scholarly journals Mobile and Wearable Sensing for the Monitoring of Diabetes-related Parameters: Systematic Review (Preprint)

2020 ◽  
Author(s):  
Ciro Rodriguez-Leon ◽  
Claudia Villalonga ◽  
Manuel Munoz-Torres ◽  
Jonatan R Ruiz ◽  
Oresti Banos

BACKGROUND Diabetes mellitus is a metabolic disorder suffered by hundreds of millions of people worldwide and causing several million deaths every year. Such a dramatic scenario puts quite some pressure on administrations, care services and the scientific community to seek novel solutions that may help controlling and dealing effectively with this condition and its consequences. OBJECTIVE This study is aimed at reviewing the literature on the use of modern mobile and wearable technology for monitoring parameters that condition the development and/or evolution of diabetes mellitus. METHODS A systematic review of articles published between January 2010 and July 2020 was performed following PRISMA guidelines. Manuscripts indexed in Web of Science and SCOPUS databases were included if they involved the measurement of diabetes-related parameters, such as blood glucose level, performed physical activity or feet condition, via wearable or mobile devices. RESULTS The search yielded 1587 articles. Altogether, 26 publications met the eligibility criteria and were included in the review. Studies used predominantly wearable devices for monitoring diabetes-related parameters. The accelerometer was by far the most used sensor, followed by the glucose monitor and the heart rate monitor. Most studies applied some kind of processing to the collected data mainly consisting of statistical analysis or machine learning for activity recognition, finding associations among health outcomes, and diagnosing conditions related to diabetes. Privacy or security issues were seldom addressed, and if so, at a rather insufficient level. CONCLUSIONS The use of mobile and wearable devices for the monitoring of diabetes-related parameters shows early promise. Its development can benefit diabetes patients, healthcare professionals and researchers. To evolve this area future research must pay special attention to privacy and security issues, the use of new emerging sensor technologies, and the combination of mobile and clinical data for a holistic and seamless understanding of the patient's health state.

10.2196/20346 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e20346
Author(s):  
Madison Milne-Ives ◽  
Caroline de Cock ◽  
Ernest Lim ◽  
Melissa Harper Shehadeh ◽  
Nick de Pennington ◽  
...  

Background The high demand for health care services and the growing capability of artificial intelligence have led to the development of conversational agents designed to support a variety of health-related activities, including behavior change, treatment support, health monitoring, training, triage, and screening support. Automation of these tasks could free clinicians to focus on more complex work and increase the accessibility to health care services for the public. An overarching assessment of the acceptability, usability, and effectiveness of these agents in health care is needed to collate the evidence so that future development can target areas for improvement and potential for sustainable adoption. Objective This systematic review aims to assess the effectiveness and usability of conversational agents in health care and identify the elements that users like and dislike to inform future research and development of these agents. Methods PubMed, Medline (Ovid), EMBASE (Excerpta Medica dataBASE), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, and the Association for Computing Machinery Digital Library were systematically searched for articles published since 2008 that evaluated unconstrained natural language processing conversational agents used in health care. EndNote (version X9, Clarivate Analytics) reference management software was used for initial screening, and full-text screening was conducted by 1 reviewer. Data were extracted, and the risk of bias was assessed by one reviewer and validated by another. Results A total of 31 studies were selected and included a variety of conversational agents, including 14 chatbots (2 of which were voice chatbots), 6 embodied conversational agents (3 of which were interactive voice response calls, virtual patients, and speech recognition screening systems), 1 contextual question-answering agent, and 1 voice recognition triage system. Overall, the evidence reported was mostly positive or mixed. Usability and satisfaction performed well (27/30 and 26/31), and positive or mixed effectiveness was found in three-quarters of the studies (23/30). However, there were several limitations of the agents highlighted in specific qualitative feedback. Conclusions The studies generally reported positive or mixed evidence for the effectiveness, usability, and satisfactoriness of the conversational agents investigated, but qualitative user perceptions were more mixed. The quality of many of the studies was limited, and improved study design and reporting are necessary to more accurately evaluate the usefulness of the agents in health care and identify key areas for improvement. Further research should also analyze the cost-effectiveness, privacy, and security of the agents. International Registered Report Identifier (IRRID) RR2-10.2196/16934


2020 ◽  
Author(s):  
Madison Milne-Ives ◽  
Caroline de Cock ◽  
Ernest Lim ◽  
Melissa Harper Shehadeh ◽  
Nick de Pennington ◽  
...  

