Clinical trial knowledge among cancer survivors in the United States: the role of health information technology.

PURPOSE: Clinical trials are essential to the advancement of cancer care. However, clinical trial knowledge and participation remain critically low among adult patients with cancer. Health information technology (HIT) could play an important role in improving clinical trial knowledge and engagement among cancer survivors. METHODS: We used data from 3,794 adults who completed the 2020 Health Information National Trends Survey, 626 (16.2%) of whom were cancer survivors. We examined the prevalence of HIT use in the study population and by cancer history using chi-squared tests. We used multivariable logistic regression models to examine the impact of HIT use on clinical trial knowledge for cancer survivors and respondents with no cancer history, respectively. RESULTS: Approximately 63.8% of cancer survivors reported having some knowledge of clinical trials. Almost half of the cancer survivors used HIT to communicate with doctors (47.1%) and make health appointments (49.4%), 68.0% used HIT to look up health information online and 42.2% used it to check test results. In the adjusted models, the use of HIT in communicating with doctors [OR 2.79; 95% CI (1.41, 5.54)], looking up health information online [OR 2.84; 95% CI (1.04, 7.77)], and checking test results [OR 2.47; 95% CI (1.12, 5.43)] was associated with having some knowledge of clinical trials. CONCLUSION: HIT use for engaging with the healthcare team and health information gathering is associated with higher clinical trial knowledge in cancer survivors. Given the rapid increase in mobile technology access globally and the increased use of HIT, digital technology can be leveraged to improve clinical trial knowledge and engagement among cancer survivors.

A Tale of 102,726 Messages: Characterizing the Modern Urologist's Portal Message Burden After Common Urologic Surgeries.

INTRODUCTION: We aimed to characterize patient portal messaging use after urologic surgery to identify administrative burden and evaluate postoperative clinical associations. METHODS: Epic was queried for all urologic surgeries performed at the Mayo Clinic enterprise between 2019 and 2022. Data from the highest volume procedures were extracted including patient-generated portal messages to their provider and emergency department (ED) visits within 6 months of surgery. Factors associated with portal users and message volume, as well as the impact of portal use on risk of subsequent ED visit, were evaluated. RESULTS: We analyzed data from 23,621 urologic procedures, which generated 102,726 patient portal messages within 6 months of surgery. We found that 55% of our cohort sent at least 1 message. Stratifying by subspecialty, endourologic surgeries generated the fewest number of messages per surgery (3.83; SD, 8.76), whereas female pelvic medicine and reconstructive surgeries yielded the most (6.05; SD, 10.92). Younger age, female sex, and White race were associated with increased portal utilization. Multivariable time-to-event analysis revealed a 33% reduction in the risk of ED presentation within 90 days after surgery for patients using the patient portal compared with those who did not. CONCLUSIONS: While only half of patients sent portal messages after surgery, active users showed a 33% reduction in ED visits, suggesting its potential to reduce health care utilization. Encouraging broader portal adoption can improve outcomes. However, the message burden for urologists necessitates solutions. Resource allocation should prioritize strategies to help urologists manage messages while preserving the established clinical benefits.

Information-seeking Behavior of Iranian Young Adults (18-28 Years Old) Regarding HPV on Social Media: A Preventive Approach to HPV.

