Top 10 Digital Health Research Papers of 2013

HIStalk Connect’s 2013 digital health research review looks at the most significant findings from the mHealth, telehealth, data analytics, and patient engagement sectors throughout the year. The studies represented were predominantly systematic reviews and meta-analyses, though several were published results from randomized control trials.

A near constant criticism of mHealth is that the hype isn’t substantiated with sound evidence. Perhaps in part because of this common complaint, 2013 saw a near 50 percent uptick in published mHealth research papers. Johns Hopkins responded by launching a new mHealth evidence portal, the goal of which is to centralize emerging best practice recommendations so organizations will have a resource to turn to when designing mHealth programs for their communities.

As always, congratulations is owed to those working to uncover these emerging trends, as well as those working to implement them in communities around the world. Here’s to an even more impressive 2014.

Big Data

1. Pharmacovigilance Using Clinical Notes

Researchers at Stanford University, using analytics and EHR data looking back 15 years, were able to pick up on trends that clearly substantiated harmful drug side effects years before FDA’s Adverse Event Reporting System was able to identify the problem and issue an alert. Researchers conclude that real-time data analytics could be a powerful compliment to the FDA’s reporting program.

2. Thrombus Aspiration during ST-Segment Elevation Myocardial Infarction

Researchers in Sweden are showing off a new clinical trial approach that uses analytics to pour through EHR data to investigate best practice treatment norms by confirming that outcomes are in fact improved when they are adhered to. During their research, they discovered that thrombus aspiration, a recommended best practice procedure performed on certain types of heart attack patients, resulted in no difference in 30-day all-cause mortality rates for patients who received the treatment vs. patients who did not.

Mobile Health

3. A text message based weight management intervention for overweight adults

A control trial analyzing the effectiveness of a text-based weight loss program measures the success of a group of overweight and obese adults who had just completed an in person weight-loss program. Following the in-person program, half of the participants were then provided 12 weeks of text-based add on interventions, while the other half received only periodic weight checks. At the end of 12 weeks, participants in the text-based program had a significantly lower body weight, waist circumference, and body mass index.

4. A Lot of Action, But Not in the Right Direction: Systematic Review and Content Analysis of Smartphone Applications for the Prevention, Detection, and Management of Cancer

A systematic review of currently available cancer detection, prevention, and management apps finds that while there are hundreds of cancer-focused apps with the potential to provide valuable patient education, and support, there is a serious lack of evidence on their effectiveness and safety.

Patient Engagement

5. Use of a Text Message Program to Raise Type 2 Diabetes Risk Awareness and Promote Health Behavior Change (Part I): Assessment of Participant Reach and Adoption

A study published in the Journal of Medical Internet Research designed to measure the participation and adoption rates of a text-based type 2 diabetes program finds that a majority of enrolled participants drop out before the end of the 14 week program, leading researchers to conclude that text-based programs, although capable of including a broader patient audience, may not be as ideal as an engagement method.

Social Media

6. Social Networking Technologies as an Emerging Tool for HIV Prevention: A Cluster Randomized Trial

A study published in the September issue of the Annals of Internal Medicine analyzes the use of social networks as an emerging tool for HIV prevention. The study followed a high-risk population of 112 homosexual men living in Los Angeles. The participants were enrolled in one of two Facebook groups. The first was used to deliver HIV specific information, while the other provided general health and wellness information.

Researchers found that 95 percent of participants enrolled in the HIV-specific Facebook group communicated using the platform, compared to 73 percent in the control group. At the conclusion of the study, 44 percent of men enrolled in the HIV group had requested and completed an HIV testing kit compared to just 20 percent in the control group.

Telehealth

7. A Multi-center Study of ICU Telemedicine Reengineering of Adult Critical Care

Researchers at the University of Massachusetts Medical School measures the effectiveness of tele-ICU programs implemented across 56 intensive care units over a five-year period, finding that, with telehealth support in the ICU,  patients leave the ICU 20 percent faster and are 16 percent more likely to survive hospitalization and be discharged.

8. The Clinical Effectiveness of Web-Based Cognitive Behavioral Therapy With Face-to-Face Therapist Support for Depressed Primary Care Patients: Randomized Controlled Trial

Findings from a randomized control trial published in the Journal of Medical Internet Research suggests that self-guided, web-based cognitive behavioral therapy sessions could be an effective supplemental service for mild and moderately depressed patients. Researchers had patients with mild to moderate depression participate in a self-guided behavioral therapy program, supplemented by brief therapist support for six weeks. At the end, patient surveys revealed that the intervention had alleviated depressive symptoms and had a significant positive effect on anxiety symptoms and overall satisfaction with life.

9. Managing hypertension in urban underserved subjects using telemedicine–a clinical trial

A clinical trial conducted at Temple University in Philadelphia followed 241 hypertensive, underserved patients through six months of outpatient interventions designed to reduced their blood pressure. Half were enrolled in a web and phone-based telehealth program, while the control group was provided the standard care protocols.

Interestingly, before and after blood pressure measurements revealed that the telehealth group did see significantly improved reductions in blood pressure as compared to the control group – but only if they were non-diabetic. Diabetics enrolled in the program saw no difference in improvement whether they were provided standard care, or telehealth care.

10. Clinical Outcome and Cost-Effectiveness of a Synchronous Telehealth Service for Seniors and Nonseniors with Cardiovascular Diseases: Quasi-Experimental Study

An analysis of the impact that telehealth services have for patients with cardiovascular disease is assessed in a study conducted at the National Taiwan University Hospital. A group of cardiovascular disease patients were recruited and teleheath services, including real-time transmission of blood pressure and blood glucose data, was arranged, above and beyond the traditional standard of care. The data was monitored and telephone counseling was conducted as needed.

Researchers found that the telehealth intervention significantly reduced readmission rates and the duration of all-cause hospital stays regardless of age. Financially, the telehealth services were also tied to reduced overall inpatient costs.


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