RESUMEN
Citizen scientists with health interests have rapidly increased efforts to conduct their own health studies on themselves and in their communities, giving rise to a new transdisciplinary field of citizen health science. This science leverages long-standing traditions of single case or N-of-1 studies in psychology and also finds influential roots in the history of self-experimentation in health and medicine. These studies frequently incorporate new digital tools such as smartphone tracking and many other mobile health or "mHealth" devices. Citizen health scientists also tend to operate in social networks of people working to maintain or improve their health, increasing the complexity and richness of opportunities tied to this new platform. Population data scientists are well-positioned to seek new ways to derive scientific inferences from data generated in citizen health science projects. This paper provides an overview of citizen health science for population data scientists, including basic definitions, historical foundations, current challenges and opportunities, and future directions.
RESUMEN
Heart failure from myocarditis may be transient or may progress to unremitting severe cardiac failure. This study was performed to determine the outcomes and prognostic features of pediatric patients with myocarditis. Patients with the diagnosis of myocarditis between 1990 and 2001 were identified through the coding system of Yale-New Haven Hospital. A total of 28 patients were included, with ages ranging from 1 day to 20 years. Before discharge, 11 patients developed unremitting severe cardiac failure. Of the remaining 17 patients, at the time of discharge 10 had normal systolic function and 7 had decreased systolic function. Unremitting cardiac failure developed in 9 of 14 patients (64%) with an ejection fraction < 30% and in only 2 of 14 (14%) of those with an ejection fraction > or = 30% on admission (p < 0.01). Furthermore, shortening fraction < 15%, left ventricular dilatation, and moderate to severe mitral regurgitation on admission as well as arrhythmia were significantly associated with development of unremitting severe cardiac failure. In this series of patients with myocarditis, by the time of discharge 39% of the patients had developed unremitting severe cardiac failure, 25% had depressed systolic function, and 36% had normal systolic function. Predictive factors at admission for poor outcome were ejection fraction < 30%, shortening fraction < 15%, left ventricular dilatation, and moderate to severe mitral regurgitation.