Background: Health information-seeking behavior refers to individuals' targeted actions to satisfy their health information needs and search for relevant disease-related information. Nowadays, social media platforms provide a great opportunity for meeting health information needs and delivering preventive education regarding human papillomavirus (HPV). The purpose of this study is the information-seeking behavior of Iranian young adults (18-28 years old) regarding HPV on social media, a preventive approach to HPV. Methods: The present descriptive-analytical study was conducted in 2023 among Iranian boys and girls aged 18-28 years. A multistage cluster sampling method was used to select 3840 participants. The data collection tool was Longo's Health Information-Seeking Behavior Questionnaire. The collected data were analyzed using the SPSS software. Results: The results showed that Iranian youth aged 18-28 were more inclined to seek information on social media about the transmission routes and preventive measures for HPV. The primary informational need regarding transmission was "I want to know the main route of HPV transmission is through vaginal and anal intercourse?", and regarding prevention, it was "Can condoms prevent HPV infection?" Additionally, the findings indicated that young individuals sought information about HPV after their first sexual encounter. Most of the information needs of the youth were fulfilled through YouTube, Instagram, and WhatsApp, mainly in video format. Approximately 85.10% of the youth were satisfied with the information obtained from social media. The results revealed a significant and positive relationship between the health information needs of young adults (18-28 years old) in the area of HPV and personal factors. Gender, age, marital status, education level, history of HPV infection, and engaging is unprotected extramarital sex were identified as significant influential factors on the level of information needs of young individuals, especially regarding HPV preventive measures (P < 0.05). Conclusion: Health authorities and disease control and prevention centers need to harness the potential of social media in meeting the informational needs of youth and providing education and awareness, especially concerning the transmission and prevention of HPV.

Healthy from the Start: Co-Designing Sleep, Nutrition and Physical Activity Resources for Young Shiftworkers-Novel Implementation and Evaluation.

INTRODUCTION: The increasing prevalence of shiftwork among young adults poses significant health risks, primarily due to its disruptive effects on sleep, nutrition and physical activity. Addressing these risks necessitates the development of tailored, evidence-based resources to support these key health behaviours. Participatory research approaches, engaging those with relevant lived experience (i.e., co-design) are a novel and effective approach in developing these resources. As such, the aim of the present study was to explore whether sleep, nutrition and physical activity resources for young shiftworkers could be developed using participatory, co-design approaches and how co-designers would rate both the approaches used and the resulting resources. METHODS: A participatory approach engaged co-designers (young, experienced or previous shiftworkers; workplace health and safety specialists; science communicators and academic experts) to complete 2-3 online questionnaires and participate in 1-2 online workshops, to co-design sleep, nutrition and physical activity resources for young shiftworkers. Following resource development, co-designers assessed both the participatory approach and the resulting resources, through an online questionnaire, which included the Public and Patient Engagement Evaluation Tool (PPEET). RESULTS: Co-designers (n = 48) participated in the development of sleep, nutrition and physical activity resources for young shiftworkers. Co-designers evaluated the participatory approach positively, with a mean rating across all PPEET items of 4.7 (±0.2) on a 5-point Likert scale. Co-designers also provided positive ratings for the resources, with the majority (91.7%) either agreeing or strongly agreeing that they were user-friendly, valuable and informative for young shiftworkers and would serve as a credible source of health information. CONCLUSION: By adopting a novel participatory approach, we successfully co-designed sleep, nutrition and physical activity resources for young shiftworkers. Participatory approaches, including co-design, should be considered when developing health interventions for shiftworkers, given the value of embedding lived experience to address their unique lifestyle challenges. PATIENT OR PUBLIC CONTRIBUTION: Co-designers and/or people with relevant lived experience were involved in all project activities: conceptualisation, design, recruitment, data collection, data analysis, knowledge translation and output generation.

Belief that Progress has Been Made in Curing Cancer Varies by Perception of Social Media Health Mis- and Disinformation, Education, Frequency of Social Media Use, and Healthcare System Trust: A Cross-Sectional Study.

OBJECTIVE: This study explored the relationship between perceptions of health mis/disinformation on social media and belief that progress has been made in curing cancer. METHODS: We analyzed cross-sectional, retrospective data collected from 4246 adult social media users in the 2022 Health Information National Trends Survey (HINTS 6). The outcome variable was the belief in whether progress has been made in curing cancer. The primary predictor variable was the perception of health mis/disinformation on social media, categorized as 'Substantial' and '< Substantial'. We also examined whether the relationship varied by health care system trust, frequency of social media use, and education. The analysis controlled for demographic, socioeconomic, and health-related factors. RESULTS: Perception of substantial social media health mis- and disinformation was associated with a lower likelihood of believing progress has been made in curing cancer (odds ratios = 0.74, 95% CI = 0.59-0.94). Persons who perceived substantial social media health mis-and disinformation and had low trust in the health care system were less likely to believe progress has been made in curing cancer: 36% (95% CI: 28-45%). Persons who perceived substantial social media health mis-and disinformation and used social media less than daily were less likely to believe progress has been made in curing cancer: 44% (95% CI: 36-52%). Persons without a college degree who perceived substantial social media health mis-and disinformation were less likely to agree that progress has been made in curing cancer: 44% (95% CI: 39-50%). CONCLUSION: Exposure to misinformation on social media may be associated with negative attitudes about advances in curing cancer, particularly among social media users with low trust in the health care system trust, less frequent social media users, or those without a college degree.

