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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.
Be a widely cited leader in the digitial health revolution and submit your paper today!
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Background: Although there are more than 60 smartphone applications (apps) for smoking cessation in China, many do not include the content and features that smokers prefer—which may make them imprac...
Background: Although there are more than 60 smartphone applications (apps) for smoking cessation in China, many do not include the content and features that smokers prefer—which may make them impractical and/or ineffective. Objective: We therefore investigated what Chinese smokers want from a smartphone app for smoking cessation. Methods: Between May 1, 2016 and August 31, 2016, eligible Chinese smokers who own smartphones (N = 357) responded to a survey collecting data on their socio-demographic characteristics and their opinions on the importance of 20 smoking cessation app design features validated in previous research. Results: Few smokers (14/319, 4.4%) had ever downloaded a smoking cessation app. More than 60% of smokers rated the following four features as very or extremely important: allow sharing the process of smoking cessation with family members and friends (67.7%), help smokers track their progress (such as amount of smoking per day) (66.8%), help with the side effects of medications and nicotine withdrawal symptoms (63.0%), and adapt to ongoing needs and interests of smokers (60.8%). Among subgroups of smokers, supportive content (e.g., information about cessation medications) features were rated as more important among females (vs. males; all p<.05) and among those age 35 and younger (vs. age 36 and older; all ps<.05). Conclusions: Contrary to a similar study of American smokers (McClure et al., 2016), Chinese smokers highly value a smoking cessation app’s reputation and ability to communicate with family members and friends as important features whereas privacy and security were less important. Women and those age 36 and over tend to value more supportive features. Overall, design of health behavior change apps should consider cultural and demographic differences.
Background: New models of scalable population-based data collection that integrate digital and mobile health data are necessary. Objective: To describe a cardiovascular digital and mobile health e-coh...
Background: New models of scalable population-based data collection that integrate digital and mobile health data are necessary. Objective: To describe a cardiovascular digital and mobile health e-cohort embedded in a traditional longitudinal cohort study, the Framingham Heart Study (FHS). Methods: We invited eligible and consenting FHS Generation 3 and Omni participants to download the eFHS app onto their smartphones and co-deployed a digital blood pressure (BP) cuff. Soon thereafter, participants were also offered a smartwatch (Apple Watch). Participants are invited to complete surveys through the eFHS app, to perform weekly BP measurements and to wear the smartwatch daily. Results: Up to July 2017, we have enrolled 790 eFHS participants, representing 75.7% of potentially eligible FHS participants. eFHS participants were, on average, 538 years of age and 57% were women. 85% (n=675) of eFHS participants completed all of the baseline survey and 59% (n=470) completed the 3-month survey. 42% (n=241 of 573) and 76% (n=306 of 405) of eFHS participants adhered to weekly digital BP and HR uploads, respectively over 12 weeks. Conclusions: We have designed an e-cohort focused on identifying novel CVD risk factors using a new smartphone app, a digital BP cuff, and a smartwatch. Despite minimal training and support, preliminary findings over a 3-month follow-up period show that uptake is high and adherence to periodic app-based surveys, weekly digital BP assessments, and smartwatch HR measures is acceptable.
Background: Technological interventions such as mobile applications (apps), online social networks and wearable trackers have the potential to influence physical activity; yet, few studies have examin...
Background: Technological interventions such as mobile applications (apps), online social networks and wearable trackers have the potential to influence physical activity; yet, few studies have examined the efficacy of an intervention bundle combining these different technologies. Objective: To pilot test an intervention composed of a social networking mobile app, connected with a wearable tracker and investigate its efficacy in improving physical activity, as well as explore participant engagement, and the usability of the app. Methods: Pre-post quasi-experimental study with one arm, where participants were subjected to the intervention for a six-month period. The primary outcome measure was the difference in daily step count between baseline and six months. Secondary outcome measures included engagement with the intervention and system usability. Descriptive and inferential statistical tests were conducted; post-hoc subgroup analyses were carried out for participants with different levels of: steps at baseline, app usage and social features usage. Results: Fifty-five participants were enrolled in the study; the mean age was 23.6 years and 28 (50.1%) were female. At six months, the retention rate was 81.8% (45/55). There was a non-significant increase of 1039 steps per day in average daily step count between baseline and 6 months (P = 0.06, 95% confidence interval [-61, 2139]). Subgroup analysis comparing the high and low physical activity groups at baseline showed that the latter significantly increased their daily step count by throughout the study 2677 steps per day (P = 0.002, 95% confidence interval [785, 3658]). Conclusions: Our study showed the efficacy of a mobile social networking intervention, integrated with a wearable tracker to promote physical activity, particularly for physically inactive subgroups of the population. Future research should explore how to address challenges faced by physically inactive people to provide tailored advices. Additionally, users’ perspectives should be explored to shed light on factors that might influence their engagement with the intervention.