BACKGROUND The high demand for health care services and the growing capability of artificial intelligence have led to the development of conversational agents designed to support a variety of health-related activities, including behavior change, treatment support, health monitoring, training, triage, and screening support. Automation of these tasks could free clinicians to focus on more complex work and increase the accessibility to health care services for the public. An overarching assessment of the acceptability, usability, and effectiveness of these agents in health care is needed to collate the evidence so that future development can target areas for improvement and potential for sustainable adoption. OBJECTIVE This systematic review aims to assess the effectiveness and usability of conversational agents in health care and identify the elements that users like and dislike to inform future research and development of these agents. METHODS PubMed, Medline (Ovid), EMBASE (Excerpta Medica dataBASE), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, and the Association for Computing Machinery Digital Library were systematically searched for articles published since 2008 that evaluated unconstrained natural language processing conversational agents used in health care. EndNote (version X9, Clarivate Analytics) reference management software was used for initial screening, and full-text screening was conducted by 1 reviewer. Data were extracted, and the risk of bias was assessed by one reviewer and validated by another. RESULTS A total of 31 studies were selected and included a variety of conversational agents, including 14 chatbots (2 of which were voice chatbots), 6 embodied conversational agents (3 of which were interactive voice response calls, virtual patients, and speech recognition screening systems), 1 contextual question-answering agent, and 1 voice recognition triage system. Overall, the evidence reported was mostly positive or mixed. Usability and satisfaction performed well (27/30 and 26/31), and positive or mixed effectiveness was found in three-quarters of the studies (23/30). However, there were several limitations of the agents highlighted in specific qualitative feedback. CONCLUSIONS The studies generally reported positive or mixed evidence for the effectiveness, usability, and satisfactoriness of the conversational agents investigated, but qualitative user perceptions were more mixed. The quality of many of the studies was limited, and improved study design and reporting are necessary to more accurately evaluate the usefulness of the agents in health care and identify key areas for improvement. Further research should also analyze the cost-effectiveness, privacy, and security of the agents. INTERNATIONAL REGISTERED REPORT RR2-10.2196/16934


Sensors ◽  
2021 ◽  
Vol 21 (11) ◽  
pp. 3613
Author(s):  
Guillermo Palacios-Navarro ◽  
Fernando Arranz Martínez ◽  
Raúl Martín Ferrer ◽  
Pedro Ramos Lorente

The objective of this study was to evaluate the performance of the different systems and techniques aimed at suppressing vibrations on optical ground-based telescopes. We identified the studies by searching three electronic databases (Science Direct, IEEE library and Web of Science) from the year 2000 to December 2020. The studies were eligible if they proposed systems focused on mitigating the effects of vibrations in optical telescopes and brought performance data. A total of nine studies met our eligibility criteria. Current evidence confirms the feasibility of adaptative optics (AO) systems based on closed-loop control to mitigate vibrations, although variations and additions should be made depending on their nature and characteristics in order to improve the performance of the proposed techniques. This systematic review was conducted to provide a state-of-the-art of the methods and techniques that have been developed over the past two decades. The review also points out some issues that demand future research.


Author(s):  
Álvaro Sicilia ◽  
Adrian Paterna ◽  
Manuel Alcaraz-Ibáñez ◽  
Mark D. Griffiths

AbstractBackground and aims: The aim of the present systematic review was to identify psychometric tools developed to assess problematic exercise in order to identify and compare their theoretical conceptualisations on which they are based. Methods: A systematic literature search was conducted in the electronic databases Web of Science, Scielo, PsychINFO, PsycTEST and SCOPUS from their inception to January 2020. Results: Seventeen assessment instruments met the eligibility criteria to be included in the present review. The instruments were classified according to their conceptualisation into five groups: (i) problematic exercise as an end of an exercise continuum, (ii) problematic exercise as a means of regulating body size and weight, (iii) problematic exercise as dependence, (iv) problematic exercise as a behavioural addiction and (v) no clear conceptualisation. Discussion: The results suggest that the conceptualisations of the assessment instruments have resulted in a strong dichotomy in relation to the primary or secondary character of the problematic exercise that might be limiting the capacity of the instruments to adequately capture the multidimensionality of this construct. Conclusions: Given the interest in understanding the complexity surrounding the problematic exercise, future research should develop more comprehensive definitions of this construct. This would allow a greater conceptual consensus to be reached that would allow progress to be made in the study of the problematic exercise.


