@Article{info:doi/10.2196/63964, author="Mushcab, Hayat and Al Ramis, Mohammed and AlRujaib, Abdulrahman and Eskandarani, Rawan and Sunbul, Tamara and AlOtaibi, Anwar and Obaidan, Mohammed and Al Harbi, Reman and Aljabri, Duaa", title="Application of Artificial Intelligence in Cardio-Oncology Imaging for Cancer Therapy--Related Cardiovascular Toxicity: Systematic Review", journal="JMIR Cancer", year="2025", month="May", day="9", volume="11", pages="e63964", keywords="artificial intelligence", keywords="cardiology", keywords="oncology", keywords="cancer therapy--induced", keywords="cardiotoxicity", keywords="cardiovascular toxicity", keywords="machine learning", keywords="imaging", keywords="radiology", abstract="Background: Artificial intelligence (AI) is a revolutionary tool yet to be fully integrated into several health care sectors, including medical imaging. AI can transform how medical imaging is conducted and interpreted, especially in cardio-oncology. Objective: This study aims to systematically review the available literature on the use of AI in cardio-oncology imaging to predict cardiotoxicity and describe the possible improvement of different imaging modalities that can be achieved if AI is successfully deployed to routine practice. Methods: We conducted a database search in PubMed, Ovid MEDLINE, Cochrane Library, CINAHL, and Google Scholar from inception to 2023 using the AI research assistant tool (Elicit) to search for original studies reporting AI outcomes in adult patients diagnosed with any cancer and undergoing cardiotoxicity assessment. Outcomes included incidence of cardiotoxicity, left ventricular ejection fraction, risk factors associated with cardiotoxicity, heart failure, myocardial dysfunction, signs of cancer therapy--related cardiovascular toxicity, echocardiography, and cardiac magnetic resonance imaging. Descriptive information about each study was recorded, including imaging technique, AI model, outcomes, and limitations. Results: The systematic search resulted in 7 studies conducted between 2018 and 2023, which are included in this review. Most of these studies were conducted in the United States (71\%), included patients with breast cancer (86\%), and used magnetic resonance imaging as the imaging modality (57\%). The quality assessment of the studies had an average of 86\% compliance in all of the tool's sections. In conclusion, this systematic review demonstrates the potential of AI to enhance cardio-oncology imaging for predicting cardiotoxicity in patients with cancer. Conclusions: Our findings suggest that AI can enhance the accuracy and efficiency of cardiotoxicity assessments. However, further research through larger, multicenter trials is needed to validate these applications and refine AI technologies for routine use, paving the way for improved patient outcomes in cancer survivors at risk of cardiotoxicity. Trial Registration: PROSPERO CRD42023446135; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023446135 ", doi="10.2196/63964", url="https://cancer.jmir.org/2025/1/e63964" } @Article{info:doi/10.2196/64208, author="Liao, Wan-Chuen and Angus, Fiona and Conley, Jane and Chen, Li-Chia", title="The Efficacy of Digital Interventions on Adherence to Oral Systemic Anticancer Therapy Among Patients With Cancer: Systematic Review and Meta-Analysis", journal="JMIR Cancer", year="2025", month="Apr", day="16", volume="11", pages="e64208", keywords="efficacy", keywords="digital interventions", keywords="oral systemic anticancer therapy", keywords="medication adherence", keywords="cancer", keywords="oral", keywords="patients with cancer", keywords="therapy", keywords="systematic review", keywords="meta-analysis", keywords="care plans", keywords="medication", keywords="treatments", keywords="mobile app", keywords="mobile applications", keywords="mHealth", keywords="multimedia platforms", keywords="digital technology", keywords="self-reported", keywords="mobile phone", abstract="Background: Digital interventions have been increasingly applied in multidisciplinary care plans to improve medication adherence to oral systemic anticancer therapy (SACT), the crucial lifesaving treatments for many cancers. However, there is still a lack of consensus on the efficacy of those digital interventions. Objectives: This systematic review and meta-analysis aimed to investigate the efficacy of digital interventions in improving adherence to oral SACTs in patients with cancer. Methods: This systematic review and meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guidelines. The protocol has been registered at PROSPERO (no. CRD42024550203). Fully published, randomized controlled trials (RCTs) in English on adults with cancer assessing digital interventions for improving adherence to oral SACTs were retrieved from MEDLINE, Embase, APA PsycINFO, and CINAHL Plus up to May 31, 2024. Adherence measures compared between digital intervention users and nonusers were extracted. The proportions of poor adherence were synthesized using a random-effects model. The pooled results were reported as the odds ratio and 95\% CI. The heterogeneity was assessed with the I2 test (\%). The mean difference and 95\% CI were calculated from the mean adherence score and SD. A risk of bias assessment was conducted using version 2 of the Cochrane Risk of Bias Assessment Tool (RoB 2) for RCTs, which ensured that a quality assessment of all included studies was conducted as recommended by the Cochrane Collaboration. Results: This study included 13 RCTs on digital interventions for improving adherence to oral SACTs in patients with cancer. The 13 RCTs, published between 2016 and 2024, were conducted in the United States, South Korea, France, Egypt, Finland, Australia, Colombia, Singapore, and Turkey. The technologies used were mobile apps (n=4), reminder systems (n=4), telephone follow-ups (n=3), and interactive multimedia platforms (n=2). Adherence was measured by surveys (n=8), relative dose intensity (n=2), pill count (n=1), self-reported missed doses (n=1), a smart pill bottle (n=1), and urine aromatase inhibitor metabolite assays (n=1). Concerns regarding risk of bias primarily involved randomization, missing outcome data, and outcome measurement, including nonblinded randomization, subjective patient-reported data, and difficulties in distinguishing between missed appointments and actual medication nonadherence. Pooled results from 11 trials showed that digital technology users had significantly lower risk of poor adherence (odds ratio 0.60, 95\% CI 0.47?0.77). Two studies reported positive mean differences in adherence scores comparing digital intervention users and nonusers. However, due to considerable heterogeneity (I{\texttwosuperior}=73.1\%), it is difficult to make a definitive conclusion from the pooled results about the effect of digital interventions upon adherence to oral anticancer therapy. Conclusions: Digital intervention users exhibited significantly lower risk of poor oral SACTs adherence than nonusers. Acknowledging individual variation and tailoring digital technologies to prioritize patient needs is essential. Trial Registration: PROSPERO CRD42024550203; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024550203 ", doi="10.2196/64208", url="https://cancer.jmir.org/2025/1/e64208" } @Article{info:doi/10.2196/65984, author="Chen, David and Alnassar, Addeen Saif and Avison, Elizabeth Kate and Huang, S. Ryan and Raman, Srinivas", title="Large Language Model Applications for Health Information Extraction in Oncology: Scoping Review", journal="JMIR Cancer", year="2025", month="Mar", day="28", volume="11", pages="e65984", keywords="artificial intelligence", keywords="chatbot", keywords="data extraction", keywords="AI", keywords="conversational agent", keywords="health information", keywords="oncology", keywords="scoping review", keywords="natural language processing", keywords="NLP", keywords="large language model", keywords="LLM", keywords="digital health", keywords="health technology", keywords="electronic health record", abstract="Background: Natural language processing systems for data extraction from unstructured clinical text require expert-driven input for labeled annotations and model training. The natural language processing competency of large language models (LLM) can enable automated data extraction of important patient characteristics from electronic health records, which is useful for accelerating cancer clinical research and informing oncology care. Objective: This scoping review aims to map the current landscape, including definitions, frameworks, and future directions of LLMs applied to data extraction from clinical text in oncology. Methods: We queried Ovid MEDLINE for primary, peer-reviewed research studies published since 2000 on June 2, 2024, using oncology- and LLM-related keywords. This scoping review included studies that evaluated the performance of an LLM applied to data extraction from clinical text in oncology contexts. Study attributes and main outcomes were extracted to outline key trends of research in LLM-based data extraction. Results: The literature search yielded 24 studies for inclusion. The majority of studies assessed original and fine-tuned variants of the BERT LLM (n=18, 75\%) followed by the Chat-GPT conversational LLM (n=6, 25\%). LLMs for data extraction were commonly applied in pan-cancer clinical settings (n=11, 46\%), followed by breast (n=4, 17\%), and lung (n=4, 17\%) cancer contexts, and were evaluated using multi-institution datasets (n=18, 75\%). Comparing the studies published in 2022?2024 versus 2019?2021, both the total number of studies (18 vs 6) and the proportion of studies using prompt engineering increased (5/18, 28\% vs 0/6, 0\%), while the proportion using fine-tuning decreased (8/18, 44.4\% vs 6/6, 100\%). Advantages of LLMs included positive data extraction performance and reduced manual workload. Conclusions: LLMs applied to data extraction in oncology can serve as useful automated tools to reduce the administrative burden of reviewing patient health records and increase time for patient-facing care. Recent advances in prompt-engineering and fine-tuning methods, and multimodal data extraction present promising directions for future research. Further studies are needed to evaluate the performance of LLM-enabled data extraction in clinical domains beyond the training dataset and to assess the scope and integration of LLMs into real-world clinical environments. ", doi="10.2196/65984", url="https://cancer.jmir.org/2025/1/e65984" } @Article{info:doi/10.2196/65820, author="Song, Gao and Zhang, Cai-qiong and Bai, Zhong-ping and Li, Rong and Cheng, Meng-qun", title="Assisted Reproductive Technology and Risk of Childhood Cancer Among the Offspring of Parents With Infertility: Systematic Review and Meta-Analysis", journal="JMIR Cancer", year="2025", month="Mar", day="12", volume="11", pages="e65820", keywords="assisted reproductive technology", keywords="childhood cancer", keywords="infertility", keywords="subfertile", keywords="risks", keywords="systematic review", abstract="Background: The relationship between assisted reproductive technology (ART) and childhood cancer risk has been widely debated. Previous meta-analyses did not adequately account for the impact of infertility, and this study addresses this gap. Objective: Our primary objective was to assess the relative risk (RR) of childhood cancer in infertile populations using ART versus non-ART offspring, with a secondary focus on comparing frozen embryo transfer (FET) and fresh embryo transfer (fresh-ET). Methods: A literature review was conducted through PubMed, Embase, Cochrane, and Web of Science, with a cutoff date of July 10, 2024. The study was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY 202470119). Inclusion criteria were based on the PICOS (Population, Intervention, Comparison, Outcomes, and Study Design) framework: infertile or subfertile couples (population), ART interventions (in vitro fertilization [IVF], intracytoplasmic sperm injection [ICSI], FET, and fresh-ET), non-ART comparison, and childhood cancer risk outcomes. Data abstraction focused on the primary exposures (ART vs non-ART and FET vs fresh-ET) and outcomes (childhood cancer risk). The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale, and the evidence quality was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Pooled estimates and 95\% CIs were calculated using random effects models. Results: A total of 18 studies were included, published between 2000 and 2024, consisting of 14 (78\%) cohort studies and 4 (22\%) case-control studies, all of which were of moderate to high quality. The cohort studies had follow-up periods ranging from 3 to 18 years. Compared with non-ART conception, ART conception was not significantly associated with an increased risk of childhood overall cancer (RR 0.95, 95\% CI 0.71?1.27; GRADE quality: low to moderate). Subgroup analyses of IVF (RR 0.86, 95\% CI 0.59?1.25), ICSI (RR 0.76, 95\% CI 0.26?2.2), FET (RR 0.98, 95\% CI 0.54?1.76), and fresh-ET (RR 0.75, 95\% CI 0.49?1.15) showed similar findings. No significant differences were found for specific childhood cancers, including leukemia (RR 0.99, 95\% CI 0.79?1.24), lymphoma (RR 1.22, 95\% CI 0.64?2.34), brain cancer (RR 1.22, 95\% CI 0.73?2.05), embryonal tumors (RR 1, 95\% CI 0.63?1.58), retinoblastoma (RR 1.3, 95\% CI 0.73?2.31), and neuroblastoma (RR 1.02, 95\% CI 0.48?2.16). Additionally, no significant difference was observed in a head-to-head comparison of FET versus fresh-ET (RR 0.99, 95\% CI 0.86?1.14; GRADE quality: moderate). Conclusions: In conclusion, this study found no significant difference in the risk of childhood cancer between offspring conceived through ART and those conceived through non-ART treatments (such as fertility drugs or intrauterine insemination) in infertile populations. While infertility treatments may elevate baseline risks, our findings suggest that whether individuals with infertility conceive using ART or non-ART methods, their offspring do not face a significantly higher risk of childhood cancer. Further research, especially comparing infertile populations who conceive naturally, is needed to better understand potential long-term health outcomes. Trial Registration: INPLASY 202470119; https://inplasy.com/?s=202470119 ", doi="10.2196/65820", url="https://cancer.jmir.org/2025/1/e65820" } @Article{info:doi/10.2196/50662, author="Ng, Shin Krystal Lu and Munisamy, Murallitharan and Lim, Yin Joanne Bee and Alshagga, Mustafa", title="The Effect of Nutritional Mobile Apps on Populations With Cancer: Systematic Review", journal="JMIR Cancer", year="2025", month="Feb", day="5", volume="11", pages="e50662", keywords="cancer", keywords="mobile app", keywords="nutrition", keywords="body composition", keywords="quality of life", keywords="mobile health", keywords="mHealth", keywords="diet", keywords="intervention", keywords="mobile phone", keywords="PRISMA", abstract="Background: Limited access to nutrition support among populations with cancer is a major barrier to sustainable and quality cancer care. Increasing use of mobile health in health care has raised concerns about its validity and health impacts. Objective: This systematic review aimed to determine the effectiveness of commercial or cancer-specific nutritional mobile apps among people living with cancer. Methods: A systematic search of the CENTRAL, Embase, PubMed (MEDLINE), and Scopus databases was carried out in May 2024. All types of intervention studies were included, except