A quantitative content analysis of topical characteristics of the online COVID-19 infodemic in the United States and Japan.

BACKGROUND: The COVID-19 pandemic has spurred the growth of a global infodemic. In order to combat the COVID-19 infodemic, it is necessary to understand what kinds of misinformation are spreading. Furthermore, various local factors influence how the infodemic manifests in different countries. Therefore, understanding how and why infodemics differ between countries is a matter of interest for public health. This study aims to elucidate and compare the types of COVID-19 misinformation produced from the infodemic in the US and Japan. METHODS: COVID-19 fact-checking articles were obtained from the two largest publishers of fact-checking articles in each language. 1,743 US articles and 148 Japanese articles in their respective languages were gathered, with articles published between 23 January 2020 and 4 November 2022. Articles were analyzed using the free text mining software KH Coder. Exploration of frequently-occurring words and groups of related words was carried out. Based on agglomeration plots and prior research, eight categories of misinformation were created. Lastly, coding rules were created for these eight categories, and a chi-squared test was performed to compare the two datasets. RESULTS: Overall, the most frequent words in both languages were related to health-related terms, but the Japan dataset had more words referring to foreign countries. Among the eight categories, differences with chi-squared p ≤ 0.01 were found after Holm-Bonferroni p value adjustment for the proportions of misinformation regarding statistics (US 40.0% vs. JP 25.7%, ϕ 0.0792); origin of the virus and resultant discrimination (US 7.0% vs. JP 20.3%, ϕ 0.1311); and COVID-19 disease severity, treatment, or testing (US 32.6% vs. JP 45.9%, ϕ 0.0756). CONCLUSIONS: Local contextual factors were found that likely influenced the infodemic in both countries; representations of these factors include societal polarization in the US and the HPV vaccine scare in Japan. It is possible that Japan's relative resistance to misinformation affects the kinds of misinformation consumed, directing attention away from conspiracy theories and towards health-related issues. However, more studies need to be done to verify whether misinformation resistance affects misinformation consumption patterns this way.

Person-based design and evaluation of MIA, a digital medical interview assistant for radiology.

Introduction: Radiologists frequently lack direct patient contact due to time constraints. Digital medical interview assistants aim to facilitate the collection of health information. In this paper, we propose leveraging conversational agents to realize a medical interview assistant to facilitate medical history taking, while at the same time offering patients the opportunity to ask questions on the examination. Methods: MIA, the digital medical interview assistant, was developed using a person-based design approach, involving patient opinions and expert knowledge during the design and development with a specific use case in collecting information before a mammography examination. MIA consists of two modules: the interview module and the question answering module (Q&A). To ensure interoperability with clinical information systems, we use HL7 FHIR to store and exchange the results collected by MIA during the patient interaction. The system was evaluated according to an existing evaluation framework that covers a broad range of aspects related to the technical quality of a conversational agent including usability, but also accessibility and security. Results: Thirty-six patients recruited from two Swiss hospitals (Lindenhof group and Inselspital, Bern) and two patient organizations conducted the usability test. MIA was favorably received by the participants, who particularly noted the clarity of communication. However, there is room for improvement in the perceived quality of the conversation, the information provided, and the protection of privacy. The Q&A module achieved a precision of 0.51, a recall of 0.87 and an F-Score of 0.64 based on 114 questions asked by the participants. Security and accessibility also require improvements. Conclusion: The applied person-based process described in this paper can provide best practices for future development of medical interview assistants. The application of a standardized evaluation framework helped in saving time and ensures comparability of results.

