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The leading peer-reviewed journal for digital medicine, and health & healthcare in the Internet age
The Journal of Medical Internet Research (JMIR), now in its 20th year, is the pioneer open access eHealth journal and is the flagship journal of JMIR Publications. It is the leading digital health journal globally in terms of quality/visibility (Impact Factor 2017: 4.671, ranked #1 out of 22 journals) and in terms of size (number of papers published). The journal focuses on emerging technologies, medical devices, apps, engineering, and informatics applications for patient education, prevention, population health and clinical care. As leading high-impact journal in its' disciplines (health informatics and health services research), it is selective, but it is now complemented by almost 30 specialty JMIR sister journals, which have a broader scope. Peer-review reports are portable across JMIR journals and papers can be transferred, so authors save time by not having to resubmit a paper to different journals.
As open access journal, we are read by clinicians, allied health professionals, informal caregivers, and patients alike, and have (as all JMIR journals) a focus on readable and applied science reporting the design and evaluation of health innovations and emerging technologies. We publish original research, viewpoints, and reviews (both literature reviews and medical device/technology/app reviews).
We are also a leader in participatory and open science approaches, and offer the option to publish new submissions immediately as preprints, which receive DOIs for immediate citation (eg, in grant proposals), and for open peer-review purposes. We also invite patients to participate (eg, as peer-reviewers) and have patient representatives on editorial boards.
Be a widely cited leader in the digitial health revolution and submit your paper today!
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Background: Social media coverage is increasingly used to spread the message of scientific publications. Traditionally, the scientific impact of an article is measured by the number of citations. At a...
Background: Social media coverage is increasingly used to spread the message of scientific publications. Traditionally, the scientific impact of an article is measured by the number of citations. At a journal level, this conventionally matures over a two-year period and it is challenging to gauge impact around the time of publication. Objective: to assess whether online attention is associated with citations and to develop a predictive model that assigns relative importance to different elements of social media coverage: the #SoMe_Impact score. Methods: We included all original articles published in 2015 in a selection of the highest-impact journals: The New England Journal of Medicine (NEJM), The Lancet, The Journal of the American Medical Association (JAMA), Nature, Cell and Science. We first characterised the change in Altmetric score over time by taking a single month’s sample of recently published articles from the same journals and gathered Altmetric data daily from the time of publication to create a mixed-effects spline models. We then obtained the overall weighted Altmetric score for all articles from 2015, the unweighted data for each Altmetric component and the two-year citation count from Scopus for each of these articles for 2016-2017. We created a stepwise multivariable linear regression model to develop a #SoME_Score that was predictive of two-year citations. The score was validated using a dataset of articles from the same journals published in 2016. Results: In our unselected sample of 145 recently published articles, social media coverage appeared to plateau approximately 14 days after publication. A total of 3,150 articles with a median citation count of 16 (IQR 5-33) and Altmetric score of 72 (IQR 28-169) were included for analysis. On multivariable regression, compared to articles in the lowest quantile of #SoME_Score, articles in the second, third and upper quantile had 21.2, 44.2 and 99.2 more citations, respectively. On the validation dataset, #SoME_Score model outperformed the Altmetric score (adjusted R2 0.17 vs 0.06, P<.001). Conclusions: Social media attention predicts citations and could be used as an early surrogate measure of scientific impact. Due to the cross-sectional study design, we cannot determine whether correlation relates to causation. Clinical Trial: NA
Background: Current guidelines of the European Society of Cardiology recommend opportunistic screening in people aged ≥65 years by pulse palpation and, if irregular, a 12-lead electrocardiogram (ECG...