observational studies, gray literature, and reference lists of key systematic reviews. Studies were eligible for inclusion if they involved (1) patients with or survivors of cancer and (2) nutrition-related mobile apps. Studies were excluded if the nutrition intervention was not delivered via mobile app or the app intervention was accompanied by dietary counseling. The review process was conducted based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Risk of Bias 2 and Risk of Bias in Nonrandomized Studies tools were used to assess the study quality. The Cochrane Review Manager (version 5.4) software was used to synthesize the results of the bias assessment. Results: A total of 13 interventions were included, comprising 783 adults or teenagers with cancer. Most studies focused on breast cancer (6/13, 46\%), overweight (6/13, 46\%), and survivors (9/13, 69\%). Data on anthropometry and body composition (7/13, 54\%; 387 participants), nutritional status (3/13, 23\%; 249 participants), dietary intake (7/13, 54\%; 352 participants), and quality of life (6/13, 46\%; 384 participants) were gathered. Experimental groups were more likely to report significant improvements in body weight or composition, dietary compliance, nutritional status, and quality of life than control groups. Conclusions: Although mobile app platforms are used to deliver nutrition interventions, the evidence for long-term efficacy, particularly in populations with cancer, remains elusive. More robust randomized controlled trials with larger sample sizes, as well as more homogeneous population characteristics and outcome measures, are warranted. Trial Registration: PROSPERO CRD42023330575; https://tinyurl.com/55v56yaj ", doi="10.2196/50662", url="https://cancer.jmir.org/2025/1/e50662" } @Article{info:doi/10.2196/56791, author="Mourato, Beatriz Maria and Pratas, Nuno and Branco Pereira, Andreia and Tar{\'e}, Filipa and Chan{\c{c}}a, Raphael and Fronteira, In{\^e}s and Dinis, Rui and Areia, Miguel", title="Effectiveness of Gastric Cancer Endoscopic Screening in Intermediate-Risk Countries: Protocol for a Systematic Review and Meta-Analysis", journal="JMIR Res Protoc", year="2025", month="Feb", day="3", volume="14", pages="e56791", keywords="gastric cancers", keywords="endoscopic screening", keywords="intermediate-risk countries", keywords="neoplasia", keywords="early detection", keywords="diagnosis", keywords="cancer screening", keywords="survival", keywords="meta-analysis", keywords="gastrointestinal cancers", abstract="Background: Gastric cancer (GC) is the fifth most prevalent neoplasm worldwide and the fourth with the highest mortality, and its geographical distribution is not homogeneous with high-risk, intermediate-risk (IR), and low-risk areas. Advanced stages at diagnosis are related to high mortality, but early detection greatly increases the chances of survival. Upper endoscopy with biopsy is the gold standard for GC diagnosis. Several studies have investigated the relevance of endoscopic screening and how to implemente it in IR countries. However, most Western societies recommend screening only in selected populations with high-risk factors for GC. No systematic reviews on GC endoscopic screening in IR countries exist. Objective: We aimed to determine the effectiveness of endoscopic GC screening in IR countries. Methods: We will include randomized and nonrandomized controlled trials, cohort studies, case-control studies, cross-sectional studies, and economic studies focusing on endoscopic screening of GC in the asymptomatic population of IR countries. The search will be conducted in MEDLINE, SCOPUS, Embase, and Web of Science. Other gray literature sources will be additionally searched. Studies published in English, Portuguese, or Spanish until September 2024 will be included. Two independent reviewers will screen the titles and abstracts of all search results. The selected studies will then be fully analyzed, and the data will be collected and coded in a database. To minimize the risk of bias, the included studies will undergo a quality analysis according to Cochrane risk of bias tools, RoB 2 of randomized trials and ROBINS-I for nonrandomized trials; Newcastle-Ottawa Quality Assessment Scale for case-control and cohort studies; and National Heart, Lung and Blood Institute study quality assessment tools for cross-sectional studies. The data collected will be cataloged in 2 categories: efficacy or effectiveness data and economic data, and separate meta-analyses will be performed for each category if appropriate. Results: This study is expected to provide results on the efficacy, effectiveness, and cost-effectiveness of endoscopic screening in an IR population. To date, 969 studies were screened for title and abstract, 75 were selected for full-text screening, and 44 were retained for data analysis. Additionally, 2 studies were selected from our manual search. Currently, the study is in the early stages of data extraction and risk of bias assessment and is expected to be published in the first quarter of 2025. Conclusions: To our knowledge, this review will be the first to provide evidence on the effectiveness of endoscopic GC screening in IR countries. In doing so, we believe we will help guide future research, inform health care decisions and assist policy makers in this area, and support future decisions to implement GC screening programs in this type of population. Trial Registration: PROSPERO CRD42024502174; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=502174 International Registered Report Identifier (IRRID): DERR1-10.2196/56791 ", doi="10.2196/56791", url="https://www.researchprotocols.org/2025/1/e56791", url="http://www.ncbi.nlm.nih.gov/pubmed/39545590" } @Article{info:doi/10.2196/54154, author="Komariah, Maria and Maulana, Sidik and Amirah, Shakira and Platini, Hesti and Rahayuwati, Laili and Yusuf, Ah and Firdaus, Hasymi Mohd Khairul Zul", title="Benefits of Remote-Based Mindfulness on Physical Symptom Outcomes in Cancer Survivors: Systematic Review and Meta-Analysis", journal="JMIR Cancer", year="2025", month="Jan", day="16", volume="11", pages="e54154", keywords="cancer", keywords="physical symptoms", keywords="mindfulness", keywords="remote-based intervention", keywords="quality of life", abstract="Background: Many cancer survivors experience a wide range of symptoms closely linked to psychological problems, highlighting the need for psychological treatment, one of the most popular being mindfulness. The use of the internet has greatly increased in the last decade, and has encouraged the use of remote-based interventions to help people living with cancer access treatment remotely via devices. Objective: The primary aim of this study was to explore the efficacy of internet-based mindfulness interventions on the physical symptoms of people living with cancer, where physical symptoms are defined as distressing somatic experiences (eg fatigue, insomnia, and pain) regardless of the underlying cause. The secondary aim was to investigate interventions for the quality of life (QoL). Methods: This study followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Relevant articles were systematically searched using electronic databases, namely Scopus, Medline through PubMed, Cumulated Index in Nursing and Allied Health Literature (CINAHL) through EBSCOhost, and Cochrane Central Database. Randomized controlled and pilot trials involving adults and/or older adults with cancer and using remote-based mindfulness interventions compared to usual care were included. The quality of the trials included in this study was assessed using the revised Cochrane risk of bias, version 2.0. This study estimated the standardized mean difference (SMD) and mean difference (MD) with 95\% CI. The I2 test was used to identify potential causes of heterogeneity. Publication bias was assessed using contour-enhanced funnel plots and the Egger linear regression test to reveal a small study effect. Results: The initial search yielded 1985 records, of which 13 studies were ultimately included. After treatment, remote-based mindfulness significantly reduced fatigue (SMD ?0.94; 95\% CI: ?1.56 to ?0.33; P=.002), sleep disturbance (SMD ?0.36; 95\% CI: ?0.60 to ?0.12; P=.004), and improved physical function (SMD .25; 95\% CI: 0.09 to 0.41; P=.002) compared to that observed before treatment. However, compared with usual care, remote-based mindfulness showed a statistically significant reduction only in sleep disturbance (SMD: ?0.37; 95\% CI: ?0.58 to ?0.16; P=.0006) after treatment. Moreover, remote-based mindfulness was not statistically significant in reducing pain both within and between groups. Conclusions: Remote-based mindfulness shows promise in reducing sleep disturbances; however, its impact on fatigue, pain, and physical function may be limited. ", doi="10.2196/54154", url="https://cancer.jmir.org/2025/1/e54154" } @Article{info:doi/10.2196/59061, author="Zhu, Siying and Dong, Yan and Li, Yumei and Wang, Hong and Jiang, Xue and Guo, Mingen and Fan, Tiantian and Song, Yalan and Zhou, Ying and Han, Yuan", title="Experiences of Patients With Cancer Using Electronic Symptom Management Systems: Qualitative Systematic Review and Meta-Synthesis", journal="J Med Internet Res", year="2024", month="Oct", day="28", volume="26", pages="e59061", keywords="electronic symptom management systems", keywords="oncology care", keywords="access to care", keywords="symptom monitoring", keywords="self-management", keywords="patient-reported outcomes", keywords="health-related outcomes", keywords="quality of life", abstract="Background: There are numerous symptoms related to cancer and its treatments that can affect the psychosomatic health and quality of life of patients with cancer. The use of electronic symptom management systems (ESMSs) can help patients with cancer monitor and manage their symptoms effectively, improving their health-related outcomes. However, patients' adhesion to ESMSs decreases over time, and little is known about their real experiences with them. Therefore, it is necessary to gain a deep understanding of patients' experiences with ESMSs. Objective: The purpose of this systematic review was to synthesize qualitative studies on the experiences of patients with cancer using ESMSs. Methods: A total of 12 electronic databases, including PubMed, Web of Science, Cochrane Library, EBSCOhost, Embase, PsycINFO, ProQuest, Scopus, Wanfang database, CNKI, CBM, and VIP, were searched to collect relevant studies from the earliest available record until January 2, 2024. Qualitative and mixed methods studies published in English or Chinese were included. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement checklist) and the ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) statement were used to improve transparency in reporting the synthesis of the qualitative research. The Critical Appraisal Skills Program (CASP) checklist was used to appraise the methodological quality of the included studies, and a meta-synthesis was conducted to interpret and synthesize the findings. Results: A total of 21 studies were included in the meta-synthesis. The experiences of patients with cancer using ESMSs were summarized into three major categories: (1) perceptions and attitudes toward ESMSs; (2) the value of ESMSs; and (3) barriers, requirements, and suggestions for ESMSs. Subsequently, 10 subcategories emerged from the 3 major categories. The meta-synthesis revealed that patients with cancer had both positive and negative experiences with ESMSs. In general, patients recognized the value of ESMSs in symptom assessment and management and were willing to use them, but they still encountered barriers and wanted them to be improved. Conclusions: This systematic review provides implications for developing future ESMSs that improve health-related outcomes for patients with cancer. Future research should focus on strengthening electronic equipment and technical support for ESMSs, improving their functional contents and participation forms, and developing personalized applications tailored to the specific needs and characteristics of patients with cancer. Trial Registration: PROSPERO CRD42023421730; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=421730 ", doi="10.2196/59061", url="https://www.jmir.org/2024/1/e59061", url="http://www.ncbi.nlm.nih.gov/pubmed/39466301" } @Article{info:doi/10.2196/56935, author="McLoughlin, E. Daniel and Moreno Echevarria, M. Fabiola and Badawy, M. Sherif", title="Lessons Learned From Shared Decision-Making With Oral Anticoagulants: Viewpoint on Suggestions for the Development of Oral Chemotherapy Decision Aids", journal="JMIR Cancer", year="2024", month="Sep", day="11", volume="10", pages="e56935", keywords="shared decision-making", keywords="SDM", keywords="decision aids", keywords="decision aids design", keywords="oral chemotherapy", keywords="oral anticoagulants", keywords="drug delivery", keywords="chemotherapy", keywords="chemo", keywords="anticoagulants", keywords="drug deliveries", keywords="cancer", keywords="oncology", keywords="oncologist", keywords="metastases", keywords="literature review", keywords="literature reviews", doi="10.2196/56935", url="https://cancer.jmir.org/2024/1/e56935", url="http://www.ncbi.nlm.nih.gov/pubmed/39187430" } @Article{info:doi/10.2196/56969, author="Goncalves Leite Rocco, Patricia and Reategui-Rivera, Mahony C. and Finkelstein, Joseph", title="Telemedicine Applications for Cancer Rehabilitation: Scoping Review", journal="JMIR Cancer", year="2024", month="Aug", day="21", volume="10", pages="e56969", keywords="telerehabilitation", keywords="telemedicine", keywords="rehabilitation", keywords="cancer", keywords="exercise", keywords="physical therapy", keywords="telehealth", keywords="remote care", keywords="digital medicine", keywords="oncology", keywords="oncologist", keywords="metastases", keywords="exercising", keywords="scoping review", keywords="scoping reviews", keywords="PubMed", abstract="Background: Cancer is a significant public health issue worldwide. Treatments such as surgery, chemotherapy, and radiation therapy often cause psychological and physiological side effects, affecting patients' ability to function and their quality of life (QoL). Physical activity is crucial to cancer rehabilitation, improving physical function and QoL and reducing cancer-related fatigue. However, many patients face barriers to accessing cancer rehabilitation due to socioeconomic factors, transportation issues, and time constraints. Telerehabilitation can potentially overcome these barriers by delivering rehabilitation remotely. Objective: The aim of the study is to identify how telemedicine is used for the rehabilitation of patients with cancer. Methods: This scoping review followed recognized frameworks. We conducted an electronic literature search on PubMed for studies published between January 2015 and May 2023. Inclusion criteria were studies reporting physical therapy telerehabilitation interventions for patients with cancer, including randomized and nonrandomized controlled trials, feasibility studies, and usability studies. In total, 21 studies met the criteria and were included in the final review. Results: Our search yielded 37 papers, with 21 included in the final review. Randomized controlled trials comprised 47\% (n=10) of the studies, with feasibility studies at 33\% (n=7) and usability studies at 19\% (n=4). Sample sizes were typically 50 or fewer participants in 57\% (n=12) of the reports. Participants were generally aged 65 years or younger (n=17, 81\%), with a balanced gender distribution. Organ-specific cancers were the focus of 66\% (n=14) of the papers, while 28\% (n=6) included patients who were in the posttreatment period. Web-based systems were the most used technology (n=13, 61\%), followed by phone call or SMS text messaging--based systems (n=9, 42\%) and mobile apps (n=5, 23\%). Exercise programs were mainly home based (n=19, 90\%) and included aerobic (n=19, 90\%), resistance (n=13, 61\%), and flexibility training (n=7, 33\%). Outcomes included improvements in functional capacity, cognitive functioning, and QoL (n=10, 47\%); reductions in pain and hospital length of stay; and enhancements in fatigue, physical and emotional well-being, and anxiety. Positive effects on feasibility (n=3, 14\%), acceptability (n=8, 38\%), and cost-effectiveness (n=2, 9\%) were also noted. Functional outcomes were frequently assessed (n=19, 71\%) with tools like the 6-minute walk test and grip strength tests. Conclusions: Telerehabilitation for patients with cancer is beneficial and feasible, with diverse approaches in study design, technologies, exercises, and outcomes. Future research should focus on developing standardized methodologies, incorporating objective measures, and exploring emerging technologies like virtual reality, wearable or noncontact sensors, and artificial intelligence to optimize telerehabilitation interventions. Addressing these areas can enhance clinical practice and improve outcomes for remote rehabilitation with patients. ", doi="10.2196/56969", url="https://cancer.jmir.org/2024/1/e56969", url="http://www.ncbi.nlm.nih.gov/pubmed/39079103" } @Article{info:doi/10.2196/49089, author="Perry, Betty Melissa and Taylor, Sally and Khatoon, Binish and Vercell, Amy and Faivre-Finn, Corinne and Velikova, Galina and Marsden, Antonia and Heal, Calvin and Yorke, Janelle", title="Examining the Effectiveness of Electronic Patient-Reported Outcomes in People With Cancer: Systematic Review and Meta-Analysis", journal="J Med Internet Res", year="2024", month="Jul", day="31", volume="26", pages="e49089", keywords="telemedicine", keywords="patient-reported outcome measure", keywords="neoplasms", keywords="quality of life", keywords="systematic review", keywords="meta-analysis", keywords="randomized controlled trial", abstract="Background: Electronic patient-reported outcomes (ePROs) are commonly used in oncology clinical practice and have shown benefits for patients and health resource use. Objective: The aim of this study was to compare the isolated effect of administering ePROs to patients with cancer versus a control condition. Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Randomized controlled trials evaluating ePRO interventions that aimed to improve health-related outcomes among patients with cancer were included. The primary outcome was health-related quality of life (HRQOL), and the secondary outcomes were symptoms, hospital admissions, unplanned visits, chemotherapy completion, survival, and satisfaction with care. The effect sizes of ePROs on health-related outcomes were analyzed as standardized mean differences (SMDs) with 95\% CIs using a random effects model. Results: The search identified 10,965 papers, of which 19 (0.17\%) from 15 studies were included. The meta-analysis showed an improvement in HRQOL at 3 months, measured by the Functional Assessment of Cancer Therapy--General (SMD 0.29, 95\% CI 0.19 to 0.39), and at 6 months, assessed using various HRQOL measures (SMD 0.21, 95\% CI 0.11 to 0.30). Of the 15 studies, 9 (60\%) reported a positive signal on HRQOL, with two-thirds of the studies (n=6, 67\%) including tailored patient advice and two-thirds (n=6, 67\%) using clinician alert systems. Conclusions: The meta-analysis showed an improvement in HRQOL at 6 months and in Functional Assessment of Cancer Therapy--General scores at 3 months for studies that included tailored advice and clinician alerts, suggesting that these elements may improve ePRO effectiveness. The findings will provide guidance for future use and help health care professionals choose the most suitable ePRO features for their patients. Trial Registration: PROSPERO CRD42020175007; https://tinyurl.com/5cwmy3j6 ", doi="10.2196/49089", url="https://www.jmir.org/2024/1/e49089" } @Article{info:doi/10.2196/58724, author="Kim, Sunghak and Wilson, Paije and Abraham, Olufunmilola", title="Investigating the Use of Serious Games for Cancer Control Among Children and Adolescents: Scoping Review", journal="JMIR Serious Games", year="2024", month="Jul", day="10", volume="12", pages="e58724", keywords="serious games", keywords="cancer control", keywords="children", keywords="adolescents", keywords="scoping review", keywords="game", keywords="games", keywords="gaming", keywords="cancer", keywords="oncology", keywords="pediatric", keywords="pediatrics", keywords="paediatric", keywords="paediatrics", keywords="child", keywords="youth", keywords="adolescent", keywords="teen", keywords="teens", keywords="teenager", keywords="teenagers", keywords="synthesis", keywords="review methods", keywords="review methodology", keywords="search", keywords="searches", keywords="searching", keywords="scoping", abstract="Background: Effective health care services that meet the diverse needs of children and adolescents with cancer are required to alleviate their physical, psychological, and social challenges and improve their quality of life. Previous studies showed that serious games help promote people's health. However, the potential for serious games to be used for successful cancer control for children and adolescents has received less attention. Objective: This scoping review aimed to map the use of serious games in cancer prevention and cancer care for children and adolescents, and provide future directions for serious games' development and implementation within the context of cancer control for children and adolescents. Methods: This study followed a combination of the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) and the JBI (Joanna Briggs Institute) framework for the conduct of scoping reviews. PubMed, CINAHL Plus Full Text, Scopus, Web of Science Core Collection, and American Psychological Association (APA) PsycINFO databases were used for the search. Results: From the initial 2750 search results, 63 papers were included in the review, with 28 quantitative, 14 qualitative, and 21 mixed method studies. Most of the studies were cancer care serious game papers (55/63, 87\%) and a small number of studies were cancer prevention serious game papers (8/63, 13\%). The majority of the included studies were published between 2019 and 2023 (cancer prevention: 5/8, 63\%; cancer care: 35/55, 64\%). The majority of the studies were conducted in Europe (cancer prevention: 3/8, 38\%; cancer care: 24/55, 44\%) and North America (cancer prevention: 4/8, 50\%; cancer care: 17/55, 31\%). Adolescents were the most represented age group in the studies' participants (cancer prevention: 8/8, 100\%; cancer care: 46/55, 84\%). All (8/8, 100\%) cancer prevention serious game papers included healthy people as participants, and 45 out of 55 (82\%) cancer care serious game papers included patients with cancer. The majority of cancer prevention serious game papers addressed game preference as a target outcome (4/8, 50\%). The majority of cancer care serious game papers addressed symptom management as a target outcome (28/55, 51\%). Of the cancer care studies examining serious games for symptom management, the majority of the studies were conducted to treat psychological (13/55, 24\%) and physical symptoms (10/55, 18\%). Conclusions: This review shows both the growth of interest in the use of serious games for cancer control among children and adolescents and the potential for bias in the relevant literature. The diverse characteristics of the included papers suggest that serious games can be used in various ways for cancer control among children and adolescents while highlighting the need to develop and implement serious games in underrepresented areas. ", doi="10.2196/58724", url="https://games.jmir.org/2024/1/e58724", url="http://www.ncbi.nlm.nih.gov/pubmed/38985502" } @Article{info:doi/10.2196/52322, author="Zeinali, Nahid and Youn, Nayung and Albashayreh, Alaa and Fan, Weiguo and Gilbertson White, St{\'e}phanie", title="Machine Learning Approaches to Predict Symptoms in People With Cancer: Systematic Review", journal="JMIR Cancer", year="2024", month="Mar", day="19", volume="10", pages="e52322", keywords="machine learning", keywords="ML", keywords="deep learning", keywords="DL", keywords="cancer symptoms", keywords="prediction model", abstract="Background: People with cancer frequently experience severe and distressing symptoms associated with cancer and its treatments. Predicting symptoms in patients with cancer continues to be a significant challenge for both clinicians and researchers. The rapid evolution of machine learning (ML) highlights the need for a current systematic review to improve cancer symptom prediction. Objective: This systematic review aims to synthesize the literature that has used ML algorithms to predict the development of cancer symptoms and to identify the predictors of these symptoms. This is essential for integrating new developments and identifying gaps in existing literature. Methods: We conducted this systematic review in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist. We conducted a systematic search of CINAHL, Embase, and PubMed for English records published from 1984 to August 11, 2023, using the following search terms: cancer, neoplasm, specific symptoms, neural networks, machine learning, specific algorithm names, and deep learning. All records that met the eligibility criteria were individually reviewed by 2 coauthors, and key findings were extracted and synthesized. We focused on studies using ML algorithms to predict cancer symptoms, excluding nonhuman research, technical reports, reviews, book chapters, conference proceedings, and inaccessible full texts. Results: A total of 42 studies were included, the majority of which were published after 2017. Most studies were conducted in North America (18/42, 43\%) and Asia (16/42, 38\%). The sample sizes in most studies (27/42, 64\%) typically ranged from 100 to 1000 participants. The most prevalent category of algorithms was supervised ML, accounting for 39 (93\%) of the 42 studies. Each of the methods---deep learning, ensemble classifiers, and unsupervised ML---constituted 3 (3\%) of the 42 studies. The ML algorithms with the best performance were logistic regression (9/42, 17\%), random forest (7/42, 13\%), artificial neural networks (5/42, 9\%), and decision trees (5/42, 9\%). The most commonly included primary cancer sites were the head and neck (9/42, 22\%) and breast (8/42, 19\%), with 17 (41\%) of the 42 studies not specifying the site. The most frequently studied symptoms were xerostomia (9/42, 14\%), depression (8/42, 13\%), pain (8/42, 13\%), and fatigue (6/42, 10\%). The significant predictors were age, gender, treatment type, treatment number, cancer site, cancer stage, chemotherapy, radiotherapy, chronic diseases, comorbidities, physical factors, and psychological factors. Conclusions: This review outlines the algorithms used for predicting symptoms in individuals with cancer. Given the diversity of symptoms people with cancer experience, analytic approaches that can handle complex and nonlinear relationships are critical. This knowledge can pave the way for crafting algorithms tailored to a specific symptom. In addition, to improve prediction precision, future research should compare cutting-edge ML strategies such as deep learning and ensemble methods with traditional statistical models. ", doi="10.2196/52322", url="https://cancer.jmir.org/2024/1/e52322", url="http://www.ncbi.nlm.nih.gov/pubmed/38502171" } @Article{info:doi/10.2196/46116, author="Zhang, Yingzi and Flannery, Marie and Zhang, Zhihong and Underhill-Blazey, Meghan and Bobry, Melanie and Leblanc, Natalie and Rodriguez, Darcey and Zhang, Chen", title="Digital Health Psychosocial Intervention in Adult Patients With Cancer and Their Families: Systematic Review and Meta-Analysis", journal="JMIR Cancer", year="2024", month="Feb", day="5", volume="10", pages="e46116", keywords="cancer", keywords="anxiety", keywords="decision-making", keywords="depression", keywords="digital health", keywords="distress", keywords="family", keywords="mental health", keywords="mortality", keywords="psychosocial intervention", keywords="quality of life", abstract="Background: Patients with cancer and their families often experience significant distress and deterioration in their quality of life. Psychosocial interventions were used to address patients' and families' psychosocial needs. Digital technology is increasingly being used to deliver psychosocial interventions to patients with cancer and their families. Objective: A systematic review and meta-analysis were conducted to review the characteristics and effectiveness of digital health interventions on psychosocial outcomes in adult patients with cancer and their family members. Methods: Databases (PubMed, Cochrane Library, Web of Science, Embase, CINAHL, PsycINFO, ProQuest Dissertations and Theses Global, and ClinicalTrials.gov) were searched for randomized controlled trials (RCTs) or quasi-experimental studies that tested the effects of a digital intervention on psychosocial outcomes. The Joanna Briggs Institute's critical appraisal checklists for RCTs and quasi-experimental studies were used to assess quality. Standardized mean differences (ie, Hedges g) were calculated to compare intervention effectiveness. Subgroup analysis was planned to examine the effect of delivery mode, duration of the intervention, type of control, and dosage on outcomes using a random-effects modeling approach. Results: A total of 65 studies involving 10,361 patients (mean 159, SD 166; range 9-803 patients per study) and 1045 caregivers or partners (mean 16, SD 54; range 9-244 caregivers or partners per study) were included in the systematic review. Of these, 32 studies were included in a meta-analysis of the effects of digital health interventions on quality of life, anxiety, depression, distress, and self-efficacy. Overall, the RCT studies' general quality was mixed (applicable scores: mean 0.61, SD 0.12; range 0.38-0.91). Quasi-experimental studies were generally of moderate to high quality (applicable scores: mean 0.75, SD 0.08; range 0.63-0.89). Psychoeducation and cognitive-behavioral strategies were commonly used. More than half (n=38, 59\%) did not identify a conceptual or theoretical framework. Most interventions were delivered through the internet (n=40, 62\%). The median number of intervention sessions was 6 (range 1-56). The frequency of the intervention was highly variable, with self-paced (n=26, 40\%) being the most common. The median duration was 8 weeks. The meta-analysis results showed that digital psychosocial interventions were effective in improving patients' quality of life with a small effect size (Hedges g=0.05, 95\% CI --0.01 to 0.10; I2=42.7\%; P=.01). The interventions effectively reduced anxiety and depression symptoms in patients, as shown by moderate effect sizes on Hospital Anxiety and Depression Scale total scores (Hedges g=--0.72, 95\% CI --1.89 to 0.46; I2=97.6\%; P<.001). Conclusions: This study demonstrated the effectiveness of digital health interventions on quality of life, anxiety, and depression in patients. Future research with a clear