Journal of Medical Internet Research

BACKGROUND: This paper explores the widely discussed relationship between electronic media use and sleep quality, indicating negative effects due to various factors. However, existing meta-analyses on the topic have some limitations. OBJECTIVE: The study aims to analyze and compare the impacts of different digital media types, such as smartphones, online games, and social media, on sleep quality. METHODS: Adhering to PRISMA guidelines, the study performed a systematic meta-analysis of literature across multiple databases, including Web of Science, MEDLINE, PsycINFO, PubMed, Science Direct, Scopus, and Google Scholar, from January 2018 to October 2023...

BACKGROUND: Disasters are becoming more frequent due to the impact of extreme weather events attributed to climate change, causing loss of lives, property and psychological trauma. Mental health response to disasters emphasizes prevention and mitigation, and mobile health (mHealth) applications have been used for mental health promotion and treatment. However, little is known about their use in the mental health components of disaster management. OBJECTIVE: This scoping review was conducted to explore the use of mobile phone applications (apps) for mental health responses to natural disasters and to identify gaps in the literature...

BACKGROUND: Dysarthria is a common post-stroke speech disorder affecting communication and psychological well-being. Traditional speech therapy is effective but often poses challenges in terms of accessibility and patient adherence. Emerging smartphone-based therapies may offer promising alternatives for the treatment of post-stroke dysarthria. OBJECTIVE: This study aimed to assess the efficacy and feasibility of smartphone-based speech therapy for improving speech intelligibility in patients with acute and early subacute post-stroke dysarthria...

BACKGROUND: Accurate and responsive epidemiological simulations of epidemic outbreaks inform decision-making to mitigate the impact of pandemics. These simulations must be grounded in quantities derived from the measurements, among which, parameters associated with contacts between individuals are notoriously difficult to estimate. Digital contact tracing data, such as that provided by Bluetooth beaconing or GPS co-locating, can provide more precise measures of contact than traditional methods based on direct observation or self-reporting...

BACKGROUND: The adoption of predictive algorithms in healthcare comes with the potential for algorithmic bias, which could exacerbate existing disparities. Fairness metrics were proposed to measure algorithmic bias, but the application to real-world tasks is limited. OBJECTIVE: This study aims to evaluate the algorithmic bias between racial and income groups associated with the application of common 30-day hospital readmission models and assesses the usefulness and interpretability of selected fairness metrics...

BACKGROUND: Few studies have used standardized nursing records with Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) to identify predictors of clinical deterioration. OBJECTIVE: To standardize the nursing documentation records of patients with coronavirus disease 2019 (COVID-19) using SNOMED CT and identify predictive factors of clinical deterioration in patients with COVID-19 via the standardized nursing records. METHODS: In this study 57,558 nursing statements from 226 patients with COVID-19 were analyzed...

BACKGROUND: Increasing healthcare expenditure in the United States has put policymakers under enormous pressure to find ways to curtail costs. Starting January 1st, 2021, hospitals operating in the U.S. were mandated to publish transparent, accessible pricing information online about the items and services in a consumer-friendly format within comprehensive machine-readable files on their websites. Is the content that is being put out by hospital systems usable? OBJECTIVE: To analyze the available files on hospitals' websites, answering the question: is price transparency information as provided usable for patients or for machines? And providing a solution...

BACKGROUND: The prevalence of obesity and its associated comorbidities continues to rise in the United States. Populations who are uninsured and from racial and ethnic minority groups continue to be disproportionately affected. These populations also experience fewer clinically meaningful outcomes in most weight loss trials. Weight gain prevention presents a useful strategy for individuals who experience barriers to weight loss. Given the often-limited weight management resources available to patients in primary care settings serving vulnerable patients, evaluating interventions with pragmatic designs may help inform the design of comprehensive obesity care delivered in primary care...

BACKGROUND: In recent years, Korean society has increasingly recognized the importance of nurses in the context of population aging and infectious disease control. However, nurses still face difficulties with regard to policy activities that are aimed at improving the nursing workforce structure and working environment. Media coverage plays an important role in public awareness of a particular issue and can be an important strategy in policy activities. OBJECTIVE: This study analyzed data from 18 years of news coverage on nursing-related issues...

BACKGROUND: Digital health and telemedicine are potentially important strategies to decrease healthcare's environmental impact and contribution to climate change by reducing transportation-related air pollution and greenhouse gas emissions. However, we currently lack robust national estimates of emissions savings attributable to telemedicine. OBJECTIVE: This study aimed to (1) determine the travel distance between participants in U.S. telemedicine sessions, and (2) estimate the net reduction in carbon dioxide (CO2) emissions attributable to telemedicine in the United States, based on national, observational data describing the geographical characteristics of telemedicine session participants...

