Effects of mhealth applications on military personnel's physical and mental health: A systematic review.

This systematic review examined the effects of mobile health (mHealth) apps on the physical and mental health outcomes of military personnel. Fourteen studies (10 RCTs, 4 non-RCTs) published between 2000 and 2022 were included. While app-based interventions did not significantly improve clinical outcomes like HbA1c and blood pressure, they showed a statistically significant reduction in symptom severity of Posttraumatic Stress Disorder symptoms (PTSD), depression, and insomnia. Patients expressed satisfaction with the apps, though statistical significance was not reported. In addition to alleviating mental health symptoms, mHealth apps appear widely accepted by military personnel. Development and implementation of evidence-based mental health apps by healthcare professionals are recommended.

Improving asthma control and quality of life via a smartphone self-management app: A randomized controlled trial.

BACKGROUND: Mobile phone applications (apps) show promise for enhancing asthma self-management, but their effectiveness varies. This study examined the effect of a smartphone asthma app on asthma control and quality of life. METHODS: Using block randomization, 60 patients with asthma were allocated to an intervention group (n = 30) or control group (n = 30) for this single-blind randomized controlled trial. At baseline, both groups completed the Asthma Control Test (ACT) and Asthma Quality of Life Questionnaire-Marks (AQLQ-M). The intervention group used a smartphone-based asthma self-management app plus their regular treatment, while the control group received only usual care. Follow-up ACT and AQLQ-M assessments occurred at 3 and 6 months. SPSS version 26 was used for analysis, including descriptive statistics, non-parametric tests (Wilcoxon and Mann-Whitney U), and analysis of variance with repeated measurements. RESULTS: Both groups showed improved asthma control and quality of life at 3 and 6 months compared to baseline. However, after 6 months the intervention group had significantly greater improvement than controls (p < 0.05). Repeated measures ANOVA revealed divergent changes in ACT and AQLQ-M scores over time, with the intervention group demonstrating greater enhancement of asthma control and quality of life (p < 0.001). CONCLUSION: This study demonstrated that use of a smartphone-based asthma self-management app improved asthma control and quality of life after 6 months compared to usual care alone. These findings indicate that guideline-based asthma apps can positively impact outcomes.

Evaluation of Completeness, Comparability, Validity, and Timeliness in Cancer Registries: A Scoping Review.

An essential aspect of cancer registration is data quality. Data quality for Cancer Registries has been reviewed in this paper using four main criteria (comparability, validity, timeliness, and completeness). Medline (via PubMed), Scopus, and Web of Science databases were searched for relevant English articles published from inception until December 2022. Each study was analyzed for its characteristics, measurement method, and data quality features. According to the present study, the majority of articles evaluated the completeness feature, and the fewest evaluated the timeliness feature. A completeness rate of 36% to 99.3% and a timeliness rate of 9% to 98.5% were observed. Standardizing metrics and reporting of data quality is necessary to maintain confidence in the usefulness of cancer registries.

Machine Learning Approaches for Detecting Coronary Artery Disease Using Angiography Imaging: A Scoping Review.

This scoping review aims to identify and summarize the current literature on Machine learning (ML) approaches for detecting coronary artery disease (CAD) using angiography imaging. We comprehensively searched several databases and identified 23 studies that met the inclusion criteria. They employed different types of angiography imaging including computed tomography and invasive coronary angiography. Several studies have used deep learning algorithms for image classification and segmentation, and our findings show that various machine learning algorithms, such as convolutional neural networks, different types of U-Net, and hybrid approaches. Studies also varied in the outcomes measured, identifying stenosis, and assessing the severity of CAD. ML approaches can improve the accuracy and efficiency of CAD detection by using angiography. The performance of the algorithms differed depending on the dataset used, algorithm employed, and features selected for analysis. Therefore, there is a need to develop ML tools that can be easily integrated into clinical practice to aid in the diagnosis and management of CAD.

Design, development, and usability evaluation of a smartphone-based application for nutrition management in patients with type II diabetes.

