The psychometric rigor of unsupervised, smartphone-based assessments and factors that impact remote protocol engagement is critical to evaluate prior to the use of such methods in clinical contexts. We evaluated the validity of a high-frequency, smartphone-based cognitive assessment protocol, including examining convergence and divergence with standard cognitive tests, and investigating factors that may impact adherence and performance (i.e., time of day and anticipated receipt of feedback vs. no feedback).

Cognitively unimpaired participants (N = 120, Mage = 68.8, 68.3% female, 87% White, Meducation = 16.5 years) completed 8 consecutive days of the Mobile Monitoring of Cognitive Change (M2C2), a mobile app-based testing platform, with brief morning, afternoon, and evening sessions. Tasks included measures of working memory, processing speed, and episodic memory. Traditional neuropsychological assessments included measures from the Preclinical Alzheimer’s Cognitive Composite battery.

Findings showed overall high compliance (89.3%) across M2C2 sessions. Average compliance by time of day ranged from 90.2% for morning sessions, to 77.9% for afternoon sessions, and 84.4% for evening sessions. There was evidence of faster reaction time and among participants who expected to receive performance feedback. We observed excellent convergent and divergent validity in our comparison of M2C2 tasks and traditional neuropsychological assessments.

This study supports the validity and reliability of self-administered, high-frequency cognitive assessment via smartphones in older adults. Insights into factors affecting adherence, performance, and protocol implementation are discussed.

The Stricker Learning Span (SLS) is a computer-adaptive digital word list memory test specifically designed for remote assessment and self-administration on a web-based multi-device platform (Mayo Test Drive). We aimed to establish criterion validity of the SLS by comparing its ability to differentiate biomarker-defined groups to the person-administered Rey’s Auditory Verbal Learning Test (AVLT).

Participants (N = 353; mean age = 71, SD = 11; 93% cognitively unimpaired [CU]) completed the AVLT during an in-person visit, the SLS remotely (within 3 months) and had brain amyloid and tau PET scans available (within 3 years). Overlapping groups were formed for 1) those on the Alzheimer’s disease (AD) continuum (amyloid PET positive, A+, n = 125) or not (A-, n = 228), and those with biological AD (amyloid and tau PET positive, A+T+, n = 55) vs no evidence of AD pathology (A−T−, n = 195). Analyses were repeated among CU participants only.

The SLS and AVLT showed similar ability to differentiate biomarker-defined groups when comparing AUROCs (p’s > .05). In logistic regression models, SLS contributed significantly to predicting biomarker group beyond age, education, and sex, including when limited to CU participants. Medium (A− vs A+) to large (A−T− vs A+T+) unadjusted effect sizes were observed for both SLS and AVLT. Learning and delay variables were similar in terms of ability to separate biomarker groups.

Remotely administered SLS performed similarly to in-person-administered AVLT in its ability to separate biomarker-defined groups, providing evidence of criterion validity. Results suggest the SLS may be sensitive to detecting subtle objective cognitive decline in preclinical AD.

Nutrition-related smartphone applications (apps) could improve children’s nutrition knowledge and skills. However, little is known about the quality of nutrition-related apps for children. This study aimed to identify and evaluate the quality of nutrition-related smartphone apps designed for children ages 4–17.

This systematic appraisal is guided by the Protocol for App Store Systematic Reviews.

Using Google’s Advanced Search, we identified 1814 apps/1184 additional apps in an updated search on iOS, of which twenty-four were eligible. The apps’ objective and subjective quality were evaluated using the twenty-three-item, five-point Mobile App Rating Scale. The objective quality scale consists of four subscales: engagement, functionality, aesthetics and information.

Most of the apps (75 %) focussed solely on promoting nutrition skills, such as making food dishes, rather than nutrition knowledge. Of the twenty-four apps, 83 % targeted children 4–8 years old. The app objective quality mean score was 3·60 ± 0·41. The subscale mean scores were 3·20 ± 0·41 for engagement, 4·24 ± 0·47 for functionality, 4·03 ± 0·51 for aesthetics and 2·94 ± 0·62 for information. The app subjective quality mean score was 2·10 ± 0·90.

More robust approaches to app development leveraging co-design approaches, including involving a multidisciplinary team of experts to provide evidence-based nutrition information, are warranted.

