International Journal Of Telemedicine And Applications[JOURNAL]
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200 papers
Ensemble Classification Model With CFS-IGWO-Based Feature Selection for Cancer Detection Using Microarray Data.
Panda P, Bisoy SK, Kautish S … +3 more , Ahmad R, Irshad A, Sarwar N
Int J Telemed Appl · 2024 · PMID 39449963 · Full text
Cancer is the top cause of death worldwide, and machine learning (ML) has made an indelible mark on the field of early cancer detection, thereby lowering the death toll. ML-based model for cancer diagnosis is done using...
Cancer is the top cause of death worldwide, and machine learning (ML) has made an indelible mark on the field of early cancer detection, thereby lowering the death toll. ML-based model for cancer diagnosis is done using two forms of data: gene expression data and microarray data. The data on gene expression levels includes many dimensions. When dealing with data with a high dimension, the efficiency of an ML-based model is decreased. Microarray data is distinguished by its high dimensionality with a greater number of features and a smaller sample size. In this work, two ensemble techniques are proposed using majority voting technique and weighted average technique. Correlation feature selection (CFS) is used for feature selection, and improved grey wolf optimizer (IGWO) is used for feature optimization. Support vector machines (SVMs), multilayer perceptron (MLP) classification, logistic regression (LR), decision tree (DT), adaptive boosting (AdaBoost) classifier, extreme learning machines (ELMs), and K-nearest neighbor (KNN) are used as classifiers. The results of each distinct base learner were then combined using weighted average and majority voting ensemble methods. Accuracy (ACC), specificity (SPE), sensitivity (SEN), precision (PRE), Matthews correlation coefficient (MCC), and F1-score (F1-S) are used to assess the performance. Our result shows that majority voting achieves better performance than the weighted average ensemble technique.
Assessment of Step Tracker Mobile Applications for the Promotion of Physical Activity by Adolescents Based on Their Weight Status.
Ponce-Ramírez CM, Mateo-Orcajada A, Abenza-Cano L … +1 more , Vaquero-Cristóbal R
Int J Telemed Appl · 2024 · PMID 39381367 · Full text
The objectives of the present study were to analyze the adherence of normal weight and overweight/obese adolescents to intervention with mobile applications; to establish the differences in the evaluation of the mobile a...
The objectives of the present study were to analyze the adherence of normal weight and overweight/obese adolescents to intervention with mobile applications; to establish the differences in the evaluation of the mobile application and in the problematic use of the mobile phone between normal weight and overweight/obese adolescents; and to determine the relationship between the distance travelled, the evaluation of the mobile applications, and the conflictive use of the mobile phone. A quasi-experimental design was carried out with the participation of 70 adolescents between 12 and 16 years old (mean age: 14.25 ± 1.23 years old; 38 normal weight and 32 overweight/obese). The adolescents completed a 10-week intervention in which they used step tracker mobile applications for the promotion of physical activity, a minimum of three times per week. Problematic mobile phone use and adolescent ratings of the application used were measured. The results showed no significant differences in adolescents' adherence to the intervention according to the mobile application used ( = 0.191) or weight status ( = 0.202). In addition, significant differences were not found in the assessment of mobile applications within the group of overweight and obese adolescents: engagement ( = 0.471), functionality ( = 0.319), aesthetics ( = 0.378), information ( = 0.184), usability ( = 0.154), or perceived impact ( = 0.139), although differences were found in the assessment made by normal-weight adolescents in information ( = 0.029), usability ( = 0.029), and perceived impact ( = 0.044), where Pacer had better scores than Pokémon Go in the first two dimensions. No greater problematic mobile phone use was found after the intervention according to weight status ( = 0.311) nor the mobile application used ( = 0.985). It can be concluded that there is similar adherence among normal weight and overweight/obese adolescents to interventions with mobile applications to promote physical activity. It is noteworthy that adolescents, regardless of weight status, showed a positive perception towards the use of these mobile applications.
Environmental Factors for Sustained Telehealth Use in Mental Health Services: A Mixed Methods Analysis.
Werkmeister B, Haase AM, Fleming T … +1 more , Officer TN
Int J Telemed Appl · 2024 · PMID 39314675 · Full text
The mental health service delivery gap remains high globally. Appropriate telehealth use may increase capacity through flexible remote care provision. Despite the historical lack of telehealth integration into publicly f...