Background: Digital technology called Virtual Reality (VR) is increasingly employed in health professions’ education. Yet, based on the current evidence, its use is narrowed around a few most applic...
Background: Digital technology called Virtual Reality (VR) is increasingly employed in health professions’ education. Yet, based on the current evidence, its use is narrowed around a few most applications and disciplines. There is a lack of an overview that would capture the diversity of different VR applications in health professions’ education and inform its use and research. Objective: This narrative review aims to explore different potential applications of VR in health professions’ education. Methods: The narrative synthesis approach to literature review was used to analyse the existing evidence. Results: We outline the role of VR features such as immersion, interactivity and feedback and explain the role of VR devices. Based on the type and scope of educational content VR can represent space, individuals, objects, structures or their combination. Application of VR in medical education encompasses environmental, organ and micro level. Environmental VR focuses on training in relation to health professionals’ environment and human interactions. Organ VR educational content targets primarily human body anatomy; and micro VR microscopic structures at the level of cells, molecules and atoms. We examine how different VR features and health professional education areas match these three VR types. Conclusions: We conclude by highlighting the gaps in the literature and providing suggestions for future research.
Background: In recent months, multiple publications have demonstrated the use of convolutional neural networks (CNN) to classify images of skin cancer as precisely as dermatologists. These CNNs failed...
Background: In recent months, multiple publications have demonstrated the use of convolutional neural networks (CNN) to classify images of skin cancer as precisely as dermatologists. These CNNs failed to outperform the International Symposium on Biomedical Imaging (ISBI) 2016 challenge in terms of average precision, however, so the technical progress represented by these studies is limited. In addition, the available reports are difficult to reproduce, due to incomplete descriptions of training procedures and the use of proprietary image databases. These factors prevent the comparison of various CNN classifiers in equal terms. Objective: To demonstrate the training of an image-classifier CNN that outperforms the winner of the ISBI 2016 challenge by using open source images exclusively. Methods: A detailed description of the training procedure is reported while the used images and test sets are disclosed fully, to insure the reproducibility of our work. Results: Our CNN classifier outperforms all recent attempts to classify the original ISBI 2016 challenge test data (full set of 379 test images), with an average precision of 0.709 (vs. 0.637 of the ISBI winner) and with an area under the receiver operating curve of 0.85. Conclusions: This work illustrates the potential for improving skin cancer classification with enhanced training procedures for CNNs, while avoiding the use of costly equipment or proprietary image data.
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Background: Acute care portals – less studied than ambulatory – may also be important to help with patient experience and engagement throughout the care continuum, especially for care transitions....
Background: Acute care portals – less studied than ambulatory – may also be important to help with patient experience and engagement throughout the care continuum, especially for care transitions. However, patient portal disparities exist and may lead to differences in access or outcomes. As such, it is important to study upstream factors in a typical hospital workflow that could lead to those disparities in safety net settings. Objective: The objective of this study was to evaluate sociodemographic characteristics associated with interest in an online portal and reasons for no interest. Methods: Nurses assessed interest in an online patient portal (yes/no) as part of the admission nursing assessment among patients at an academic urban safety net hospital and recorded responses in the electronic health record (EHR), including reasons for no interest. We extracted patient responses from the EHR. Results: Among 23995 hospitalizations over a two year period, 31% reported interest in an online portal. Interest was lower in older, non-White, non-English speaking and homeless patients. Reasons for “no” interest included: “not interested/other reason” (42%); "no ability to use/access computers/internet” (30%); “doesn’t speak English” (11%); or “physically or mentally unable” (9%). Conclusions: In a safety net system, patient interest in an online portal—a required step prior to enrollment—is low with significant disparities by sociodemographic characteristics. In order to avoid worsening the digital divide, new strategies are needed embedded within routine workflows to engage vulnerable safety net patients in the use of online health technologies.