医学互联网研究杂志

2019冠状病毒病疫苗相关社交媒体数据的精细情绪分析:比较研究

2022 - 10 - 17 - t11:00:02内

背景:新型冠状病毒(COVID-19)的出现和必要的人群隔离导致寻求与大流行相关信息的社交媒体新用户数量空前。目前，全球约有45亿用户，社交媒体数据为近实时分析与疾病暴发和疫苗接种有关的大量文本提供了机会。官员可以利用这些分析制定适当的公共卫生信息、数字干预措施、教育材料和政策。我们的研究调查并比较了2020年1月1日至2022年3月1日期间在2个流行的社交媒体平台——reddit和twitter上表达的与COVID-19疫苗相关的公众情绪。为了完成这项任务，我们创建了一个微调的DistilRoBERTa模型来预测大约950万条推文和7万条Reddit评论的情绪。为了微调我们的模型，我们的团队手动标记3600条推文的情绪，然后通过反向翻译增强我们的数据集。然后，我们使用Python编程语言和hugs Face情感分析管道进行微调模型，对每个社交媒体平台的文本情感进行分类。结果:我们的结果确定，在Twitter上表达的平均情绪更多是负面(5215,830 /9,518,270,54.8%)而不是正面，在Reddit上表达的情绪更多是正面(42,316/67,962,62.3%)而不是负面。尽管这些社交媒体平台之间的平均情绪有所不同，但这两个平台在大流行期间与疫苗相关的关键进展中表现出的情绪相似。考虑到在社交媒体平台上表现出的这种情绪共享的类似趋势，Twitter和Reddit仍然是公共卫生官员可以用来增强疫苗信心和打击错误信息的宝贵数据来源。 As the spread of misinformation poses a range of psychological and psychosocial risks (anxiety and fear, etc), there is an urgency in understanding the public perspective and attitude toward shared falsities. Comprehensive educational delivery systems tailored to a population’s expressed sentiments that facilitate digital literacy, health information–seeking behavior, and precision health promotion could aid in clarifying such misinformation.

从现实数据调查助听器听力项目的提供和使用背景:观察性研究

2022 - 10 - 17 - t10:45:03内

背景:听力程序使助听器(HA)用户能够针对特定的听力情况更改设备设置，从而个性化他们的听力体验。然而，在现实世界中使用这种倾听程序来支持临床决策和评估HA治疗的成功的调查是缺乏的。我们的目的是调查在市场上大量HA用户中提供监听程序的情况，以及这些程序通常使用的环境。首先，我们分析了向32,336个市场HA用户提供了多少程序以及哪些程序。其次，我们从1312个被选择的用户中调查了332,271个节目选择，以调查使用特定节目的声音环境，以及这些环境是否反映了所使用节目名称所传达的收听意图。我们的分析基于连接智能手机的HAs记录的真实世界纵向数据。在我们的样本中，57.71%(18,663/32,336)的HA用户拥有针对特定侦听情况的程序，这一比例高于之前报告的比例，很可能是由于纳入标准的原因。在关联规则挖掘的基础上，我们确定了一个主要的附加收听程序Speech in Noise，该程序在用户中出现频率较高，通常在提供其他附加程序时提供。我们还确定了2个次要附加程序(Comfort和Music)，它们经常出现在获得≥3个程序的用户中，通常与Speech in Noise一起提供。此外，有2个节目(TV和Remote Mic)与使用外部附件有关，未发现与其他节目相关。 On average, users selected Speech in Noise, Comfort, and Music in louder, noisier, and less-modulated (all P<.01) environments compared with the environment in which they selected the default program, General. The difference from the sound environment in which they selected General was significantly larger in the minutes following program selection than in the minutes preceding it. Conclusions: This study provides a deeper insight into the provision of listening programs on a large scale and demonstrates that additional listening programs are used as intended and according to the sound environment conveyed by the program name.