Treatment for tinnitus focuses on supportive therapies. Long waiting times in the National Health Service encourage telemedicine options as an alternative. This study aimed to review the literature on telemedicine in the management of tinnitus and analyse its impact on the burden of tinnitus, long-term, anxiety, depression, insomnia and quality of life.

PubMed, Embase, Cochrane Library, Google Scholar, Scopus and Web of Science were searched. English randomised, controlled trials with adult participants suffering from tinnitus were included. A random effects model looking at standardised mean differences between intervention and control groups was utilised.

Eleven randomised, controlled trials were included. Nine studies looked at internet-based cognitive behavioural therapy. A z-value of 9.87 (p < 0.00001; I2 = 21 per cent) showed telemedicine approaches may be better at reducing tinnitus burden compared with passive controls.

Telemedicine options have multiple benefits, but more research will be needed to conclusively say they are better than alternatives.

Technology-based interventions (TBIs) are a useful approach when attempting to provide therapy to more patients with psychosis.

Randomized controlled trials of outcomes of TBIs v. face-to-face interventions in psychosis were identified in a systematic search conducted in PubMed/Ovid MEDLINE. Data were extracted independently by two researchers, and standardized mean changes were pooled using a three-level model and network meta-analysis.

Fifty-eight studies were included. TBIs complementing treatment as usual (TAU) were generally superior to face-to-face interventions (g = 0.16, p ≤ 0.0001) and to specific outcomes, namely, neurocognition (g = 0.13, p ≤ 0.0001), functioning (g = 0.25, p = 0.006), and social cognition (g = 0.32, p ≤ 0.05). Based on the network meta-analysis, the effect of two TBIs differed significantly from zero; these were the TBIs cognitive training for the neurocognitive outcome [g = 0.16; 95% confidence interval (CI) 0.09–0.23] and cognitive behavioral therapy for quality of life (g = 1.27; 95% CI 0.46–2.08). The variables educational level, type of medication, frequency of the intervention, and contact during the intervention moderated the effectiveness of TBIs over face-to-face interventions in neurocognition and symptomatology.

TBIs are effective for the management of neurocognition, symptomatology, functioning, social cognition, and quality of life outcomes in patients with psychosis. The results of the network meta-analysis showed the efficacy of some TBIs for neurocognition, symptomatology, and quality of life. Therefore, TBIs should be considered a complement to TAU in patients with psychosis.

To investigate the effectiveness of eTansiyon smartphone application in blood pressure control in patients with hypertension.

Global prevalence of hypertension and the burden of chronic illness care, especially in primary care, are increasing in world. We have developed eTansiyon to ensure the continuity of patient-physician relationship, so it may help to improve the lifestyle of patients with hypertension, increase their adherence to treatment and achieve the target blood pressure.

This study was a non-randomized controlled study. The sample was selected by random sampling method among the patients registered in 6 Family Health Units (FHUs). Randomization was performed at the FHU level; the units were randomized to 4 control group (CG) and 2 intervention group (IG), so that randomization in this study was 2:1. Both groups were followed up for at least four months. In addition to CG, IG were provided to use eTansiyon. Obtained data were analysed to evaluate differences between groups at the beginning and end of the study, intra-group changes after follow-up and interaction between groups and follow-up period.

The study was performed with 124 patients in CG and 61 patients in IG. At the end of the study, the average systolic blood pressure/diastolic blood pressure (SBP/DBP) of office and home was significantly lower in IG compared to CG (P < 0.001, MD 9.5 mmHg; P = 0.007, MD 3.8 mmHg; P < 0.001, MD 10.6 mmHg; P < 0.001, MD 4.8 mmHg, respectively), and it was found that the proportion of people with target blood pressure in IG was significantly higher than CG (P < 0.001, 49.2%(n = 30) and 22.6%(n = 28), respectively). Repeated measures ANOVA and generalized estimating equations results showed that follow-up period and interaction between groups were significant in terms of office and home SBP/DBP and target blood pressure level during follow-up period (P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.024, respectively).

Although several studies preliminary supported the effects of using smartphone mental health application (app) in patients with bipolar disorder (BD), patients’ subjective experience deserves more attention.

The present study aimed to explore how the BD patient experienced while using the APP in detecting their mood relapse warning signs (MRW app) which has been developed by our team (Su et al., 2021).