The mental health service delivery gap remains high globally. Appropriate telehealth use may increase capacity through flexible remote care provision. Despite the historical lack of telehealth integration into publicly funded mental health services, during COVID-19 lockdowns, services rapidly switched to telephone and audiovisual care provision. In Aotearoa New Zealand (NZ), this was abandoned when no longer required by COVID-19 restrictions. This study explores environmental factors associated with telehealth implementation and ongoing use or discontinuation across a multiregional outpatient mental health service. This work contributes to understanding system-level factors influencing telehealth use and thus informs policy and practice in postpandemic environments. This mixed methods study applied an interpretive description methodology. Semistructured interviews with 33 mental health clinicians were thematically analysed. Qualitative findings were reframed and evaluated using time series analyses of population-level quantitative data (prior to and throughout the pandemic). Findings were synthesised with qualitative themes to develop an understanding of environmental factors contributing to telehealth use. Findings highlighted an increase in clients assessed by mental health services and declining clinician numbers, contributing to pressure placed on clinicians. There was a lack of culture supporting telehealth, including limited awareness, leadership, and champions to facilitate implementation. Some teams provided services suited to telehealth; other subspeciality teams had limited applications for telehealth. There was a general lack of policy and guidelines to support telehealth use and limited technical support for clinicians unfamiliar with audiovisual software. Disorganised telehealth adoption in the study regions provides insight into wider environmental drivers affecting telehealth uptake. For telehealth to become a workable service delivery mode following COVID-19, stewardship and culture shifts are required, including policy development, technical support, and resources to support clinical teams. Telehealth may address growing service demand by improving interfaces with primary care and providing timely access to specialist input.
Factors Influencing Public Attitudes and Willingness to Utilize Telepharmacy Services in the UAE.
Jarab AS, Al-Qerem W, Mukattash T … +7 more , Al-Azayzih A, Kharaba Z, Heshmeh SA, Al-Momani J, Hamdan R, Al Hamarneh YN, Eberhardt J
Int J Telemed Appl · 2024 · PMID 39188938 · Full text
Telepharmacy, utilizing telecommunications to dispense pharmaceutical products and deliver patient care, offers numerous benefits for both the public and pharmacists. Previous research on exploring attitudes and willingn...
Telepharmacy, utilizing telecommunications to dispense pharmaceutical products and deliver patient care, offers numerous benefits for both the public and pharmacists. Previous research on exploring attitudes and willingness to use telepharmacy services has primarily focused on pharmacists rather than the general population. This study is aimed at assessing the attitudes and willingness of the United Arab Emirates (UAE) population to utilize telepharmacy services and identifying the factors influencing their inclination to use these services. In this cross-sectional study, a survey was distributed using convenience and snowball sampling to individuals aged 18 or older across the UAE through various social media platforms, including Twitter, Facebook, and WhatsApp. The survey domains included sociodemographics, attitudes, and readiness to utilize a telepharmacy service. A binary logistic regression analysis was conducted to investigate the variables associated with participants' willingness to utilize telepharmacy in the future. In total, 963 individuals participated in the study. Participants showed overall positive attitudes towards telepharmacy, with 70.9% believing that telepharmacy saved time and effort. While only 32% of the participants acknowledged that numerous telepharmacy services were available for use in the UAE, most were interested in using telepharmacy services in the future (79.2%). Participants who had higher attitude scores (AOR = 1.147, 95% confidence interval [CI]: 1.11-1.18) and those who had used these services previously (AOR = 3.270, 95% CI: 1.692-6.320) were more interested in using telepharmacy services in the future. Forthcoming healthcare strategies should focus on expanding the availability of telepharmacy services throughout various regions of the country. This expansion will facilitate the broader utilization of these services and ultimately contribute to improved health outcomes.
Functional and Nonfunctional Requirements of Virtual Clinic Mobile Applications: A Systematic Review.
Parsaei Z, Jangi M, Tahmasebian S … +1 more , Ehteshami A
Int J Telemed Appl · 2024 · PMID 38899062 · Full text
The Virtual Clinic Mobile Application (VCMA) is a valuable tool for managing and remotely monitoring patients with various medical conditions. It can alleviate the strain on outpatient services and offer follow-up option...
The Virtual Clinic Mobile Application (VCMA) is a valuable tool for managing and remotely monitoring patients with various medical conditions. It can alleviate the strain on outpatient services and offer follow-up options for patients who do not require a physical examination. A thorough understanding of recent literature can assist in identifying suitable functionalities for new development and future improvement of current applications (apps). This review study is aimed at identifying functional and nonfunctional requirements for VCMA. This study conducted a systematic search using databases such as PubMed, Scopus, ISI Web of Science, Science Direct, ProQuest, and IEEE to gather requirements of VCMA articles published in English from the inception of the databases up to April 2022. Out of a total of 1223 articles, 76 met the inclusion criteria. These articles were then analyzed using conventional content analysis to extract and categorize their requirements. Two main themes and 8 subthemes in terms of VCMA requirements were extracted as follows: (1) functional requirements with 3 subthemes (demographic data documentation, health record, general features of the user interface (UI)); (2) nonfunctional requirements with 5 subthemes (usability, accessibility, compatibility, efficiency, and security). The findings highlight the importance of mHealth solutions for virtual care and the need for the development of apps based on the extracted functional and nonfunctional requirements for VCMA; however, controlled trials are necessary. It is recommended that transparent reporting of mHealth interventions be prioritized to enable effective interpretation of the extracted data.
