%0 Journal Article %@ 2369-1999 %I JMIR Publications %V 11 %N %P e68516 %T Leveraging Artificial Intelligence for Digital Symptom Management in Oncology: The Development of CRCWeb %A Liu,Darren %A Lin,Yufen %A Yan,Runze %A Wang,Zhiyuan %A Bold,Delgersuren %A Hu,Xiao %K colorectal cancer %K health disparity %K health equity %K generative artificial intelligence %K large language model %K software engineering %K artificial intelligence %D 2025 %7 16.6.2025 %9 %J JMIR Cancer %G English %X Digital health interventions offer promise for scalable and accessible health care, but access is still limited by some participatory challenges, especially for disadvantaged families facing limited health literacy, language barriers, low income, or living in marginalized areas. These issues are particularly pronounced for patients with colorectal cancer (CRC), who often experience distressing symptoms and struggle with educational materials due to complex jargon, fatigue, or reading level mismatches. To address these issues, we developed and assessed the feasibility of a digital health platform, CRCWeb, to improve the accessibility of educational resources on symptom management for disadvantaged patients with CRC and their caregivers facing limited health literacy or low income. CRCWeb was developed through a stakeholder-centered participatory design approach. Two-phase semistructured interviews with patients, caregivers, and oncology experts informed the iterative design process. From the interviews, we developed the following 5 key design principles: user-friendly navigation, multimedia integration, concise and clear content, enhanced accessibility for individuals with vision and reading disabilities, and scalability for future content expansion. Initial feedback from iterative stakeholder engagements confirmed high user satisfaction, with participants rating CRCWeb an average of 3.98 out of 5 on the postintervention survey. Additionally, using generative artificial intelligence tools, including large language models like ChatGPT and multimedia generation tools such as Pictory, complex health care guidelines were transformed into concise, easily comprehensible multimedia content, and made accessible through CRCWeb. User engagement was notably higher among disadvantaged participants with limited health literacy or low income, who logged into the platform 2.52 times more frequently than nondisadvantaged participants. The structured development approach of CRCWeb demonstrates that generative artificial intelligence–powered multimedia interventions can effectively address health care accessibility barriers faced by disadvantaged patients with CRC and caregivers with limited health literacy or low income. This structured approach highlights how digital innovations can enhance health care.International Registered Report Identifier (IRRID): RR2-10.2196/48499 %R 10.2196/68516 %U https://cancer.jmir.org/2025/1/e68516 %U https://doi.org/10.2196/68516 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 11 %N %P e65848 %T Chatbot for the Return of Positive Genetic Screening Results for Hereditary Cancer Syndromes: Prompt Engineering Project %A Coen,Emma %A Del Fiol,Guilherme %A Kaphingst,Kimberly A %A Borsato,Emerson %A Shannon,Jackilen %A Smith,Hadley %A Masino,Aaron %A Allen,Caitlin G %K prompt engineering %K few-shot learning %K retrieval-augmented generation %K population screening program %K cancer %K genetics %K screening %K syndrome %K genomic %K counseling %K large language model %K LLM %K engineering %K chatbot %K prompt %K RAG %K mobile phone %D 2025 %7 10.6.2025 %9 %J JMIR Cancer %G English %X The increasing demand for population-wide genomic screening and the limited availability of genetic counseling resources have created a pressing need for innovative service delivery models. Chatbots powered by large language models (LLMs) have shown potential in genomic services, particularly in pretest counseling, but their application in returning positive population-wide genomic screening results remains underexplored. Leveraging advanced LLMs like GPT-4 offers an opportunity to address this gap by delivering accurate, contextual, and user-centered communication to individuals receiving positive genetic test results. This project aimed to design, implement, and evaluate a chatbot integrated with GPT-4, tailored to support the return of positive genomic screening results in the context of South Carolina’s In Our DNA SC program. This initiative offers free genetic screening to 100,000 individuals, with over 33,000 results returned and numerous positive findings for conditions such as Lynch syndrome, hereditary breast and ovarian cancer syndrome, and familial hypercholesterolemia. A 3-step prompt engineering process using retrieval-augmented generation and few-shot techniques was used to create the chatbot. Training materials included patient frequently asked questions, genetic counseling scripts, and patient-derived queries. The chatbot underwent iterative refinement based on 13 training questions, while performance was evaluated through expert ratings on responses to 2 hypothetical patient scenarios. The 2 scenarios were intended to represent common but distinct patient profiles in terms of gender, race, ethnicity, age, and background knowledge. Domain experts rated the chatbot using a 5-point Likert scale across 8 predefined criteria: tone, clarity, program accuracy, domain accuracy, robustness, efficiency, boundaries, and usability. The chatbot achieved an average score of 3.86 (SD 0.89) across all evaluation metrics. The highest-rated criteria were tone (mean 4.25, SD 0.71) and usability (mean 4.25, SD 0.58), reflecting the chatbot’s ability to communicate effectively and provide a seamless user experience. Boundary management (mean 4.0, SD 0.76) and efficiency (mean 3.88, SD 1.08) also scored well, while clarity and robustness received ratings of 3.81 (SD 1.05) and 3.81 (SD 0.66), respectively. Domain accuracy was rated 3.63 (SD 0.96), indicating satisfactory performance in delivering genetic information, whereas program