description of the methodology to enhance the ability to perform meta-analysis is needed. Moreover, this study provides preliminary evidence to support the integration of existing digital health psychosocial interventions in clinical practice. Trial Registration: PROSPERO CRD42020189698; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=189698 ", doi="10.2196/46116", url="https://cancer.jmir.org/2024/1/e46116", url="http://www.ncbi.nlm.nih.gov/pubmed/38315546" } @Article{info:doi/10.2196/45145, author="Lim, Chun Dwight Su and Kwok, Benedict and Williams, Patricia and Koczwara, Bogda", title="The Impact of Digital Technology on Self-Management in Cancer: Systematic Review", journal="JMIR Cancer", year="2023", month="Nov", day="22", volume="9", pages="e45145", keywords="self-management", keywords="self-management support", keywords="self-management core skills", keywords="digital technology", keywords="digital health", keywords="mHealth", keywords="mobile health", keywords="eHealth", keywords="cancer", keywords="theoretical frameworks", keywords="predictors of effect", keywords="chronic disease", keywords="skills", keywords="decision-making", keywords="cancer treatment", abstract="Background: Self-management (SM) plays an important role in supporting patients' adaptation to and management of the symptoms of chronic diseases. Cancer is a chronic disease that requires patients to have responsibility in management. Digital technology has the potential to enhance SM support, but there is little data on what SM skills are most commonly supported by digital technology. Objective: This review aimed to examine the SM core skills that were enabled and supported by digital interventions in people with cancer and identify any predictors of the effect of digital health intervention on SM core skills. Methods: Three electronic databases (MEDLINE, Scopus, and CINAHL) were searched for papers, published from January 2010 to February 2022, that reported randomized controlled trials (RCTs) involving patients with cancer or survivors of cancer where a digital technology intervention was evaluated and change in 1 or more SM core skills was a measured outcome. Results: This systematic review resulted in 12 studies that were eligible to identify which SM core skills were enabled and supported by digital intervention. The total number of participants in the 12 studies was 2627. The most common SM core skills targeted by interventions were decision-making, goal setting, and partnering with health professionals. A total of 8 (67\%) out of 12 RCTs demonstrated statistically significant improvement in outcomes including self-efficacy, survivorship care knowledge and attitude, quality of life, increased knowledge of treatment, and emotional and social functioning. A total of 5 (62\%) out of 8 positive RCTs used theoretical considerations in their study design; whereas in 1 (25\%) out of 4 negative RCTs, theoretical considerations were used. In 3 studies, some factors were identified that were associated with the development of SM core skills, which included younger age (regression coefficient [RC]=--0.06, 95\% CI --0.10 to --0.02; P=.002), computer literacy (RC=--0.20, 95\% CI --0.37 to --0.03; P=.02), completing cancer treatment (Cohen d=0.31), male sex (SD 0.34 in social functioning; P=.009), higher education (SD 0.19 in social functioning; P=.04), and being a recipient of chemotherapy (SD 0.36 in depression; P=.008). In all 3 studies, there were no shared identical factors that supported the development of SM core skills, whereby each study had a unique set of factors that supported the development of SM core skills. Conclusions: Digital technology for patients with cancer appears to improve SM core skills including decision-making, goal setting, and partnering with health care partners. This effect is greater in people who are younger, male, educated, highly computer literate, completing cancer treatment, or a recipient of chemotherapy. Future research should focus on targeting multiple SM core skills and identifying predictors of the effect of digital technology intervention. Trial Registration: PROSPERO CRD42021221922; https://tinyurl.com/mrx3pfax ", doi="10.2196/45145", url="https://cancer.jmir.org/2023/1/e45145", url="http://www.ncbi.nlm.nih.gov/pubmed/37991831" } @Article{info:doi/10.2196/42044, author="Kanodia, Sweekrity and Thalabard, Christophe Jean and Lhoste, Kevin", title="Categorization and Analysis of Primary Care mHealth Apps Related to Breast Health and Breast Cancer: Systematic Search in App Stores and Content Analysis", journal="JMIR Cancer", year="2023", month="Sep", day="7", volume="9", pages="e42044", keywords="breast cancer", keywords="breast self-examination", keywords="BSE", keywords="primary care", keywords="mobile applications", keywords="mobile apps", keywords="breast health", keywords="early diagnosis", abstract="Background: Breast cancer is the most common cause of cancer mortality among women globally. The use of mobile health tools such as apps and games is increasing rapidly, even in low- and middle-income countries, to promote early diagnosis and to manage care and support of survivors and patients. Objective: The primary objective of this review was to categorize selected mobile health apps related to breast health and prevention of breast cancer, based on features such as breast self-examination (BSE) training and reminders, and to analyze their current dissemination. An ancillary objective was to highlight the limitations of existing tools and suggest ways to improve them. Methods: We defined strict inclusion and exclusion criteria, which required apps to have titles or descriptions that suggest that they were designed for the general public, and not for patients with breast cancer or health workers. Apps that focused on awareness and primary care via self-check were included, while those that focused on topics such as alternative treatments and medical news were excluded. Apps that were not specifically related to breast cancer were also excluded. Apps (in any language) that appeared in the search with keywords were included. The database consisted of apps from AppAgg and Google Play Store. Only 85 apps met the inclusion criteria. Selected apps were categorized on the basis of their alleged interactive features. Descriptive statistics were obtained, and available language options, the number of downloads, and the cost of the apps were the main parameters reviewed. Results: The selected apps were categorized on the basis of the following features: education, BSE training, reminders, and recording. Of the 85 selected apps, 72 (84.7\%) focused on disseminating breast cancer information. BSE training was provided by only 47\% (n=40) of the apps, and very few had reminder (n=26, 30.5\%) and recording (n=11, 12.9\%) features. The median number of downloads was the highest for apps with recording features (>1000 downloads) than those with education, BSE training, reminder, and recording features (>5000 downloads). Most of these apps (n=74, 83.5\%) were monolingual, and around 80.3\% (n=49) of these apps were in English. Almost all the apps on Google Play Store were free of charge. Conclusions: Although there exist several apps on Google Play Store to promote awareness about breast health and cancer, the usefulness of most of them appears debatable. To provide a complete breast health package to the users, such apps must have all of the following features: reminders or notifications and symptom recording and tracking. There is still an urgent need to scientifically evaluate existing apps in the target populations in order to make them more functional and user-friendly. ", doi="10.2196/42044", url="https://cancer.jmir.org/2023/1/e42044", url="http://www.ncbi.nlm.nih.gov/pubmed/37676704" } @Article{info:doi/10.2196/40875, author="Laitio, Anna-Mari and Giunti, Guido and Halonen, Raija", title="Perceived Barriers and Facilitators in Using Patient-Reported Outcome Systems for Cancer Care: Systematic Mapping Study", journal="JMIR Cancer", year="2023", month="Jun", day="28", volume="9", pages="e40875", keywords="patient-reported outcome system", keywords="barriers", keywords="facilitators", keywords="cancer", keywords="health care professionals", abstract="Background: Cancer is a major global health problem. Patient-reported outcome (PRO) systems have been developed to support the treatment of patients with cancer. Although clear evidence of the benefits of the routine use of electronic patient-reported outcomes (ePROs) exists, engaging physicians in using these systems has been challenging. Objective: This study aims to identify and analyze what is currently known about health care professionals' (HCPs) perceived barriers and facilitators that exist and influence the use of ePRO systems for cancer care. Methods: We carried out a systematic mapping study by conducting searches of 3 databases (Association for Computing Machinery, PubMed, and Scopus). Eligible papers were published between 2010 and 2021, and they described HCPs' perspectives on using ePROs. The data on the included papers were extracted, a thematic meta-synthesis was performed, and 7 themes were summarized into 3 categories. Results: A total of 17 papers were included in the study. The HCPs' perceived barriers and facilitators of using ePROs can be summarized into 7 themes: clinical workflow, organization and infrastructure, value to patients, value to HCPs, digital health literacy, usability, and data visualization and perceived features. These themes can be further summarized into 3 categories: work environment, value to users, and suggested features. According to the study, ePROs should be interoperable with hospital electronic health records and adapted to the hospital workflow. HCPs should get appropriate support for their use. Additional features are needed for ePROs, and special attention should be paid to data visualization. Patients should have the option to use web-based ePROs at home and complete it at the time most valuable to the treatment. Patients' ePRO notes need attention during clinical visits, but ePRO use should not limit patient-clinician face-to-face communication. Conclusions: The study revealed that several aspects need improvement in ePROs and their operating environments. By improving these aspects, HCPs' experience with ePROs will enhance, and thus, there will be more facilitating factors for HCPs to use ePROs than those available today. More national and international knowledge about using ePROs is still needed to cover the need for information to develop them and their operating environments to meet the needs of HCPs. ", doi="10.2196/40875", url="https://cancer.jmir.org/2023/1/e40875", url="http://www.ncbi.nlm.nih.gov/pubmed/37379076" } @Article{info:doi/10.2196/45037, author="Peyrachon, Romane and R{\'e}billard, Am{\'e}lie", title="Effects of Active Video Games in Patients With Cancer: Systematic Review", journal="JMIR Cancer", year="2023", month="May", day="26", volume="9", pages="e45037", keywords="exergaming", keywords="cancer", keywords="physical activity", keywords="fatigue", keywords="endurance", keywords="strength", keywords="adjuvant therapy", keywords="cancer therapy", keywords="cancer treatment", keywords="video games", keywords="digital health intervention", keywords="cancer patient", abstract="Background: Physical activity (PA) is now considered an adjuvant therapy in cancer treatment; nevertheless, multiple barriers could reduce PA engagement during treatment. Active video games (AVGs) lead to the achievement of mild- to moderate-intensity PA and represent a promising tool for regular movement and exercise. Objective: This paper aims to review the current literature and provide updated content on the physiological and psychological effects of AVG-based interventions in patients with cancer undergoing treatment. Methods: Four electronic databases were investigated. Studies reporting on AVG interventions delivered to patients undergoing treatment were included. A total of 21 articles (17 interventions) were identified for data extraction and quality assessment. Results: A total of 362 patients with cancer participated in the studies (number of participants 3-70). The majority underwent treatment for breast, lung, prostate, hematologic, or oral or laryngeal cancer. The types and stages of cancer varied in all studies. Participants ranged in age from 3 to 93 years. Four studies included patients with pediatric cancer. The duration of interventions ranged from 2 to 16 weeks, with a minimum of 2 sessions per week and a maximum of 1 daily session. Sessions were supervised in 10 studies, and 7 included home-based interventions. AVG interventions improved endurance, quality of life, cancer-related fatigue, and self-efficacy. Effects were mixed on strength, physical function, and depression. AVGs did not affect activity level, body composition, or anxiety. Compared with standard physiotherapy, physiological effects were lower or similar, and psychological effects were higher or similar. Conclusions: Overall, our results suggest that AVGs can be recommended to patients undergoing cancer treatment, given the physiological and psychological benefits. When AVGs are proposed, supervision of the sessions should be considered as it can limit dropouts. In the future, it is important to develop AVGs that combine endurance and muscle strengthening, with the possibility of achieving moderate to high exercise intensity, depending on the physical abilities of the patients, as indicated in the World Health Organization's recommendations. ", doi="10.2196/45037", url="https://cancer.jmir.org/2023/1/e45037", url="http://www.ncbi.nlm.nih.gov/pubmed/37234028" } @Article{info:doi/10.2196/37330, author="Vaffis, Shannon and Whaley, Soluna and Axon, Rhys David and Hall-Lipsy, Elizabeth and Hincapie, Ana and Slack, Marion and Warholak, Terri", title="Features of Cancer mHealth Apps and Evidence for Patient Preferences: Scoping Literature Review", journal="JMIR Cancer", year="2023", month="Apr", day="28", volume="9", pages="e37330", keywords="scoping review", keywords="mHealth", keywords="mobile health", keywords="health app", keywords="cancer", keywords="oncology", keywords="disease self-management", keywords="self-management", keywords="chronic disease", keywords="tablet", keywords="smartphone", keywords="digital health", keywords="eHealth", keywords="feature", abstract="Background: Cancer is increasingly being treated as a chronic disease rather than an acute one-time illness. Additionally, oral anticancer therapies, as opposed to intravenous chemotherapy, are now available for an increasing number of cancer indications. Mobile health (mHealth) apps for use on mobile devices (eg, smartphones or tablets) are designed to help patients with medication adherence, symptom tracking, and disease management. Several previous literature reviews have been conducted regarding mHealth apps for cancer. However, these studies did not address patient preferences for the features of cancer mHealth apps. Objective: The primary aim was to review the scientific literature that describes the features and functions of mHealth apps designed for cancer self-management. Methods: As the purpose of this review was to explore the depth and breadth of research on mHealth app features for cancer self-management, a scoping review methodology was adopted. Four databases were used for this review: PubMed/MEDLINE, Embase, CINAHL, and PsycINFO. Citation and reference searches were conducted for manuscripts meeting