Video Based Assessment of Treatment Urgency in Outpatient Orthopaedic and Trauma Patients - a Pilot Trial. / Videobasierte Einschätzung der Behandlungsdringlichkeit - eine Pilotstudie für ambulante Patienten in der Orthopädie und Unfallchirurgie.

INTRODUCTION: When consulting a specialist in orthopaedics and trauma surgery, personal assessment and manual clinical examination by the doctor on site are essential. Nevertheless, implementation of video consultation hours has been made legally easier in Germany. The present pilot study examines the possibility of video-based assessment of the urgency of treatment in outpatient orthopaedic and trauma patients. MATERIALS AND METHODS: Within an ex ante study design, 40 patients with an orthopaedic clinical picture for trauma surgery with elective, urgent or emergency indication were selected from consultation hours. A short questionnaire was filled in based on the information provided and a medical colleague simulated a movement sequence based on the patient information. After modification to the "red flags" and "yellow flags" established in spinal orthopaedics, nine short questions were recorded, which inquire about the urgency of a medical consultation. The video-based movement sequence is based on a 60 s long instruction video in which motor tests and movement sequences are demonstrated: Cervical spine movement in all levels, elevation of the upper extremity, test of the finger-floor distance when "bending forward over-bending", possibility of crouching from standing and getting up again, standing on heels and toes. RESULTS: In 91.1% (n = 328) of the cases, the diagnosis was associated with the same joint or the same pathological entity. In 37.5% (n = 135) of the cases an emergency indication was seen, in 10.8% (n = 39) of the cases an urgent indication and in 51.6% (n = 186) of the cases it was seen to offer an elective indication. 12.5% (n = 45) of the cases were evaluated as "false positives" with regard to an emergency or urgent presentation. This means that the test persons were classified as "emergency" or "urgent", although there was no preventable dangerous course or medical emergency. 18 cases (5%) were evaluated as "false negative". DISCUSSION: The screening questionnaire presented and the short video assessment are technically feasible and practicable method for the initial evaluation in video-based online medical consultation. In addition, the questionnaire presented in combination with the short video assessment was suitable as an instrument for assessing the urgency of the consultation and selecting preventable dangerous processes and acute emergencies. CONCLUSION: The questionnaire, in combination with the short video assessment, is a suitable method for the social distancing requirements during limited accessibility of the medical system. Nevertheless, a false negative rate of 5% is too high to implement the questionnaire presented into daily clinics without further optimisation.

Examining the Hand in the Video Consultation. / Die Untersuchung der Hand in der Videosprechstunde.

BACKGROUND: Video consultations could support patient care in hand surgery during social distancing in the COVID-19 era. According to the literature, images of hand and fingers can support telediagnosis in hand emergencies. We present this feasibility study on online video consultation in hand surgery. METHODS: A structured examination was designed to query the medical history and examine motor skills, sensitivity, strength and function tests of the hand. Thirty examinations on both hands were carried out by online video consultation, then in direct contact and compared with each other. RESULTS: With 4560 evaluated range of movement of the hand and finger joints, there was a high correlation between the measurement methods of R = 0.995 (p < 0.0001, confidence interval 0.9946 - 0.9954). In the video-based examination, 84.6% of the measured values showed a deviation of less than 5° compared to the direct examination, 92.8% less than 10° deviation. Good accordance was also found in the patient's medical history. An estimating examination of sensitivity, function and strength during video examination is feasible with simple auxiliary aids. Deficits are evident in the detection of scars, in function tests and the absence of haptic findings. CONCLUSION: Online video consultation allows hand examination with sufficient documentation of hand and finger movements (range of motion) and proper evaluation of symptoms. It cannot replace direct examination but complement patient care in hand surgery even beyond the current COVID-19 pandemic.

Facebook usage on smartphones and gray matter volume of the nucleus accumbens.

A recent study has implicated the nucleus accumbens of the ventral striatum in explaining why online-users spend time on the social network platform Facebook. Here, higher activity of the nucleus accumbens was associated with gaining reputation on social media. In the present study, we touched a related research field. We recorded the actual Facebook usage of N=62 participants on their smartphones over the course of five weeks and correlated summary measures of Facebook use with gray matter volume of the nucleus accumbens. It appeared, that in particular higher daily frequency of checking Facebook on the smartphone was robustly linked with smaller gray matter volumes of the nucleus accumbens. The present study gives additional support for the rewarding aspects of Facebook usage. Moreover, it shows the feasibility to include real life behavior variables in human neuroscientific research.

Contributing to Overall Life Satisfaction: Personality Traits Versus Life Satisfaction Variables Revisited-Is Replication Impossible?

Virtually everybody would agree that life satisfaction is of immense importance in everyday life. Thus, it is not surprising that a considerable amount of research using many different methodological approaches has investigated what the best predictors of life satisfaction are. In the present study, we have focused on several key potential influences on life satisfaction including bottom-up and top-down models, cross-cultural effects, and demographic variables. In four independent (large scale) surveys with sample sizes ranging from N = 488 to 40,297, we examined the associations between life satisfaction and various related variables. Our findings demonstrate that prediction of overall life satisfaction works best when including information about specific life satisfaction variables. From this perspective, satisfaction with leisure showed the highest impact on overall life satisfaction in our European samples. Personality was also robustly associated with life satisfaction, but only when life satisfaction variables were not included in the regression model. These findings could be replicated in all four independent samples, but it was also demonstrated that the relevance of life satisfaction variables changed under the influence of cross-cultural effects.