Barriers and Facilitators Experienced During the Implementation of Web-Based Teleradiology System in Public Hospitals of the Northwest Ethiopia: An Interpretive Description Study.
Nigatu AM, Yilma TM, Gezie LD … +4 more , Gebrewold Y, Gullslett MK, Mengiste SA, Tilahun B
Int J Telemed Appl · 2024 · PMID 38883327 · Full text
Teleradiology allows distant facilities to electronically transmit images for interpretation, thereby bridging the radiology service gap between urban and rural areas. The technology improves healthcare quality, treatmen...
Teleradiology allows distant facilities to electronically transmit images for interpretation, thereby bridging the radiology service gap between urban and rural areas. The technology improves healthcare quality, treatment options, and diagnostic accuracy. However, in low resource settings like Ethiopia, teleradiology services are limited, posing challenges for implementation. Therefore, this study is aimed at exploring the factors that facilitated or hindered the implementation of web-based teleradiology in the public hospitals of the South Gondar Zone, Northwest Ethiopia. In this study, a purposive sampling method was employed to select seventeen participants, including hospital managers, physicians, emergency surgeons, and radiologists, for an in-depth interview (IDI). The interviews were conducted from March to May 2023. A reflexive thematic analysis was conducted using an abductive coding technique at the semantic/explicit level. Data were collected through semistructured interviews conducted face-to-face and virtually, with audio recordings transcribed, translated, and analyzed using Open Code version 4.02 software. Trustworthiness was ensured through prolonged engagement, reflective journaling, and review by coauthors. The study examined eight main themes, with barriers to sustainable teleradiology implementation falling into five categories: technological, organizational, environmental, individual, and workflow and communication. Conversely, identified facilitators included improved radiology service efficiency, system accessibility, collaboration opportunities, and user trust in the radiology ecosystem. Within each theme, factors with potential impacts on teleradiology system sustainability were identified, such as the lack of system handover mechanisms, absence of a central image consultation center, and inadequate staffing of full-time radiologists and technical personnel. The study highlights the positive user perception of a web-based teleradiology system's user-friendliness and efficiency. Overcoming challenges and leveraging facilitators are crucial for optimizing teleradiology and improving service delivery and patient outcomes. A centralized consultation center with dedicated radiologists and technical personnel is recommended for maximizing efficiency.
An Ensemble Feature Selection Approach-Based Machine Learning Classifiers for Prediction of COVID-19 Disease.
Hossen MJ, Ramanathan TT, Al Mamun A
Int J Telemed Appl · 2024 · PMID 38660584 · Full text
The respiratory disease of coronavirus disease 2019 (COVID-19) has wreaked havoc on the economy of every nation by infecting and killing millions of people. This deadly disease has taken a toll on the life of the entire...
The respiratory disease of coronavirus disease 2019 (COVID-19) has wreaked havoc on the economy of every nation by infecting and killing millions of people. This deadly disease has taken a toll on the life of the entire human race, and an exact cure for it is still not developed. Thus, the control and cure of this disease mainly depend on restricting its transmission rate through early detection. The detection of coronavirus infection facilitates the isolation and exclusive care of infected patients. This research paper proposes a novel data mining system that combines the ensemble feature selection method and machine learning classifier for the effective identification of COVID-19 infection. Different feature selection approaches including chi-square test, recursive feature elimination (RFE), genetic algorithm (GA), particle swarm optimization (PSO), and random forest are evaluated for their effectiveness in enhancing the classification accuracy of the machine learning classifiers. The classifiers that are considered in this research work are decision tree, naïve Bayes, -nearest neighbor (KNN), multilayer perceptron (MLP), and support vector machine (SVM). Two COVID-19 datasets were used for testing from which the best features supporting the dataset were extracted by the proposed system. The performance of the machine learning classifiers based on the ensemble feature selection methods is analyzed.
Screening for Atrial Fibrillation by Digital Health Technology in Older People in Homecare Settings: A Feasibility Trial.
Sandberg EL, Halvorsen S, Berge T … +4 more , Grimsmo J, Atar D, Grenne BL, Jortveit J
Int J Telemed Appl · 2024 · PMID 38567031 · Full text
AIMS: Users of homecare services are often excluded from clinical trials due to advanced age, multimorbidity, and frailty. Atrial fibrillation (AF) is a common and frequently undiagnosed arrhythmia in the elderly and is...
