combination of these vital signs with a robust algorithm based on machine learning leads to further improvement in positive predictive accuracy. TRIAL REGISTRATION:International Standard Randomized Controlled Trial Number (ISRCTN): 40367841; http://www.isrctn.com/ISRCTN40367841 (Archived by WebCite at http://www.webcitation.org/6olpMWNpc).
journal_name
J Med Internet Resjournal_title
Journal of medical Internet researchauthors
Shah SA,Velardo C,Farmer A,Tarassenko Ldoi
10.2196/jmir.7207subject
Has Abstractpub_date
2017-03-07 00:00:00pages
e69issue
3eissn
1439-4456issn
1438-8871pii
v19i3e69journal_volume
19pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Web-based programs for smoking prevention are being increasingly used with some success among adolescents. However, little is known about the mechanisms that link the experience of such programs to intended nicotine or tobacco control outcomes. OBJECTIVE:Based on the experiential learning theory and extende...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,随机对照试验
doi:10.2196/jmir.7174
更新日期:2017-02-16 00:00:00
abstract:BACKGROUND:Internet-based health resources can support informal caregivers who are caring for children or adolescents with health care needs. However, few studies discriminate informal caregivers' needs from those of their care recipients or those of people caring for adults. OBJECTIVE:This study reviews the literatur...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
doi:10.2196/jmir.4124
更新日期:2016-03-03 00:00:00
abstract:BACKGROUND:Three-dimensional scans are increasingly used to quantify biological topographical changes and clinical health outcomes. Traditionally, the use of 3D scans has been limited to specialized centers owing to the high cost of the scanning equipment and the necessity for complex analysis software. Technological a...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/17150
更新日期:2020-11-27 00:00:00
abstract:BACKGROUND:Advance care planning is the process of discussing health care treatment preferences based on patients' personal values, and it often involves the completion of advance directives. In the first months of 2020, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began circulatin...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/21385
更新日期:2020-08-11 00:00:00
abstract:BACKGROUND:There is substantial interest in use of the Internet for surveys, but there have been few health-oriented, large, randomized trials of general population surveys on the Internet. It is unclear whether providing the option to respond via Internet increases the response rate, and to what degree the results wil...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,随机对照试验
doi:10.2196/jmir.9.5.e40
更新日期:2007-12-31 00:00:00
abstract:BACKGROUND:Internet disease management has the promise of improving care in patients with heart failure but evidence supporting its use is limited. We have designed a Heart Failure Internet Communication Tool (HFICT), allowing patients to enter messages for clinicians, as well as their daily symptoms, weight, blood pre...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.7.1.e8
更新日期:2005-03-26 00:00:00
abstract:BACKGROUND:Increasing cases of diabetes, a general lack of routinely operational prevention, and a long history of separating disease prevention and treatment call for immediate engagement of frontier clinicians. This applies especially to village doctors who work in rural China where the majority of the nation's vast ...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,随机对照试验
doi:10.2196/jmir.3228
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Misinformation about COVID-19 is common and has been spreading rapidly across the globe through social media platforms and other information systems. Understanding what the public knows about COVID-19 and identifying beliefs based on misinformation can help shape effective public health communications to ens...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/23805
更新日期:2021-01-07 00:00:00
abstract::Focusing on primary cancer prevention can reduce its incidence. Changing health behaviors is critical to cancer prevention. Modifiable cancer risk factors include lifestyle behaviors related to vaccination, physical activity, weight control and maintenance, alcohol consumption, and tobacco use. These health habits are...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.8882
更新日期:2018-06-05 00:00:00
abstract:BACKGROUND:The traditional vertical system of sharing information from sources of scientific authority passed down to the public through local health authorities and clinicians risks being made obsolete by emerging technologies that facilitate rapid horizontal information sharing. The rise of Public Health 2.0 requires...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.2982
更新日期:2014-01-14 00:00:00
abstract:BACKGROUND:Facial nerve palsy leaves people unable to move muscles on the affected side of their face. Challenges exist in patients accessing facial neuromuscular retraining (NMR), a therapy used to strengthen muscle and improve nerve function. Access to therapy could potentially be improved through the use of digital ...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/20406
更新日期:2020-10-05 00:00:00
abstract:BACKGROUND:Internet use for health information is important, given the rise of electronic health (eHealth) that integrates technology into health care. Despite the perceived widespread use of the internet, a persistent "digital divide" exists in which many individuals have ready access to the internet and others do not...