accuracy received the lowest score of 3.25 (SD 1.39), highlighting the need for improvements in delivering program-specific details. This project demonstrates the feasibility of using LLM-powered chatbots to support the return of positive genomic screening results. The chatbot effectively handled open-ended patient queries, maintained conversational boundaries, and delivered user-friendly responses. However, enhancements in program-specific accuracy are essential to maximize its utility. Future research will explore hybrid chatbot designs that combine the strengths of LLMs with rule-based components to improve scalability, accuracy, and accessibility in genomic service delivery. The findings underscore the potential of generative artificial intelligence tools to address resource limitations and improve the accessibility of genomic health care services. %R 10.2196/65848 %U https://cancer.jmir.org/2025/1/e65848 %U https://doi.org/10.2196/65848 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 11 %N %P e53887 %T Process Re-Engineering and Data Integration Using Fast Healthcare Interoperability Resources for the Multidisciplinary Treatment of Lung Cancer %A Lin,Ching-Hsiung %A Wang,Bing-Yen %A Lin,Sheng-Hao %A Shih,Pei Hsuan %A Lee,Chin-Jing %A Huang,Yung Ting %A Chen,Shih Chieh %A Pan,Mei-Lien %K multidisciplinary team meetings %K process re-engineering %K multidisciplinary cancer care %K Fast Healthcare Interoperability Resources %K tumor board %K multidisciplinary team %K cancer %K lung cancer %K treatment %K lung %K health care professionals %K health care %K MDT %K digitize %K API %K hospital %K information system %K HIS %K medical data %K platform %K data integration %K information and communication technology %K ICT %K decision support %K eHealth %K digital tools %K clinic %K patient care %K application programming interface %K hospital information system %D 2025 %7 5.5.2025 %9 %J JMIR Cancer %G English %X Multidisciplinary team (MDT) meetings play a critical role in cancer care by fostering collaboration between different health care professionals to develop optimal treatment recommendations. However, meeting scheduling and coordination rely heavily on manual work, making information-sharing and integration challenging. This results in incomplete information, affecting decision-making efficiency and impacting the progress of MDT. This project aimed to optimize and digitize the MDT workflow by interviewing the members of an MDT and implementing an integrated information platform using the Fast Healthcare Interoperability Resources (FHIR) standard. MDT process re-engineering was conducted at a central Taiwan medical center. To digitize the workflow, our hospital adopted the NAVIFY Tumor Board (NTB), a cloud-based platform integrating medical data using international standards, including Logical Object Identifiers, Names, and Codes, Systemized Nomenclature of Medicine–Clinical Terms, M-code, and FHIR. We improved our hospital’s information system using application programming interfaces to consolidate data from various systems, excluding sensitive cases. Using FHIR, we aggregated, analyzed, and converted the data for seamless integration. Using a user experience design, we gained insights into the lung cancer MDT’s processes and needs. We conducted 2 phases: pre- and post-NTB integration. Ethnographic observations and stakeholder interviews revealed pain points. The affinity diagram method categorizes the pain points during the discussion process, leading to efficient solutions. We divided the observation period into 2 phases: before and after integrating the NTB with the hospital information system. In phase 1, there were 83 steps across the 6 MDT activities, leading to inefficiencies and potential delays in patient care. In phase 2, we streamlined the tumor board process into 33 steps by introducing new functions and optimizing the data entry for pathologists. We converted the related medical data to the FHIR format using 6 FHIR resources and improved our hospital information system by developing functions and application programming interfaces to interoperate among various systems; consolidating data from different sources, excluding sensitive cases; and enhancing overall system efficiency. The MDT workflow reduced steps by 60% (50/83), lowering the coordinated activity time from 30 to 5 minutes. Improved efficiency boosted productivity and coordination in each case of manager feedback. This study optimized and digitized the workflow of MDT meetings, significantly enhancing the efficiency and accuracy of the tumor board process to benefit both medical professionals and patients. Based on FHIR, we integrated the data scattered across different information systems in our hospital and established a system interoperability interface that conformed to the standard. While digitizing the work of MDT meetings, we also promoted the optimization and transformation of related information systems and improved their service quality. We recommend additional research to assess the usability of a tumor board platform. %R 10.2196/53887 %U https://cancer.jmir.org/2025/1/e53887 %U https://doi.org/10.2196/53887 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 11 %N %P e65566 %T Ethical Design of Data-Driven Decision Support Tools for Improving Cancer Care: Embedded Ethics Review of the 4D PICTURE Project %A Bak,Marieke %A Hartman,Laura %A Graafland,Charlotte %A Korfage,Ida J %A Buyx,Alena %A Schermer,Maartje %A , %+ Institute of History and Ethics in Medicine, Department of Preclinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Ismaninger Street 22, München, 81675, Germany, 49 43480533, marieke.bak@tum.de %K shared decision-making %K oncology %K IT %K ethics %K decision support tools %K big data %K medical decision-making %K artificial intelligence %D 2025 %7 10.4.2025 %9 Original Paper %J JMIR Cancer %G English %X Oncology patients often face complex choices between treatment regimens with different risk-benefit ratios. The 4D PICTURE (Producing Improved Cancer Outcomes Through User-Centered Research) project