Correction: Evaluating the Clinical Feasibility of an Artificial Intelligence-Powered, Web-Based Clinical Decision Support System for the Treatment of Depression in Adults: Longitudinal Feasibility Study.

[This corrects the article DOI: 10.2196/31862.].

Oscillometry to support clinical assessment in asthmatic preschoolers: Real-life impact.

In preschoolers, asthma control is assessed clinically using history and physical examination. In certain centres, oscillometry is used to support clinical assessment; yet its clinical utility for asthma management remains to be quantified. The objectives were to determine if oscillometry, as adjunct to clinical assessment, influences asthma assessment, management and control, compared to clinical assessment alone in preschoolers. We conducted a cross-sectional study in children aged 3-5 years with a confirmed asthma diagnosis. Oscillometry-tested preschoolers were matched by propensity score to untested children. The co-primary outcomes, the likelihood of a persistent asthma phenotype and a maintenance therapy prescription at the index visit, were examined by multivariable logistic regression. Asthma control over the next year was examined by cumulative logistic regression in the nested retrospective cohort with available drug claim data. The cohort comprised 726 (249 oscillometry-tested; 477 untested) children with 57.4% male (median age: 4.6 years). Propensity score matching resulted in comparable groups. Compared to controls, oscillometry-tested children were more frequently labelled with a persistent phenotype (67% vs. 50%; adjusted OR [95% CI]: 2.34 [1.66-3.34]) with no significant difference in maintenance therapy prescription (65% vs. 58%; 1.37 [0.98-1.92]); but experienced a lower likelihood of poor control over the next year (adjusted OR [95% CI]: 0.24 [0.08-0.74]). The association between the addition of oscillometry to clinical assessment with more persistent phenotype labelling and better asthma control supports its clinical utility; no significant impact on maintenance therapy prescription was observed at the index visit.

Evaluating the Clinical Feasibility of an Artificial Intelligence-Powered, Web-Based Clinical Decision Support System for the Treatment of Depression in Adults: Longitudinal Feasibility Study.

BACKGROUND: Approximately two-thirds of patients with major depressive disorder do not achieve remission during their first treatment. There has been increasing interest in the use of digital, artificial intelligence-powered clinical decision support systems (CDSSs) to assist physicians in their treatment selection and management, improving the personalization and use of best practices such as measurement-based care. Previous literature shows that for digital mental health tools to be successful, the tool must be easy for patients and physicians to use and feasible within existing clinical workflows. OBJECTIVE: This study aims to examine the feasibility of an artificial intelligence-powered CDSS, which combines the operationalized 2016 Canadian Network for Mood and Anxiety Treatments guidelines with a neural network-based individualized treatment remission prediction. METHODS: Owing to the COVID-19 pandemic, the study was adapted to be completed entirely remotely. A total of 7 physicians recruited outpatients diagnosed with major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Patients completed a minimum of one visit without the CDSS (baseline) and 2 subsequent visits where the CDSS was used by the physician (visits 1 and 2). The primary outcome of interest was change in appointment length after the introduction of the CDSS as a proxy for feasibility. Feasibility and acceptability data were collected through self-report questionnaires and semistructured interviews. RESULTS: Data were collected between January and November 2020. A total of 17 patients were enrolled in the study; of the 17 patients, 14 (82%) completed the study. There was no significant difference in appointment length between visits (introduction of the tool did not increase appointment length; F2,24=0.805; mean squared error 58.08; P=.46). In total, 92% (12/13) of patients and 71% (5/7) of physicians felt that the tool was easy to use; 62% (8/13) of patients and 71% (5/7) of physicians rated that they trusted the CDSS. Of the 13 patients, 6 (46%) felt that the patient-clinician relationship significantly or somewhat improved, whereas 7 (54%) felt that it did not change. CONCLUSIONS: Our findings confirm that the integration of the tool does not significantly increase appointment length and suggest that the CDSS is easy to use and may have positive effects on the patient-physician relationship for some patients. The CDSS is feasible and ready for effectiveness studies. TRIAL REGISTRATION: ClinicalTrials.gov NCT04061642; http://clinicaltrials.gov/ct2/show/NCT04061642.

Acute cardiovascular exercise promotes functional changes in cortico-motor networks during the early stages of motor memory consolidation.

A single bout of cardiovascular exercise performed immediately after practicing a visuo-motor tracking task has been shown to improve the long-term retention of this motor skill through an optimization of the memory consolidation process. The mechanisms underlying the time-dependent effects of acute cardiovascular exercise on motor memory consolidation, however, remain poorly understood. In this study, we sought to determine the impact of a single bout of cardiovascular exercise performed immediately after motor skill practice on those mechanisms using electroencephalography (EEG) and electromyography (EMG). Specifically, we assessed exercise-induced changes in the activity and connectivity of cortico-motor networks during early consolidation and the impact of these changes on skill retention. Participants practiced a visuo-motor tracking task followed by either a short bout of intense exercise or a rest period. EEG along with EMG data of hand muscles were collected during the production of low-force isometric contractions. Event-related desynchronization, functional connectivity and corticomuscular coherence were measured at baseline, 30, 60 and 90 min after the bout of exercise or the rest period. Improvements in motor memory were inferred via retention tests of the motor skill performed 8 and 24 h after motor practice. We found that participants who performed the single bout of exercise showed better motor skill retention 24 h after motor practice. This improvement in skill retention in the exercise group was associated with significant decreases in beta-band event-related desynchronization in EEG electrodes located over the left sensorimotor areas. We also found that after exercise, alpha-, and even more significantly, beta-band functional connectivity, increased between EEG electrodes located over left and right sensorimotor areas. The exercise group also showed greater beta-band corticomuscular coherence but only in a small number of electrodes. Neither functional connectivity nor corticomuscular coherence measures correlated with skill retention scores. This is the first study exploring brain mechanisms underlying the summative effects of motor learning and cardiovascular exercise on motor memory consolidation. We have identified potential neural substrates through which a single bout of acute exercise, when performed in close temporal proximity to motor practice, strengthens motor memories. Our findings provide new mechanistic insights into a better understanding of the complex temporal relationship existing between cardiovascular exercise and motor memory consolidation.