关于外周动脉疾病和间歇性跛行治疗和管理的基于互联网的信息的可信度、准确性和全面性:综述

2022 - 10 - 17 - t10:30:16内

背景:外周动脉疾病(PAD)影响着全球数百万人，该疾病管理的核心组成部分是自我管理。互联网是许多人获取健康信息的重要来源。然而，关于外周动脉疾病治疗建议的网站内容还没有得到充分评价。本研究旨在评估通过通用搜索引擎找到的网站的可信度、准确性和全面性，将其内容与当前PAD和间歇性跛行(IC)的治疗和管理指南进行比较。方法:对美国和英国的医院、大学、政府、消费者组织和专业协会的网站进行了审查。网站建议的外周动脉疾病和内源性心脏病的治疗是按照国家健康和护理卓越研究所(NICE)和美国心脏协会(AHA)的指南进行编码的。主要结果是网站可信度(4项美国医学协会杂志的基准)，网站准确性(就准确推荐的百分比而言)和网站推荐的全面性(就适当覆盖的指南推荐的百分比而言)。次要结果是可读性(Flesch-Kincaid等级)和网站质量(网络健康基金会的行为准则)。结果:经过筛选，62个网站被纳入分析。只有45%(28/62)的网站通过声明在NICE指南发布后进行了更新，达到了可信度要求。 Declaration of authorship and funding and the presence of reference lists were less commonly reported. Regarding accuracy, 81% (556/685) of website recommendations were deemed accurate on following NICE’s and the AHA’s recommendations. Comprehensiveness was low, with an average of 40% (25/62) of guideline treatment recommendations being appropriately covered by websites. In most cases, readability scores revealed that the websites were too complex for web-based consumer health information. Conclusions: Web-based information from reputable sources about the treatment and management of PAD and IC are generally accurate but have low comprehensiveness, credibility, and readability.

在大流行期间，通过社交媒体增强卫生保健工作者对科学和疫苗接种的信任:使用基于地点的方法产生影响

2022 - 10 - 17 - t10:30:03内

鉴于大流行期间在社交媒体上传播卫生错误信息的广泛和协调一致的努力，特别是围绕疫苗接种的努力，许多临床医生和科学家团体在社交媒体上组织起来，利用国家或国际视角处理错误信息和推广疫苗接种。尽管记录这种社交媒体努力的影响，特别是在社区一级，可能具有挑战性，但对社交媒体运动采取一种更加本地化或“基于地方的方法”，可能有效地在社区一级处理错误信息和改善公共卫生成果。我们旨在描述和记录芝加哥卫生保健工作者在社交媒体上协调小组的基于地点的策略的有效性，以处理错误信息并提高他们所服务的社区的接种率。伊利诺斯州医疗专业人员行动协作团队(IMPACT)成立于2020年3月，以应对COVID-19大流行，由芝加哥主要学术教学医院(如芝加哥大学、西北大学、伊利诺斯大学和拉什大学)和社区组织的代表组成。IMPACT采用基于地点的方法，通过在多个社交媒体平台(如Facebook、Twitter和Instagram)上进行众包，与数千名伊利诺伊州卫生保健工作者和公众组成的基层网络进行合作，以确定疫情期间改善当地卫生保健服务的差距、需求和观点。为了解决疫苗的错误信息问题，IMPACT制作了8张"揭穿谬误"信息图和14张"疫苗信息系列"信息图，产生了34万次印象，为芝加哥公共图书馆疫苗教育的发展提供了信息。IMPACT发布了13封政策信，重点关注不同的主题，如卫生保健工作者个人防护装备、普遍戴口罩和接种疫苗，通过社交媒体收集了4000多名卫生保健工作者的签名，并提交给政策制定者;它在高影响力的新闻媒体上发表了50多篇关于COVID-19主题的专栏文章，并为200多篇地方和国家新闻特写提供了稿件。IMPACT利用在IMPACT社交媒体渠道上的众包方式，动员了卫生保健人员和非专业志愿者，为约12万人举办了400场疫苗活动，其中许多在芝加哥受影响最严重的社区。该小组的建议影响了公共卫生认识运动和倡议，以及研究、宣传和政策建议，并获得了地方和国家奖项。 Conclusions: A coordinated group of health care workers on social media, using a hyperlocal place-based approach, can not only work together to address misinformation but also collaborate to boost vaccination rates in their surrounding communities.