aims to support patients, their families, and clinicians with these complex decisions by developing data-driven decision support tools (DSTs) for patients with breast cancer, prostate cancer, and melanoma as part of care path redesign using a methodology called MetroMapping. There are myriad ethical issues to consider as the project will create data-driven prognostic models and develop conversation tools using artificial intelligence while including patient perspectives by setting up boards of experiential experts in 8 different countries. This paper aims to review the key ethical challenges related to the design and development of DSTs in oncology. To explore the ethics of DSTs in cancer care, the project adopted the Embedded Ethics approach—embedding ethicists into research teams to sensitize team members to ethical aspects and assist in reflecting on those aspects throughout the project. We conducted what we call an embedded review of the project drawing from key literature on topics related to the different work packages of the 4D PICTURE project, whereas the analysis was an iterative process involving discussions with researchers in the project. Our review identified 13 key ethical challenges related to the development of DSTs and the redesigning of care paths for more personalized cancer care. Several ethical aspects were related to general potential issues of data bias and privacy but prompted specific research questions, for instance, about the inclusion of certain demographic variables in models. Design methodology in the 4D PICTURE project can provide insights related to design justice, a novel consideration in health care DSTs. Ethical points of attention related to health care policy, such as cost-effectiveness, financial sustainability, and environmental impact, were also identified, along with challenges in the research process itself, emphasizing the importance of epistemic justice, the role of embedded ethicists, and psychological safety. This viewpoint highlights ethical aspects previously neglected in the digital health ethics literature and zooms in on real-world challenges in an ongoing project. It underscores the need for researchers and leaders in data-driven medical research projects to address ethical challenges beyond the scientific core of the project. More generally, our tailored review approach provides a model for embedding ethics into large data-driven oncology research projects from the start, which helps ensure that technological innovations are designed and developed in an appropriate and patient-centered manner. %M 40209225 %R 10.2196/65566 %U https://cancer.jmir.org/2025/1/e65566 %U https://doi.org/10.2196/65566 %U http://www.ncbi.nlm.nih.gov/pubmed/40209225 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 11 %N %P e63486 %T Adapting a Self-Guided eHealth Intervention Into a Tailored Therapist-Guided eHealth Intervention for Survivors of Colorectal Cancer %A Lyhne,Johanne Dam %A Smith,Allan ‘Ben’ %A Carstensen,Tina Birgitte Wisbech %A Beatty,Lisa %A Bamgboje-Ayodele,Adeola %A Klein,Britt %A Jensen,Lars Henrik %A Frostholm,Lisbeth %K fear of cancer recurrence %K therapist-guided %K self-guided %K online intervention %K colorectal cancer %K digital health %K psychosocial intervention %K survivorship %K eHealth %K adaptation %K survivors %K oncologists %K therapists %K acceptability %K mobile phone %D 2025 %7 5.3.2025 %9 %J JMIR Cancer %G English %X Therapist-guided eHealth interventions have been shown to engage users more effectively and achieve better outcomes than self-guided interventions when addressing psychological symptoms. Building on this evidence, this viewpoint aimed to describe the adaptation of iConquerFear, a self-guided eHealth intervention targeting fear of cancer recurrence, into a therapist-guided version (TG-iConquerFear) tailored specifically for survivors of colorectal cancer (CRC). The goal was to optimize patient outcomes while minimizing the need for extensive resources. The adaptation process followed the Information System research framework, which facilitated a systematic integration of knowledge and iterative testing. Drawing on insights from the original iConquerFear development, as well as feedback from end users, oncologists, and therapists, we began by identifying areas for improvement. These insights formed the foundation for the first design cycle. Initial internal testing revealed the need for several adjustments to enhance the intervention. While the core concept of iConquerFear remained unchanged, we made significant modifications to improve access by optimizing the platform for mobile devices, to support adherence by expanding the exercises, and to equip therapists with tools such as reflective questions and a monitoring control panel. External field testing with 5 survivors of CRC provided further validation. Participants reported a high level of acceptability, and their feedback guided additional minor points to consider incorporating in future versions. This study illustrates how a self-guided eHealth intervention can be successfully adapted into a therapist-guided format for fear of cancer recurrence, tailored to meet the needs of survivors of CRC. The described approach serves as a valuable framework for integrating therapist guidance into similar interventions, ensuring their relevance and effectiveness for targeted populations.Trial Registration: ClinicalTrials.gov NCT04287218; https://clinicaltrials.gov/study/NCT04287218 International Registered Report Identifier (IRRID): RR2-10.1186/s12885-020-06731-6 %R 10.2196/63486 %U https://cancer.jmir.org/2025/1/e63486 %U https://doi.org/10.2196/63486 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 11 %N %P e66633 %T Developing Effective Frameworks for Large Language Model–Based Medical Chatbots: Insights From Radiotherapy Education With ChatGPT %A Chow,James C L %A Li,Kay %+ Department of Medical Physics, Princess Margaret Cancer Centre, University Health Network, Rm 7-606, 7/F, 700 University Ave, Toronto, ON, M5G 1X6, Canada, 1 416 946 4501, james.chow@uhn.ca %K