digital therapy

数字治疗
  • 文章类型: Journal Article
    In the context of population aging, the growing problem of Alzheimer\'s disease (AD) poses a great challenge to mankind. Although there has been considerable progress in exploring the etiology of AD, i.e., the important role of amyloid plaques and neurofibrillary tangles in the progression of AD has been widely accepted by the scientific community, traditional treatment and monitoring modalities have significant limitations. Therefore novel evaluation and treatment modalities for Alzheimer\'s disease are called for emergence. In this research, we sought to review the effectiveness of digital treatment based on monitoring using functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG). This work searched four electronic databases using a keyword approach and focused on journals focusing on AD and geriatric cognition. Finally, 21 articles were included. The progress of digital therapy and outcome monitoring in AD was reviewed, including digital therapy approaches on different platforms and different neuromonitoring techniques. Because biomarkers such as theta coherence, alpha and beta rhythms, and oxyhemoglobin are effective in monitoring the cognitive level of AD patients, and thus the efficacy of digital therapies, this review particularly focuses on the biomarker validation results of digital therapies. The results show that digital treatment based on biomarker monitoring has good effectiveness. And the effectiveness is reflected in the numerical changes of biomarker indicators monitored by EEG and fNIRS before and after digital treatment. Increases or decreases in the values of these indicators collectively point to improvements in cognitive function (mostly moderate to large effect sizes). The study is the first to examine the state of digital therapy in AD from the perspective of multimodal monitoring, which broadens the research perspective on the effectiveness of AD and gives clinical therapists a \"reference list\" of treatment options. They can select a specific protocol from this \"reference list\" in order to tailor digital therapy to the needs of individual patients.
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  • 文章类型: Systematic Review
    背景:头晕和眩晕可由各种因素引起,如外周前庭和中枢疾病。尽管必要时建议与专家协商,有严重眩晕症状的患者可能活动受限,这可能会干扰医院就诊。COVID-19的传播进一步限制了头晕患者的住院次数;因此,需要一种能够在时间和地理限制下进行更准确治疗的医疗方法。远程医疗已经普及,由于近年来智能手机和平板设备的普及,设备和系统的使用使提供有效的医疗成为可能。然而,以前的范围审查没有绘制现有的眩晕和头晕远程医疗研究,并且没有关于哪些设备和系统应该用于特定疾病的建议。
    目的:这篇综述的目的是绘制和评估以前关于使用信息通信技术的研究,智能手机,以及用于治疗眩晕患者的应用程序,并讨论引入远程医疗以提高医疗质量并创造在患者之间建立安全和信任的环境的附加值。
    方法:根据Arksey和O\'Malley的方法学框架,并根据PRISMA-ScR(系统评价的首选报告项目和范围评价的荟萃分析扩展)指南进行范围审查。PubMed,MEDLINE,和Cochrane图书馆数据库进行检索,以检索以前发表于2000年1月至2023年5月期间的智能手机辅助远程医疗治疗眩晕的报告.两位作者独立评估资格并提取数据。
    结果:这篇综述包括20篇论文,报道了用于前庭功能障碍的远程医疗设备或系统。在报告使用设备或应用程序的研究中,2与回忆和主观症状有关,12个与客观考试有关,7与远程诊断有关,7例与治疗和康复有关。
    结论:随着技术的进步,在头晕患者中使用远程医疗可能是可行的。在未来,有必要考虑如何将远程医疗用于头晕治疗,并开发一种有效的治疗系统,将现场医疗和有效使用设备相结合,以管理严重眩晕和相关疾病。在眩晕治疗中顺利引入远程医疗有望提高治疗质量,增加患者接受医疗护理的机会,并减少时间和旅行成本,导致患者之间的安全感和信任感。
    Dizziness and vertigo can be caused by various factors, such as peripheral vestibular and central disorders. Although consultations with specialists are advisable when necessary, patients with severe vertigo symptoms may have limited mobility, which may interfere with hospital visits. The spread of COVID-19 has further limited the number of hospital visits for patients with dizziness; therefore, a method of medical care that enables more accurate treatment under time and geographical constraints is needed. Telemedicine has become widespread, owing to the popularity of smartphone and tablet devices in recent years, and the use of devices and systems has made it possible to provide efficient medical care. However, no previous scoping review has mapped existing studies on telemedicine for vertigo and dizziness, and no recommendations have been made regarding which devices and systems should be used for specific diseases.