了解英国NHS COVID-19接触者追踪App使用一年后的信任和使用变化:纵向混合方法研究

2022 - 10 - 14 - t11:00:25内

为应对2019冠状病毒病大流行，数字接触者追踪(DCT)应用程序已经实施。研究的重点是了解这些应用程序的接受和采用情况，但还需要更多的工作来了解可能有助于它们持续使用的因素。这是公共卫生的关键，因为DCT应用程序需要很高的吸收率，以减少病毒在一般人群中的传播。本研究旨在了解国民健康服务测试的使用变化;追踪(T&T) COVID-19 DCT应用程序，并探索公众对该应用程序的信任在一年内是如何演变的。我们开展了一项纵向混合方法研究，包括2020年12月的一项数字调查和2021年11月的另一项数字调查和采访，其中详细探讨了9名参与者的回答。采用主题分析法对访谈记录进行分析。本文主要通过主题分析来揭示参与者回答背后的原因。在本文中，通过专题分析产生的5个主题进行了讨论:T&T应用程序的缺陷，有用性和功能影响对应用程序的信任，对英国政府的低信任，对其他利益相关者的不同程度的信任，公众意识和合规随着时间的推移而下降。不信任源于参与者在应用程序中遇到的社会技术缺陷，并导致对应用程序的有用性的担忧。 Similarly, mistrust in the government was linked to perceived poor pandemic handling and the creation and procurement of the app. However, more variability in trust in other stakeholders was highlighted depending on perceived competence and intentions. For example, Big Tech companies (ie, Apple and Google), large hospitality venues, and private contractors were seen as more capable, but participants mistrust their intentions, and small hospitality venues, local councils, and the National Health Service (ie, public health system) were seen as well-intentioned but there is mistrust in their ability to handle pandemic matters. Participants reported complying, or not, with T&T and pandemic guidance to different degrees but, overall, observed a drop in compliance over time. Conclusions: These findings contribute to the wider implications of changes in DCT app use over time for public health. Findings suggest that trust in the wider T&T app ecosystem could be linked to changes in the use of the app; however, further empirical and theoretical work needs to be done to generalize the results because of the small, homogeneous sample. Initial novelty effects occurred with the app, which lessened over time as public concern and media representation of the pandemic decreased and normalization occurred. Trust in the sociotechnical capabilities of the app, stakeholders involved, and salience maintenance of the T&T app in conjunction with other measures are needed for sustained use.

监督机器学习在声音障碍筛查和诊断中的有效性:系统综述和元分析

2022 - 10 - 14 - t11:00:03内

背景:在调查语音障碍时，包括语音筛查和诊断在内的一系列过程都被使用。这两种方法的标准化测试都有限，受临床医生经验和主观判断的影响。机器学习(ML)算法已被用作筛选或诊断语音障碍的客观工具。然而，ML算法在评估和诊断语音障碍方面的有效性还没有得到足够的学术重视。本系统综述旨在评估ML算法在筛查和诊断语音障碍中的有效性。方法:在5个数据库中进行电子检索。研究检查了任何ML算法在检测病理声音样本中的性能(准确性、敏感性和特异性)。两名审稿人独立选择了这些研究，从纳入的研究中提取了数据，并评估了偏倚的风险。使用RevMan 5软件(Cochrane图书馆)的诊断准确性研究质量评估2工具评估各研究的方法学质量。提取研究、人群和指标检验的特征，并进行荟萃分析，以汇集ML技术的准确性、敏感性和特异性。 The issue of heterogeneity was addressed by discussing possible sources and excluding studies when necessary. Results: Of the 1409 records retrieved, 13 studies and 4079 participants were included in this review. A total of 13 ML techniques were used in the included studies, with the most common technique being least squares support vector machine. The pooled accuracy, sensitivity, and specificity of ML techniques in screening voice disorders were 93%, 96%, and 93%, respectively. Least squares support vector machine had the highest accuracy (99%), while the K-nearest neighbor algorithm had the highest sensitivity (98%) and specificity (98%). Quadric discriminant analysis achieved the lowest accuracy (91%), sensitivity (89%), and specificity (89%). Conclusions: ML showed promising findings in the screening of voice disorders. However, the findings were not conclusive in diagnosing voice disorders owing to the limited number of studies that used ML for diagnostic purposes; thus, more investigations are needed. While it might not be possible to use ML alone as a substitute for current diagnostic tools, it may be used as a decision support tool for clinicians to assess their patients, which could improve the management process for assessment. Trial Registration: PROSPERO CRD42020214438; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214438

