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The leading peer-reviewed journal for digital medicine, and health & healthcare in the Internet age
The Journal of Medical Internet Research (JMIR), now in its 20th year, is the pioneer open access eHealth journal and is the flagship journal of JMIR Publications. It is the leading digital health journal globally in terms of quality/visibility (Impact Factor 2017: 4.671, ranked #1 out of 22 journals) and in terms of size (number of papers published). The journal focuses on emerging technologies, medical devices, apps, engineering, and informatics applications for patient education, prevention, population health and clinical care. As leading high-impact journal in its' disciplines (health informatics and health services research), it is selective, but it is now complemented by almost 30 specialty JMIR sister journals, which have a broader scope. Peer-review reports are portable across JMIR journals and papers can be transferred, so authors save time by not having to resubmit a paper to different journals.
As open access journal, we are read by clinicians, allied health professionals, informal caregivers, and patients alike, and have (as all JMIR journals) a focus on readable and applied science reporting the design and evaluation of health innovations and emerging technologies. We publish original research, viewpoints, and reviews (both literature reviews and medical device/technology/app reviews).
We are also a leader in participatory and open science approaches, and offer the option to publish new submissions immediately as preprints, which receive DOIs for immediate citation (eg, in grant proposals), and for open peer-review purposes. We also invite patients to participate (eg, as peer-reviewers) and have patient representatives on editorial boards.
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Numerous reviews and meta-analyses have pointed to technology’s enormous potential to improve the appeal, effectiveness, cost, and reach of mental health interventions. Yet the promise of digital me...
Numerous reviews and meta-analyses have pointed to technology’s enormous potential to improve the appeal, effectiveness, cost, and reach of mental health interventions. Yet the promise of digital mental health interventions for youth has not been realized. Significant challenges have been repeatedly identified including engagement, fidelity, and the lack of personalization. We introduce the main tenets of design thinking and explain how they can specifically address these challenges, with an entirely new toolbox of mindsets and practices. We also provide examples of a new wave of digital interventions to demonstrate the applicability of design thinking to a wide range of intervention goals. Moving forward, it will be critical for scientists and clinicians to implement their scientific standards, methods and review outlets to evaluate the contribution of design thinking on the next iteration of digital mental health interventions for youth.
Background: Technology companies with large data sets have the potential to fuel discovery in the health sciences and gain valuable insights for their own businesses by sharing their data with academi...
Background: Technology companies with large data sets have the potential to fuel discovery in the health sciences and gain valuable insights for their own businesses by sharing their data with academic researchers. However, many companies are wary about such sharing due to concerns about ethics, data security, logistics, and public relations. To date, neither the academic literature nor the technology community has provided guidance for companies considering academic data sharing. Without such guidance, few companies are willing to take on the potential work and risks involved in non-commercial data sharing, and the scientific and societal potential for their data consequently goes unrealized. Objective: In this paper, we describe the 18-month long pilot of a data sharing program led by Crisis Text Line (CTL), a not-for-profit technology company that provides a free, 24/7 text-line for people in crisis. The primary goal of the pilot was to design and develop a rigorous framework of principles for the safe and ethical sharing of user data. By implementing and studying a pilot program based on these principles, CTL aimed to gain experience that would help them optimize their own future data sharing programs and to make public the results of the study in order to inform similar decisions made by others. Methods: CTL used a stakeholder-based policy process to develop a feasible and ethical data sharing program. The process comprised: forming a data ethics committee; identifying policy challenges and solutions; announcing the program and generating interest; and revising the policy and launching the program. Once the pilot was complete, CTL examined how well the program ran and compared it with other potential program models. Results: The policy development process yielded key principles and protocols for addressing core ethical challenges and these were then used to govern a pilot research program which assessed over 100 applications, of which 20 were accepted. An internal evaluation determined that the pilot was successful in the goals of sharing scientific data and protecting client confidentiality. Financial and human capital requirements for maintaining this particular form of open data program were challenging. However, alternative models that could enact the same principles were identified. Conclusions: The set of principles derived from this pilot provided a secure foundation on which CTL was able to further iterate in the development of new data sharing programs. The principles offer a framework that other organizations can use to create safe and ethical programs of their own. Open data programs are important and feasible to establish, but they require significant long-term commitments to support the responsible sharing of data. Organizations considering developing open data programs should evaluate the value and sensitivity of the data as well as available resources for program start-up and maintenance when selecting their path forward.