the inclusion criteria. A gray literature search was also conducted. Data?extracted from manuscripts?included author, title, publication date, study type, sampling type, cancer type, treatment, age of participants, features, availability (free or subscription), design input, and patient preferences. Finally, the features listed for each app were compared, highlighting similarities across platforms as well as features unique to each app. Results: After the removal of duplicates, 522 manuscripts remained for the title and abstract review, with 51 undergoing full-text review. A total of 7 manuscripts (referred to as studies hereafter) were included in the final scoping review. App features described in each study varied from 2 to 11, with a median of 4 features per app. The most reported feature was a symptom or side effect tracker, which was reported in 6 studies. Two apps specified the inclusion of patients and health care providers during the design, while 1 app noted that IT and communications experts provided design input. The utility of the apps for end users was measured in several ways, including acceptability (measuring the end users' experience), usability (assessing the functionality and performance by observing real users completing tasks), or qualitative data (reports from end users collected from interviews or focus groups). Conclusions: This review explored the literature on cancer mHealth apps. Popular features within these mHealth apps include symptom trackers, cancer education, and medication trackers. However, these apps and features are often developed with little input from patients. Additionally, there is little information regarding patient preferences for the features of existing apps. While the number of cancer-related apps available for download continues to increase, further exploration of patient preferences for app features could result in apps that better meet patient disease self-management needs. ", doi="10.2196/37330", url="https://cancer.jmir.org/2023/1/e37330", url="http://www.ncbi.nlm.nih.gov/pubmed/37115587" } @Article{info:doi/10.2196/39012, author="Lima, Souza Vivian Cristina Gama and Soares, Souza Raquel de and Santos, dos Willian Alves and Alves, Paulo and Fuly, Claro Patricia dos Santos", title="Scientific Publications on Nursing for COVID-19 in Patients With Cancer: Scoping Review", journal="JMIR Cancer", year="2022", month="Nov", day="25", volume="8", number="4", pages="e39012", keywords="COVID-19", keywords="review", keywords="nursing", keywords="coronavirus infection", keywords="oncology nursing", abstract="Background: The needs of patients with cancer must be met, especially in times of crisis. The advent of the pandemic triggered a series of strategic actions by the nursing team to preserve the health of patients and professionals---hence the importance of studies on nursing care actions provided to patients with cancer during the COVID-19 pandemic. It is known that these patients are susceptible to severe COVID-19. However, no previous review has summarized the findings of scientific studies on nursing for COVID-19 in patients with cancer. Objective: This study aims to map the topics addressed in scientific studies on nursing for COVID-19 in patients with cancer. Methods: A scoping review was conducted using the methodology described in the Joanna Briggs Institute Reviewers' Manual 2015. The research question was elaborated using the population, concept, and context framework: What topics have been studied in nursing publications about COVID-19 in adult patients with cancer? The searches were carried out in 8 databases between April and November 2021 without time restrictions. Results: In total, 973 publications were identified using the search strategies in the databases, and 12 papers were retrieved by consulting the references. A total of 31 (3.2\%) publications were included in the final analysis, generating 4 thematic categories on the subject: ``restructuring the services: how oncology nursing was adapted during the pandemic,'' ``experiences of patients and performance of the nursing team during the COVID-19 pandemic,'' ``protocols and recommendations for dealing with the COVID-19 pandemic,'' and ``challenges and the role of oncology nurses facing the COVID-19 pandemic.'' Conclusions: Several strategies used by oncology nurses to face the COVID-19 pandemic in the international scenario were identified. Reports about the restructuring of services and the team's reactions to the pandemic predominated. However, there is a lack of reports regarding emotional support strategies for health care professionals. Another gap identified was the scarcity of clinical studies on the activities developed by oncology nurses. Therefore, there is a need for clinical research in the oncology area and emotional coping strategies to support oncology nurses. ", doi="10.2196/39012", url="https://cancer.jmir.org/2022/4/e39012", url="http://www.ncbi.nlm.nih.gov/pubmed/36219752" } @Article{info:doi/10.2196/39068, author="Lyall, Matthew and Crawford, Rebecca and Bell, Timothy and Mamolo, Carla and Neuhof, Alexander and Levy, Courtney and Heyes, Anne", title="Characterizing the Patient Journey in Multiple Myeloma: Qualitative Review", journal="JMIR Cancer", year="2022", month="Sep", day="22", volume="8", number="3", pages="e39068", keywords="multiple myeloma", keywords="literature review", keywords="patient-centered insights", keywords="patient experience", keywords="patient perspectives", keywords="patient-reported information", keywords="social media", keywords="YouTube", abstract="Background: The patient experience of multiple myeloma (MM) is multifaceted and varies substantially between individuals. Current published information on the patient perspective and treatment of MM is limited, making it difficult to gain insights into patient needs regarding the condition. Objective: In this review, a combined research method approach (ie, the review of published literature and social media posts) was undertaken to provide insight into patients' perspectives on the burden and treatment of MM, the impact of the COVID-19 pandemic, and the impact of MM on caregivers of patients with MM. Methods: Targeted searches of PubMed and PsycINFO were conducted from November 16, 2010, to November 16, 2020; in parallel, patient-reported information derived from social media posts from 6 patient advocacy websites and YouTube were searched. The review of patient advocacy websites and YouTube targeted patient-reported information from patients with a self-reported diagnosis of MM who discussed their experience of MM and its treatments. Results: A total of 27 articles and 138 posts were included (patient-reported information included data from 76 individuals), and results from both sources showed that patients experienced a variety of symptoms and treatment side effects, including neuropathy, fatigue, nausea, and back pain. These can affect areas of health-related quality of life (HRQOL), including physical functioning; emotional, psychological, and social well-being; the ability to work; and relationships. Patients valued involvement in treatment decision-making, and both the patient-reported information and the literature indicated that efficacy and tolerability strongly influence treatment decision-making. For patients, caregivers, and physicians, the preference for treatments was strongest when associated with increased survival. Caregivers can struggle to balance care responsibilities and jobs, and their HRQOL is affected in several areas, including emotional-, role-, social-, and work-related aspects of life. The COVID-19 pandemic has challenged patients' ability to manage MM because of limited hospital access and restrictions that negatively affected their lives, psychological well-being, and HRQOL. Unmet patient needs identified in the literature and patient-reported information were for more productive appointments with health care professionals, better-tolerated therapies, and more support for themselves and their caregivers. Conclusions: The combination of published literature and patient-reported information provides valuable and rich details on patient experiences and perceptions of MM and its treatment. The data highlighted that patients' HRQOL is impeded not only by the disease but also by treatment-related side effects. Patients in the literature and patient-reported information showed a strong preference for treatments that prolong life, and patients appeared to value participation in treatment decisions. However, there remain unmet needs and areas for further research, including treatment, caregiver burden, and how to conduct appointments with health care professionals. This may help improve the understanding of the journey of patients with MM. Plain Language Summary: Multiple Myeloma (MM) is the second most common cancer that affects blood cells. In this study, researchers wanted to know patients' views on the effects of MM and the treatments they received. Researchers also looked at the impact of the COVID-19 pandemic on patients' treatment and the impact of MM on caregivers. To this end, the researchers reviewed information from 27 published studies and 138 social media posts by 76 patients with MM. Patients commonly reported nerve pain, tiredness, feeling sick, and back pain caused by MM and the treatments they received. The effects of MM and treatments affected patients' physical function; emotional, psychological, and social well-being; ability to work; and relationships. The researchers found that patients wanted to be involved in decisions related to their treatment. The effectiveness against MM and known negative effects strongly influenced the choice of treatments for patients. Increased survival was the strongest factor in the choice of treatment for patients, caregivers, and doctors. Researchers found that the emotional-, role-, social-, and work-related aspects of caregivers' lives were affected by caring for patients with MM. The COVID-19 pandemic also affected the ability of patients to manage their MM because of limited hospital access and the effects of restrictions that impacted their lives and psychological well-being. Finally, the researchers identified some areas requiring improvement, including unproductive appointments with health care professionals, the need for treatments with fewer negative effects, and more support for patients with MM and their caregivers. This information may be useful to improve and understand the experience of patients with MM. ", doi="10.2196/39068", url="https://cancer.jmir.org/2022/3/e39068", url="http://www.ncbi.nlm.nih.gov/pubmed/36136395" } @Article{info:doi/10.2196/36255, author="Leslie, Monica and Beatty, Lisa and Hulbert-Williams, Lee and Pendrous, Rosina and Cartwright, Tim and Jackson, Richard and and Hulbert-Williams, J. Nicholas", title="Web-Based Psychological Interventions for People Living With and Beyond Cancer: Meta-Review of What Works and What Does Not for Maximizing Recruitment, Engagement, and Efficacy", journal="JMIR Cancer", year="2022", month="Jul", day="8", volume="8", number="3", pages="e36255", keywords="cancer", keywords="neoplasms", keywords="survivors", keywords="psychosocial oncology", keywords="internet-based intervention", keywords="psychosocial intervention", abstract="Background: Despite high levels of psychological distress experienced by many patients with cancer, previous research has identified several barriers to accessing traditional face-to-face psychological support. Web-based psychosocial interventions have emerged as a promising alternative. Objective: This meta-review aimed to synthesize evidence on recruitment challenges and enablers, factors that promote engagement and adherence to web-based intervention content, and factors that promote the efficacy of web-based psychosocial interventions for patients with cancer and cancer survivors. Methods: We conducted a systematic search of previous reviews that investigated the recruitment, engagement, and efficacy of web-based and app-based psychosocial interventions in adult patients with cancer and cancer survivors. We searched PubMed, CINAHL, PsycINFO, and the Cochrane Library database for relevant literature. The search terms focused on a combination of topics pertaining to neoplasms and telemedicine. Two independent authors conducted abstract screening, full text screening, and data extraction for each identified article. Results: A total of 20 articles met eligibility criteria. There was inconsistency in the reporting of uptake and engagement data; however, anxiety about technology and perceived time burden were identified as 2 key barriers. Web-based psychosocial oncology interventions demonstrated efficacy in reducing depression and stress but reported weak to mixed findings for distress, anxiety, quality of life, and well-being. Although no factors consistently moderated intervention efficacy, preliminary evidence indicated that multicomponent interventions and greater communication with a health care professional were preferred by participants and were associated with superior effects. Conclusions: Several consistently cited barriers to intervention uptake and recruitment have emerged, which we recommend future intervention studies address. Preliminary evidence also supports the superior efficacy of multicomponent interventions and interventions that facilitate communication with a health care professional. However, a greater number of appropriately powered clinical trials, including randomized trials with head-to-head comparisons, are needed to enable more confident conclusions regarding which web-based psychosocial oncology interventions work best and for whom. Trial Registration: PROSPERO CRD42020202633; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=202633 ", doi="10.2196/36255", url="https://cancer.jmir.org/2022/3/e36255", url="http://www.ncbi.nlm.nih.gov/pubmed/35802418" } @Article{info:doi/10.2196/32370, author="Ramos Herrera, Mart{\'i}n Igor and Lemus Flores, Guadalupe Mar{\'i}a and Reyna Sevilla, Antonio and Gonz{\'a}lez Casta{\~n}eda, Ernesto Miguel and Torres Guti{\'e}rrez, Adolfo Fernando and Crocker Sagastume, Crist{\'o}bal Ren{\'e} and Robles Pastrana, Dios Juan De and V{\'a}zquez Castellanos, Luis Jos{\'e}", title="Public Policies and Programs for the Prevention and Control of Breast Cancer in Latin American Women: Scoping Review", journal="JMIR Cancer", year="2022", month="Jul", day="6", volume="8", number="3", pages="e32370", keywords="breast cancer", keywords="scoping review", keywords="public policy", keywords="prevention programs", keywords="systematic review", abstract="Background: Breast cancer has positioned itself worldwide as one of the main public health problems, especially in Latin America. In some countries, several programs for the prevention and control of breast cancer in women have been developed and implemented on a permanent basis, but there are no public reports on the policies that originated such programs. Objective: A scoping review of scientific publications that identify the type, extent, and scope of policies and programs for the prevention and control of breast cancer in Latin American women was performed, and the main results were presented in this paper. Methods: This scoping review was carried out according to the method by Arksey and O'Malley based on 3 fundamental questions about breast cancer prevention and control policies in Latin America: their type, extent and scope, and reference framework. The search period was from 2000 