@文章{信息:doi/10.2196/15819，作者=“Collinge, William and Soltysik, Robert and Yarnold, Paul”，标题=“利用在线个人健康信息减少纤维肌痛影响:纵向观察研究”，期刊=“J医学互联网研究”，年=“2020”，月=“四月”，日=“7”，卷=“22”，数=“4”，页=“e15819”，关键词=“纤维肌痛;纤维肌痛的影响;卫生信息学;预测分析;症状减轻;功能状态;个性化医学;背景:个人健康信息学有潜力帮助患者发现影响结果的个性化健康管理策略。纤维肌痛(FM)是一种复杂的慢性疾病，需要个性化的治疗策略，可以通过个人健康信息数据的分析来提供信息。开发了一个具有动态反馈的在线健康日记计划，以帮助FM患者确定预测其个人结果的症状管理策略，并发现使用该计划可降低症状水平。 Objective: The aim of this study was to determine longitudinal associations between program use and functional impact of FM as measured by scores on a standardized assessment instrument, the Fibromyalgia Impact Questionnaire (FIQ). Methods: Participants were self-identified as diagnosed with FM and recruited via online FM advocacy websites. Participants used an online health diary program (``SMARTLog'') to report symptom ratings, behaviors, and management strategies used. Based on single-subject analysis of the accumulated data over time, individualized recommendations (``SMARTProfile'') were then provided by the automated feedback program. Indices of program use comprised of cumulative numbers of SMARTLogs completed and SMARTProfiles received. Participants included in this analysis met a priori criteria of sufficient program use to generate SMARTProfiles (ie, ≥22 SMARTLogs completed). Users completed the FIQ at baseline and again each subsequent month of program use as follow-up data for analysis. Kendall tau-b, a nonparametric statistic that measures both the strength and direction of an ordinal association between two repeated measured variables, was computed between all included FIQ scores and both indices of program use for each subject at the time of each completed FIQ. Results: A total of 76 users met the a priori use criteria. The mean baseline FIQ score was 61.6 (SD 14.7). There were 342 FIQ scores generated for longitudinal analysis via Kendall tau-b. Statistically significant inverse associations were found over time between FIQ scores and (1) the cumulative number of SMARTLogs completed (tau-b=--0.135, P<.001); and (2) the cumulative number of SMARTProfiles received (tau-b=--0.133, P<.001). Users who completed 61 or more SMARTLogs had mean follow-up scores of 49.9 (n=25, 33{\%} of the sample), an 18.9{\%} drop in FM impact. Users who generated 11 or more new SMARTProfiles had mean follow-up scores of 51.8 (n=23, 30{\%} of the sample), a 15.9{\%} drop. Conclusions: Significant inverse associations were found between FIQ scores and both indices of program use, with FIQ scores declining as use increased. Based on established criteria for rating FM severity, the top one-third of users in terms of use had clinically significant reductions from ``severe'' to ``moderate'' FM impact. These findings underscore the value of self-management interventions with low burden, high usability, and high perceived relevance to the user. Trial Registration: ClinicalTrials.gov NCT02515552; https://clinicaltrials.gov/ct2/show/NCT02515552 ", issn="1438-8871", doi="10.2196/15819", url="//www.mybigtv.com/2020/4/e15819", url="https://doi.org/10.2196/15819", url="http://www.ncbi.nlm.nih.gov/pubmed/32131045" }