Bridging clinical informatics and implementation science to improve cancer symptom management in ambulatory oncology practices: experiences from the IMPACT consortium.

Objectives: To report lessons from integrating the methods and perspectives of clinical informatics (CI) and implementation science (IS) in the context of Improving the Management of symPtoms during and following Cancer Treatment (IMPACT) Consortium pragmatic trials. Materials and Methods: IMPACT informaticists, trialists, and implementation scientists met to identify challenges and solutions by examining robust case examples from 3 Research Centers that are deploying systematic symptom assessment and management interventions via electronic health records (EHRs). Investigators discussed data collection and CI challenges, implementation strategies, and lessons learned. Results: CI implementation strategies and EHRs systems were utilized to collect and act upon symptoms and impairments in functioning via electronic patient-reported outcomes (ePRO) captured in ambulatory oncology settings. Limited EHR functionality and data collection capabilities constrained the ability to address IS questions. Collecting ePRO data required significant planning and organizational champions adept at navigating ambiguity. Discussion: Bringing together CI and IS perspectives offers critical opportunities for monitoring and managing cancer symptoms via ePROs. Discussions between CI and IS researchers identified and addressed gaps between applied informatics implementation and theory-based IS trial and evaluation methods. The use of common terminology may foster shared mental models between CI and IS communities to enhance EHR design to more effectively facilitate ePRO implementation and clinical responses. Conclusion: Implementation of ePROs in ambulatory oncology clinics benefits from common understanding of the concepts, lexicon, and incentives between CI implementers and IS researchers to facilitate and measure the results of implementation efforts.

Design and Implementation of a Community Driven Clinical Trial Information Management System for Precision Oncology Settings.

INTRODUCTION: Trial recruitment is a crucial factor for precision oncology, potentially improving patient outcomes and generating new scientific evidence. To identify suitable, biomarker-based trials for patients' clinicians need to screen multiple clinical trial registries which lack support for modern trial designs and offer only limited options to filter for in- and exclusion criteria. Several registries provide trial information but are limited regarding factors like timeliness, quality of information and capability for semantic, terminology enhanced searching for aspects like specific inclusion criteria. METHODS: We specified a Fast Healthcare Interoperable Resources (FHIR) Implementation Guide (IG) to represent clinical trials and their meta data. We embedded it into a community driven approach to maintain clinical trial data, which is fed by openly available data sources and later annotated by platform users. A governance model was developed to manage community contributions and responsibilities. RESULTS: We implemented Community Annotated Trial Search (CATS), an interactive platform for clinical trials for the scientific community with an open and interoperable information model. It provides a base to collaboratively annotate clinical trials and serves as a comprehensive information source for community members. Its terminology driven annotations are coined towards precision oncology, but its principles can be transferred to other contexts. CONCLUSION: It is possible to use the FHIR standard and an open-source information model represented in our IG to build an open, interoperable clinical trial register. Advanced features like user suggestions and audit trails of individual resource fields could be represented by extending the FHIR standard. CATS is the first implementation of an open-for-collaboration clinical trial registry with modern oncological trial designs and machine-to-machine communication in mind and its methodology could be extended to other medical fields besides precision oncology. Due to its well-defined interfaces, it has the potential to provide automated patient recruitment decision support for precision oncology trials in digital applications.

Recommendations to improve use and dissemination of patient versions of oncological clinical practice guidelines in Germany: results of a multi-stakeholder workshop.