AIMS: Users of homecare services are often excluded from clinical trials due to advanced age, multimorbidity, and frailty. Atrial fibrillation (AF) is a common and frequently undiagnosed arrhythmia in the elderly and is associated with severe mortality, morbidity, and healthcare costs. Timely identification prevents associated complications through evidence-based treatment. This study is aimed at assessing the feasibility of AF screening using new digital health technology in older people in a homecare setting. METHODS: Users of homecare services ≥ 65 years old with at least one additional risk factor for stroke in two Norwegian municipalities were assessed for study participation by nurses. Participants performed a continuous prolonged ECG recording using a patch ECG device (ECG247 Smart Heart Sensor). RESULTS: A total of 144 individuals were assessed for study participation, but only 18 (13%) were included. The main reasons for noninclusion were known AF and/or anticoagulation therapy (25%), severe cognitive impairment (26%), and lack of willingness to participate (36%). The mean age of participants performing the ECG test was 81 (SD ± 7) years, and 9 (50%) were women. All ECG tests were interpretable; the mean ECG monitoring time was 104 hours (IQR 34-338 hours). AF was detected in one individual (6%). CONCLUSION: This feasibility study highlights the challenges of enrolling older people receiving homecare services in clinical trials. However, all included participants performed an interpretable and prolonged continuous ECG recording with a digital ECG patch device. This trial is registered with NCT04700865.
Comparison of Goal Achievement during an Early, Intensive Nutrition Intervention Delivered to People with Upper Gastrointestinal Cancer by Telephone Compared with Mobile Application.
Furness K, Huggins CE, Hanna L … +3 more , Croagh D, Sarkies M, Haines TP
Int J Telemed Appl · 2024 · PMID 38567030 · Full text
OBJECTIVE: This study is aimed at exploring whether the mode of nutrition intervention delivery affected participant goal achievement in a three-arm randomised controlled trial of early and intensive nutrition interventi...
OBJECTIVE: This study is aimed at exploring whether the mode of nutrition intervention delivery affected participant goal achievement in a three-arm randomised controlled trial of early and intensive nutrition intervention delivered to upper gastrointestinal cancer patients. METHODS: Newly diagnosed upper gastrointestinal cancer patients were recruited from four tertiary hospitals in Melbourne, Australia. Participants in the intervention groups received a regular nutrition intervention for 18 weeks from an experienced dietitian via telephone or mobile application (app) using behaviour change techniques to assist in goal achievement. Univariate and multiple regression models using STATA determined goal achievement, dose, and frequency of contact between groups. A value <0.05 was considered statistically significant. RESULTS: The telephone group ( = 38) had 1.99 times greater frequency of contact with the research dietitian (95% CI: 1.67 to 2.36, < 0.001) and 2.37 times higher frequency of goal achievement (95% CI: 1.1 to 5.11, = 0.03) compared with the mobile app group ( = 36). The higher dose (RR 0.03) of intervention and more behaviour change techniques employed in the telephone group compared with the mobile app group increased participant goal achievement (95% CI: 0.01 to 0.04, < 0.001). . Telephone nutrition intervention delivery led to a higher frequency of goal achievement compared to the mobile app intervention. There was also a higher number of behaviour change techniques employed which may have facilitated the greater goal achievement. Mobile app-based delivery may have poorer acceptance in this population with high levels of withdrawal. . We need to ensure that specifically designed technologies for our target populations are fit for purpose, efficacious, and acceptable to both patients and healthcare providers. This trial is registered with ACTRN12617000152325.
Telehealth and Technology for Diabetes in Pregnancy Clinics: Staff Perspectives from South Auckland, New Zealand.
Singhal M, Oyston C
Int J Telemed Appl · 2024 · PMID 38516417 · Full text
Providing care for patients with diabetes in pregnancy (DiP) provides unique challenges beyond those faced in standard antenatal care or diabetes outside of pregnancy. Teleclinics (use of telephone, email, or other techn...
Providing care for patients with diabetes in pregnancy (DiP) provides unique challenges beyond those faced in standard antenatal care or diabetes outside of pregnancy. Teleclinics (use of telephone, email, or other technologies) as an alternative to in-person clinic appointments have become more widely used for care since the start of the COVID-19 pandemic. To understand how teleclinics might be improved for ongoing use, it is important to understand the experiences and perceptions of the clinicians involved in DiP care. . To understand staff experiences of DiP teleclinics and gain their perspectives on if and how teleclinics and other technologies might be best used in the future. . A qualitative study using semistructured interviews of healthcare providers in a large DiP service. Twenty staff members (midwifery, obstetrics, physician, dietician, and administration) were approached to participate. Fifteen staff across 5 specialties consented to be interviewed. Template analysis of interview transcripts was performed, with a focus on 3 themes: collaboration and working together are important for providing care for DiP, a need for flexibility in scheduling and the ability to individualise the way care is provided, and challenges to adapting to new technology. . Potential benefits of teleclinics were acknowledged, but respondents also viewed teleclinics as not suitable for all DiP patients due to different needs and risks. Challenges to using teleclinics include establishing good rapport and the current limited infrastructure and patient resources. . Healthcare providers viewed teleclinics as a way of supporting rather than replacing current care. Maintaining flexibility in clinic scheduling to allow incorporation of teleclinics into patient's current schedule of visits and providing extra technical and administrative support are important considerations for developing a teleclinic service.