抑郁症的数字心理健康干预:用户参与的范围审查

2022 - 10 - 14 - t10:45:20内

虽然许多数字心理健康干预措施(DMHIs)已被发现是有效的，但患者参与DMHIs已日益成为现实世界临床环境中实施的一个关注事项。为了解决参与性问题，我们必须首先了解在随机对照试验(rct)背景下的标准参与性水平是什么，以及如何与其他治疗方法进行比较。本范围综述旨在检查旨在治疗抑郁症症状的基于移动应用程序的干预rct中干预参与的报告状态。我们试图确定哪些是用户粘性指标，哪些不是常规报告的指标，以及所报告的指标反映了标准的用户粘性水平。我们对7个数据库进行了系统搜索，以确定符合我们的合格标准的研究，即评估成人使用基于移动应用程序的干预的rct，其中抑郁症状是主要结果。然后，我们从每篇文章中提取了两种信息:干预细节和DMHI参与指数。我们的团队推导出了一个最小必要DMHI业务报告的5元素框架，并指导我们的数据提取。该框架包括(1)在注册时向参与者传达的应用程序使用建议，以及在报告时的应用程序使用标准;(2)被分配到干预组的患者接受干预的比率;(3)报告的应用使用指标水平，特别是使用次数和使用时间; (4) duration of app use metrics (ie, weekly use patterns); and (5) number of intervention completers. Results: Database searching yielded 2083 unique records. Of these, 22 studies were eligible for inclusion. Only 64% (14/22) of studies included in this review specified rate of intervention uptake. Level of use metrics was only reported in 59% (13/22) of the studies reviewed. Approximately one-quarter of the studies (5/22, 23%) reported duration of use metrics. Only half (11/22, 50%) of the studies reported the number of participants who completed the app-based components of the intervention as intended or other metrics related to completion. Findings in those studies reporting metrics related to intervention completion indicated that between 14.4% and 93.0% of participants randomized to a DMHI condition completed the intervention as intended or according to a specified adherence criteria. Conclusions: Findings suggest that engagement was underreported and widely varied. It was not uncommon to see completion rates at or below 50% (11/22) of those participants randomized to a treatment condition or to simply see completion rates not reported at all. This variability in reporting suggests a failure to establish sufficient reporting standards and limits the conclusions that can be drawn about level of engagement with DMHIs. Based on these findings, the 5-element framework applied in this review may be useful as a minimum necessary standard for DMHI engagement reporting.