Toward Psychoinformatics: Computer Science Meets Psychology.

The present paper provides insight into an emerging research discipline called Psychoinformatics. In the context of Psychoinformatics, we emphasize the cooperation between the disciplines of psychology and computer science in handling large data sets derived from heavily used devices, such as smartphones or online social network sites, in order to shed light on a large number of psychological traits, including personality and mood. New challenges await psychologists in light of the resulting "Big Data" sets, because classic psychological methods will only in part be able to analyze this data derived from ubiquitous mobile devices, as well as other everyday technologies. As a consequence, psychologists must enrich their scientific methods through the inclusion of methods from informatics. The paper provides a brief review of one area of this research field, dealing mainly with social networks and smartphones. Moreover, we highlight how data derived from Psychoinformatics can be combined in a meaningful way with data from human neuroscience. We close the paper with some observations of areas for future research and problems that require consideration within this new discipline.

Recorded Behavior as a Valuable Resource for Diagnostics in Mobile Phone Addiction: Evidence from Psychoinformatics.

Psychologists and psychiatrists commonly rely on self-reports or interviews to diagnose or treat behavioral addictions. The present study introduces a novel source of data: recordings of the actual problem behavior under investigation. A total of N = 58 participants were asked to fill in a questionnaire measuring problematic mobile phone behavior featuring several questions on weekly phone usage. After filling in the questionnaire, all participants received an application to be installed on their smartphones, which recorded their phone usage for five weeks. The analyses revealed that weekly phone usage in hours was overestimated; in contrast, numbers of call and text message related variables were underestimated. Importantly, several associations between actual usage and being addicted to mobile phones could be derived exclusively from the recorded behavior, but not from self-report variables. The study demonstrates the potential benefit to include methods of psychoinformatics in the diagnosis and treatment of problematic mobile phone use.

Smartphone usage in the 21st century: who is active on WhatsApp?

BACKGROUND: Mounting evidence shows that smartphone usage heavily disrupts our work life and social activities. Moreover, it is possible that overuse could resemble addictive tendencies. A key contributing factor to smartphone overuse seems to be usage of the messaging application WhatsApp. Although WhatsApp is one of the most commonly used communication applications on smartphones, research in this area is scarce. Given the huge societal debate on the impact of smartphone usage on our daily lives, the present study undertook a large-scale investigation in order to provide numbers on smartphone usage generally-and use of WhatsApp in particular, with the aim of providing a basis for a scientific debate. METHODS: In a large sample of N = 2,418 users, we recorded WhatsApp behaviour over a 4 week period. RESULTS: Our data show that use of WhatsApp accounted for 19.83% (= 32.11 min) of all smartphone behaviour (compare: Facebook only 9.38% = 15.19 min). The mean of general daily smartphone usage was 161.95 min. Females used WhatsApp for significantly longer periods of time than males and younger age was associated with longer duration of WhatsApp use. While the personality trait Extraversion was positively associated with daily WhatsApp use, Conscientiousness showed an inverse correlation with the length of daily WhatsApp use. CONCLUSIONS: The numbers on smartphone usage in the present study show that the smartphone dominates our daily life. In particular WhatsApp is a driving force, here. Given the length of daily smartphone and WhatsApp usage, more studies need to be conducted to better understand smartphone usage.

The importance of analogue zeitgebers to reduce digital addictive tendencies in the 21st century.

Analogue zeitgebers such as wristwatches and alarm clocks are essential for structuring everyday life. Since the dawn of the digital revolution - particularly since the advent of the smartphone - mobile phones have increasingly replaced analogue zeitgebers as a means of telling time. This functionality may prove problematic, in that it may contribute to the overuse of digital media (e.g. when checking the time turns into extended use of other smartphone utilities, including Internet-based applications). Of N = 3084 participants, 45% reported wearing a wristwatch and 67% used an analogue alarm clock. We observed that participants who reported using analogue zeitgebers used their mobile-/smartphone significantly less. Use of analogue zeitgebers may prove a practical tool for therapeutic and preventative interventions for problematic Internet use in an increasingly digital age.

Psycho-informatics: Big Data shaping modern psychometrics.

For the first time in history, it is possible to study human behavior on great scale and in fine detail simultaneously. Online services and ubiquitous computational devices, such as smartphones and modern cars, record our everyday activity. The resulting Big Data offers unprecedented opportunities for tracking and analyzing behavior. This paper hypothesizes the applicability and impact of Big Data technologies in the context of psychometrics both for research and clinical applications. It first outlines the state of the art, including the severe shortcomings with respect to quality and quantity of the resulting data. It then presents a technological vision, comprised of (i) numerous data sources such as mobile devices and sensors, (ii) a central data store, and (iii) an analytical platform, employing techniques from data mining and machine learning. To further illustrate the dramatic benefits of the proposed methodologies, the paper then outlines two current projects, logging and analyzing smartphone usage. One such study attempts to thereby quantify severity of major depression dynamically; the other investigates (mobile) Internet Addiction. Finally, the paper addresses some of the ethical issues inherent to Big Data technologies. In summary, the proposed approach is about to induce the single biggest methodological shift since the beginning of psychology or psychiatry. The resulting range of applications will dramatically shape the daily routines of researches and medical practitioners alike. Indeed, transferring techniques from computer science to psychiatry and psychology is about to establish Psycho-Informatics, an entire research direction of its own.