2020 ◽  
Author(s):  
Kurt D Shulver ◽  
Nicholas A Badcock

We report the results of a systematic review and meta-analysis investigating the relationship between perceptual anchoring and dyslexia. Our goal was to assess the direction and degree of effect between perceptual anchoring and reading ability in typical and atypical (dyslexic) readers. We performed a literature search of experiments explicitly assessing perceptual anchoring and reading ability using PsycInfo (Ovid, 1860 to 2020), MEDLINE (Ovid, 1860 to 2019), EMBASE (Ovid, 1883 to 2019), and PubMed for all available years up to June (2020). Our eligibility criteria consisted of English-language articles and, at minimum, one experimental group identified as dyslexic - either by reading assessment at the time, or by previous diagnosis. We assessed for risk of bias using an adapted version of the Newcastle-Ottawa scale. Six studies were included in this review, but only five (n = 280 participants) were included in the meta-analysis (we were unable to access the necessary data for one study).The overall effect was negative, large and statistically significant; g = -0.87, 95% CI [-1.47, 0.27]: a negative effect size indicating less perceptual anchoring in dyslexic versus non-dyslexic groups. Visual assessment of funnel plot and Egger’s test suggest minimal bias but with significant heterogeneity; Q (4) = 9.70, PI (prediction interval) [-2.32, -0.58]. The primary limitation of the current review is the small number of included studies. We discuss methodological limitations, such as limited power, and how future research may redress these concerns. The variability of effect sizes appears consistent with the inherent variability within subtypes of dyslexia. This level of dispersion seems indicative of the how we define cut-off thresholds between typical reading and dyslexia populations, but also the methodological tools we use to investigate individual performance.


Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 528
Author(s):  
Cristian Lieneck ◽  
Brooke Herzog ◽  
Raven Krips

The delivery of routine health care during the COVID-19 global pandemic continues to be challenged as public health guidelines and other local/regional/state and other policies are enforced to help prevent the spread of the virus. The objective of this systematic review is to identify the facilitators and barriers affecting the delivery of routine health care services during the pandemic to provide a framework for future research. In total, 32 articles were identified for common themes surrounding facilitators of routine care during COVID-19. Identified constructed in the literature include enhanced education initiatives for parents/patients regarding routine vaccinations, an importance of routine vaccinations as compared to the risk of COVID-19 infection, an enhanced use of telehealth resources (including diagnostic imagery) and identified patient throughput/PPE initiatives. Reviewers identified the following barriers to the delivery of routine care: conservation of medical providers and PPE for non-routine (acute) care delivery needs, specific routine care services incongruent the telehealth care delivery methods, and job-loss/food insecurity. Review results can assist healthcare organizations with process-related challenges related to current and/or future delivery of routine care and support future research initiatives as the global pandemic continues.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kam-Suen Chan ◽  
Eric Yuk-Fai Wan ◽  
Weng-Yee Chin ◽  
Will Ho-Gi Cheng ◽  
Margaret Kay Ho ◽  
...  

Abstract Background The rising prevalence of non-communicable diseases (NCDs) such as diabetes mellitus (DM) and hypertension (HT) has placed a tremendous burden on healthcare systems around the world, resulting in a call for more effective service delivery models. Better continuity of care (CoC) has been associated with improved health outcomes. This review examines the association between CoC and health outcomes in patients with DM and/or HT. Methods This was a systematic review with searches carried out on 13 March 2021 through PubMed, Embase, MEDLINE and CINAHL plus, clinical trials registry and bibliography reviews. Eligibility criteria were: published in English; from 2000 onwards; included adult DM and/or HT patients; examined CoC as their main intervention/exposure; and utilised quantifiable outcome measures (categorised into health indicators and service utilisation). The study quality was evaluated with Critical Appraisal Skills Programme (CASP) appraisal checklists. Results Initial searching yielded 21,090 results with 42 studies meeting the inclusion criteria. High CoC was associated with reduced hospitalisation (16 out of 18 studies), emergency room attendances (eight out of eight), mortality rate (six out of seven), disease-related complications (seven out of seven), and healthcare expenses (four out of four) but not with blood pressure (two out of 13), lipid profile (one out of six), body mass index (zero out of three). Six out of 12 studies on diabetic outcomes reported significant improvement in haemoglobin A1c by higher CoC. Variations in the classification of continuity of care and outcome definition were identified, making meta-analyses inappropriate. CASP evaluation rated most studies fair in quality, but found insufficient adjustment on confounders, selection bias and short follow-up period were common limitations of current literatures. Conclusion There is evidence of a strong association between higher continuity of care and reduced mortality rate, complication risks and health service utilisation among DM and/or HT patients but little to no improvement in various health indicators. Significant methodological heterogeneity in how CoC and patient outcomes are assessed limits the ability for meta-analysis of findings. Further studies comprising sufficient confounding adjustment and standardised definitions are needed to provide stronger evidence of the benefits of CoC on patients with DM and/or HT.


