4. Kasemsarn P, Boonchai W.
Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol
University, Bangkok, Thailand.
PMID: 23414363 [PubMed - as supplied by publisher]
9. BMJ Qual Saf. 2013 Mar;22(3):183-6. doi: 10.1136/bmjqs-2012-001744. Epub 2013 Feb
1.Patient-centred healthcare, social media and the internet: the perfect storm?
Rozenblum R, Bates DW.
PMID: 23378660 [PubMed - in process]
10. Acta Odontol Scand. 2013 Jan 28. [Epub ahead of print]
Patient safety incidents reported by Finnish dentists; results from an internet-based survey.
Hiivala N, Mussalo-Rauhamaa H, Murtomaa H.
Department of Oral Public Health, Institute of Dentistry, University of Helsinki , Helsinki , Finland.
Abstract Background. Few data are available on dental patient safety (PS), as most PS studies have focused on other
activities in health care. Objective. To detect types and causes of dental PS incidents (PSIs), including adverse events
(AEs) and near misses (NMs), in Finnish dental care. Material and methods. Altogether 1041 privately or publicly
employed dentists in southern Finland completed a structured questionnaire using an internet-based system (Webropol)
in 2010. Results. Nearly one third of the dentists reported some PSI in the previous 12 months. Of the 872 reported
events, 53% were classified as AEs, 45% as NMs and 2% remained unclassified. Nearly half of the PSIs had occurred
during some form of dental treatment. One third of the AEs were related to dental equipment, devices and supplies.
Most of the reported AEs resulted in little or no permanent harm to patients. However, 13% of AEs were considered as
serious enough to potentially cause severe harm or did in fact cause permanent harm. Conclusions. Reported dental PSIs
in Finland are in many respects similar to those reported in other countries. Compared to all annual dental visits in
Finland, severe dental AEs seem to be relatively rare. Less severe AEs and NMs are not uncommon, especially in dental
surgery, endodontic and restorative treatment. The results of this retrospective study, however, reveal more about
incident types than their true prevalence and that further studies on dental PS are needed.
PMID: 23351166 [PubMed - as supplied by publisher]
11. Trials. 2013 Jan 24;14:25. doi: 10.1186/1745-6215-14-25.
Use of the 'patient journey' model in the internet-based pre-fitting counseling of a person with hearing disability: study
protocol for a randomized controlled trial.
Manchaiah VK, Stephens D, Andersson G, Rönnberg J, Lunner T.
Centre for Long Term and Chronic Conditions, College of Human and Health
Sciences, Swansea University, Room 167, Glyndwr Building, Swansea SA2 8PP, United Kingdom.
V.K.C.Manchaiah@swansea.ac.uk
BACKGROUND: Hearing impairment is one of the most frequent chronic conditions. Persons with a hearing
impairment (PHI) have various experiences during their 'journey' through hearing loss. In our previous studies we have
developed a 'patient journey' model of PHI and their communication partners (CPs). We suggest this model could be
useful in internet-based pre-fitting counseling of a person with hearing disability (PHD).
METHODS/DESIGN: A randomized controlled trial (RCT) with waiting list control (WLC) design will be used in this
study. One hundred and fifty eight participants with self-reported hearing disability (that is, score > 20 in the Hearing
Handicap Questionnaire (HHQ)) will be recruited to participate in this study. They will be assigned to one of two
groups (79 participants in each group): (1) Information and counseling provision using the 'patient journey' model; and
(2) WLC. They will participate in a 30 day (4 weeks) internet-based counseling program based on the 'patient journey'
model. Various outcome measures which focuses on hearing disability, depression and anxiety, readiness to change and
acceptance of hearing disability will be administered pre (one week before) and post (one week and six months after)
intervention to evaluate the effectiveness of counseling.
DISCUSSION: Internet-based counseling is being introduced as a viable option for audiological rehabilitation. We
predict that the 'patient journey' model will have several advantages during counseling of a PHD. Such a program, if
proven effective, could yield cost and time-efficient ways of managing hearing disability.
TRIAL REGISTRATION: ClinicalTrials.gov Protocol Registration System NCT01611129.
PMCID: PMC3561257
PMID: 23347711 [PubMed - in process]
12. Contemp Clin Trials. 2013 Mar;34(2):305-11. doi: 10.1016/j.cct.2012.12.002. Epub
2012 Dec 14.
6. 15. Neuropsychiatr Dis Treat. 2012;8:483-9. doi: 10.2147/NDT.S36780. Epub 2012 Oct 23.
Outcomes analysis of Internet-based CME initiatives for diagnosis and treatment of fibromyalgia patients: transition
from education to physician behavior to patient health.
Somasekhar MM, Berney S, Rausch C, Degnan J.
The Albert J Finestone Office for Continuing Medical Education, Philadelphia, PA, USA.