    The aim of this review was to map and assess previous studies on the use of information communications technology, smartphones, and apps for treating patients with vertigo and discuss the added value of introducing telemedicine to improve the quality of medical care and create an environment that builds security and trust among patients.
    A scoping review was conducted with the methodological framework of Arksey and O\'Malley and in accordance with the of the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews) guidelines. The PubMed, MEDLINE, and Cochrane Library databases were searched to retrieve previous reports on smartphone-assisted telemedicine treatment for vertigo published between January 2000 and May 2023. Two authors independently assessed eligibility and extracted data.
    This review included 20 papers that reported devices or systems for telemedicine for vestibular dysfunction. Among studies that reported the use of a device or app, 2 were related to anamnesis and subjective symptoms, 12 were related to objective examination, 7 were related to remote diagnosis, and 7 were related to treatment and rehabilitation.
    With the advancement of technology, the use of telemedicine in patients with dizziness may be feasible. In the future, it will be necessary to consider how telemedicine can be used in dizziness treatment and develop an effective treatment system combining in-person medical care and the effective use of devices for the management of severe vertigo and related diseases. The smooth introduction of telemedicine in vertigo treatment is expected to improve the quality of treatment, increase opportunities for patients to receive medical care, and reduce time and travel costs, leading to a sense of security and trust among patients.
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  • 文章类型: Journal Article
    自从2019年冠状病毒病流行导致学生的心理健康问题,如压力,焦虑,甚至抑郁症。减少青少年心理健康问题的干预措施需要以数字方式进行,以减少2019年冠状病毒病的传播。这项研究的目的是探索数字治疗的方法,以减少2019年冠状病毒病期间学生的焦虑和抑郁症状。本研究采用范围审查研究设计。来自NAHL的研究数据库,PubMed,和Scopus数据库。本研究使用PRISMA扩展进行范围审查(PRISMA-ScR),并使用JBI质量评估进行质量评估。本研究的文章纳入标准为全文,随机对照试验或准实验研究设计,英语语言,学生样本,以及COVID-19大流行期间的发布期(2019-2022年)。发现有13篇讨论数字治疗的文章,发现减少焦虑和抑郁的数字治疗模型包括通过数字模块进行指导,通过视频的方向,和异步讨论通过在线会议。本研究的样本范围为37-1986名学生。大部分文章来自发达国家。数字治疗的交付服务包括三个阶段,即心理教育,解决问题,和实施解决问题的策略。作者发现有四种数字治疗方法,即提高心理能力,偏见改变干预,自助干预,正念干预。数字化治疗的实施还是要注意影响学生的各个方面,所以治疗师需要注意身体,心理,精神,和文化方面。在这里我们强调,在COVID-19大流行期间,通过关注影响学生的所有方面,数字治疗干预措施被证明可以通过降低学生的抑郁和焦虑水平来改善心理健康。
    The learning method has changed from offline to online since Coronavirus Disease 2019 pandemic cause mental health problems in students such as stress, anxiety, and even depression. Interventions to reduce mental health problems in adolescents need to be carried out digitally to reduce the transmission of Coronavirus Disease 2019. The purpose of this study is to explore methods of digital therapy to reduce symptoms of anxiety and depression among students during the Coronavirus Disease 2019. A scoping review study design was used in this study. Database the study from CINAHL, PubMed, and Scopus databases. This study used PRISMA Extension for Scoping Reviews (PRISMA-ScR) and for quality appraisal used JBI Quality Appraisal. The inclusion criteria for articles in this study are full text, randomized control trial or quasi-experiment research design, English language, students sample, and the publication period during COVID-19 pandemic (2019-2022). There were found 13 articles discussing digital therapy and it was found that the digital therapy model to reduce anxiety and depression includes directions through digital modules, directions via video, and asynchronous discussions via online meeting. The sample range in this study is 37-1986 students. Most of the articles come from developed countries. Delivery services of digital therapy consist of three phases, namely psycho-education, problem-solving, and implementation of problem-solving strategies. The authors found that there are four digital therapy methods, namely Improving psychological abilities, Bias-modification intervention, Self-help intervention, and Mindfulness intervention. The implementation of digital therapy must still pay attention to various aspects that affect students, so that therapists need to pay attention to physical, psychological, spiritual, and cultural aspects. Here we highlight, digital therapy interventions are proven for improving mental health by reducing depression and anxiety levels among students during the COVID-19 pandemic by paying attention to all aspects that affect students.