BACKGROUND: Oncological patients have high information needs that are often unmet. Patient versions of oncological clinical practice guidelines (PVG) translate clinical practice guidelines into laypersons' language and might help to address patients' information needs. Currently, 30 oncological PVG have been published in Germany and more are being developed. Following a large multi-phase project on oncological PVGs in Germany, recommendations to improve use and dissemination of PVG were adopted in a multi-stakeholder workshop. METHODS: Organisations representing users of PVGs (patients, medical personnel, and multipliers), creators, initiators/funding organisations of PVGs, and organisations with methodological expertise in the development of clinical practice guidelines or in patient health information were invited to participate. The workshop included a World Café for discussion of pre-selected recommendations and structured consensus procedure for of all recommendations. Recommendations with agreement of > 75% were approved, and in case of ≤ 75% agreement, recommendations were rejected. RESULTS: The workshop took place on 24th April 2023 in Cologne, Germany. Overall, 23 people from 24 organisations participated in the discussion. Of 35 suggested recommendations 28 recommendations reached consensus and were approved. The recommendations referred to the topics dissemination (N = 13), design and format (N = 7), (digital) links (N = 5), digitalisation (N = 4), up-to-dateness (N = 3), and use of the PVG in collaboration between healthcare providers and patients (N = 3). CONCLUSION: The practical recommendations consider various perspectives and can help to improve use and dissemination of oncological PVG in Germany. The inclusion of different stakeholders could facilitate the transfer of the results into practice.

Standardizing Multidisciplinary Case Conferences and Improving Communication Between Referring Physicians and Radiologists: A Quality Improvement Initiative.

Purpose: Assess the effectiveness of standardizing multidisciplinary case conferences (MDCs). Methods: Anonymous electronic surveys gauged opinions of abdominal radiologists engaged in recurring MDCs. A standardized Excel template, following Cancer Care Ontario guidelines and relevant literature, was distributed to MDC managers. Physicians were instructed to send cases 36 hours prior to MDC. Template adherence was assessed at 1.5 and 8 months. A follow-up survey at 4 months evaluated the intervention's effectiveness. Results: 27/34 abdominal radiologists provided 47 baseline responses, and 12 delegated radiologists provided 23 follow-up responses. "Often/always" being provided the image's location increased from 36% (17/47) at baseline to 70% (16/23) at follow-up. Non-adherence to the 36-hour cut-off decreased from 36% (16/45) to 17% (4/23). 72% disagreed that uploading remote imaging to hospital servers is easy (33/46), similar to follow-up (18/23, 78%). In assessing the intervention, 41% noted improved standardization (9/22), another 41% considered MDCs already standardized (9/22), and 18% reported no change (4/22). Those reporting no change experienced a higher frequency of non-adherence to the 36-hour cut-off (3/4, 75%) than others (1/18, 6%), and less frequent "often/always" ratings for image location being provided (3/4, 75%) than others (2/18, 11%). 89% (25/28) of MDCs adhered to the template. Issues regarding last-minute add-on cases may be mitigated through EPIC force functions. Artificial intelligence advancements may assist in retrieving external images and patient information. Conclusion: Adherence to MDC standardization was high, allowing for more efficient preparation, potentially reducing radiologist administrative burdens. Future force functions and artificial intelligence integration into electronic patient records may further augment this.

Sounding out solutions: using SONAR to connect participants with relevant healthcare resources.

OBJECTIVE: This article outlines a scalable system developed by the All of Us Research Program's Genetic Counseling Resource to vet a large database of healthcare resources for supporting participants with health-related DNA results. MATERIALS AND METHODS: After a literature review of established evaluation frameworks for health resources, we created SONAR, a 10-item framework and grading scale for health-related participant-facing resources. SONAR was used to review clinical resources that could be shared with participants during genetic counseling. RESULTS: Application of SONAR shortened resource approval time from 7 days to 1 day. About 256 resources were approved and 8 rejected through SONAR review. Most approved resources were relevant to participants nationwide (60.0%). The most common resource types were related to support groups (20%), cancer care (30.6%), and general educational resources (12.4%). All of Us genetic counselors provided 1161 approved resources during 3005 (38.6%) consults, mainly to local genetic counselors (29.9%), support groups (21.9%), and educational resources (21.0%). DISCUSSION: SONAR's systematic method simplifies resource vetting for healthcare providers, easing the burden of identifying and evaluating credible resources. Compiling these resources into a user-friendly database allows providers to share these resources efficiently, better equipping participants to complete follow up actions from health-related DNA results. CONCLUSION: The All of Us Genetic Counseling Resource connects participants receiving health-related DNA results with relevant follow-up resources on a high-volume, national level. This has been made possible by the creation of a novel resource database and validation system.