Background: Current guidelines of the European Society of Cardiology recommend opportunistic screening in people aged ≥65 years by pulse palpation and, if irregular, a 12-lead electrocardiogram (ECG). However, evolving technology may offer new opportunities to allow a better penetrance of screening in the general population at relatively low cost and with minimal logistic efforts, which may further lower the threshold for screening. Smartphones may offer an interesting modality to aid AF diagnosis, as their use has exponentially increased in recent years and is continuing to grow. Objective: This study tested the diagnostic accuracy of the FibriCheck AF algorithm for the detection of atrial fibrillation (AF) based on smartphone photoplethysmography (PPG) and single-lead electrocardiography (ECG) signals. Methods: A convenience sample of patients, aged 65 and older, with and without a known history of AF, was recruited from 17 primary care facilities. Patients with an active pacemaker rhythm were excluded. A PPG signal was obtained with the backside camera of an iPhone 5S. Simultaneously, a single‑lead ECG was registered using a dermal patch with a wireless connection to the same smartphone. PPG and single-lead ECG signals were analysed using the FibriCheck AF algorithm. At the same time, a 12‑lead ECG was obtained and interpreted off-line by independent cardiologists to determine the presence of AF. Results: A total of 102/223 subjects (46%) were in AF. PPG signal quality was sufficient for analysis in 93%, and single‑lead ECG quality was sufficient in 94% of the participants. After removing insufficient quality measurements, the sensitivity and specificity were 96% (95% CI 89-99%) and 97% (95% CI 91-99%) for the PPG signal versus 95% (95% CI 88-98%) and 97% (95% CI 91-99%) for the single‑lead ECG, respectively. False-positive results were mainly due to premature ectopic beats. In 196 subjects where the signal quality of both techniques was adequate, PPG and single‑lead ECG yielded a similar diagnosis in 192 subjects (98%). Conclusions: The FibriCheck AF algorithm had a very good sensitivity and specificity to detect AF based on both the smartphone PPG and the single-lead ECG signals in a primary care convenience sample.
Advances made in information technology are changing public health at an unprecedented rate. Participatory surveillance systems are contributing to public health by actively engaging Web-based communi...
Advances made in information technology are changing public health at an unprecedented rate. Participatory surveillance systems are contributing to public health by actively engaging Web-based communities of volunteer citizens to report symptoms of public health threats and also by empowering individuals to promptly respond to them. However, such Web-based model raises its own set of ethical issues, on top of those inherent to more traditional forms of public health surveillance. Research ethics is undergoing significant changes in the digital era where it is not sufficient to consider only participants’ physical and psychological well-being, but also the protection of their sensitive data. In this paper, the Web-based platform of Influenzanet is used as a case study to illustrate those ethical challenges which participant-surveillance-systems involving the use of Web-based platforms and mobile apps have to deal with. These ethical challenges include the issues of electronic consent, the protection of participants’ privacy and the promotion of justice. Our analysis is followed by recommendations to strengthen ethical approaches in the field of Web-based public health surveillance, with a particular focus on the role of research ethics committees.
Background: To our knowledge, few studies have examined the use of wearable sensing devices to effectively integrate information communication technologies and apply them to health care issues (partic...
Background: To our knowledge, few studies have examined the use of wearable sensing devices to effectively integrate information communication technologies and apply them to health care issues (particularly those pertaining to posture correction). Objective: A novel system for posture correction involving the application of wearable sensing technology was developed in this study. Methods: The newly developed system consists of the combination of three subsystems, namely, a smart necklace, smart phone, and notebook computer. The gravitational acceleration data of a user is collected and analyzed by an MPU-6050 sensor housed in the smart necklace when the necklace is worn, with that data being used by the necklace to determine the user's upper body posture. When poor posture is detected by the necklace, the necklace sends the user’s smart phone a reminder to correct his or her posture; a mobile app that was also developed as part of the study allows the necklace to transmit such messages to the phone. The standard values (base values for posture assessment) of the necklace can also be set through the app, as can the timing of the aforementioned reminders and the activation of the posture image calibration function on the notebook computer. The notebook computer is enabled to use a depth camera to read the relevant data, to identify the skeletal structure and joint reference points of the user, and to compute calculations relating to those reference points, after which the computer then sends signals to the necklace to enable calibration of the necklace's standard values. Results: The system effectively enables a user to monitor and correct his or her own posture, which in turn will assist the user in preventing spine-related diseases and, consequently, living a more effective and healthy life. Conclusions: The proposed system makes it possible for: 1) the user to self-correct his or her posture without resorting to the use of heavy, thick, or stuffy corrective clothing; 2) the necklace's standard values to be quickly calibrated via the use of posture imaging; and 3) the need for complex wiring to be eliminated through the effective application of the Internet of Things, as well as by implementing wireless communication between the smart necklace, smart phone, and notebook computer.