Purpose: Information technology (IT)-based interventions, especially mobile health (mHealth), possess a great potential for promoting self-management in patients with chronic diseases, including diabetes type II. The present study was aimed to design and develop a smartphone-based application (app) for nutrition management in patients with type II diabetes and evaluation of its usability. Methods: In this study, a three-phase research approach was followed; (1) To determine the information content and functionalities of the app, a five-point Likert scale checklist including six parts was developed based on reviews of clinical practice guidelines and specialized databases. The checklist was then given to ten experts in endocrinology and metabolism, internal medicine, and nutrition, and those items with a mean score higher than 3.75 were approved. (2) In Android Studio, the app was designed and developed using Java language. (3) The Questionnaire for User Interaction Satisfaction (QUIS) was used to assess the app's usability by 21 patients with type II diabetes, ten IT experts, and seven endocrinologists, internal medicine practitioners, and nutritionists over one month. Mean scores were divided into three levels: weak (0-3), average (3-6), and good (6-9). Results: According to experts' view, 17 out of 22 educational content and 17 out of 27 functionalities were approved. The app's most important educational content was the timing of meals for insulin patients and the definition of diabetes and its complications. The designed app had the following functionalities: providing educational information, recording information, performing calculations, representing data graphically, setting reminders, and communicating with physicians. The most important features of the app were the insulin dose calculation, reminders for doctors' appointments, setting times for tests and blood glucose measurements, and also tracking weight, blood glucose levels, and blood pressure. In terms of usability evaluation, the app was rated "good" level by diabetic patients (7.83 ± 0.74), IT experts (8.1 ± 0.66), and physicians (8.03 ± 0.95). Conclusion: Given the desirable evaluation of the app by patients, physicians, and IT experts, it can be concluded that the developed app has the required functionalities for nutrition management of patients with type II diabetes. Smartphone-based apps appear to be able to improve self-management, the quality of care and health in patients with diabetes, and reduce many of their unnecessary visits to healthcare centers, and costs. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-022-01140-x.

Effects and characteristics of clinical decision support systems on the outcomes of patients with kidney disease: a systematic review.

OBJECTIVES: This systematic review was conducted to investigate the characteristics and effects of clinical decision support systems (CDSSs) on clinical and process-of-care outcomes of patients with kidney disease. METHODS: A comprehensive systematic search was conducted in electronic databases to identify relevant studies published until November 2020. Randomized clinical trials evaluating the effects of using electronic CDSS on at least one clinical or process-of-care outcome in patients with kidney disease were included in this study. The characteristics of the included studies, features of CDSSs, and effects of the interventions on the outcomes were extracted. Studies were appraised for quality using the Cochrane risk-of-bias assessment tool. RESULTS: Out of 8722 retrieved records, 11 eligible studies measured 32 outcomes, including 10 clinical outcomes and 22 process-of-care outcomes. The effects of CDSSs on 45.5% of the process-of-care outcomes were statistically significant, and all the clinical outcomes were not statistically significant. Medication-related process-of-care outcomes were the most frequently measured (54.5%), and CDSSs had the most effective and positive effect on medication appropriateness (18.2%). The characteristics of CDSSs investigated in the included studies comprised automatic data entry, real-time feedback, providing recommendations, and CDSS integration with the Computerized Provider Order Entry system. CONCLUSION: Although CDSS may potentially be able to improve processes of care for patients with kidney disease, particularly with regard to medication appropriateness, no evidence was found that CDSS affects clinical outcomes in these patients. Further research is thus required to determine the effects of CDSSs on clinical outcomes in patients with kidney diseases.

Pregnant women's use and attitude toward Mobile phone features for self-management.

BACKGROUND: This study aimed to examine the current use of mobile phones by pregnant women and their attitudes towards the use of a variety of prenatal care services through mHealth. METHODS: This descriptive cross-sectional study was conducted in Iran in 2021. The study population included 168 pregnant women who referred to specialist obstetrics and gynecology clinic. The data collection tool was a questionnaire that included the demographics of the participants, their current mobile phone usage, and their attitudes toward mobile phone use for prenatal care services. The data were analyzed in SPSS with descriptive and analytical statistics. RESULTS: The majority of participants (84.2%) had a smartphone and access to mobile internet. More than half of the respondents (58.9%) used their mobile phone for (only) phone calls, and 36.7% occasionally used mobile internet to access prenatal care services. To get information about the pregnancy and to communicate with other pregnant women, the participants mainly used social media, and to get reminders, they preferred phone calls. CONCLUSIONS: In this study, pregnant women have a positive attitude towards using mobile phones for obtaining health services and prefer social media to seek prenatal care services. There seems to be a need for pregnant women to have high levels of digital health literacy and be advised by healthcare providers on using this technology to access prenatal care services.