Diet and physical activity advice for colorectal cancer survivors: critical synthesis of public-facing guidance.

PURPOSE: Colorectal cancer (CRC) survivors report that diet and physical activity guidance from healthcare professionals following discharge from care is limited. Survivors seek advice from alternative sources. This study critically synthesised the English language diet and physical activity guidance available online for CRC survivors. METHODS: We conducted an internet search to identify national cancer organisations (NCO) in countries with high CRC incidence rates. We searched NCO website content for guidance related to diet and physical activity. Recommendations were categorised by cancer phase (prevention/survivorship), cancer type, and the intended outcome (health or cancer-control-CRC recurrence/CRC-specific mortality). A synthesised guideline was derived from recommendations consistently made by at least half of the sources. RESULTS: We identified 12 NCOs from six countries, by whom 27 diet and physical activity recommendations were made. For CRC prevention, over 80% of recommendations were aimed at improving cancer-control outcomes. For CRC survivorship, less than 40% of recommendations were aimed at improving cancer-control outcomes. Physical activity was the only recommendation present on more than 50% of NCO websites aimed at improving cancer-control outcomes for CRC survivorship. CONCLUSION: Diet and physical activity guidance for CRC survivors on NCO websites is limited and primarily based on recommendations for improving general health, not improving cancer-control outcomes. NCO websites frequently refer survivors to primary prevention guidance, potentially reflecting the lack of evidence specific to CRC survivorship. There is a need for diet and physical activity advice for survivors that is evidence-based, comprehensive, and consistent across organisations and tailored to specific cancer sites.

Assessing the Quality and Reliability of Videos Related to Fibromyalgia on TikTok: A Comprehensive Analysis.

Introduction Fibromyalgia, characterized by chronic musculoskeletal pain and associated symptoms, poses significant challenges in diagnosis and management. While social media platforms like TikTok have emerged as popular sources of health information, their variable content quality necessitates critical evaluation. This study aimed to assess the quality and reliability of TikTok videos related to fibromyalgia, thereby enhancing the understanding of their impact on patient education and self-management. Methods A cross-sectional observational study was conducted in June 2024, which analyzed 150 TikTok videos using search terms like "Fibromyalgia", "Fibromyalgia Symptoms", and "Fibromyalgia Treatment". Videos were evaluated for inclusion based on relevance and language (English), by employing the Global Quality Scale (GQS) and Quality Criteria for Consumer Health Information (DISCERN) score for assessment. Statistical analysis was performed by using IBM SPSS Statistics v21.0 (IBM Corp., Armonk, NY). The Kruskall-Wallis test was employed, and a p-value less than 0.05 was deemed statistically significant. Results Of the 150 videos initially reviewed, 96 (64%) met the inclusion criteria. Content categories included disease description (34, 35.42%), symptoms (81, 84.38%), management (64, 66.67%), and personal experiences (63, 65.63%). The videos were uploaded by doctors (8, 8.33%), patients (63, 65.63%), healthcare workers ( 7, 7.29%), and others (18, 18.75%). Mean GQS scores varied significantly by uploader type: doctors (4.63 ± 0.52), healthcare workers (3.43 ± 0.79), patients (2.37 ± 0.81), and others (2.11 ± 0.47) (p<0.001). DISCERN scores followed a similar trend: doctors (3.88 ± 0.64), healthcare workers (2.14 ± 1.46), patients (1.08 ± 0.27), and others (1.61 ± 0.50) (p<0.001). Conclusions TikTok serves as a pivotal platform for fibromyalgia-related discourse, predominantly shaped by patient-generated content. However, even though it provides insights into symptoms and management strategies, gaps exist in comprehensive medical guidance and preventive measures. The study underscores the critical role of healthcare professionals in enhancing content reliability and educational value on social media. Future research should explore cultural and linguistic diversity to broaden the accessibility and relevance of health information on platforms like TikTok.

Enhancing Clinical Practice: Creating Dynamic Medical Content in Electronic Medical Records.