artificial intelligence %K AI %K AI in medical education %K radiotherapy chatbot %K large language models %K LLMs %K medical chatbots %K health care AI %K ethical AI in health care %K personalized learning %K natural language processing %K NLP %K radiotherapy education %K AI-driven learning tools %D 2025 %7 18.2.2025 %9 Viewpoint %J JMIR Cancer %G English %X This Viewpoint proposes a robust framework for developing a medical chatbot dedicated to radiotherapy education, emphasizing accuracy, reliability, privacy, ethics, and future innovations. By analyzing existing research, the framework evaluates chatbot performance and identifies challenges such as content accuracy, bias, and system integration. The findings highlight opportunities for advancements in natural language processing, personalized learning, and immersive technologies. When designed with a focus on ethical standards and reliability, large language model–based chatbots could significantly impact radiotherapy education and health care delivery, positioning them as valuable tools for future developments in medical education globally. %M 39965195 %R 10.2196/66633 %U https://cancer.jmir.org/2025/1/e66633 %U https://doi.org/10.2196/66633 %U http://www.ncbi.nlm.nih.gov/pubmed/39965195 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 10 %N %P e57276 %T Artificial Intelligence as a Potential Catalyst to a More Equitable Cancer Care %A Garcia-Saiso,Sebastian %A Marti,Myrna %A Pesce,Karina %A Luciani,Silvana %A Mujica,Oscar %A Hennis,Anselm %A D'Agostino,Marcelo %+ Pan American Health Organization, 525 23rd st NW, Washington, DC, 20037, United States, 1 7034737961, dagostim@paho.org %K digital health %K public health %K cancer %K artificial intelligence %K AI %K catalyst %K cancer care %K cost %K costs %K demographic %K epidemiological %K change %K changes %K healthcare %K equality %K health system %K mHealth %K mobile health %D 2024 %7 12.8.2024 %9 Viewpoint %J JMIR Cancer %G English %X As we enter the era of digital interdependence, artificial intelligence (AI) emerges as a key instrument to transform health care and address disparities and barriers in access to services. This viewpoint explores AI's potential to reduce inequalities in cancer care by improving diagnostic accuracy, optimizing resource allocation, and expanding access to medical care, especially in underserved communities. Despite persistent barriers, such as socioeconomic and geographical disparities, AI can significantly improve health care delivery. Key applications include AI-driven health equity monitoring, predictive analytics, mental health support, and personalized medicine. This viewpoint highlights the need for inclusive development practices and ethical considerations to ensure diverse data representation and equitable access. Emphasizing the role of AI in cancer care, especially in low- and middle-income countries, we underscore the importance of collaborative and multidisciplinary efforts to integrate AI effectively and ethically into health systems. This call to action highlights the need for further research on user experiences and the unique social, cultural, and political barriers to AI implementation in cancer care. %M 39133537 %R 10.2196/57276 %U https://cancer.jmir.org/2024/1/e57276 %U https://doi.org/10.2196/57276 %U http://www.ncbi.nlm.nih.gov/pubmed/39133537 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 10 %N %P e52985 %T Using a Mobile Messenger Service as a Digital Diary to Capture Patients’ Experiences Along Their Interorganizational Treatment Path in Gynecologic Oncology: Lessons Learned %A Baum,Eleonore %A Thiel,Christian %A Kobleder,Andrea %A Bernhardsgrütter,Daniela %A Engst,Ramona %A Maurer,Carola %A Koller,Antje %+ Institute of Applied Nursing Science, School of Health, Eastern Switzerland University of Applied Sciences, Neumarkt 3, Vadianstrasse 29, St.Gallen, 9000, Switzerland, 41 58 257 12 13, antje.koller@ost.ch %K mobile apps %K computer security %K confidentiality %K data collection %K oncology %K breast neoplasms %K mobile phone %D 2024 %7 29.7.2024 %9 Viewpoint %J JMIR Cancer %G English %X A digital diary in the form of a mobile messenger service offers a novel method for data collection in cancer research. Little is known about the things to consider when using this data collection method in clinical research for patients with cancer. In this Viewpoint paper, we discuss the lessons we learned from using a qualitative digital diary method via a mobile messenger service for data collection in oncology care. The lessons learned focus on three main topics: (1) data quality, (2) practical aspects, and (3) data protection. We hope to provide useful information to other researchers who consider this method for their research with patients. First, in this paper, we argue that the interactive nature of a digital diary via a messenger service is very well suited for the phenomenological approach and produces high-quality data. Second, we discuss practical issues of data collection with a mobile messenger service, including participant and researcher interaction. Third, we highlight corresponding aspects around technicalities, particularly those regarding data security. Our views on data privacy and information security are summarized in a comprehensive checklist to inform fellow researchers on the selection of a suitable messenger service for different scenarios. In our opinion, a digital diary via a mobile messenger service can provide high-quality data almost in real time and from participants’ daily lives. However, some considerations must be made to ensure that patient data are sufficiently protected. The lessons we learned can guide future qualitative research using this relatively novel method for data collection in cancer research. %M 39073852 %R 10.2196/52985 %U https://cancer.jmir.org/2024/1/e52985 %U https://doi.org/10.2196/52985 %U http://www.ncbi.nlm.nih.gov/pubmed/39073852 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 10 %N %P e56168 %T An Introduction to the OutSMART Cancer Serious Game: Current and Future Directions %A