为妊娠期糖尿病孕妇设计的App和web系统的文化和数字健康素养的适宜性:范围审查

2022 - 10 - 14 - t10:45:03内

背景:被诊断为妊娠期糖尿病(GDM)的妇女的患病率正在急剧增加。增强患者自我管理的移动技术为被诊断为GDM的女性提供了许多优势。然而，据我们所知，尽管存在用于GDM管理的移动卫生(mHealth)和远程医疗系统，但关于其文化和数字卫生素养适当程度的证据有限。本综述旨在搜索和评估为GDM女性设计的移动健康和远程医疗系统的文献。我们对这些技术的评估主要集中在其文化和数字健康素养的适当性，以及系统在改善血糖控制和母婴预后方面的有效性。我们使用Arksey和O’malley改编的框架进行了范围审查。我们搜索了四个相关研究的电子数据库:PubMed、MEDLINE (EBSCO)、Web of Science和Scopus。这些数据库是在2010年1月至2022年1月之间进行搜索的。入选标准为诊断为GDM的孕妇、使用远程医疗进行监测和管理的孕妇以及弱势或弱势患者。我们使用了与移动应用程序和远程医疗相关的术语:GDM， 弱势群体，周边， 文化适宜性， 数字健康素养。 Studies were screened and selected independently by 2 authors. We extracted the study data on a Microsoft Excel charting table and categorized them into final themes. The results were categorized according to the cultural and digital health literacy features presented. Results: We identified 17 studies that reported on 12 telemedicine and mHealth app interventions. We assessed the studies in three domains: cultural appropriateness, digital health literacy, and maternal and infant outcomes. In the literature, we found that existing digital technologies may improve glycemic control and diabetes self-management. However, there is a lack of assessment of cultural and digital health literacy appropriateness for pregnant women diagnosed with GDM. Considerations in app design regarding cultural appropriateness were found in only 12% (2/17) of the studies, and only 25% (3/12) of the interventions scored ≥3 out of 5 in our assessment of digital health literacy. Conclusions: mHealth and telemedicine can be an effective platform to improve the clinical management of women with GDM. Although studies published on the use of mHealth and telemedicine systems exist, there is a limited body of knowledge on the digital health literacy and cultural appropriateness of the systems designed for women diagnosed with GDM. In addition, as our study was restricted to the English language, relevant studies may have been excluded. Further research is needed to evaluate, design, and implement better tailored apps regarding cultural and digital literacy appropriateness for enhancing pregnant women’s self-management as well as the effectiveness of these apps in improving maternal and infant health outcomes.

开放环境下卫生保健研究的安全协作平台:访问控制问责的视角

2022 - 10 - 14 - t10:30:02内

随着信息技术在卫生保健领域的应用，国家卫生机构越来越多地收集和存储各种电子卫生数据。由于这些电子健康数据可以推进现代医疗保健系统，使其更智能，许多研究人员希望在他们的研究中使用这些数据。然而，使用电子健康数据会带来隐私和安全问题。支持卫生保健研究的分析环境还必须考虑许多需求。由于这些原因，各国通常为卫生保健提供研究平台，但一些数据提供者(如患者)仍然担心其电子健康数据的安全和隐私。因此，需要一个更安全的卫生保健研究平台，保证电子健康数据的效用，同时关注其安全性和隐私性。本研究旨在实现一个比以往卫生保健研究平台更安全的卫生保健研究平台——卫生保健大数据平台(HBDP)。HBDP采用基于属性的加密技术，实现开放环境中存储的eHealth数据的细粒度访问控制和加密。此外，在HBDP中，平台管理员可以通过私有区块链执行适当的后续操作(例如，阻止非法用户)和监视。换句话说，HBDP支持访问控制中的问责制。 Methods: We first identified potential security threats in the health care domain. We then defined the security requirements to minimize the identified threats. In particular, the requirements were defined based on the security solutions used in existing health care research platforms. We then proposed the HBDP, which meets defined security requirements (ie, access control, encryption of stored eHealth data, and accountability). Finally, we implemented the HBDP to prove its feasibility. Results: This study carried out case studies for illegal user detection via the implemented HBDP based on specific scenarios related to the threats. As a result, the platform detected illegal users appropriately via the security agent. Furthermore, in the empirical evaluation of massive data encryption (eg, 100,000 rows with 3 sensitive columns within 46 columns) for column-level encryption, full encryption after column-level encryption, and full decryption including column-level decryption, our approach achieved approximately 3 minutes, 1 minute, and 9 minutes, respectively. In the blockchain, average latencies and throughputs in 1Org with 2Peers reached approximately 18 seconds and 49 transactions per second (TPS) in read mode and approximately 4 seconds and 120 TPS in write mode in 300 TPS. Conclusions: The HBDP enables fine-grained access control and secure storage of eHealth data via attribute-based encryption cryptography. It also provides nonrepudiation and accountability through the blockchain. Therefore, we consider that our proposal provides a sufficiently secure environment for the use of eHealth data in health care research.

更正:用于远程初级保健的远程会诊设备，会诊站:多地点前瞻性队列研究

2022 - 10 - 13 - t13:00:19内