journal_title:Journal of medical Internet research
pub_type: 历史文章,杂志文章
doi:10.2196/11931
更新日期:2019-05-14 00:00:00
abstract:BACKGROUND:Spouses and partners ("partners") of women at-risk for ("previvors") and surviving with hereditary breast/ovarian cancer are a primary source of support within their families. Yet, little is known about partners' needs for psychoeducational intervention to enhance their cancer risk knowledge, coping, and sup...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.1847
更新日期:2012-01-18 00:00:00
abstract:BACKGROUND:Individuals with chronic obstructive pulmonary disease (COPD) live with the burden of a progressive life-threatening condition that is often accompanied by anxiety and depression. The severity of the condition is usually considered from a clinical perspective and characterized according to the Global Initiat...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/10924
更新日期:2019-06-02 00:00:00
abstract:BACKGROUND:In December 2019, the COVID-19 outbreak started in China and rapidly spread around the world. Lack of a vaccine or optimized intervention raised the importance of characterizing risk factors and symptoms for the early identification and successful treatment of patients with COVID-19. OBJECTIVE:This study ai...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,meta分析
doi:10.2196/20509
更新日期:2020-10-02 00:00:00
abstract:BACKGROUND:Over the past decade, physician-rating websites have been gaining attention in scientific literature and in the media. However, little knowledge is available about the awareness and the impact of using such sites on health care professionals. It also remains unclear what key predictors are associated with th...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.2702
更新日期:2013-08-28 00:00:00
abstract:BACKGROUND:By 2035, it is expected that older adults (aged 65 years and older) will outnumber children and will represent 78 million people in the US population. As the aging population continues to grow, it is critical to reduce disparities in their representation in medical research. OBJECTIVE:This study aimed to de...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/15035
更新日期:2019-10-29 00:00:00
abstract:BACKGROUND:Enormous amounts of data are recorded routinely in health care as part of the care process, primarily for managing individual patient care. There are significant opportunities to use these data for other purposes, many of which would contribute to establishing a learning health system. This is particularly t...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.9134
更新日期:2018-05-29 00:00:00
abstract:BACKGROUND:Conversational assistants, such as Siri, Alexa, and Google Assistant, are ubiquitous and are beginning to be used as portals for medical services. However, the potential safety issues of using conversational assistants for medical information by patients and consumers are not understood. OBJECTIVE:To determ...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/11510
更新日期:2018-09-04 00:00:00
abstract:BACKGROUND:Obesity is a highly prevalent condition with important health implications. Face-to-face interventions to treat obesity demand a large number of human resources and time, generating a great burden to individuals and health system. In this context, the internet is an attractive tool for delivering weight loss...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,meta分析
doi:10.2196/jmir.9609
更新日期:2019-01-08 00:00:00
abstract:BACKGROUND:Misdiagnosis, arbitrary charges and annoying queues, and clinic waiting times among others are long-standing phenomena in the medical industry across the world, These factors can con-tribute to patient anxiety about misdiagnosis by clinicians. However, with the increasing use of big data growth in biomedical...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/22841
更新日期:2021-01-20 00:00:00
abstract:BACKGROUND:In response to the high cost of HIV pre-exposure prophylaxis (PrEP) medications in Canada, community organizations have created internet-based guides detailing how to legally order generic medications online and travel to collect them in the United States. However, little is known about the patients followin...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/12076
更新日期:2019-07-22 00:00:00
abstract:BACKGROUND:Effectiveness of and engagement with website-delivered physical activity interventions is moderate at best. Increased exposure to Internet interventions is reported to increase their effectiveness; however, there is a lack of knowledge about which specific intervention elements are able to maintain website e...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.1792
更新日期:2012-01-11 00:00:00
abstract:BACKGROUND:Decision support systems based on reinforcement learning (RL) have been implemented to facilitate the delivery of personalized care. This paper aimed to provide a comprehensive review of RL applications in the critical care setting. OBJECTIVE:This review aimed to survey the literature on RL applications for...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
doi:10.2196/18477
更新日期:2020-07-20 00:00:00
abstract:BACKGROUND:The application of mobile health (mHealth) platforms to monitor recovery in the postdischarge period has increased in recent years. Despite widespread enthusiasm for mHealth, few studies have evaluated the usability and user experience of mHealth in patients with surgical drainage. OBJECTIVE:Our objectives ...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/17686
更新日期:2020-08-28 00:00:00
abstract::A growing number of investigators have commented on the lack of models to inform the design of behavioral intervention technologies (BITs). BITs, which include a subset of mHealth and eHealth interventions, employ a broad range of technologies, such as mobile phones, the Web, and sensors, to support users in changing ...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
doi:10.2196/jmir.3077
更新日期:2014-06-05 00:00:00
abstract:BACKGROUND:Personally controlled health management systems (PCHMS), which include a personal health record (PHR), health management tools, and consumer resources, represent the next stage in consumer eHealth systems. It is still unclear, however, what features contribute to an engaging and efficacious PCHMS. OBJECTIVE...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.2414
更新日期:2013-05-06 00:00:00
abstract:BACKGROUND:Web-based self-help interventions for problem drinking are coming of age. They have shown promising results in terms of cost-effectiveness, and they offer opportunities to reach out on a broad scale to problem drinkers. The question now is whether certain groups of problem drinkers benefit more from such Web...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,随机对照试验
doi:10.2196/jmir.1102
更新日期:2008-11-22 00:00:00
abstract:BACKGROUND:Diabetic retinopathy (DR), a common complication of diabetes mellitus, is the leading cause of impaired vision in adults worldwide. Smartphone ophthalmoscopy involves using a smartphone camera for digital retinal imaging. Utilizing smartphones to detect DR is potentially more affordable, accessible, and easi...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,meta分析,评审
doi:10.2196/16658
更新日期:2020-05-15 00:00:00
abstract:BACKGROUND:Improving recovery from acute symptoms and preventing relapse are two significant challenges in severe mental illness. We developed a personalized smartphone-based app to monitor symptoms in real time and validated its acceptance, reliability, and validity. OBJECTIVE:To assess (i) acceptability of continuou...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,随机对照试验
doi:10.2196/17019
更新日期:2020-08-13 00:00:00