High Diagnostic Accuracy of Long-Term Electrocardiogram Interpretation by General Practitioners.
Jortveit J, Boskovic M, Sandberg EL … +2 more , Vegsundvåg J, Halvorsen S
Int J Telemed Appl · 2024 · PMID 38425473 · Full text
AIMS: Traditional long-term ECG monitoring systems have primarily been used by cardiologist. New remote and wearable easy-to-use devices have led to increased use of ECG recordings also outside cardiology clinics. The ai...
AIMS: Traditional long-term ECG monitoring systems have primarily been used by cardiologist. New remote and wearable easy-to-use devices have led to increased use of ECG recordings also outside cardiology clinics. The aims of this study were to assess the feasibility and diagnostic accuracy of interpretation of the one-lead ECG recordings from a patch ECG device (ECG247 Smart Heart Sensor system) by general practitioners (GP). METHODS: Norwegian GPs were invited to digitally assess 10 long-term ECG recordings with different arrhythmias performed by the ECG247 Smart Heart Sensor system. For all ECG examinations, the presence/absence of different arrhythmias was registered. RESULTS: A total of 40 GPs accepted the invitation and assessed all the 10 long-term ECG recordings. All the tests were assessed as interpretable by all the GPs. Arrhythmias (atrial fibrillation/flutter, supraventricular tachycardia, and ventricular tachycardia) were correctly identified in most cases, with sensitivity of 98% (95% CI 95-99%), specificity of 75% (95% CI 68-82%), and diagnostic accuracy of 89% (85-92%). Incorrect automatic system algorithm interpretations were rarely corrected by the GPs. CONCLUSION: GPs interpreted one-lead recordings by the ECG247 Smart Heart Sensor system with high diagnostic accuracy for common arrhythmias. However, in cases with rare arrhythmias, we recommend consulting a cardiologist to confirm the diagnosis before treatment is initiated. This trial is registered with NCT04700865.
Feasibility of Leveraging Consumer Wearable Devices with Data Platform Integration for Patient Vital Monitoring in Low-Resource Settings.
Effah Kaufmann E, Tackie R, Pitt JB … +10 more , Mba S, Akwetey B, Quaye D, Mills G, Nyame C, Bulley H, Glucksberg M, Ghomrawi H, Appeadu-Mensah W, Abdullah F
Int J Telemed Appl · 2024 · PMID 38362543 · Full text
Manual monitoring of vital signs, which often fails to capture the onset of deterioration, is the main monitoring modality in most Ghanaian hospitals due to the high cost and inadequate supply of patient bedside monitors...
Manual monitoring of vital signs, which often fails to capture the onset of deterioration, is the main monitoring modality in most Ghanaian hospitals due to the high cost and inadequate supply of patient bedside monitors. Consumer wearable devices (CWDs) are emerging, relatively low-cost technologies for continuous monitoring of physiological status; however, their validity has not been established in low-resource clinical settings. We aimed to (1) investigate the validity of the heart rate (HR) and oxygen saturation (SpO2) data from two widely used CWDs, the Fitbit Versa 2 and Xiaomi Mi Smart Band 6, against gold standard bedside monitors in one Ghanaian hospital and (2) develop a web application to capture and display CWD data in a clinician-friendly way. A healthy volunteer simultaneously wore both CWDs and blood pressure cuffs to measure HR and SpO2. To test for concordance, we conducted the Bland-Altman and mean absolute percentage error analyses. We also developed a web application that retrieves and displays CWD data in near real time as text and graphical trends. Compared to gold standards (patient monitor and manual), the Fitbit Versa 2 had 96.87% and 96.67% measurement accuracies for HR, and the Xiaomi Mi Smart Band 6 had 94.24% and 93.21% measurement accuracies for HR. The Xiaomi Mi Smart Band 6 had 98.79% measurement accuracy for SpO2. The strong concordance between CWD and gold standards supports the potential implementation of these devices as a novel method of vital sign monitoring to replace manual monitoring, thus saving costs and improving patient outcomes. Further studies are needed for confirmation.
Enhancing Aotearoa, New Zealand's Free Healthline Service through Image Upload Technology.
Wilson MK, Pienaar F, Large R … +2 more , Wright M, Todd VF
Int J Telemed Appl · 2024 · PMID 38344112 · Full text
BACKGROUND: Healthline is one of the 39 free telehealth services that Whakarongorau Aotearoa/New Zealand Telehealth Services provides to New Zealanders. In early 2021, an image upload system for viewing service user-uplo...