Background: Clinical trial protocol includes all the steps that should be conducted in clinical trial and all clinical trial start with development of the protocol. And the protocol is kinds of proced...
Background: Clinical trial protocol includes all the steps that should be conducted in clinical trial and all clinical trial start with development of the protocol. And the protocol is kinds of procedure manual that consists of appropriate combination of related elements, so one element selection generally affects the next element selection. To development the protocol, researchers refer a published guides or electronic protocol templates. The detail elements of the protocol are designed based on the previous data which is retrieved separately in public database of clinical trial. Specifically, researchers retrieve for preliminary information using text based user input keywords, then they extract the elements. However, the current retrieve approaches do not provide a method to interactively select for a combination of the elements. Objective: The purpose of our study is to provide context-dependent protocol element selection system for the development of objective and successful clinical trial protocols. In detail, we construct a database that can retrieve protocols by combined analysis of elements. Moreover, we develop a web-based interactive protocol element wise selection application using constructed database. Methods: We have constructed a key-value type database for searching element combinations. To build the database, we have defined structure of protocol within five factors; design, subject, variables, statistical issue and descriptions. In this study, five factors are defined as a subset of protocol elements and we have manually classified them from collected information in public database. Then, we have developed a web application to implement interactive method for retrieving selected combination of protocol element. The application in the form of a connected tree provides options to select the next element according to the decision of previous element. Therefore, a researcher can retrieve the structure of the combined protocol. Also, the application supports a function for retrieve various selected protocol structure at the same time. Results: We have developed a database and search application for protocol structure retrieval. The database is built on individual protocol information extracted from previous 184,634 clinical trials and provides 13,210 integrated structural information. Furthermore, the database contains various semantic information of the protocols to filter protocols in search application. We did technical validation for evaluating of the database with ‘Cancer and Other Neoplasms’ category of clinicaltrials.gov. By comparing with the clinicaltrials.gov our method has better performance in predicting phenotypic features. Our F1 score was 0.515, while F1 score of clinicaltrials.gov was 0.377. Finally, we developed web application, CLinical trial protocol database System(CLIPS), which provides users with search our database interactively based on protocol elements. CLIPS is available at http://corus.kaist.edu/clips. Conclusions: We have developed database and application to interactively search clinical trial protocols efficiently. We believe that our system is helpful for conducting a new clinical trial. Furthermore, we expect that the database would be utilized as meta-analysis in clinical trials for various purposes. Clinical Trial: None
Background: Regular physical activity (PA) is an essential component of a successful type 2 diabetes treatment. However, despite the manifest evidence for the numerous health benefits of regular PA, m...