A well designed outcomes research study was performed in which 20 primary care physicians were selected to
participate. Each physician had more than 30 fibromyalgia patients in their practice. The study design consisted of four
phases. In phase one, physicians undertook a self-assessment of their practice. Phase two of the study involved
diagnosis and treatment of a virtual case vignette. The third phase consisted of analysis of the data from phase two
andproviding feedback from an expert rheumatologist, and the fourth phase was to complete patient report forms for
five patients in their practice. The year-long study was completed by 12 physicians and resulted in data on 60 patients.
The results of this study provide an insight into how physicians are diagnosing and treating patients with fibromyalgia.
In this study, we transition from continuing medical education to physician behavior to patient outcomes.
PMCID: PMC3484898
PMID: 23118542 [PubMed]
16. J Med Internet Res. 2012 Oct 11;14(5):e137. doi: 10.2196/jmir.2202.
Conducting research on the Internet: medical record data integration with patient-reported outcomes.
Cascade E, Marr P, Winslow M, Burgess A, Nixon M.
Digital Patient Unit, Quintiles, Durham, NC 27707, United States. elisa.cascade@quintiles.com
BACKGROUND: The growth in the number of patients seeking health information online has given rise to new direct-
to-patient research methods, including direct patient recruitment and study conduct without use of physician sites.
While such patient-centric designs offer time and cost efficiencies, the absence of physician-reported data is a key
concern, with potential impact on both scientific rigor and operational feasibility.
OBJECTIVE: To (1) gain insight into the viability of collecting patient-reported outcomes and medical record
information in a sample of gout patients through a direct-to-patient approach (ie, without the involvement of physician
sites), and (2) evaluate the validity of patient-reported diagnoses collected during a patient-reported outcomes plus
medical record (PRO+MR) direct-to-patient study.
METHODS: We invited a random sample of MediGuard.org members aged 18 to 80 years to participate via email
based on a gout treatment or diagnosis in their online profiles. Interested members clicked on an email link to access
study information, consent to participate electronically, and be screened for eligibility. The first 50 consenting
participants completed an online survey and provided electronic and wet signatures on medical record release forms for
us to obtain medical charts from their managing physicians.
RESULTS: A total of 108 of 1250 MediGuard.org members (8.64%) accessed study information before we closed the
study at 50 completed surveys. Of these 108 members who took the screener, 50 (46.3%) completed the study, 19
(17.6%) did not pass the screening, 5 (4.6%) explicitly declined to participate due to the medical record requirement,
and 34 (31.5%) closed the browser without completing the survey screener. Ultimately, we obtained 38 of 50 charts
(76%): 28 collected using electronic signature and 10 collected based on wet signature on a paper form. Of the 38
charts, 37 cited a gout diagnosis (35 charts) or use of a gout medication (2 charts). Only 1 chart lacked any mention of
gout.
CONCLUSIONS: Patients can be recruited directly for observational study designs that include patient-reported
outcomes and medical record data with over 75% data completeness. Although the validity of self-reported diagnosis is
often a concern in Internet-based studies, in this PRO+MR study pilot, nearly all (37 of 38)charts confirmed patient-
reported data.
PMCID: PMC3510750
PMID: 23060427 [PubMed - indexed for MEDLINE]
17. Open Rheumatol J. 2012;6:190-8. doi: 10.2174/1874312901206010190. Epub 2012 Aug2.
Musculoskeletal health professional use of internet resources for personal and patient education: results from an online
national survey.
Nicolaou M, Armstrong R, Hassell AB, Walker D, Birrell F.
7. Rheumatology, Northumbria Healthcare NHS Foundation, Ashington, Northumberland,
UK.
OBJECTIVES: To study the current practice of computer use in musculoskeletal
health professionals for their education and that of their patients.
METHODS: A survey questionnaire, designed by a working group including
representatives from Arthritis Research UK and the British Society for
Rheumatology, was made available on surveymonkey.com and the link distributed by
email.
RESULTS: 190 health professionals responded. Rheumatology professionals made up
two thirds of the participants. The modal age group of responders was under 40
years (37%). 97% had spent some educational time on a computer. Females were
younger and spent more time using the computer for education purposes. The
preferred learning modality was interactive online content (71%). The most common
methods of educating patients were the Consultant and Specialist nurse while the
web is used by 40% of the health professionals. The most common barrier to
education was 'Insufficient resources for education groups'. Rheumatologists were
more likely to log Continuous Professional Development (CPD) online, complete
online modules and have mandatory training online. UpToDate and Arthritis
Research UK were the highest rated websites for health professional and patient
education respectively.
CONCLUSIONS: This is the first national survey of E-learning in the
musculoskeletal health profession, with a large proportion of Rheumatologists.
Almost all use computer based learning. Use of the internet for patient education
is low. Highly rated educational websites are available for both professionals
and patients.