BACKGROUND: Healthline is one of the 39 free telehealth services that Whakarongorau Aotearoa/New Zealand Telehealth Services provides to New Zealanders. In early 2021, an image upload system for viewing service user-uploaded images was implemented into the Healthline service. AIMS: The aim of this research was to understand the utilisation of Healthline's image upload system by clinicians and service users in New Zealand. METHODS: This is a retrospective observational study analysing Healthline image upload data over a two-year period: March 2021 through to December 2022. A total of 40,045 images were analysed, including demographics of the service users who uploaded an image: ethnicity, age group, and area of residence. The outcome or recommendation of the Healthline call was also assessed based on whether an image was included. RESULTS: Images uploaded accounted for 6.0% of total Healthline calls ( = 671,564). This research found that more service users were advised to go to an Emergency Department if they did not upload an image compared to service users who used the tool (13.5% vs. 7.7%), whereas a higher proportion of service users were given a lower acuity outcome if they included an image, including visiting an Urgent Care (24.0% vs. 16.9%) and GP (36.7% vs. 24.3%). CONCLUSION: Service users who did not upload an image had a higher proportion of Emergency Department outcomes than service users who did use the tool. This image upload tool has shown the potential to decrease stress on Emergency Departments around Aotearoa, New Zealand, through increased lower acuity outcomes.
Clinicodemographic Profile and Clinical Outcome of Children Presenting to Telemedicine Center at Institute of National Importance of India: A Prospective Observational Study.
Yankappa N, Kumar A, Prasad A … +2 more , Tiwari L, Kumar P
Int J Telemed Appl · 2024 · PMID 38327874 · Full text
BACKGROUND: There is a global shortage of healthcare professionals, especially in developing countries, leading to disparities in access to healthcare, worsened by the pandemic. Telemedicine is emerging as a solution, wi...
BACKGROUND: There is a global shortage of healthcare professionals, especially in developing countries, leading to disparities in access to healthcare, worsened by the pandemic. Telemedicine is emerging as a solution, with growing adoption worldwide due to advancements in technology and increased awareness. . The establishment of telemedicine depends on resources, infrastructure, and knowledge about healthcare needs. Further studies are needed to monitor and address evolving issues in telemedicine. . Rural health disparities stem from multiple factors, like limited healthcare access, workforce shortages, lifestyle choices, and lower socioeconomic status, leading to higher mortality and chronic diseases. Addressing these challenges is vital for rural community well-being. Telemedicine centers present a promising solution, bridging gaps, and improving healthcare outcomes for underserved remote populations. . Objective: This study assessed the clinicodemographic profile and clinical outcome of children presenting to the telemedicine center at the Institute of National Importance in India. Design: Prospective observational study. Setting: A single-center tertiary care level. Participants: This study included 79 children aged up to 18 years. . In our study, 79 children using telemedicine found a near-equal gender distribution. 8.9% needed emergency care, with common complaints being respiratory issues, fever, abdominal pain, and vomiting. After two weeks, 83.5% showed improvement, emphasizing telemedicine's effectiveness in pediatric care. CONCLUSION: Our study underscores telemedicine's positive impact on pediatric healthcare, emphasizing its potential to enhance access, outcomes, and cost-efficiency. Wider telemedicine adoption can reduce morbidity and mortality, support preventive care, and streamline posttreatment services, alleviating pressure on specialized facilities. While our focus was pediatrics, the telemedicine model is adaptable to various age groups and conditions, but it should be seen as a valuable supplement to, not a total substitute for, in-person healthcare visits.
Developing a Content Model of a Mobile-Based Application to Manage Patients with Low-Back and Neck Pain.
Farjami Rad Y, Shahmoradi L, Nakhostin Ansari N … +3 more , Hasson S, Ebrahimi M, Rahmani Katigari M
Int J Telemed Appl · 2024 · PMID 38223335 · Full text
INTRODUCTION: As a complementary tool in health, the design of mobile applications to influence care and increase awareness of patients has grown a lot. The purpose of this study is to design and validate the content mod...
INTRODUCTION: As a complementary tool in health, the design of mobile applications to influence care and increase awareness of patients has grown a lot. The purpose of this study is to design and validate the content model of a mobile-based application for managing patients with low-back and neck pain. METHODS: This descriptive-analytical study was conducted in two main stages to determine the content model of the application. The first stage consisted of three steps: finding the right exercise, determining the right scale to assess the pain intensity, and determining the appropriate features of the application. In the second stage, data elements collected from the previous stage were prepared in the form of a questionnaire that was given to 12 experts in physical therapy and sports medicine for validation. After collecting the questionnaire, data elements in all parts were analyzed based on the content validity ratio (CVR) and descriptive statistics indicators. RESULT: The content of the application was prepared in the three axes of exercises for low-back and neck pain, assessment of pain intensity, and features of the application. In the axis of sports exercises, 8 exercises for back pain and 3 exercises for neck pain were included according to the reference books. A Functional Rating Index (FRI) scale with 10 elements was selected in the axis of determining pain intensity. Also, 12 features such as the daily exercise section, using the animation, and using an audio file to explain how to do exercises were included in the model. CONCLUSION: According to the gaps identified in the existing applications, determining the content model of the application that is based on evidence and according to the opinion of experts is useful in improving the apps. The content model of this study was presented in 3 axes to increase the patient's willingness to do exercises, the correct way to perform exercises, conservative treatment, and check the progress of the treatment. The software developers can use these findings as a basis for designing new apps to manage low-back pain and neck pain.