Correlation of sensitization to food allergens in Iranian patients with migraine and tension headaches.

OBJECTIVES: Headache is one of the most common neurological disorders around the world. Previous studies have proposed associations of food allergies with headaches. Therefore, this study evaluated the frequency of sensitization to food allergens in patients with migraine and tension headaches and their correlations with these disorders. METHODS: The study subjects consisted of 20 patients with migraine headache and 20 subjects with tension headache. Headache disorders were confirmed by a specialist. Food allergen sensitization was diagnosed by skin prick test (SPT) or radioallergosorbent test (RAST), clinical history, and physical examination. RESULTS: There was no significant difference in age and gender between patients with migraine and tension headaches. Other results showed sensitization to food allergens, such as egg, wheat, fish, banana, orange, and soybean, in patients with migraine headache was similar to those in subjects with tension headache. However, patients with migraine headache significantly differed from individuals with tension headache in allergic responses to tree nut (P=0.047), peanut (P=0.028), and cow's milk (P=0.044). CONCLUSION: The results of this study showed that sensitization to food allergens may relate to migraine headache which their diagnosis can help to better control and manage the disease.

The effectiveness of tele-triage during the COVID-19 pandemic: A systematic review and narrative synthesis.

BACKGROUND: Telehealth services were used by healthcare centers during the COVID-19 pandemic in order to identify and manage patients at the forefront of the healthcare system. As one of these technologies, tele-triage refers to the assessment of a patient's health status through telephone or another means of communication and recommending treatment or providing appropriate referrals in emergency rooms and primary care offices. This study aimed to perform a systematic review of the evidence on the effectiveness of tele-triage, as one of these technologies, during the COVID-19 pandemic. METHODS: Medline (via PubMed), Scopus, and Web of Science databases were searched for relevant English articles published since the pandemic's onset until December 30, 2021. Studies investigating the tele-triage's effect on patient safety, clinical outcomes, and patient satisfaction were included. Data on study characteristics, intervention characteristics, and their effects on study outcomes were extracted separately by two authors. A narrative synthesis of the included studies was ultimately performed. RESULTS: Out of the 6312 retrieved studies, 14 met the inclusion criteria. The tele-triage intervention was offered by an algorithm-based system in eight studies (57.14%) and by healthcare providers in six other studies (42.86%) to determine the patient's level of care. According to the results, tele-triage interventions during COVID-19 can reduce unnecessary emergency room visits (by 1.2-22.2%), improve clinical outcomes after intervention (such as would closure in diabetic feet), reduce mortality and injuries, and ensure patient satisfaction with tele-triage (53-98%). CONCLUSIONS: This study found that tele-triage interventions reduced unnecessary visits, improved clinical outcomes, reduced mortality, and injuries, increased patient satisfaction, reduced healthcare provider workload, improved access to primary care consultation, and increased patient safety and satisfaction. Therefore, tele-triage systems are not only suitable for providing acute and emergency care remotely but they are also recommended as an alternative tool to monitor and diagnose COVID-19.

Designing a national model for assessment of nursing informatics competency.

BACKGROUND: Due to the need for informatics competencies in the field of nursing, the present study was conducted to design a psychometric instrument to determine the qualification of informatics competencies of employed nurses in educational care centers. METHODS: The questionnaire was made by reviewing existing scientific resources and assessment tools. Two hundred nurses were selected using simple random sampling. Structural equation modeling was used using the measurement model technique and the average variance was calculated. Linear structural relations (LISREL) software was used to test the assumptions and correlations of the model. RESULTS: Findings showed relatively good estimation in the fit of first-order measurement model. The informatics knowledge subscale with a determining rate of 0.90 had the greatest explanatory effect among the subscales and informatics skill with a determining rate of 0.67 and basic computer skill with a determining rate of 0.60 were observed. The second-order measurement model of fitness indicators showed that the three factors can well explain the multidimensional construct of informatics competency. CONCLUSIONS: The designed tool can be used to develop educational strategies in relation to nursing students in the field of informatics and prepare them in the rich environment of information technology, which can be helpful in training nursing instructors.