Abraham,Olufunmilola %A McCarthy,Tyler J %+ Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Rm 2515 Rennebohm Hall, 777 Highland Ave, Madison, WI, 53705, United States, 1 6082634498, olufunmilola.abraham@wisc.edu %K serious game %K cancer %K health education %K adolescents %K health behavior %K United States %K young people %K adolescent %K teenager %K teenagers %K cancer prevention %K education %K cancer risk %K tool %K OutSMART Cancer %K innovative %K game development %K cancer awareness %K prevention %K wellness %D 2024 %7 29.5.2024 %9 Viewpoint %J JMIR Cancer %G English %X Given that cancer is a challenging disease that plagues millions of individuals of all age groups and socioeconomic statuses globally, developmentally appropriate education is often lacking for young people, particularly adolescents. Increasing cancer awareness and prevention education among adolescents using innovative strategies, such as game-based learning, is critical in reducing the burden of this disease. Adolescents are understudied in the field of cancer prevention and control, yet vulnerable as they tackle creating life-long health behavior patterns. Targeting cancer prevention education for adolescents has the potential to support long-term healthy behavior and reduce their risk of cancer. This paper provides an overview of the Collaborative Research on MEdication use and family health (CRoME) Lab’s novel game-based cancer prevention education tool. OutSMART Cancer is an innovative, novel educational intervention in the form of a serious game. Serious games are educational tools that seek to impart knowledge and improve behaviors in their players. This game covers information related to breast cancer, colon cancer, and lung cancer. This viewpoint is a summary of the developmental process for the OutSMART Cancer game. We describe in detail the work preceding initial game development, the current version of the game, future directions for the game, and its educational potential. The long-term goal of OutSMART Cancer is to improve cancer awareness and knowledge regarding prevention behaviors in adolescents and support a lifetime of health and wellness. %M 38809587 %R 10.2196/56168 %U https://cancer.jmir.org/2024/1/e56168 %U https://doi.org/10.2196/56168 %U http://www.ncbi.nlm.nih.gov/pubmed/38809587 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 10 %N %P e53956 %T Need for Culturally Competent and Responsive Cancer Education for African Immigrant Families and Youth Living in the United States %A Abraham,Olufunmilola %A Agoke,Adeola %A Sanuth,Kazeem %A Fapohunda,Abimbola %A Ogunsanya,Motolani %A Piper,Megan %A Trentham-Dietz,Amy %+ Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Room 2515 Rennebohm Hall, 777 Highland Avenue, Madison, WI, 53705, United States, 1 6082634498, olufunmilola.abraham@wisc.edu %K African immigrant %K youth %K adolescent %K adolescents %K teen %K teens %K teenager %K teenagers %K cancer awareness %K health disparities %K culturally competent education %K African %K Black %K immigrant %K cultural %K culturally %K cancer %K oncology %K patient education %K awareness %K prevention %K disparity %K disparities %D 2024 %7 6.3.2024 %9 Viewpoint %J JMIR Cancer %G English %X Cancer prevalence data for Black Americans is monolithic and fails to consider the diverse cultures and backgrounds within that community. For instance, African immigrants constitute a meaningful proportion of the foreign-born Black immigrants in the United States (42%), but the prevalence of cancer in the African immigrant community itself is unknown. Therefore, without accurate cancer prevalence data, it is impossible to identify trends and other key factors that are needed to support the health of African immigrants and their children. Moreover, it is impossible to understand how the culture and language of subgroups influence their cancer-related health behavior. While research in this area is limited, the existing literature articulates the need for culturally responsive and culturally tailored cancer education for African immigrants and their adolescent children, which is what we advocate for in this viewpoint paper. Existing projects demonstrate the feasibility of culturally responsive programming for adults; however, few projects include or focus on adolescents or children born to African immigrants. To best meet the needs of this understudied community, researchers must use culturally competent interventions alongside familiar, usable media. For adolescents, technology is ubiquitous thus, the creation of a culturally tailored digital intervention has immense potential to improve cancer awareness and prevention for youth and their community. More research is needed to address many of the existing research gaps and develop a rich understanding of the unique experience of cancer among African immigrant families that can be used to inform intervention development. Through this viewpoint, we review the current state of cancer-related research among African immigrant families in the United States. In this paper, we acknowledge the current knowledge gaps and issues surrounding measurement and then discuss the factors relevant to designing an educational intervention targeted at African immigrants and the role of African immigrant youth. %M 38447129 %R 10.2196/53956 %U https://cancer.jmir.org/2024/1/e53956 %U https://doi.org/10.2196/53956 %U http://www.ncbi.nlm.nih.gov/pubmed/38447129 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 26 %N %P e50000 %T Improvement of Cancer Prevention and Control: Reflection on the Role of Emerging Information Technologies %A Dong,Pei %A Mao,Ayan %A Qiu,Wuqi %A Li,Guanglin %+ Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Number 3 YaBao Road, Chaoyang District, Beijing, 100020, China, 86 01052328731, mao.ayan@imicams.ac.cn %K emerging information technologies %K cancer %K prevention and control %D 2024 %7 27.2.2024 %9 Viewpoint %J J Med Internet Res %G English %X Cancer has become an important public health problem affecting the health of Chinese residents, as well as residents