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  • 文章类型: Journal Article
    背景:下腰痛(LBP)是全球因残疾而损失数年的主要原因,给医疗系统带来巨大的经济负担。数字治疗护理(DTC)计划提供可扩展、普遍可及,以及LBP多学科治疗的低成本方法。此外,新颖的决策支持干预措施,如个性化反馈消息,推送通知,和数据驱动的活动建议通过指导用户完成计划,同时旨在提高整体参与度和可持续的行为改变,从而放大DTC。
    目的:本系统综述旨在综合有关DTC应用对LBP患者的影响的最新科学文献,并概述附加决策支持干预措施的实施。包括它们对用户保留率和流失率的影响。
    方法:我们搜索了书目数据库,包括MEDLINE,科克伦图书馆,WebofScience,和物理治疗证据数据库,从2016年3月1日至2020年10月15日,根据PRISMA(系统审查和荟萃分析的首选报告项目)指南,并根据先前发表的相关系统审查进行了本审查。除了随机对照试验(RCTs),我们还纳入了至少一项回顾性比较研究的证据水平的研究设计.这使得能够考虑现实世界的用户生成的数据,并提供有关在现实环境中DTC应用程序的采用和有效性的信息。对于偏差风险的评估,我们在随机对照试验和非随机试验的干预工具的非随机研究中使用了偏差风险2工具和偏差风险,分别。纳入的研究是关于主要和次要结局指标的叙述性综合,DTC部件,应用决策支持干预措施,用户保留,和流失率。
    结果:我们检索到1388条引文,其中12项研究纳入本综述。在12项研究中,6项(50%)为随机对照试验,6项(50%)为非随机试验。在所有纳入的研究中,与基线值相比,DTC干预组的疼痛水平降低,功能增强.组间比较显示,67%(4/6)的随机对照试验显示疼痛和功能水平显著改善。研究人群大多是同质的,以女性为主,正常至中等体重的年轻至中年参与者。方法学质量评估揭示了中度到高度的偏差风险,尤其是在非随机试验中。
    结论:本系统评价显示DTC对LBP患者的益处。还有证据表明,决策支持干预措施有利于应用程序的整体参与,并提高参与者自我管理恢复过程的能力。最后,在未来对数字健康干预试验的系统评价中,包括对现实世界用户生成数据的回顾性评估研究,可以揭示对益处的新见解,挑战,以及DTC程序的实际采用。
    BACKGROUND: Low back pain (LBP) is the leading cause of worldwide years lost because of disability, with a tremendous economic burden for health care systems. Digital therapeutic care (DTC) programs provide a scalable, universally accessible, and low-cost approach to the multidisciplinary treatment of LBP. Moreover, novel decision support interventions such as personalized feedback messages, push notifications, and data-driven activity recommendations amplify DTC by guiding the user through the program while aiming to increase overall engagement and sustainable behavior change.
    OBJECTIVE: This systematic review aims to synthesize recent scientific literature on the impact of DTC apps for people with LBP and outline the implementation of add-on decision support interventions, including their effect on user retention and attrition rates.