to 2019, and the search was carried out in the following databases: MEDLINE (PubMed), MEDLINE (EbscoHost), CINAHL (EbscoHost), Academic Search Complete (EbscoHost), ISI Web of Science (Science Citation Index), and Scopus in English, Spanish, and Portuguese, and Scielo, Cochrane, and MEDES-MEDicina in Spanish and Portuguese. Of the 743 studies found, 20 (2.7\%) were selected, which were analyzed using descriptive statistics and qualitative content analysis. Results: The selected studies identified several Latin American countries that have generated policies and programs to prevent and control breast cancer in women, focusing mainly on risk communication, prevention and timely detection, effective access to health services, improvement of the screening process, and evaluation of screening programs. Evaluation criteria and greater participation of civil society in policy design and program execution are still lacking. This could undoubtedly help eliminate existing barriers to effective action. Conclusions: Although several Latin American countries have generated public policies and action programs for the prevention and control of breast cancer, a pending issue is the evaluation of the results to analyze the effectiveness and impact of their implementation given the magnitude of the public health problem it represents and because women and civil society play an important role in its prevention and control. International Registered Report Identifier (IRRID): RR2-10.2196/12624 ", doi="10.2196/32370", url="https://cancer.jmir.org/2022/3/e32370", url="http://www.ncbi.nlm.nih.gov/pubmed/35793130" } @Article{info:doi/10.2196/37093, author="van Deursen, Liza and Versluis, Anke and van der Vaart, Rosalie and Standaar, Lucille and Struijs, Jeroen and Chavannes, Niels and Aardoom, J. Jiska", title="eHealth Interventions for Dutch Cancer Care: Systematic Review Using the Triple Aim Lens", journal="JMIR Cancer", year="2022", month="Jun", day="14", volume="8", number="2", pages="e37093", keywords="cancer", keywords="eHealth", keywords="digital care", keywords="Triple Aim", keywords="population health", keywords="quality of care", keywords="costs", keywords="systematic review", keywords="psychosocial", keywords="intervention", keywords="mobile phone", abstract="Background: Globally, the burden of cancer on population health is growing. Recent trends such as increasing survival rates have resulted in a need to adapt cancer care to ensure a good care experience and manageable expenditures. eHealth is a promising way to increase the quality of cancer care and support patients and survivors. Objective: The aim of this systematic review was 2-fold. First, we aimed to provide an overview of eHealth interventions and their characteristics for Dutch patients with and survivors of cancer. Second, we aimed to provide an overview of the empirical evidence regarding the impact of eHealth interventions in cancer care on population health, quality of care, and per capita costs (the Triple Aim domains). Methods: The electronic databases Web of Science, PubMed, Cochrane, and Ovid PsycINFO were searched using 3 key search themes: eHealth interventions, cancer care, and the Netherlands. The identified interventions were classified according to predetermined criteria describing the intervention characteristics (eg, type, function, and target population). Their impact was subsequently examined using the Triple Aim framework. Results: A total of 38 interventions were identified. Most of these were web portals or web applications functioning to inform and self-manage, and target psychosocial factors or problems. Few interventions have been tailored to age, disease severity, or gender. The results of this study indicate that eHealth interventions could positively affect sleep quality, fatigue, and physical activity of patients with and survivors of cancer. Inconclusive results were found regarding daily functioning and quality of life, psychological complaints, and psychological adjustment to the disease. Conclusions: eHealth can improve outcomes in the Triple Aim domains, particularly in the population health and quality of care domains. Cancer-related pain and common symptoms of active treatment were not targeted in the included interventions and should receive more attention. Further research is needed to fully understand the impact of eHealth interventions in cancer care on participation, accessibility, and costs. The latter can be examined in economic evaluations by comparing eHealth interventions with care as usual. ", doi="10.2196/37093", url="https://cancer.jmir.org/2022/2/e37093", url="http://www.ncbi.nlm.nih.gov/pubmed/35699991" } @Article{info:doi/10.2196/34833, author="Dang, Ha Thu and Forkan, Mohammad Abdur Rahim and Wickramasinghe, Nilmini and Jayaraman, Prakash Prem and Alexander, Marliese and Burbury, Kate and Schofield, Penelope", title="Investigation of Intervention Solutions to Enhance Adherence to Oral Anticancer Medicines in Adults: Overview of Reviews", journal="JMIR Cancer", year="2022", month="Apr", day="27", volume="8", number="2", pages="e34833", keywords="digital", keywords="intervention", keywords="medication adherence", keywords="oncology", keywords="oral anticancer", keywords="systematic review", abstract="Background: Adherence to anticancer medicines is critical for the success of cancer treatments; however, nonadherence remains challenging, and there is limited evidence of interventions to improve adherence to medicines in patients with cancer. Objective: This overview of reviews aimed to identify and summarize available reviews of interventions to improve adherence to oral anticancer medicines in adult cancer survivors. Methods: A comprehensive search of 7 electronic databases was conducted by 2 reviewers who independently conducted the study selection, quality assessment using the A Measurement Tool to Assess Systematic Reviews 2, and data extraction. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist was adapted to report the results. Results: A total of 29 reviews were included in the narrative synthesis. The overall quality of the systematic reviews was low. The 4 main strategies to promote adherence were focused on education, reminders, behavior and monitoring, and multicomponent approaches. Digital technology--based interventions were reported in most reviews (27/29, 93\%). A few interventions applied theories (10/29, 34\%), design frameworks (2/29, 7\%), or engaged stakeholders (1/29, 3\%) in the development processes. The effectiveness of interventions was inconsistent between and within reviews. However, interventions using multiple strategies to promote adherence were more likely to be effective than single-strategy interventions (12/29, 41\% reviews). Unidirectional communication (7/29, 24\% reviews) and technology alone (11/29, 38\% reviews) were not sufficient to demonstrate improvement in adherence outcomes. Nurses and pharmacists played a critical role in promoting patient adherence to oral cancer therapies, especially with the support of digital technologies (7/29, 24\% reviews). Conclusions: Multicomponent interventions are potentially effective in promoting patient adherence to oral anticancer medicines. The seamless integration of digital solutions with direct clinical contacts is likely to be effective in promoting adherence. Future research for developing comprehensive digital adherence interventions should be evidence-based, theory-based, and rigorously evaluated. ", doi="10.2196/34833", url="https://cancer.jmir.org/2022/2/e34833", url="http://www.ncbi.nlm.nih.gov/pubmed/35475978" } @Article{info:doi/10.2196/29581, author="Steeb, Theresa and Reinhardt, Lydia and Harla{\ss}, Matthias and Heppt, Vincent Markus and Meier, Friedegund and Berking, Carola", title="Assessment of the Quality, Understandability, and Reliability of YouTube Videos as a Source of Information on Basal Cell Carcinoma: Web-Based Analysis", journal="JMIR Cancer", year="2022", month="Mar", day="11", volume="8", number="1", pages="e29581", keywords="basal cell carcinoma", keywords="YouTube", keywords="videos", keywords="patient education", keywords="shared decision-making", keywords="quality", keywords="reliability", keywords="internet", keywords="information", abstract="Background: Patients with skin cancer increasingly watch online videos to acquire disease-related information. Until now, no scientific evaluation of the quality of videos available for German-speaking patients with basal cell carcinoma (BCC) has been performed. Objective: In this study, we aimed to identify and evaluate videos about BCC provided on YouTube. Methods: A video search on YouTube was conducted in July 2020, using German BCC-related keywords (eg, ``Basalzellkarzinom,'' ``Basaliom,'' ``wei{\ss}er hautkrebs,'' and ``heller hautkrebs''). The first three pages (ie, 60 videos) were searched by two independent researchers for each keyword. Two authors evaluated videos that met the predefined eligibility criteria. The quality of the information of the videos was evaluated using the DISCERN tool and the Global Quality Scale (GQS). The understandability and actionability were assessed with the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V). The reliability was assessed with the JAMA (Journal of the American Medical Association) criteria score. Subgroup differences were identified using the Kruskal-Wallis test. Results: A total of 41 videos were included in the evaluation. The mean assessment scores were as follows: DISCERN, 3.3 (SD 0.80); GQS, 3.8 (SD 1.1); JAMA, 27.74\% (SD 22.1\%); understandability, 70.8\% (SD 13.3\%); and actionability, 45.9\% (SD 43.7\%). These values indicated that the videos were of medium to good quality and had good understandability, low actionability, and poor reliability. The quality of videos provided by health professionals was significantly higher than that of videos provided by laypersons. Conclusions: Optimization of health-related videos about BCC is desirable. In particular, adaptation to reliability criteria is necessary to support patient education and increase transparency. ", doi="10.2196/29581", url="https://cancer.jmir.org/2022/1/e29581", url="http://www.ncbi.nlm.nih.gov/pubmed/35275067" } @Article{info:doi/10.2196/33355, author="Goodman, William and Bagnall, Anne-Marie and Ashley, Laura and Azizoddin, Desiree and Muehlensiepen, Felix and Blum, David and Bennett, I. Michael and Allsop, Matthew", title="The Extent of Engagement With Telehealth Approaches by Patients With Advanced Cancer: Systematic Review", journal="JMIR Cancer", year="2022", month="Feb", day="17", volume="8", number="1", pages="e33355", keywords="systematic review", keywords="advanced cancer", keywords="engagement", keywords="digital health", keywords="telehealth", keywords="mobile phone", abstract="Background: Telehealth approaches are increasingly being used to support patients with advanced diseases, including cancer. Evidence suggests that telehealth is acceptable to most patients; however, the extent of and factors influencing patient engagement remain unclear. Objective: The aim of this review is to characterize the extent of engagement with telehealth interventions in patients with advanced, incurable cancer reported in the international literature. Methods: This systematic review was registered with PROSPERO (International Prospective Register of Systematic Reviews) and is reported in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. A comprehensive search of databases was undertaken for telehealth interventions (communication between a patient with advanced cancer and their health professional via telehealth technologies), including MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, Sociological Abstracts, and Web of Science, from the inception of each electronic database up until December 31, 2020. A narrative synthesis was conducted to outline the design, population, and context of the studies. A conceptual framework of digital engagement comprising quantitative behavioral measures (frequency, amount, duration, and depth of use) framed the analysis of engagement with telehealth approaches. Frequency data were transformed to a percentage (actual patient engagement as a proportion of intended engagement), and the interventions were characterized by intensity (high, medium, and low intended engagement) and mode of delivery for standardized comparisons across studies. Results: Of the 19,676 identified papers, 40 (0.2\%) papers covering 39 different studies were eligible for inclusion, dominated by US studies (22/39, 56\%), with most being research studies (26/39, 67\%). The most commonly reported measure of engagement was frequency (36/39, 92\%), with substantial heterogeneity in the way in which it was measured. A standardized percentage of actual patient engagement was derived from 17 studies (17/39, 44\%; n=1255), ranging from 51\% to 100\% with a weighted average of 75.4\% (SD 15.8\%). A directly proportional relationship was found between intervention intensity and actual patient engagement. Higher engagement occurred when a tablet, computer, or smartphone app was the mode of delivery. Conclusions: Understanding engagement for people with advanced cancer can guide the development of telehealth approaches from their design to monitoring as part of routine care. With increasing telehealth use, the development of meaningful and context- and condition-appropriate measures of telehealth engagement is needed to address the current heterogeneity in reporting while improving the understanding of optimal implementation of telehealth for oncology and palliative care. Trial Registration: PROSPERO (International Prospective Register of Systematic Reviews) CRD42018117232; https://www.crd.york.ac.uk/prospero/display\_record.php?ID=CRD42018117232 ", doi="10.2196/33355", url="https://cancer.jmir.org/2022/1/e33355", url="http://www.ncbi.nlm.nih.gov/pubmed/35175205" } @Article{info:doi/10.2196/27850, author="Xu, Lu and Sanders, Leslie and Li, Kay and Chow, L. James C.", title="Chatbot for Health Care and Oncology Applications Using Artificial Intelligence and Machine Learning: Systematic Review", journal="JMIR Cancer", year="2021", month="Nov", day="29", volume="7", number="4", pages="e27850", keywords="chatbot", keywords="artificial intelligence", keywords="machine learning", keywords="health", keywords="medicine", keywords="communication", keywords="diagnosis", keywords="cancer therapy", keywords="ethics", keywords="medical biophysics", keywords="mobile phone", abstract="Background: Chatbot is a timely topic applied in various fields, including medicine and health care, for human-like knowledge transfer and communication. Machine learning, a subset of artificial intelligence, has been proven particularly applicable in health care, with the ability for complex dialog management and conversational flexibility. Objective: This review article aims to report on the recent advances and current trends in chatbot technology in medicine. A brief historical overview, along with the developmental progress and design characteristics, is first introduced. The focus will be on cancer therapy, with in-depth discussions and examples of diagnosis, treatment, monitoring, patient support, workflow efficiency, and health promotion. In addition, this paper will explore the limitations and areas of concern, highlighting ethical, moral, security, technical, and regulatory standards and evaluation issues to explain the hesitancy in implementation. Methods: A search of the literature published in