Background: Concussion is a common injury amongst Canadian children and adolescents that leads to a range of neurobehavioral deficits. However, noticeable gaps continue to exist in the management of p...
Background: Concussion is a common injury amongst Canadian children and adolescents that leads to a range of neurobehavioral deficits. However, noticeable gaps continue to exist in the management of pediatric concussion with inadequate application of best practice guidelines that can lead to poor health outcomes. Objective: To describe the development and assess the usability of a smartphone application to aid youth in self-managing concussion. A secondary objective was to assess the usefulness of the application. Methods: An agile user-centered design approach was used to develop the technology, followed by a formative lab-based usability study for assessment and improvement proposals. Youth ages 10 to 18 years with a history of concussion and healthcare professionals involved in concussion management were recruited. The study included participants performing 12 tasks with the smartphone application while using the ‘think aloud’ protocol, administration of the System Usability Scale (SUS), post-test questionnaire, and a semi-structured interview. Results: Developed a smartphone application prototype ‘NeuroCare’ that is an easily accessible pediatric concussion management intervention which provides easy access to expert informed concussion management strategies and helps guide youth in self-managing and tracking their concussion recovery. Seven youth ages 10 to 18 years with a history of concussion and seven healthcare professionals were recruited. The mean SUS score was 81.9, mean task success rates were greater than 90% for 92% (11/12) of tasks, 92% (11/12) of tasks had a total error frequency of less than 11 errors, and mean task completion times were less than 2 minutes for 100% of tasks. Conclusions: Results suggest this application has high usability, is acceptable to users, and may be useful in helping youth self-manage concussion.
Background: In addition to addiction and substance abuse, motivational interviewing (MI) is increasingly being integrated in treating other clinical issues such as mental health problems. Despite many...
Background: In addition to addiction and substance abuse, motivational interviewing (MI) is increasingly being integrated in treating other clinical issues such as mental health problems. Despite many technological adaptations of MI, most of them have focused on delivering the action-oriented treatment, leaving its relational component unexplored or vaguely described. This study intends an early design of a conversational sequence of both technical and relational components of MI for a mental health concern. Objective: This case study aims to design a conversational sequence for a brief motivational interview to be delivered by a Web-based text messaging application (“chatbot”) and investigate its conversational experience for stress management with graduate students. Methods: A brief conversational sequence was designed by incorporating both technical (change talk) and relational (O-A-R-S) components of MI, inspired by the summons-answer sequence by Schegloff. A Web-based text messaging app, Bonobot, was built as a research prototype to deliver the sequence in an online conversation. A total of 30 full-time graduate students who self-reported stress in regard of their school life were recruited for a survey of demographic information and perceived stress (PSS-10), and a semi-structured interview. Interviews were transcribed verbatim and analyzed by Braun and Clarke’s thematic method. Themes that reflect the process, impact of, and needs for the conversational experience are reported. Results: Participants had a high level of perceived stress (M=22.5, SD=5.0). Our findings include themes as follows: Evocative Questions and Clichéd Feedback; Self-Reflection and Potential Consolation; and Need for Information and Contextualized Feedback. Participants particularly favored the relay of change talk questions, but were less satisfied with the emotional responses that filled in-between. Change talk was a good means of reflecting on themselves, and some of Bonobot’s encouragements related to graduate school life were appreciated. Participants suggested the conversation provide informational support, as well as more personalized emotional feedback. Conclusions: A conversational sequence that incorporates technical and relational components of MI was presented in this case study. Participant feedback suggests sequencing change talk questions and emotional responses can facilitate a conversation for stress management, with change talk possibly offering a chance of self-reflection. More diversified sequences, along with more contextualized emotional feedback, should follow to offer better conversational experience and to confirm any empirical effect. Clinical Trial: n/a