Knowledge Is (Still) Key: Awareness to Shape Trends in Telemedicine Use during the Pandemic Based on Management Perceptions and Implementation Systems.
Hawa NI, Soesilo TEB, Nuraeni N
Int J Telemed Appl · 2023 · PMID 38093718 · Full text
OBJECTIVES: The digital revolution has brought rapid developments to the health sector. People were taking advantage of telemedicine technology during the COVID-19 pandemic. Telemedicine is highly recommended during a pa...
OBJECTIVES: The digital revolution has brought rapid developments to the health sector. People were taking advantage of telemedicine technology during the COVID-19 pandemic. Telemedicine is highly recommended during a pandemic because it will reduce the transmission rate of viruses, and it is considered adequate and low-cost. However, a fundamental challenge still occurs; most people need to be used to telemedicine technology. Presumably, inadequate education and lack of experience regarding the use of telemedicine are obstacles for society in utilizing telemedicine. METHODS: This study is aimed at determining the factors that influence the use of telemedicine. It focused on variables such as data confidentiality, administration, and knowledge to measure potential factors that pushed people to utilize telemedicine. We used a quantitative approach, using multivariate analysis, namely, simple linear regression. Most of our respondents are people aged 18-30 years young. RESULTS: All respondents stated that administration factors in the implementation of telemedicine were good. Through the Chi-square test, the data safety factor has no effect ( value =0.090 or >0.05) on telemedicine implementation, while the knowledge factor has a significant effect on telemedicine implementation with a value =0.043 (<0.005). The multivariate analysis explained that the knowledge variable influenced telemedicine use with a value =0.033 (<0.05), meaning it contributed 1.624 times to telemedicine. CONCLUSION: This study discusses the factors that influence the use of telemedicine. The study's results explain that the knowledge variable is the most significant factor influencing telemedicine use. is an intellectual property that everyone must have to capitalize on with telemedicine. A lack of knowledge will become an information gap and a barrier for someone to reach new tools/technologies.
Real-Time Remote Patient Monitoring and Alarming System for Noncommunicable Lifestyle Diseases.
Ko HYK, Tripathi NK, Mozumder C … +2 more , Muengtaweepongsa S, Pal I
Int J Telemed Appl · 2023 · PMID 38020047 · Full text
Telemedicine and remote patient monitoring (RPM) systems have been gaining interest and received adaptation in healthcare sectors since the COVID-19 pandemic due to their efficiency and capability to deliver timely healt...
Telemedicine and remote patient monitoring (RPM) systems have been gaining interest and received adaptation in healthcare sectors since the COVID-19 pandemic due to their efficiency and capability to deliver timely healthcare services while containing COVID-19 transmission. These systems were developed using the latest technology in wireless sensors, medical devices, cloud computing, mobile computing, telecommunications, and machine learning technologies. In this article, a real-time remote patient monitoring system is proposed with an accessible, compact, accurate, and low-cost design. The implemented system is designed to an end-to-end communication interface between medical practitioners and patients. The objective of this study is to provide remote healthcare services to patients who need ongoing care or those who have been discharged from the hospital without affecting their daily routines. The developed monitoring system was then evaluated on 1177 records from MIMIC-III clinical dataset (aged between 19 and 99 years). The performance analysis of the proposed system achieved 88.7% accuracy in generating alerts with logistic regression classification algorithm. This result reflects positively on the quality and robustness of the proposed study. Since the processing time of the proposed system is less than 2 minutes, it can be stated that the system has a high computational speed and is convenient to use in real-time monitoring. Furthermore, the proposed system will fulfil to cover the lower doctor-to-patient ratio by monitoring patients from remote locations and aged people who reside in their residences.
Evaluation of Awareness and Attitude of Telemedicine among Primary Healthcare Workers in Deprived Area Health Centers.
Mazandarani M, Lashkarbolouk N, Hashemi M
Int J Telemed Appl · 2023 · PMID 37794852 · Full text
BACKGROUND: Telemedicine has the potential to make healthcare more efficient, organized, and available and is a more beneficial technology that can ease preventive treatment and improve long-term health management. This...