The integration of Electronic Medical Records (EMRs) revolutionized healthcare but often retained limitations from paper-based structures. This study proposes a framework for developing dynamic medical content specifically adapted to the clinical context including medical specialty and diseases. Tailoring content to this dynamic context offers several benefits, including improved access to relevant information, streamlined workflows, and potentially better patient outcomes. We applied our framework to develop neurosurgical content, focusing on brain tumors. The method involves defining the medical specialty, outlining user journeys, and iteratively developing artifacts like assessment forms, dashboards, and order sets. Standardized terminologies ensure consistency and interoperability. Our results demonstrate a successful development of content meeting user needs and clinical relevance. While initial implementation focused on neurosurgery, exploring scalability and AI integration offers promising avenues for further advancement. Future studies could quantitatively evaluate the impact of this method on user satisfaction and patient outcomes.

Integration of Oncological Data into openEHR: A Path Towards Improved Cancer Care and Research.

The integration of tumor-related diagnosis and therapy data is a key factor for cancer-related collaborative projects and research projects on-site. The Medical Data Integration Center (MeDIC) of the University Hospital Schleswig-Holstein, resulting from the Medical Informatics Initiative and Network University Medicine in Germany, has agreed on an openEHR-based data management based on a centralized repository with harmonized annotated data. Consequently, the oncological data should be integrated into the MeDIC to interconnect the information and thus gain added value. A uniform national data set for tumor-related reports is already defined for the cancer registries. Therefore, this work aims to transform the national oncological basis data set for tumor documentation (oBDS) so that it can be stored and utilized properly in the openEHR repository of the MeDIC. In a previous work openEHR templates representing the oncological basis data set were modeled. These templates were used to implement a processing pipeline including a metadata repository, which defines the mappings between the elements, a FHIR terminology service for annotation and validation, resulting in a tool to automatically build openEHR compositions from oBDS data. The prototype proved the feasibility of the referred mapping, integration into the MeDIC is straightforward and the architecture introduced is adaptable to future needs by design.

Comparative Analysis of Artificial Intelligence Platforms: ChatGPT-3.5 and GoogleBard in Identifying Red Flags of Low Back Pain.

BACKGROUND: Low back pain (LBP) is a prevalent healthcare concern that is frequently responsive to conservative treatment. However, it can also stem from severe conditions, marked by 'red flags' (RF) such as malignancy, cauda equina syndrome, fractures, infections, spondyloarthropathies, and aneurysm rupture, which physicians should be vigilant about. Given the increasing reliance on online health information, this study assessed ChatGPT-3.5's (OpenAI, San Francisco, CA, USA) and GoogleBard's (Google, Mountain View, CA, USA) accuracy in responding to RF-related LBP questions and their capacity to discriminate the severity of the condition. METHODS: We created 70 questions on RF-related symptoms and diseases following the LBP guidelines. Among them, 58 had a single symptom (SS), and 12 had multiple symptoms (MS) of LBP. Questions were posed to ChatGPT and GoogleBard, and responses were assessed by two authors for accuracy, completeness, and relevance (ACR) using a 5-point rubric criteria. RESULTS: Cohen's kappa values (0.60-0.81) indicated significant agreement among the authors. The average scores for responses ranged from 3.47 to 3.85 for ChatGPT-3.5 and from 3.36 to 3.76 for GoogleBard for 58 SS questions, and from 4.04 to 4.29 for ChatGPT-3.5 and from 3.50 to 3.71 for GoogleBard for 12 MS questions. The ratings for these responses ranged from 'good' to 'excellent'. Most SS responses effectively conveyed the severity of the situation (93.1% for ChatGPT-3.5, 94.8% for GoogleBard), and all MS responses did so. No statistically significant differences were found between ChatGPT-3.5 and GoogleBard scores (p>0.05). CONCLUSIONS: In an era characterized by widespread online health information seeking, artificial intelligence (AI) systems play a vital role in delivering precise medical information. These technologies may hold promise in the field of health information if they continue to improve.

A Bilingual Readability Assessment of Online Breast Cancer Screening and Treatment Information.