BACKGROUND: Panic disorder is a common and important disease in clinical practice that decreases individual productivity and increases health care use. Treatments comprise medication and cognitive behavioral therapy. However, adverse medication effects and poor treatment compliance mean new therapeutic models are needed. OBJECTIVE: We hypothesized that digital therapy for panic disorder may improve panic disorder symptoms and that treatment response would be associated with brain activity changes assessed with functional near-infrared spectroscopy (fNIRS)...

BACKGROUND: The continuous monitoring and recording of patients' pain status is a major problem in current research on postoperative pain management. In the large number of original or review articles focusing on different approaches for pain assessment, many researchers have investigated how computer vision (CV) can help by capturing facial expressions. However, there is a lack of proper comparison of results between studies to identify current research gaps. OBJECTIVE: The purpose of this systematic review and meta-analysis was to investigate the diagnostic performance of artificial intelligence models for multilevel pain assessment from facial images...

BACKGROUND: The digital health divide for socioeconomic disadvantage describes a pattern in which patients considered socioeconomically disadvantaged, who are already marginalized through reduced access to face-to-face health care, are additionally hindered through less access to patient-initiated digital health. A comprehensive understanding of how patients with socioeconomic disadvantage access and experience digital health is essential for improving the digital health divide. Primary care patients, especially those with chronic disease, have experience of the stages of initial help seeking and self-management of their health, which renders them a key demographic for research on patient-initiated digital health access...

Modern machine learning approaches have led to performant diagnostic models for a variety of health conditions. Several machine learning approaches, such as decision trees and deep neural networks, can, in principle, approximate any function. However, this power can be considered to be both a gift and a curse, as the propensity toward overfitting is magnified when the input data are heterogeneous and high dimensional and the output class is highly nonlinear. This issue can especially plague diagnostic systems that predict behavioral and psychiatric conditions that are diagnosed with subjective criteria...

BACKGROUND: The digitalization of public and health sectors worldwide is fundamentally changing health systems. With the implementation of digital health services in health institutions, a focus on digital health literacy and the use of digital health services have become more evident. In Denmark, public institutions use digital tools for different purposes, aiming to create a universal public digital sector for everyone. However, this digitalization risks reducing equity in health and further marginalizing citizens who are disadvantaged...

BACKGROUND: Health apps are increasingly recognized as crucial tools for enhancing health care delivery. Many countries, particularly those in sub-Saharan Africa, can substantially benefit from using health apps to support self-management and thus help to achieve universal health coverage and the third sustainable development goal. However, most health apps published in app stores are of unknown or poor quality, which poses a risk to patient safety. Regulatory standards and guidance can help address this risk and promote patient safety...

BACKGROUND: Digital health technologies (dHTs) offer a unique opportunity to address some of the major challenges facing health care systems worldwide. However, the implementation of dHTs raises some concerns, such as the limited understanding of their real impact on health systems and people's well-being or the potential risks derived from their use. In this context, health technology assessment (HTA) is 1 of the main tools that health systems can use to appraise evidence and determine the value of a given dHT...

BACKGROUND: Children whose parents have alcohol use problems are at an increased risk of several negative consequences, such as poor school performance, an earlier onset of substance use, and poor mental health. Many would benefit from support programs, but the figures reveal that only a small proportion is reached by existing support. Digital interventions can provide readily accessible support and potentially reach a large number of children. Research on digital interventions aimed at this target group is scarce...

Practitioners of digital health are familiar with disjointed data environments that often inhibit effective communication among different elements of the ecosystem. This fragmentation leads in turn to issues such as inconsistencies in services versus payments, wastage, and notably, care delivered being less than best-practice. Despite the long-standing recognition of interoperable data as a potential solution, efforts in achieving interoperability have been disjointed and inconsistent, resulting in numerous incompatible standards, despite the widespread agreement that fewer standards would enhance interoperability...

BACKGROUND: The COVID-19 pandemic has led to a substantial increase in health information, which has, in turn, caused a significant rise in cyberchondria and anxiety among individuals who search for web-based medical information. To cope with this information overload and safeguard their mental well-being, individuals may adopt various strategies. However, the effectiveness of these strategies in mitigating the negative effects of information overload and promoting overall well-being remains uncertain...