    METHODS: We searched bibliographic databases, including MEDLINE, Cochrane Library, Web of Science, and the Physiotherapy Evidence Database, from March 1, 2016, to October 15, 2020, in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and conducted this review based on related previously published systematic reviews. Besides randomized controlled trials (RCTs), we also included study designs with the evidence level of at least a retrospective comparative study. This enables the consideration of real-world user-generated data and provides information regarding the adoption and effectiveness of DTC apps in a real-life setting. For the appraisal of the risk of bias, we used the Risk of Bias 2 Tool and the Risk of Bias in Non-Randomized Studies of Interventions Tool for the RCTs and nonrandomized trials, respectively. The included studies were narratively synthesized regarding primary and secondary outcome measures, DTC components, applied decision support interventions, user retention, and attrition rates.
    RESULTS: We retrieved 1388 citations, of which 12 studies are included in this review. Of the 12 studies, 6 (50%) were RCTs and 6 (50%) were nonrandomized trials. In all included studies, lower pain levels and increased functionality compared with baseline values were observed in the DTC intervention group. A between-group comparison revealed significant improvements in pain and functionality levels in 67% (4/6) of the RCTs. The study population was mostly homogeneous, with predominantly female, young to middle-aged participants of normal to moderate weight. The methodological quality assessment revealed moderate to high risks of biases, especially in the nonrandomized trials.
    CONCLUSIONS: This systematic review demonstrates the benefits of DTC for people with LBP. There is also evidence that decision support interventions benefit overall engagement with the app and increase participants\' ability to self-manage their recovery process. Finally, including retrospective evaluation studies of real-world user-generated data in future systematic reviews of digital health intervention trials can reveal new insights into the benefits, challenges, and real-life adoption of DTC programs.
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  • 文章类型: Journal Article
    The objective of this study is to compare game-based digital therapeutic device and other DHI like (smartphone apps, wearable technologies) for ADHD with the current pharmacological and behavior therapy. The FDA has approved a game-based digital therapeutic device - EndeavorRx, for the treatment of ADHD in pediatric patients belonging to the age group of 8-12 years old. This has been primarily recommended for the treatment of inattentive or combined-type ADHD who have demonstrated an attention issue. This is the first game-based therapeutic device to be approved by the FDA for any type of condition. According to the FDA, this has been shown to improve attention which is measured by computer-based testing. Objective: The objective of this study is to compare a game-based digital therapeutic device and other DHI (smartphone apps, wearable technologies) with the current pharmacological and behavior therapy used in the treatment of ADHD.
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  • 文章类型: Journal Article
    回顾了有关精神病和妄想中推理偏见的最新文献。简要总结了从系统评价和荟萃分析中得出的最新知识,以得出结论。在更全面地讨论最近关于信仰灵活性应用于妄想的实证文献之前。将对与整个妄想连续体的信念灵活性和反对不确定证据的偏见(BADE)研究有关的方法和证据进行严格评估,以及对改善认知疗法的启示。将提出推理的双重过程模型,其中卡尼曼(卡尼曼,2011)被推广为“快速和慢速思维”,为整合进一步研究和指导临床实践提供有用的理论框架。将描述专门针对患有痛苦妄想的人的快速和慢速思维的疗法的出现。
    The recent literature on reasoning biases in psychosis and delusions is reviewed. The state-of-the-art knowledge from systematic reviews and meta-analyses on the evidence for jumping to conclusions is briefly summarised, before a fuller discussion of the more recent empirical literature on belief flexibility as applied to delusions. The methodology and evidence in relation to studies of belief flexibility and the Bias Against Disconfirmatory Evidence (BADE) across the delusional continuum will be critically appraised, and implications drawn for improving cognitive therapy. It will be proposed that dual process models of reasoning, which Kahneman (Kahneman, 2011) popularised as \'fast and slow thinking\', provide a useful theoretical framework for integrating further research and informing clinical practice. The emergence of therapies which specifically target fast and slow thinking in people with distressing delusions will be described.
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