INTRODUCTION: Presenting health information at a sixth-grade reading level is advised to accommodate the general public's abilities. Breast cancer (BC) is the second-most common malignancy in women, but the readability of online BC information in English and Spanish, the two most commonly spoken languages in the United States, is uncertain. METHODS: Three search engines were queried using: "how to do a breast examination," "when do I need a mammogram," and "what are the treatment options for breast cancer" in English and Spanish. Sixty websites in each language were studied and classified by source type and origin. Three readability frameworks in each language were applied: Flesch Kincaid Reading Ease, Flesch Kincaid Grade Level, and Simple Measure of Gobbledygook (SMOG) for English, and Fernández-Huerta, Spaulding, and Spanish adaptation of SMOG for Spanish. Median readability scores were calculated, and corresponding grade level determined. The percentage of websites requiring reading abilities >sixth grade level was calculated. RESULTS: English-language websites were predominantly hospital-affiliated (43.3%), while Spanish websites predominantly originated from foundation/advocacy sources (43.3%). Reading difficulty varied across languages: English websites ranged from 5th-12th grade (Flesch Kincaid Grade Level/Flesch Kincaid Reading Ease: 78.3%/98.3% above sixth grade), while Spanish websites spanned 4th-10th grade (Spaulding/Fernández-Huerta: 95%/100% above sixth grade). SMOG/Spanish adaptation of SMOG scores showed lower reading difficulty for Spanish, with few websites exceeding sixth grade (1.7% and 0% for English and Spanish, respectively). CONCLUSIONS: Online BC resources have reading difficulty levels that exceed the recommended sixth grade, although these results vary depending on readability framework. Efforts should be made to establish readability standards that can be translated into Spanish to enhance accessibility for this patient population.

Health Information Seeking on the Internet Among Patients With and Without Cancer in a Region Affected by the 2011 Fukushima Triple Disaster: Cross-Sectional Study.

BACKGROUND: Health information seeking via the internet among patients with cancer in disaster-affected areas is underresearched. OBJECTIVE: This study aims not only to assess the extent and means of web-based health information seeking among patients with cancer living in the disaster-affected area of the 2011 Fukushima triple disaster but also to compare these patterns with those without cancer, identifying distinct and shared factors influencing their web-based health information behaviors. METHODS: We surveyed 404 patients (263 with and 141 without cancer) from the surgery department outpatient office at Minamisoma Municipal General Hospital, from October 2016 to January 2017. The survey included self-administered questions on internet and digital device use. Descriptive analyses were performed to examine the use patterns of digital devices and the internet and their impact on health information seeking across different age groups of patients with and without cancer. Multivariable logistic regression was used to examine factors associated with web-based health information seeking, stratifying by cancer diagnosis. RESULTS: The proportion of participants who sought health information on the internet was comparable between patients with cancer and patients without cancer (19% vs 17.4%; P=.71). Digital device use varied significantly with age, with peak smartphone use occurring among the youngest cohorts for both groups. Multivariable logistic regression revealed that patients with cancer using smartphones or tablets daily were significantly more likely to gather web-based health information (odds ratio [OR] for smartphones 3.73, 95% CI 1.58-8.80; OR for tablets 5.08, 95% CI 1.27-20.35). Trust in institutional websites also significantly influenced web-based health information gathering among patients with cancer (OR 2.87, 95% CI 1.13-7.25). Conversely, among patients without cancer, unemployment was associated with a lower likelihood of seeking web-based health information (OR 0.26, 95% CI 0.08-0.85), whereas trust in both institutional and personal websites significantly increased this likelihood (OR for institutional websites 6.76, 95% CI 2.19-20.88; OR for personal websites 6.97, 95% CI 1.49-32.58). CONCLUSIONS: This study reveals that a small proportion of both patients with cancer and patients without cancer engage in health information seeking via the internet, influenced by age, digital device use, and trust in institutional websites. Given the growing prevalence of digital literacy, strategies to enhance accessible and reliable web-based health information should be developed, particularly for patients with cancer in postdisaster settings. Future efforts should focus on tailored health communication strategies that address the unique needs of these populations.