all over the world. With the improvement of cancer prevention and treatment, the growth of the mortality rate of cancers has slowed down gradually, but the incidence rate is still increasing rapidly, and cancers still impose heavy disease and economic burdens. Cancer screening and early cancer diagnosis and treatment are important ways to reduce the burden of cancer-related diseases. At present, various projects for early cancer diagnosis and treatment have been implemented in China. With the expansion of the coverage of these projects, the problems related to project implementation, operation, and management have emerged gradually. In recent years, emerging information technologies have been applied in the field of health and have facilitated health management and clinical decision-making. Meanwhile, China announced multiple policies to encourage and promote the application of information technologies in the field of health. Therefore, combined with the analysis of major problems in cancer prevention and control projects, this paper probes into how to apply information technologies such as biological information mining, artificial intelligence, and electronic information collection technology to various stages of cancer prevention and control. Information technologies realize the integrated management of prevention and control processes, for example, mobilization and preliminary identification, high-risk assessment, clinical screening, clinical diagnosis and treatment, tracking and follow-up, and biological sample management of high-risk groups, and promote the efficient implementation of cancer prevention and control projects in China. %M 38412009 %R 10.2196/50000 %U https://www.jmir.org/2024/1/e50000 %U https://doi.org/10.2196/50000 %U http://www.ncbi.nlm.nih.gov/pubmed/38412009 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 8 %N 2 %P e36258 %T Optimizing Social Support in Oncology with Digital Platforms %A Katsaros,Dimos %A Hawthorne,James %A Patel,Jay %A Pothier,Kaitlin %A Aungst,Timothy %A Franzese,Chris %+ Matchstick LLC, 715 Main Street, 2nd Floor, Boonton, NJ, 07005, United States, 1 5086491222, dimosk@matchstickllc.com %K social support %K chronic disease %K social networks %K oncology %K cancer %K digital biomarkers %K digital health %K caregiver support %D 2022 %7 24.6.2022 %9 Viewpoint %J JMIR Cancer %G English %X Increased cancer prevalence and survival rates coupled with earlier patient discharges from hospitals have created a greater need for social support. Cancer care is both short term and long term, requiring acute treatments, treatments for remission, and long-term screenings and treatment regimens. Health care systems are already overwhelmed and often struggle to provide social support systems for everyone. Caregivers are limited in number, and even when they are available, they often lack necessary information, skills, or resources to meet the needs of patients with cancer. The act of caregiving presents various challenges, and caregivers themselves often need social support as well. Despite these needs, most social support programs are targeted toward patients alone. Given the prevalence of cancer and known needs of these patients and their caregivers, the ability to identify those who need social support is crucial. Further, the scalability and overall availability of social support programs is vital for successful patient care. This paper establishes the benefits of social support for both patients and caregivers coping with cancer treatments, explores innovative ways of identifying patients who may need social support using digital tools, and reviews potential advantages of digital social support programs. %M 35749161 %R 10.2196/36258 %U https://cancer.jmir.org/2022/2/e36258 %U https://doi.org/10.2196/36258 %U http://www.ncbi.nlm.nih.gov/pubmed/35749161 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 8 %N 2 %P e31461 %T Physicians’ Perceptions of and Satisfaction With Artificial Intelligence in Cancer Treatment: A Clinical Decision Support System Experience and Implications for Low-Middle–Income Countries %A Emani,Srinivas %A Rui,Angela %A Rocha,Hermano Alexandre Lima %A Rizvi,Rubina F %A Juaçaba,Sergio Ferreira %A Jackson,Gretchen Purcell %A Bates,David W %+ Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont Street, OBC-3, Boston, MA, 02120, United States, 1 6177327063, semani1@partners.org %K artificial intelligence %K cancer %K low-middle–income countries %K physicians %K perceptions %K Watson for Oncology %K implementation %K local context %D 2022 %7 7.4.2022 %9 Viewpoint %J JMIR Cancer %G English %X As technology continues to improve, health care systems have the opportunity to use a variety of innovative tools for decision-making, including artificial intelligence (AI) applications. However, there has been little research on the feasibility and efficacy of integrating AI systems into real-world clinical practice, especially from the perspectives of clinicians who use such tools. In this paper, we review physicians’ perceptions of and satisfaction with an AI tool, Watson for Oncology, which is used for the treatment of cancer. Watson for Oncology has been implemented in several different settings, including Brazil, China, India, South Korea, and Mexico. By focusing on the implementation of an AI-based clinical decision support system for oncology, we aim to demonstrate how AI can be both beneficial and challenging for cancer management globally and particularly for low-middle–income countries. By doing so, we hope to highlight the need for additional research on user experience and the unique social, cultural, and political barriers to the successful implementation of AI in low-middle–income countries for cancer care. %M 35389353 %R 10.2196/31461 %U https://cancer.jmir.org/2022/2/e31461 %U https://doi.org/10.2196/31461 %U http://www.ncbi.nlm.nih.gov/pubmed/35389353 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 7 %N 4 %P e29912 %T First-line Advanced Cutaneous Melanoma Treatments: Where Do We Stand? %A Abdulkarim,Louay S %A Motley,Richard J %+ Department of Dermatology, Cardiff University, Glamorgan House, University Hospital Wales, Heath Park, Cardiff, CF14 4XW, United Kingdom, 44 7852509164, louaysaak@gmail.com %K advanced cutaneous melanoma %K first-line treatments %K immunotherapy %K targeted therapy %K combinational therapy %K dermatologic adverse events %K cutaneous side effects %D 2021 %7 15.12.2021 %9 Viewpoint %J JMIR Cancer %G English %X Cutaneous melanoma has always been a dreaded diagnosis because of its high mortality rate and its proclivity for invasiveness and metastasis. Historically, advanced melanoma treatment has been limited to chemotherapy and nonspecific immunotherapy agents that display poor curative potential and high toxicity. However, during the last decade, the evolving understanding of the mutational burden of melanoma and immune system evasion mechanisms has led to the development of targeted therapy and specific immunotherapy agents that have transformed the landscape of advanced melanoma treatment. Despite the considerable strides in understanding the clinical implications of these agents, there is a scarcity of randomized clinical trials that directly compare the efficacy of the aforementioned agents; hence, there are no clear preferences among the available first-line options. In addition, the introduction of these agents was associated with a variety of dermatologic adverse events, some of which have shown a detrimental effect on the continuity of treatment. This holds especially true in light of the current fragmentation of care provided by the managing health care professionals. In this study, we attempt to summarize the current understanding of first-line treatments. In addition, the paper describes the indirect comparative evidence that aids in bridging the gap in the literature. Furthermore, this paper sheds light on the impact of the scarcity of dermatology specialist input in the management of dermatologic adverse events associated with advanced melanoma treatment. It also looks into the potential avenues where dermatologic input can bridge the gap in the care provided by oncologists, thus standardizing the care provided to patients with melanoma presenting with dermatologic adverse events. %M 34914610 %R 10.2196/29912 %U https://cancer.jmir.org/2021/4/e29912 %U https://doi.org/10.2196/29912 %U http://www.ncbi.nlm.nih.gov/pubmed/34914610 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 7 %N 4 %P e24984 %T Secondhand Smoke Exposure of Expectant Mothers in China: Factoring in the Role of Culture in Data Collection %A Su,Zhaohui %A McDonnell,Dean %A Abbas,Jaffar %A Shi,Lili %A Cai,Yuyang %A Yang,Ling %+ Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, United States, 1 5128399965, szh@utexas.edu %K cancer %K secondhand smoking %K secondhand smoke %K expectant mothers %K pregnant women %K China %K transitional Chinese culture %K “doing the month” %K smoking %K pregnancy %K women %K China %K culture %K behavior %D 2021 %7 7.10.2021 %9 Viewpoint %J JMIR Cancer %G English %X Cancer is the leading cause of death worldwide. Tobacco smoking, including secondhand smoking, causes cancer and is responsible for over 22% of global cancer deaths. The adverse impacts of secondhand smoke are more pronounced for expectant mothers, and can deteriorate both mothers’ and infants’ health and well-being. Research suggests that secondhand smoke significantly increases expectant mothers’ risk of miscarriage, cancer, and other chronic disease conditions, and exposes their unborn babies to an increased likelihood of having life-long poor health. In China, a pregnant woman’s family members, such as her husband, parents, or in-laws, are the most likely people to be smoking around her. Due to traditional Chinese cultural practices, even though some expectant mothers understand the harm of secondhand smoke, they may be reluctant to report their family members’ smoking behaviors. Resulting in severe underreporting, this compromises health experts’ ability to understand the severity of the issue. This paper proposes a novel approach to measure secondhand smoke exposure of pregnant women in the Chinese context. The proposed system could act as a stepping stone that inspires creative methods to help researchers more accurately measure secondhand smoking rates of expectant mothers in China. This, in turn, could help health experts better establish cancer control measures for expectant mothers and decrease their cancer risk. %M 34617907 %R 10.2196/24984 %U https://cancer.jmir.org/2021/4/e24984 %U https://doi.org/10.2196/24984 %U http://www.ncbi.nlm.nih.gov/pubmed/34617907 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 6 %N 2 %P e24222 %T Virtual Cancer Care During the COVID-19 Pandemic and Beyond: A Call for Evaluation %A Levine,Oren Hannun %A McGillion,Michael %A Levine,Mark %+ Department of Oncology, McMaster University, Room 104, G Wing, 711 Concession Street, Hamilton, ON, L8V 1C3, Canada, 1 905 527 2299 ext 42176, mlevine@mcmaster.ca %K care %K patient-physician relationship %K patient-centered care %K oncology care delivery %K virtual visits %K telehealth %K virtual care %K cancer %K oncology %K evaluation %K COVID-19 %D 2020 %7 24.11.2020 %9 Viewpoint %J JMIR Cancer %G English %X The interplay of virtual care and cancer care in the context of the COVID-19 pandemic is unique and unprecedented. Patients with cancer are at increased risk of SARS-CoV-2 infection and have worse outcomes than patients with COVID-19 who do not have cancer. Virtual care has been introduced quickly and extemporaneously in cancer treatment centers worldwide to maintain COVID-19–free zones. The outbreak of COVID-19 in a cancer center could have devastating consequences. The virtual care intervention that was first used in our cancer center, as well as many others, was a landline telephone in an office or clinic that connected a clinician with a patient. There is a lack of virtual care evaluation from the perspectives of patients and oncology health care providers. A number of factors for assessing oncology care delivered through a virtual care