2021 ◽  
Vol 14 ◽  
Author(s):  
Joel Owen ◽  
Louise Crouch-Read ◽  
Matthew Smith ◽  
Paul Fisher

Abstract For more than a decade, Improving Access to Psychological Therapies (IAPT) has been training a new workforce of psychological therapists. Despite evidence of stress and burnout both in trainee mental health professionals, and qualified IAPT clinicians, little is known about these topics in IAPT trainees. Consequently, this systematic review sought to establish the current state of the literature regarding stress and burnout in IAPT trainees. Electronic databases were searched to identify all published and available unpublished work relating to the topic. On the basis of pre-established eligibility criteria, eight studies (including six unpublished doctoral theses) were identified and assessed for quality. This review identifies that research into the experience of IAPT trainees is under-developed. Existing evidence tentatively suggests that IAPT trainees may experience levels of stress and burnout that are higher than their qualified peers and among the higher end of healthcare professionals more generally. The experience of fulfilling dual roles as mental health professionals and university students concurrently appears to be a significant source of stress for IAPT trainees. More research regarding the levels and sources of stress and burnout in IAPT trainees is urgently needed to confirm and extend these findings. Recommendations for future research in the area are given. Key learning aims (1) To establish the current state of the literature regarding stress and burnout in IAPT trainees. (2) To raise practitioner, service and education-provider awareness regarding the levels and perceived sources of stress and burnout in IAPT trainees. (3) To make recommendations regarding future research on the topic.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sara Lena Lueckmann ◽  
Jens Hoebel ◽  
Julia Roick ◽  
Jenny Markert ◽  
Jacob Spallek ◽  
...  

Abstract Background Utilization of primary-care and specialist physicians seems to be associated differently with socioeconomic status (SES). This review aims to summarize and compare the evidence on socioeconomic inequalities in consulting primary-care or specialist physicians in the general adult population in high-income countries. Methods We carried out a systematic search across the most relevant databases (Web of Science, Medline) and included all studies, published since 2004, reporting associations between SES and utilization of primary-care and/or specialist physicians. In total, 57 studies fulfilled the eligibility criteria. Results Many studies found socioeconomic inequalities in physician utilization, but inequalities were more pronounced in visiting specialists than primary-care physicians. The results of the studies varied strongly according to the operationalization of utilization, namely whether a physician was visited (probability) or how often a physician was visited (frequency). For probabilities of visiting primary-care physicians predominantly no association with SES was found, but frequencies of visits were higher in the most disadvantaged. The most disadvantaged often had lower probabilities of visiting specialists, but in many studies no link was found between the number of visits and SES. Conclusion This systematic review emphasizes that inequalities to the detriment of the most deprived is primarily a problem in the probability of visiting specialist physicians. Healthcare policy should focus first off on effective access to specialist physicians in order to tackle inequalities in healthcare. PROSPERO registration number CRD42019123222.


Perfusion ◽  
2021 ◽  
pp. 026765912110370
Author(s):  
Kristina Frain ◽  
Paul Rees

Objectives: Mortality rates in patients with acute myocardial infarction and cardiogenic shock (AMI-CS) remain persistently high despite advances over the past decade in percutaneous mechanical circulatory support. This systematic review aims to analyse the existing literature to compare mortality outcomes in patients mechanically supported by intra-aortic balloon pump or percutaneous Impella 2.5/CP© for AMI-CS undergoing emergency revascularisation. Methods: The following MeSH terms were applied to the databases Ovid Medline, Ovid Embase, Cochrane and Web of Science: ‘Intra-aortic balloon pump’, ‘Impella’, ‘Cardiogenic shock’, ‘Myocardial Infarction’ and ‘Mortality’. This yielded 2643 studies. Using predefined inclusion and exclusion criteria, the studies were initially screened by title and abstract before full text analysis. Results: Fourteen studies met eligibility criteria: two randomised controlled trials (RCTs) and 12 observational studies. Data from a total of 21,006 patients were included across the studies. Notably, one study claimed reduced mortality with IABP versus control, and one study concluded that Impella© improved survival rates over the IABP. The average 30-day all-cause mortality in patients supported by IABP was 38.1%, 54.3% in Impella© groups and 39.4% in control groups. Conclusion: AMI-CS presents an important cohort of patients in whom conducting RCTs is difficult. As a result, the literature is limited. Analysis of the available literature suggests that there is insufficient evidence to support superior survival in those supported by IABP or Impella© when compared to control despite suggestions that the Impella© offers superior haemodynamic support. Limitations of the studies have been discussed to outline suggestions for future research.


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