the past 20 years was conducted using the IEEE Xplore, PubMed, Web of Science, Scopus, and OVID databases. The screening of chatbots was guided by the open-access Botlist directory for health care components and further divided according to the following criteria: diagnosis, treatment, monitoring, support, workflow, and health promotion. Results: Even after addressing these issues and establishing the safety or efficacy of chatbots, human elements in health care will not be replaceable. Therefore, chatbots have the potential to be integrated into clinical practice by working alongside health practitioners to reduce costs, refine workflow efficiencies, and improve patient outcomes. Other applications in pandemic support, global health, and education are yet to be fully explored. Conclusions: Further research and interdisciplinary collaboration could advance this technology to dramatically improve the quality of care for patients, rebalance the workload for clinicians, and revolutionize the practice of medicine. ", doi="10.2196/27850", url="https://cancer.jmir.org/2021/4/e27850", url="http://www.ncbi.nlm.nih.gov/pubmed/34847056" } @Article{info:doi/10.2196/24722, author="Marthick, Michael and McGregor, Deborah and Alison, Jennifer and Cheema, Birinder and Dhillon, Haryana and Shaw, Tim", title="Supportive Care Interventions for People With Cancer Assisted by Digital Technology: Systematic Review", journal="J Med Internet Res", year="2021", month="Oct", day="29", volume="23", number="10", pages="e24722", keywords="digital health", keywords="telehealth", keywords="eHealth", keywords="neoplasm", keywords="supportive care", keywords="systematic review", keywords="mobile phone", abstract="Background: Although relatively new, digital health interventions are demonstrating rapid growth because of their ability to facilitate access and overcome issues of location, time, health status, and most recently, the impact of a major pandemic. With the increased uptake of digital technologies, digital health has the potential to improve the provision of supportive cancer care. Objective: This systematic review aims to evaluate digital health interventions for supportive cancer care. Methods: Published literature between 2000 and 2020 was systematically searched in MEDLINE, PubMed, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, and Scopus. Eligible publications were randomized controlled trials of clinician-led digital health interventions to support adult cancer patients. The interventions included were determined by applying a digital health conceptual model. Studies were appraised for quality using the revised Cochrane risk of bias tool. Results: Twenty randomized controlled trials met the inclusion criteria for the analysis. Interventions varied by duration, frequency, degree of technology use, and applied outcome measures. Interventions targeting a single tumor stream, predominantly breast cancer, and studies involving the implementation of remote symptom monitoring have dominated the results. In most studies, digital intervention resulted in significant positive outcomes in patient-reported symptoms, levels of fatigue and pain, health-related quality of life, functional capacity, and depression levels compared with the control. Conclusions: Digital health interventions are helpful and effective for supportive care of patients with cancer. There is a need for high-quality research. Future endeavors could focus on the use of valid, standardized outcome measures, maintenance of methodological rigor, and strategies to improve patient and health professional engagement in the design and delivery of supportive digital health interventions. Trial Registration: PROSPERO CRD42020149730; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=149730 ", doi="10.2196/24722", url="https://www.jmir.org/2021/10/e24722", url="http://www.ncbi.nlm.nih.gov/pubmed/34714246" } @Article{info:doi/10.2196/31212, author="Rebelo, Artur and Ukkat, J{\"o}rg and Klose, Johannes and Ronellenfitsch, Ulrich and Kleeff, J{\"o}rg", title="Surgery With Arterial Resection for Hilar Cholangiocarcinoma: Protocol for a Systematic Review and Meta-analysis", journal="JMIR Res Protoc", year="2021", month="Oct", day="5", volume="10", number="10", pages="e31212", keywords="meta-analysis", keywords="cholangiocarcinoma", keywords="arterial resection", keywords="surgery", keywords="vascular resections", keywords="cardiology", keywords="outcomes", keywords="mortality", keywords="morbidity", keywords="perioperative", keywords="cancer", keywords="tumor", keywords="liver", keywords="liver cancer", abstract="Background: In light of recent advances in multimodality treatment, an analysis of vascular resection outcomes in surgery for hilar cholangiocarcinoma is lacking. Objective: The aim of this meta-analysis is to summarize the currently available evidence on outcomes of patients undergoing arterial resection for the treatment of hilar cholangiocarcinoma. Methods: A systematic literature search in the databases PubMed/MEDLINE, Cochrane Library, and CINAHL, and the trial registries ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform will be carried out. Predefined outcomes are mortality (100-day and in-hospital), morbidity (Clavien-Dindo classification, any type of complication), vascular complications (thrombosis or stenosis of the portal vein or hepatic artery, pseudoaneurysms), liver failure, postoperative bleeding, duration of surgery, reoperation rate, length of hospital stay, survival time, actuarial survival (2-, 3-, and 5-year survival), complete/incomplete resection rates, histologic arterial invasion, and lymph node positivity (number of positive lymph nodes and lymph node ratio). Results: Database searches will commence in December 2020. The meta-analysis will be completed by December 2021. Conclusions: Our findings will enable us to present the current evidence on the feasibility, safety, and oncological effectiveness of surgery for hilar cholangiocarcinoma with arterial resection. Our data will support health care professionals and patients in their clinical decision-making. Trial Registration: PROSPERO 223396; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=223396 International Registered Report Identifier (IRRID): DERR1-10.2196/31212 ", doi="10.2196/31212", url="https://www.researchprotocols.org/2021/10/e31212", url="http://www.ncbi.nlm.nih.gov/pubmed/34609321" } @Article{info:doi/10.2196/28869, author="Hopstaken, S. Jana and Verweij, Lynn and van Laarhoven, M. Cees J. H. and Blijlevens, A. Nicole M. and Stommel, J. Martijn W. and Hermens, G. Rosella P. M.", title="Effect of Digital Care Platforms on Quality of Care for Oncological Patients and Barriers and Facilitators for Their Implementation: Systematic Review", journal="J Med Internet Res", year="2021", month="Sep", day="24", volume="23", number="9", pages="e28869", keywords="digital care platforms", keywords="cancer care", keywords="eHealth", keywords="telemedicine", keywords="health care services", keywords="fragmentation of care", keywords="health care fragmentation", keywords="oncology", keywords="quality of care", keywords="barriers", keywords="facilitators", keywords="patient experience", abstract="Background: Oncological health care services are challenged by the increasing number of cancer survivors, long-term follow-up care, and fragmentation of care. Digital care platforms are potential tools to deliver affordable, patient-centered oncological care. Previous reviews evaluated only one feature of a digital care platform or did not evaluate the effect on enhancement of information, self-efficacy, continuity of care, or patient- and health care provider--reported experiences. Additionally, they have not focused on the barriers and facilitators for implementation of a digital care platform in oncological care. Objective: The aim of this systematic review was to collect the best available evidence of the effect of a digital care platform on quality of care parameters such as enhancement of available information, self-efficacy, continuity of care, and patient- and health care provider--reported experiences. Additionally, barriers and facilitators for implementation of digital care platforms were analyzed. Methods: The PubMed (Medline), Embase, CINAHL, and Cochrane Library databases were searched for the period from January 2000 to May 2020 for studies assessing the effect of a digital care platform on the predefined outcome parameters in oncological patients and studies describing barriers and facilitators for implementation. Synthesis of the results was performed qualitatively. Barriers and facilitators were categorized according to the framework of Grol and Wensing. The Mixed Methods Appraisal Tool was used for critical appraisal of the studies. Results: Seventeen studies were included for final analysis, comprising 8 clinical studies on the effectiveness of the digital care platform and 13 studies describing barriers and facilitators. Usage of a digital care platform appeared to enhance the availability of information and self-efficacy. There were no data available on the effect of a digital care platform on the continuity of care. However, based on focus group interviews, digital care platforms could potentially improve continuity of care by optimizing the exchange of patient information across institutes. Patient-reported experiences such as satisfaction with the platform were considerably positive. Most barriers for implementation were identified at the professional level, such as the concern for increased workload and unattended release of medical information to patients. Most facilitators were found at the patient and innovation levels, such as improved patient-doctor communication and patient empowerment. There were few barriers and facilitators mentioned at the economic and political levels. Conclusions: The use of digital care platforms is associated with better quality of care through enhancement of availability of information and increased self-efficacy for oncological patients. The numerous facilitators identified at the patient level illustrate that patients are positive toward a digital care platform. However, despite these favorable results, robust evidence concerning the effectiveness of digital care platforms, especially from high-quality studies, is still lacking. Future studies should therefore aim to further investigate the effectiveness of digital care platforms, and the barriers and facilitators to their implementation at the economic and political levels. ", doi="10.2196/28869", url="https://www.jmir.org/2021/9/e28869", url="http://www.ncbi.nlm.nih.gov/pubmed/34559057" } @Article{info:doi/10.2196/30492, author="Higashi, T. Robin and Sweetenham, W. John and Israel, D. Aimee and Tiro, A. Jasmin", title="COVID-19 Communication From Seven Health Care Institutions in North Texas for English- and Spanish-Speaking Cancer Patients: Mixed Method Website Study", journal="JMIR Cancer", year="2021", month="Aug", day="31", volume="7", number="3", pages="e30492", keywords="COVID-19", keywords="coronavirus", keywords="safety net", keywords="internet", keywords="communication", abstract="Background: The COVID-19 pandemic has created an urgent need to rapidly disseminate health information, especially to those with cancer, because they face higher morbidity and mortality rates. At the same time, the pandemic's disproportionate impact on Latinx populations underscores the need for information to reach Spanish speakers. However, the equity of COVID-19 information communicated through institutions' online media to Spanish-speaking cancer patients is unknown. Objective: We conducted a multimodal, mixed method document review study to evaluate the equity of online information about COVID-19 and cancer available to English- and Spanish-speaking populations from seven health care institutions in North Texas, where one in five adults is Spanish-speaking. Our focus was less on the ``digital divide,'' which conveys disparities in access to computers and the internet based on the race/ethnicity, education, and income of at-risk populations; rather, our study asks the following question: to what extent is online content useful and culturally appropriate in meeting Spanish speakers' information needs? Methods: We reviewed 50 websites (33 English and 17 Spanish) over a period of 1 week in the middle of May 2020. We sampled seven institutions' main oncology and COVID web pages, and both internal (institutional) and external (noninstitutional) linked content. We conducted several analyses for each sampled page, including (1) thematic content analysis, (2) literacy level analysis using Readability Studio software, (3) coding using the Patient Education and Materials Assessment Tool (PEMAT), and (4) descriptive analysis of video and diversity content. Results: The themes most frequently addressed on English and Spanish websites differed. While ``resources/FAQs'' were frequently cited themes on both websites, English websites more frequently addressed ``news/updates'' and ``cancer+COVID,'' and Spanish websites addressed ``protection'' and ``COVID data.'' Spanish websites had on average a lower literacy level (11th grade) than English websites (13th grade), although still far above the recommended guideline of 6th to 8th grade. The PEMAT's overall average accessibility score was the same for English (n=33 pages) and Spanish pages (n=17 pages) at 82\%. Among the Dallas-Fort Worth organizations, the average accessibility of Spanish pages (n=7) was slightly lower than that of English pages (n=19) (77\% vs 81\%), due mostly to the discrepancy in English-only videos and visual aids. Of the 50 websites, 12 (24\%) had embedded videos; however, 100\% of videos were in English, including one on a Spanish website. Conclusions: We identified an uneven response among the seven health care institutions for providing equitable information to Spanish-speaking Dallas-Fort Worth residents concerned about COVID and cancer. Spanish speakers lack equal access in both diversity of content about COVID-19 and access to other websites, leaving an already vulnerable cancer patient population at greater risk. We recommend several specific actions to enhance content and navigability for Spanish speakers. ", doi="10.2196/30492", url="https://cancer.jmir.org/2021/3/e30492", url="http://www.ncbi.nlm.nih.gov/pubmed/34346886" } @Article{info:doi/10.2196/12071, author="McCann, Lisa and McMillan, Anne Kathryn and Pugh, Gemma", title="Digital Interventions to Support Adolescents and Young Adults With Cancer: Systematic Review", journal="JMIR Cancer", year="2019", month="Jul", day="31", volume="5", number="2", pages="e12071", keywords="adolescent", keywords="neoplasms", keywords="telemedicine", keywords="systematic review", keywords="eHealth", abstract="Background: The last decade has seen an increase in the number of digital health interventions designed to support adolescents and young adults (AYAs) with cancer. Objective: The objective of this review was to identify, characterize, and fully assess the quality, feasibility, and efficacy of existing digital health interventions developed specifically for AYAs, aged between 13 and 39 years, living with or beyond a cancer diagnosis. Methods: Searches were performed in PubMed, EMBASE, and Web of Science to identify digital health interventions designed specifically for AYA living with or beyond a cancer diagnosis. Data on the characteristics and outcomes of each intervention were synthesized. Results: A total of 4731 intervention