Background: Regular physical activity (PA) is an essential component of a successful type 2 diabetes treatment. However, despite the manifest evidence for the numerous health benefits of regular PA, most patients with type 2 diabetes remain inactive, often due to low motivation and lack of PA enjoyment. A recent and promising approach to help overcome these PA barriers and motivate inactive individuals to change their PA behavior is PA-promoting smartphone games. While short-term results of these games are encouraging, the long-term success in effectively changing PA behavior has to date not been confirmed. It is possible that an insufficient incorporation of motivational elements or flaws in gameplay and storyline in these games affect the long-term motivation to play and thereby prevent sustained changes in PA behavior. We aimed to address these design challenges by developing a PA-promoting smartphone game that incorporates established behavior change techniques and specifically targets inactive type 2 diabetes patients. Objective: To investigate if a self-developed, behavior change technique-based smartphone game designed by an interdisciplinary team is able to motivate inactive individuals with type 2 diabetes for regular use and thereby increase their intrinsic PA motivation. Methods: Thirty-six inactive, overweight type 2 diabetes patients (45-70 years of age) were randomly assigned to either the intervention group or the control group (one-time lifestyle counseling). Participants were instructed to play the smartphone game or to implement the recommendations from the lifestyle counseling autonomously during the 24-week intervention period. Intrinsic PA motivation was assessed with an abridged 12-item version of the Intrinsic Motivation Inventory (IMI) before and after the intervention. In addition, adherence to the game-proposed PA recommendations during the intervention period was assessed in the intervention group via the phone-recorded game usage data. Results: Intrinsic PA motivation (IMI total score) increased significantly in the intervention group (+6.4 (SD 4.2; P < .001) points) while it decreased by 1.9 (SD 16.5; P = .623) points in the control group. The adjusted difference between both groups was 8.1 (95% CI 0.9, 15.4; P = .029) points. The subscales ‘interest/enjoyment’ (+2.0 (SD 1.9) points, P < .001) and ‘perceived competence’ (+2.4 (SD 2.4) points, P < .001) likewise increased significantly in the intervention group while they did not change significantly in the control group. The usage data revealed that participants in the intervention group used the game for an average of 131.1 (SD 48.7) minutes of in-game walking and for an average of 15.3 (SD 24.6) minutes of strength training per week. Conclusions: In inactive individuals with type 2 diabetes, a novel smartphone game incorporating established motivational elements and personalized PA recommendations elicits significant increases in intrinsic PA motivation that are accompanied by de-facto improvements in PA adherence over 24 weeks. Clinical Trial: ClinicalTrials.gov (NCT02657018), registered on January 15th, 2016, last status update on April 27th, 2018.
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Background: A significant recent innovation is the development of internet-based psychological treatments for suicidal thinking. However, we know very little about individuals experiencing suicidal id...
Background: A significant recent innovation is the development of internet-based psychological treatments for suicidal thinking. However, we know very little about individuals experiencing suicidal ideation who seek help through online services, and in particular, their previous health service usage patterns. Objective: The current study aimed to examine service use history and its correlates amongst adults experiencing suicidal ideation who enrolled in an online suicidal ideation treatment trial. Methods: Participants (N = 418) at pre-intervention reported demographic information, clinical characteristics, and health service use over the previous six-months. Results: Participants had a high rate of service use in the six months before enrolling in the treatment trial. The two most common contact points were General Practitioners (GPs) and mental health professionals. Notably, those with a previous single suicide attempt had lower odds of contact with any service than those with no attempt. Furthermore, those living in rural or remote areas had lower odds of contacting GPs or mental health professionals than those living in metropolitan areas. Conclusions: Our study shows that individuals enrolling in an e-health intervention trial have often received treatment from GPs or mental health professionals. These services can therefore play an important role in preventing the escalation of suicidal thinking. Enrolment in our online treatment trial suggests though that face-to-face health services may not be enough. Finally, our study highlights the need to improve the provision of coordinated and assertive care after a suicide attempt, as well as health service availability and utilisation for those living in rural and remote areas.
Background: The melanoma incidence and mortality rates in rural and remote communities are exponentially higher than in urban areas. Digital health could be used to close the urban/rural gap for melan...
Background: The melanoma incidence and mortality rates in rural and remote communities are exponentially higher than in urban areas. Digital health could be used to close the urban/rural gap for melanoma and improve access to post-treatment and support care services. Objective: To understand how digital health is currently used for melanoma post-treatment care and determine its benefits for Australian rural and remote areas. Methods: A systematic search of PubMed, Medline, Google Scholar, Scopus was conducted in March 2018. Findings were clustered per type of intervention and related-direct outcomes. Results: Five studies met the inclusion criteria, but none of them investigated the benefits of digital health for melanoma post-treatment care in rural and remote areas of Australia. A number of empirical studies demonstrated consumers’ acceptance toward digital intervention for post-treatment care. Findings did not take into consideration individual, psychological and socioeconomic factors, even though studies show their significant impacts on melanoma quality of aftercare. Conclusions: Digital interventions may to be used as an adjunct service by clinicians during melanoma post-treatment care, especially in regions that are lower-resourced by practitioners and health infrastructure, such as rural and remote Australia. Technology could be used to reduce the disparity in melanoma incidence, mortality rates and accessibility to post-treatment care management between urban and rural/remote populations.