The use of mobile phone functionalities by patients with asthma and their desire to use for self-care purposes.

BACKGROUND: Mobile health (mHealth) has good potential for promoting self-care in patients suffering from chronic diseases. The patients' positive attitude toward this technology is a key factor for the successful implementation. The present study was conducted to investigate the asthma patients' use of mobile phone functionalities and their desire to receive self-care services through this technology. METHODS: This survey study was conducted in Iran in 2018. The study population consisted of 146 patients suffering from asthma. The data collection tool was a questionnaire containing items on the demographic characteristics of patients, current use of mobile phone functionalities, and desire to use them for receiving self-care services. Data were analyzed using descriptive and analytical statistics. RESULTS: Out of the 160 questionnaires distributed, 146 (91.25%) were completed. The majority of the participants had smartphones (84.9%). Less than half of the participants occasionally used mobile phone functionalities including mobile phone calls (42.5%) and mobile Internet (40.4%) to receive asthma-related information. A significant number of the participants had never used smartphone applications (72.6%) and E-mail (66.4%) to receive asthma-related information. The participants had their greatest use of Internet search, followed by social media, to receive information about asthma symptoms, allergenic and irritating substances, medicinal therapy, and how to use therapy aids. The participants were most willing to use social media for receiving asthma information, communicating with other patients, receiving reminders about doctor's appointment, and receiving warnings about the lack of asthma control. CONCLUSION: In Iran as a developing country, asthma patients use Internet search mostly to receive instructional information and are willing to use social media rather than other mobile phone functionalities to receive self-care services. These patients believe that mobile phones are appropriate for receiving instructional information and reminders.

Mobile phone usage in patients with type II diabetes and their intention to use it for self-management: a cross-sectional study in Iran.

BACKGROUND: Mobile health has potential for promotion of self-management in patients with chronic diseases. This study was conducted to investigate smartphone usage in patients with type II diabetes and their intention to use it for self-management. METHODS: This cross-sectional study was conducted in 2018 with 176 patients with type II diabetes visiting a specialized diabetes clinic or one of two endocrinology and metabolism specialists in north of Iran. Data were collected using a validated questionnaire containing items on demographic characteristics, disease information, use of mobile phones, smartphones and the internet, and intention to use mobile phones for diabetes self-management. RESULTS: The majority of the participants had mobile phones (94.9%), smartphones (61.1%), and daily access to the internet (81.3%), and used phones two hours per day on average (80.1%). They mostly used mobile phones to contact friends (89.2%) and search for information (50.6%), and their greatest intention for using smartphones and the internet for self-management was related to dietary planning (96%), checking blood glucose (90.9%), and contacting specialists (87.5%). Younger participants were more interested in using smartphone applications (apps) (P < 0.001). About half of the participants argued that using apps can be interesting (54%) and useful (50%) for diabetes management, and intended to use apps much more in future (48.3%). CONCLUSIONS: The majority of patients with type II diabetes are inclined to use mobile phone and the Internet, especially to plan their diet, check blood glucose, and contact their doctors. The present study provides valuable information for designing and implementing interventions based on mHealth to promote self-management in type II diabetes.

Phone-based interventions to control gestational weight gain: a systematic review on features and effects.