intervention have been described, including patient rapport, frailty, delicate conversations, team-based care, resident education, patient safety, technical effectiveness, privacy, operational effectiveness, and resource utilization. These factors are organized according to the National Quality Forum framework for the assessment of telehealth in oncology. This includes the following 4 domains of assessing outcomes: experience, access to care, effectiveness, and financial impact or cost. In terms of virtual care and oncology, the pandemic has opened the door to change. The lessons learned during the initial period of the pandemic have given rise to opportunities for the evolution of long-term virtual care. The opportunity to evaluate and improve virtual care should be seized upon. %M 33180741 %R 10.2196/24222 %U http://cancer.jmir.org/2020/2/e24222/ %U https://doi.org/10.2196/24222 %U http://www.ncbi.nlm.nih.gov/pubmed/33180741 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 6 %N 2 %P e20288 %T Telehealth and Palliative Care for Patients With Cancer: Implications of the COVID-19 Pandemic %A Grewal,Udhayvir Singh %A Terauchi,Stephanie %A Beg,Muhammad Shaalan %+ Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, , United States, 1 5136416314, muhammad.beg@utsouthwestern.edu %K COVID-19 %K telehealth %K palliative care %K telepalliative care %K patients with cancer %K telemedicine %D 2020 %7 24.11.2020 %9 Viewpoint %J JMIR Cancer %G English %X It has been reported that the incidence of SARS-CoV-2 infection is higher in patients with cancer than in the general population and that patients with cancer are at an increased risk of developing severe life-threatening complications from COVID-19. Increased transmission and poor outcomes noted in emerging data on patients with cancer and COVID-19 call for aggressive isolation and minimization of nosocomial exposure. Palliative care and oncology providers are posed with unique challenges due to the ongoing COVID-19 pandemic. Telepalliative care is the use of telehealth services for remotely delivering palliative care to patients through videoconferencing, telephonic communication, or remote symptom monitoring. It offers great promise in addressing the palliative and supportive care needs of patients with advanced cancer during the ongoing pandemic. We discuss the case of a 75-year-old woman who was initiated on second-line chemotherapy, to highlight how innovations in technology and telehealth-based interventions can be used to address patients’ palliative and supportive care needs in the ongoing epidemic. %M 33049695 %R 10.2196/20288 %U http://cancer.jmir.org/2020/2/e20288/ %U https://doi.org/10.2196/20288 %U http://www.ncbi.nlm.nih.gov/pubmed/33049695 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 5 %N 1 %P e12317 %T Designing and Testing Apps to Support Patients With Cancer: Looking to Behavioral Science to Lead the Way %A Hamel,Lauren M %A Thompson,Hayley S %A Albrecht,Terrance L %A Harper,Felicity WK %+ Population Studies and Disparities Research Program, Department of Oncology, Wayne State University, 4100 John R St, Detroit, MI, 48201, United States, 1 5868633884, hamell@karmanos.org %K behavioral science %K cancer %K mobile apps %K evidence-based practice %K smartphone %K mHealth %D 2019 %7 22.4.2019 %9 Viewpoint %J JMIR Cancer %G English %X Background: Behavioral science has a long and strong tradition of rigorous experimental and applied methodologies, which have produced several influential and far-reaching theoretical frameworks and have guided countless inquiries of human behavior in various contexts. In cancer care, behavioral scientists have established a firm foundation of research focused on understanding the experience of cancer and using that understanding to design and implement theory- and evidenced-based interventions to help patients cope with the cancer experience. Given the rich behavioral research base in oncology, behavioral scientists are ideally positioned to lead the integration of evidence-based science on behavior and behavior change into the development of smartphone apps supporting patients with cancer. Smartphone apps are being disseminated to patients with cancer with claims of being able to help them negotiate areas of vulnerability in their cancer experience. However, the vast majority of these apps are developed without the rigor and expertise of behavioral scientists. Objective: In this article, we have illustrated the importance of behavioral science leading the development and evaluation of apps to support patients with cancer by providing an illustrative scientific process that our team of behavioral scientists, patient stakeholders, medical oncologists, and software developers used to empirically design and evaluate 2 patient-focused apps: the Discussion of Cost App (DISCO App) and MyPatientPal. Methods: Using a focused literature review and a descriptive roadmap of our team’s process for designing and evaluating patient-focused behavioral apps for patients with cancer, we have demonstrated how behavioral scientists are integral to the development of empirically sound apps to help support patients with cancer. Specifically, we have illustrated the process by which our multidisciplinary team combined the established user-centered design principles and behavioral science theory and scientific rigor to design and evaluate 2 patient-focused apps. Results: On the basis of initial acceptability and feasibility testing among patients and providers, our team has demonstrated how critical behavioral science is for designing and evaluating app-based interventions for patients with cancer. Conclusions: Behavioral science can and should be coupled with user-centered design principles to provide theoretical guidance and the rigor of the scientific method, thereby adding the much-needed and critical evidence for these types of app-based interventions for patients with cancer. %M 31066691 %R 10.2196/12317 %U http://cancer.jmir.org/2019/1/e12317/ %U https://doi.org/10.2196/12317 %U http://www.ncbi.nlm.nih.gov/pubmed/31066691