studies were identified through the searches; 38 interventions (43 research papers) met the inclusion criteria. Most (20/38, 53\%) were website-based interventions. Most studies focused on symptom management and medication adherence (15, 39\%), behavior change (15, 39\%), self-care (8, 21\%), and emotional health (7, 18\%). Most digital health interventions included multiple automated and communicative functions such as enriched information environments, automated follow-up messages, and access to peer support. Where reported (20, 53\% of studies), AYAs' subjective experience of using the digital platform was typically positive. The overall quality of the studies was found to be good (mean Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields scores >68\%). Some studies reported feasibility outcomes (uptake, acceptability, and attrition) but were not sufficiently powered to comment on intervention effects. Conclusions: Numerous digital interventions have been developed and designed to support young people living with and beyond a diagnosis of cancer. However, many of these interventions have yet to be deployed, implemented, and evaluated at scale. ", doi="10.2196/12071", url="http://cancer.jmir.org/2019/2/e12071/", url="http://www.ncbi.nlm.nih.gov/pubmed/31368438" } @Article{info:doi/10.2196/12593, author="Speller, Brittany and Micic, Selena and Daly, Corinne and Pi, Lebei and Little, Tari and Baxter, N. Nancy", title="Oncofertility Decision Support Resources for Women of Reproductive Age: Systematic Review", journal="JMIR Cancer", year="2019", month="Jun", day="6", volume="5", number="1", pages="e12593", keywords="decision aids", keywords="health education materials", keywords="fertility", keywords="cancer", keywords="young women", keywords="decision-making", keywords="patient education", abstract="Background: Cancer treatments have the potential to cause infertility among women of reproductive age. Many cancer patients do not receive sufficient oncofertility information or referrals to reproductive specialists prior to starting cancer treatment. While health care providers cite lack of awareness on the available oncofertility resources, the majority of cancer patients use the internet as a resource to find additional information to supplement discussions with their providers. Objective: Our aim was to identify and characterize Web-based oncofertility decision aids and health education materials accessible for women of reproductive age with a diagnosis of any cancer. Methods: We searched five databases and the gray literature for the years 1994-2018. The developer and content information for identified resources was extracted. Each resource underwent a quality assessment. Results: We identified 31 open access resources including 4 decision aids and 27 health educational materials. The most common fertility preservation options listed in the resources included embryo (31/31, 100\%), egg (31, 100\%), and ovarian tissue freezing (30, 97\%). Notably, approximately one-third (11, 35\%) contained references and 5 (16\%) had a reading level of grade 8 or below. Resources were of varying quality; two decision aids from Australia and the Netherlands, two booklets from Australia and the United Kingdom, and three websites from Canada and the United States rated as the highest quality. Conclusions: This comprehensive review characterizes numerous resources available to support patients and providers with oncofertility information, counseling, and decision making. More focus is required to improve the awareness and the access of existing resources among patients and providers. Providers can address patient information needs by leveraging or adapting existing resources to support clinical discussions and their specific patient population. ", doi="10.2196/12593", url="http://cancer.jmir.org/2019/1/e12593/", url="http://www.ncbi.nlm.nih.gov/pubmed/31199289" } @Article{info:doi/10.2196/cancer.7952, author="Kalf, RJ Rachel and Makady, Amr and ten Ham, MT Renske and Meijboom, Kim and Goettsch, G. Wim and ", title="Use of Social Media in the Assessment of Relative Effectiveness: Explorative Review With Examples From Oncology", journal="JMIR Cancer", year="2018", month="Jun", day="08", volume="4", number="1", pages="e11", keywords="social media", keywords="relative effectiveness", keywords="real-world data", keywords="patient reported outcomes", abstract="Background: An element of health technology assessment constitutes assessing the clinical effectiveness of drugs, generally called relative effectiveness assessment. Little real-world evidence is available directly after market access, therefore randomized controlled trials are used to obtain information for relative effectiveness assessment. However, there is growing interest in using real-world data for relative effectiveness assessment. Social media may provide a source of real-world data. Objective: We assessed the extent to which social media-generated health data has provided insights for relative effectiveness assessment. Methods: An explorative literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify examples in oncology where health data were collected using social media. Scientific and grey literature published between January 2010 and June 2016 was identified by four reviewers, who independently screened studies for eligibility and extracted data. A descriptive qualitative analysis was performed. Results: Of 1032 articles identified, eight were included: four articles identified adverse events in response to cancer treatment, three articles disseminated quality of life surveys, and one study assessed the occurrence of disease-specific symptoms. Several strengths of social media-generated health data were highlighted in the articles, such as efficient collection of patient experiences and recruiting patients with rare diseases. Conversely, limitations included validation of authenticity and presence of information and selection bias. Conclusions: Social media may provide a potential source of real-world data for relative effectiveness assessment, particularly on aspects such as adverse events, symptom occurrence, quality of life, and adherence behavior. This potential has not yet been fully realized and the degree of usefulness for relative effectiveness assessment should be further explored. ", doi="10.2196/cancer.7952", url="http://cancer.jmir.org/2018/1/e11/", url="http://www.ncbi.nlm.nih.gov/pubmed/29884607" } @Article{info:doi/10.2196/cancer.7926, author="van Eenbergen, C. Mies and van de Poll-Franse, V. Lonneke and Krahmer, Emiel and Verberne, Suzan and Mols, Floortje", title="Analysis of Content Shared in Online Cancer Communities: Systematic Review", journal="JMIR Cancer", year="2018", month="Apr", day="03", volume="4", number="1", pages="e6", keywords="cancer", keywords="survivors", keywords="support groups", keywords="internet", abstract="Background: The content that cancer patients and their relatives (ie, posters) share in online cancer communities has been researched in various ways. In the past decade, researchers have used automated analysis methods in addition to manual coding methods. Patients, providers, researchers, and health care professionals can learn from experienced patients, provided that their experience is findable. Objective: The aim of this study was to systematically review all relevant literature that analyzes user-generated content shared within online cancer communities. We reviewed the quality of available research and the kind of content that posters share with each other on the internet. Methods: A computerized literature search was performed via PubMed (MEDLINE), PsycINFO (5 and 4 stars), Cochrane Central Register of Controlled Trials, and ScienceDirect. The last search was conducted in July 2017. Papers were selected if they included the following terms: (cancer patient) and (support group or health communities) and (online or internet). We selected 27 papers and then subjected them to a 14-item quality checklist independently scored by 2 investigators. Results: The methodological quality of the selected studies varied: 16 were of high quality and 11 were of adequate quality. Of those 27 studies, 15 were manually coded, 7 automated, and 5 used a combination of methods. The best results can be seen in the papers that combined both analytical methods. The number of analyzed posts ranged from 200 to 1,500,000; the number of analyzed posters ranged from 75 to 90,000. The studies analyzing large numbers of posts mainly related to breast cancer, whereas those analyzing small numbers were related to other types of cancers. A total of 12 studies involved some or entirely automatic analysis of the user-generated content. All the authors referred to two main content categories: informational support and emotional support. In all, 15 studies reported only on the content, 6 studies explicitly reported on content and social aspects, and 6 studies focused on emotional changes. Conclusions: In the future, increasing amounts of user-generated content will become available on the internet. The results of content analysis, especially of the larger studies, give detailed insights into patients' concerns and worries, which can then be used to improve cancer care. To make the results of such analyses as usable as possible, automatic content analysis methods will need to be improved through interdisciplinary collaboration. ", doi="10.2196/cancer.7926", url="http://cancer.jmir.org/2018/1/e6/", url="http://www.ncbi.nlm.nih.gov/pubmed/29615384" } @Article{info:doi/10.2196/cancer.7312, author="van Eenbergen, C. Mies and van de Poll-Franse, V. Lonneke and Heine, Peter and Mols, Floortje", title="The Impact of Participation in Online Cancer Communities on Patient Reported Outcomes: Systematic Review", journal="JMIR Cancer", year="2017", month="Sep", day="28", volume="3", number="2", pages="e15", keywords="cancer", keywords="survivors", keywords="patient reported outcomes", keywords="Internet", keywords="support groups", abstract="Background: In recent years, the question of how patients' participating in online communities affects various patient reported outcomes (PROs) has been investigated in several ways. Objectives: This study aimed to systematically review all relevant literature identified using key search terms, with regard to, first, changes in PROs for cancer patients who participate in online communities and, second, the characteristics of patients who report such effects. Methods: A computerized search of the literature via PubMed (MEDLINE), PsycINFO (5 and 4 stars), Cochrane Central Register of Controlled Trials, and ScienceDirect was performed. Last search was conducted in June 2017. Studies with the following terms were included: (cancer patient) and (support group or health communities) and (online or Internet). A total of 21 studies were included and independently assessed by 2 investigators using an 11-item quality checklist. Results: The methodological quality of the selected studies varied: 12 were of high quality, eight were of adequate quality, and only one was of low quality. Most of the respondents were women (about 80\%), most with breast cancer; their mean age was 50 years. The patients who were active in online support groups were mostly younger and more highly educated than the nonusers. The investigated PROs included general well-being (ie, mood and health), anxiety, depression, quality of life, posttraumatic growth, and cancer-related concerns. Only marginal effects---that is, PRO improvements---were found; in most cases they were insignificant, and in some cases they were contradictory. Conclusions: The main shortcoming of this kind of study is the lack of methodological instruments for reliable measurements. Furthermore, some patients who participate in online communities or interact with peers via Internet do not expect to measure changes in their PROs. If cancer survivors want to meet other survivors and share information or get support, online communities can be a trustworthy and reliable platform to facilitate opportunities or possibilities to make this happen. ", doi="10.2196/cancer.7312", url="http://cancer.jmir.org/2017/2/e15/", url="http://www.ncbi.nlm.nih.gov/pubmed/28958985" } @Article{info:doi/10.2196/jmir.4009, author="Agboola, O. Stephen and Ju, Woong and Elfiky, Aymen and Kvedar, C. Joseph and Jethwani, Kamal", title="The Effect of Technology-Based Interventions on Pain, Depression, and Quality of Life in Patients With Cancer: A Systematic Review of Randomized Controlled Trials", journal="J Med Internet Res", year="2015", month="Mar", day="13", volume="17", number="3", pages="e65", keywords="telehealth", keywords="connected health", keywords="cancer", keywords="telephone", keywords="pain", keywords="depression", keywords="quality of life", keywords="systematic review", keywords="randomized controlled trials", abstract="Background: The burden of cancer is increasing; projections over the next 2 decades suggest that the annual cases of cancer will rise from 14 million in 2012 to 22 million. However, cancer patients in the 21st century are living longer due to the availability of novel therapeutic regimens, which has prompted a growing focus on maintaining patients' health-related quality of life. Telehealth is increasingly being used to connect with patients outside of traditional clinical settings, and early work has shown its importance in improving quality of life and other clinical outcomes in cancer care. Objective: The aim of this study was to systematically assess the literature for the effect of supportive telehealth interventions on pain, depression, and quality of life in cancer patients via a systematic review of clinical trials. Methods: We searched PubMed, EMBASE, Google Scholar, CINAHL, and PsycINFO in July 2013 and updated the literature search again in January 2015 for prospective randomized trials evaluating the effect of telehealth interventions in cancer care with pain, depression, and quality of life as main outcomes. Two of the authors independently reviewed and extracted data from eligible randomized controlled trials, based on pre-determined selection criteria. Methodological quality of studies was assessed by the Cochrane Collaboration risk of bias tool. Results: Of the 4929 articles retrieved from databases and relevant bibliographies, a total of 20 RCTs were included in the final review. The studies were largely heterogeneous in the type and duration of the intervention as well as in outcome assessments. A majority of the studies were telephone-based interventions that remotely connected patients with their health care provider or health coach. The intervention times ranged from 1 week to 12 months. In general, most of the studies had low risk of bias across the domains of the Cochrane Collaboration risk of bias tool, but most of the studies had insufficient information about the allocation concealment domain. Two of the three studies focused on pain control reported significant effects of the intervention; four of the nine studies focus on depression reported significant effects, while only the studies that were focused on quality of life reported significant effects. Conclusions: This systematic review demonstrates the potential of telehealth interventions in improving outcomes in cancer care. However, more high-quality large-sized trials are needed to demonstrate cogent evidence of its effectiveness. ", doi="10.2196/jmir.4009", url="http://www.jmir.org/2015/3/e65/", url="http://www.ncbi.nlm.nih.gov/pubmed/25793945" }