Objective: The aim of this study was to summarize the evidence regarding the effects and the features of phone-based interventions to control gestational weight gain (GWG).Methods: We included studies that evaluated the effects of phone-based interventions on controlling GWG. The characteristics of studies, effects, and features of interventions were extracted.Results: A total of 12 studies met the inclusion criteria. Outcomes were categorized into three groups (GWG control, proportion of women returning to pre-pregnancy weight, and proportion of women who exceeded the Institute of Medicine recommendations for GWG). Although most studies (66%) showed a statistically significant positive effect of phone-based interventions on the GWG control, the effects on the other outcome categories were found to be inconsistent. While the included studies used phone call and short messaging service (SMS), no study used the other functions of telephones and mobile phones such as video call, internet access, social networks, and smartphone applications. Regarding the functionalities, phone calls were used to provide guidance for healthy weight gain and communication with healthcare providers. SMS provided reminders, educational materials, and guidance.Conclusion: Phone-based interventions can help pregnant women control GWG by providing guidance, reminders, and educational materials. When these interventions use multiple functionalities, they are more effective in controlling GWG.

Enhancing Asthma Patients' Self-Management through Smartphone-Based Application: Design, Usability Evaluation, and Educational Intervention.

OBJECTIVE: The aim of this study was to design and evaluate a smartphone-based application for improving self-management in patients with asthma and evaluate its effects on their knowledge. METHODS: In this applied research, based on the Clinical Practice Guideline and a systematic review, a questionnaire was designed to determine the application information content and functionality requirements by 15 pediatric and adult asthma and allergy specialist. Then the application was designed and developed using Adobe Air software on the Android operating system. Usability evaluation of the mobile application was performed using the standard questionnaire for user interaction satisfaction (QUIS), which completed by 30 patients with asthma, 8 information technology (IT) specialists, and 2 asthma and allergy specialists. Self-management knowledge of 30 asthma patients was measured using a researcher-made questionnaire before and after using the application. RESULTS: The number of specialists in the both Delphi rounds was 15 and the mean work experiences were 17.6 years. The most important elements for asthma self-management were avoiding exposure to allergen and triggers (96%), drug treatment (94.6%), and how to use the therapeutic tools (92.4%), and the most important functionalities were alerting the patients when they did not control asthma (92%), setting reminders for timely drug use (85.4%) and therapeutic tools (82.6%), recording prescription drugs (82.6%), and peak flow meter values (82%). Usability evaluation showed that 30 patients with asthma, 8 IT specialists, and 2 physicians evaluated the application at a "good" level. The mean score of the patients' knowledge before intervention was 2.43 ± 0.95 which after intervention was significantly increased to 4.3 ± 0.56 (p < 0.001). CONCLUSION: Considering the desirable outcomes of application evaluation and a positive impact of this educational intervention on asthma patients' knowledge, it is possible to use mobile-based self-management programs to help these patients to manage illness and gain knowledge and self-management skills.

Patient Self-Management of Asthma Using Mobile Health Applications: A Systematic Review of the Functionalities and Effects.

Objective The aim of this systematic review was to summarize the evidence regarding the effects of mobile health applications (mHealth apps) for self-management outcomes in patients with asthma and to assess the functionalities of effective interventions. Methods We systematically searched Medline, Scopus, and the Cochrane Central Register of Controlled Trials. We included English-language studies that evaluated the effects of smartphone or tablet computer apps on self-management outcomes in asthmatic patients. The characteristics of these studies, effects of interventions, and features of mHealth apps were extracted. Results A total of 10 studies met all the inclusion criteria. Outcomes that were assessed in the included studies were categorized into three groups (clinical, patient-reported, and economic). mHealth apps improved asthma control (five studies) and lung function (two studies) from the clinical outcomes. From the patient-reported outcomes, quality of life (three studies) was statistically significantly improved, while there was no significant impact on self-efficacy scores (two studies). Effects on economic outcomes were equivocal, so that the number of visits (in two studies) and admission and hospitalization-relevant outcomes (in one study) statistically significantly improved; and in four other studies, these outcomes did not improve significantly. mHealth apps features were categorized into seven categories (inform, instruct, record, display, guide, remind/alert, and communicate). Eight of the 10 mHealth apps included more than one functionality. Nearly all interventions had the functionality of recording user-entered data and half of them had the functionality of providing educational information and reminders to patients. Conclusion Multifunctional mHealth apps have good potential in the control of asthma and in improving the quality of life in such patients compared with traditional interventions. Further studies are needed to identify the effectiveness of these interventions on outcomes related to medication adherence and costs.