The MRW app collects 2 passive (location and GPS removal distance) and 6 self-reported data (daily mood, wake and sleep time, the brief record of mood and life, voice pitch, speech tone and rhythm, facial expression, and weekly emotional scale). By using qualitative research design, 15 patients recruited from the psychiatric outpatient department in a medical center were in-depth interviewed.

Four themes were identified as their subjective experience to use the app as: including positive and negative experience, facilitators, price, and barriers. Interconnected relationship was found in each theme; and counterbalancing associations between positive vs. negative experience, facilitators vs. price and barriers were also demonstrated.

Such first-person experience of using the app in illness detection could unveil technological myths and present its impacts upon patients’ lives in the real world. Implication for practice and future studies were be discussed.

No significant relationships.

Modern day otolaryngology has expanded beyond the ear, nose and throat to include head and neck surgery and aesthetic facial procedures. Photographic documentation is important within this expanded horizon. The spectrum of clinical photography includes photomicrographs, endoscopic photographs, peri-operative photography and medical social photography.

This article aimed to review the standard guidelines essential to obtain, store and disseminate photographs and looked at setting up a small clinic with minimal gadgets to suit clinical photography requirements. Elaboration of basic photography techniques in otolaryngology was reviewed, with examples of photographs taken in a clinic by a clinician. Advances and innovation in clinical photography, in the form of smartphone photography, artificial intelligence, device editing and newer hardware and software in otorhinolaryngology was reviewed.

Having a professional photographer to aid a clinician is a luxury. Simple knowledge and regular practice of basic photography guidelines by a clinician is imperative.

Growing evidence studying pathological online behaviour has shown an increasing rate of internet addictions in younger populations across the globe.

The current study aims to investigate the prevalence of smartphone internet addiction of youths in Hong Kong, and its associations with gender and depression.

A total of 1,164 participants’ preliminary data were extracted from the Hong Kong Youth Epidemiological Study of Mental Health, a territory-wide, household-based study of mental health in youths aged between 15-24. Internet usage behaviors, socio-demographic and psychosocial characteristics of the participants were assessed. The Chen Internet Addiction Scale was modified to measure smartphone internet addiction (SIA). Symptoms of depression were assessed using the Patient Health Questionnaire. Mann-Whitney U tests were used to examine (i) SIA across gender and (ii) depressive symptoms between high and no to low SIA groups. Linear regression model was used to evaluate the association between SIA and depression.

The prevalence of smartphone internet addiction was 27.8% using the cut-off scores of 67/68. Women had higher SIA scores than men (U=144239.50, p=0.001). Participants with high SIA were associated with a higher severity in depression than those with no-to-low SIA (U=89187.00, p<0.001). Regression analysis revealed a significant positive correlation between depression and SIA after adjusting for confounding factors (B=0.099, t=9.138, p<0.001).

Our findings suggest a gender difference on online behaviour using smartphones. Further investigations are needed on whether SIA may exacerbate severity of common mental disorders.

Paediatric cardiology fellows, tasked with studying a large and dynamic field, may benefit from a quick-access digital resource that reflects contemporary practice. The objective of this study was to evaluate the effectiveness of a paediatric cardiology handbook smartphone app in enhancing the accessibility of information such as guidelines and recommendations for paediatric cardiology fellows.

The Peds Cardiology Handbook app (iOS) was designed using XCode and Swift programming. A pre-app survey and download instructions were sent to the US paediatric cardiology fellows, followed by a post-app survey. Fellows were asked to rate the ease of rapid access to various types of information. Responses were compared pre- and post-app using McNemar’s test and Wilcoxon signed-rank test.

Two-hundred and thirty paediatric cardiology fellows were contacted; 23% (n = 53) completed both the pre- and post-app surveys and were included for analysis. After using the app, fellows found it easier to quickly access information in eight out of nine domains evaluated (p < 0.05). All fellows found the app easy to use (100%), most felt that the app was well-organised (98%), contained reliable information (92%), and was useful for finding quick answers to clinical questions (87%).

The Peds Cardiology Handbook iPhone app is a useful, reliable tool that provides quick access to high-yield information, including guidelines and references. Overall, paediatric cardiology fellows found it easier to rapidly access clinically relevant information after using the app. Future studies may be necessary to evaluate long-term use and impact on evidence-based practice.