BACKGROUND: Telemedicine has the potential to make healthcare more efficient, organized, and available and is a more beneficial technology that can ease preventive treatment and improve long-term health management. This is especially essential for those who face financial or regional reasons to get quality treatment. Telemedicine in Iran is a new medical field and a noble way to access medical facilities for populations living in deprived areas, and the primary healthcare workers in these deprived medical centers are the implementers of telemedicine in those areas; we aimed to investigate the awareness and attitude towards telemedicine among all the healthcare workers in these centers. METHOD: This is a descriptive cross-sectional study at the Health Centers of Raz County in North Khorasan Province, Iran, and 149 healthcare workers were included. For collecting information, we used a questionnaire that consisted of two parts. The first part contains the demographic data of health care workers, and the second part includes the 5-point Likert scale questionnaire (questions on telemedicine awareness, attitude, and self-report readiness). RESULT: Most participants (51%) were male, and 69.8% were married. The most frequent sources of information about telemedicine are colleagues (40.3%), continuing education (24.7%), and social media and the internet (10.1%). Awareness did not significantly relate to gender, age, marital status, or work experience, but awareness of physicians and midwives is higher than other groups ( < 0.05). The awareness of healthcare workers using continuing education, articles, workshops, or conferences was significantly higher ( < 0.05). The attitude scores for most questions are above 3.4 and reflect a positive attitude about telemedicine. Attitudes did not show a significant relation to gender, age, marital status, or work experience. CONCLUSION: Using telemedicine in developing countries, rural or urban areas have a high potential to improve epidemiological investigations, disease control, and clinical case management. Providing healthcare professionals with more information about new technologies in healthcare, such as telemedicine, can help get a more realistic picture of their perceptions.
Apps in Clinical Practice: Usage Behaviour of Trauma Surgeons and Radiologists in Northern Germany.
Keitsch M, Reiter A, Strahl A … +3 more , Frosch KH, Berger-Groch J, Priemel M
Int J Telemed Appl · 2023 · PMID 37564895 · Full text
INTRODUCTION: Apps, in general, are an integral part of our daily lives. To investigate the current usage behaviour of trauma surgeons and radiologists regarding medical apps in clinical practice and to find out if and h...
INTRODUCTION: Apps, in general, are an integral part of our daily lives. To investigate the current usage behaviour of trauma surgeons and radiologists regarding medical apps in clinical practice and to find out if and how the current range of medical apps can be improved, we surveyed trauma surgeons and radiologists in northern Germany. . An online questionnaire was sent to 100 trauma surgeons and 100 radiologists in northern Germany. Participants were asked about the frequency of their use of medical apps in clinical practice, which apps were used most often, how useful participants thought apps were, and in which area they would like to see improvements. The most frequently mentioned apps were finally analyzed. RESULTS: The survey study showed that 87.4% of the trauma surgeons and 67.4% of the radiologists use medical apps on a regular basis at work. It also revealed that trauma surgeons used medical apps much more often than radiologists and that young doctors were more likely to rely on medical apps than chief physicians. 80.0% of the participants would pay at least 5 euros for a medical app. Trauma surgeons see the greatest need for support in their daily work from medical apps in the area of treatment, while radiologists seek more support in the area of classification. CONCLUSION: The study underscored the broad acceptance of medical apps in everyday clinical practice. As the physicians are willing to spend money and stated a general interest and need for further developments, there is high potential for the future. This trial is registered with DRKS00026766.
Feasibility of Conducting Sit-to-Stand Tests Using Video Consultation.
Ng DP, Thiviyan P, Shrida S … +1 more , Ng LWC
Int J Telemed Appl · 2023 · PMID 39280702 · Full text
OBJECTIVE: This study is aimed at ascertaining the feasibility of conducting the 1-minute sit-to-stand (1MSTS) and 30-second sit-to-stand (30SSTS) tests for healthy participants via video consultation. A secondary aim wa...
OBJECTIVE: This study is aimed at ascertaining the feasibility of conducting the 1-minute sit-to-stand (1MSTS) and 30-second sit-to-stand (30SSTS) tests for healthy participants via video consultation. A secondary aim was to compare the relationship between the 1MSTS and 30SSTS. METHODS: A total of 63 participants were recruited via the Singapore Institute of Technology emails and social media in 2020 during the peak of COVID-19. Prior to the sit-to-stand testing, all participants completed the consent form and physical activity questionnaires. Anthropometric data such as height and weight were also collected prior to testing. An instructional video detailing the sit-to-stand (STS) movement and the requirements for the environment set-up were sent to the participants via email. All STS tests were conducted virtually via the Zoom application. Healthy participants aged 21 to 55 years old performed a 1MSTS and 30SSTS each in random order. RESULTS: All recruited participants completed the STS tests with no reported adverse events. Majority of participants were from the 21- to 25-year-old age groups, and the average number of repetitions performed by this group was 21.9 ± 5.6 for the 30SSTS and 44.7 ± 12.6 for the 1MSTS. CONCLUSION: Conducting the STS tests via video consultation was demonstrated to be safe and feasible. The number of repetitions performed in the 1MSTS is correlated to that of the 30SSTS, but 1MSTS has the ability to elicit a greater HR response among younger adults.
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