PMCID: PMC3415626
PMID: 22970071 [PubMed]
18. Inform Health Soc Care. 2013 Mar;38(2):93-103. doi: 10.3109/17538157.2012.710688.
Epub 2012 Sep 7.
Integration of computer and Internet-based programmes into psychiatric
out-patient care of adolescents with depression.
Kurki M, Hätönen H, Koivunen M, Anttila M, Välimäki M.
Department of Nursing Science, University of Turku and Primary Health Care
Organization of the city of Vantaa, Finland. marjo.kurki@utu.fi
The aim of this explorative study was to describe nurses' opportunities to
integrate computer and Internet-based programmes in psychiatric out-patient care
among adolescents with depression. Therefore, nurses' daily computer use and
possible problems related to it were investigated. The data were collected by
conducting focus group interviews with Finnish registered nurses (n =12) working
at the out-patient clinics of two university central hospitals. The data were
analysed using inductive content analysis. The analysis showed that nurses used
the computer and Internet in their daily work for data transmission and informal
interaction with adolescents. Findings revealed that nurses have good computer
skills, a positive attitude towards using the computer and Internet and were
motivated to make use of both on a daily basis. Problems faced in daily computer
use were a lack of instructions and education, and lack of help and support. We
can conclude that nurses have good opportunities to implement computer and
Internet-based programmes in adolescent out-patient care. These results are
encouraging keeping in mind that adolescents are the most active Internet users
in society.
PMID: 22958142 [PubMed - in process]
8. 19. Ann R Coll Surg Engl. 2012 Jul;94(5):300-1. doi:
10.1308/003588412X13171221590250.
Evaluation of internet derived patient information.
Ward JB, Leach P.
Cardiff University, UHW Main Building, Heath Park, Cardiff CF14 4XN, UK.
jamesward33@hotmail.com
INTRODUCTION: The internet is a widely used, powerful resource for patients to
research medical conditions. There is an extensive amount of information
available on the internet. It is important for patient information to be accurate
and in an easily accessible format. This article aims to assess the quality of
patient information on hydrocephalus and compares the findings with recent
evaluations in other surgical specialties.
METHODS: The term 'hydrocephalus' was searched for on the search engines
http://www.google.com/, http://www.bing.com/ and http://www.yahoo.com/. The top
20 results of these searches were assessed using the University of Michigan
consumer health website evaluation checklist.
RESULTS: The quality of patient information websites on hydrocephalus is highly
variable. Websites rarely provide sufficient authorship information, do not
review their information regularly enough and only reference material
occasionally. The background of the provider was found to influence the quality
of the website, with academic and care providers creating the best websites.
CONCLUSIONS: On comparing our findings with those of recent studies from other
surgical specialties, it was found that there was often a conflict of interest
between the background of the provider and the information supplied. It is
recommended that clinicians personally research material for their patients to be
able to guide them to suitable, accurate websites.
PMID: 22943222 [PubMed - indexed for MEDLINE]
20. J Plast Surg Hand Surg. 2012 Sep;46(3-4):248-51. doi:
10.3109/2000656X.2012.697376.
Role of the internet in communication between patient and surgeon before
rhinoplasty.
Szychta P, Zieliński T, Rykała J, Witmanowski H, Kruk-Jeromin J.
Department of Oncological Surgery and Breast Diseases, Polish Mother's Memorial
Hospital - Research Institute, Lodz, Poland. szychta@yahoo.pl
Our aim was to assess the use of the internet for patients considering
rhinoplasty, to identify the influence of the medical information acquired, and
to review favourable and adverse aspects of the acquired knowledge online. A
prospective study was conducted on 106 patients listed for post-traumatic or
aesthetic rhinoplasty. We surveyed 18 questions to evaluate demographic and
sociological data, and the importance of the information acquired from the
internet. Respondents searched online for description of operations, contact with
other patients, and with the surgeon, and for preoperative and postoperative
pictures. Patients who were considering aesthetic rhinoplasty were given medical
information by a third party or from the internet, and those who were having
post-traumatic corrections were usually referred by their general practitioner.
We conclude that the internet is an important source of medical information about
rhinoplasty for patients, but it does not contain enough data. It plays an
essential part, particularly for those patients having the operation for
aesthetic reasons, in contrast to those having post-traumatic correction.
Reviewing and certifying the plastic surgical websites would validate certified
9. services. Independent, direct contact with the doctor helps patients to obtain
more accurate, personalized knowledge. In addition, surgeons should support
patients by giving them a list of verified websites, which would contribute to
increased doctor-patient communication.
PMID: 22909242 [PubMed - indexed for MEDLINE]
21. BMC Med Inform Decis Mak. 2012 Aug 6;12:87. doi: 10.1186/1472-6947-12-87.
Patient access to complex chronic disease records on the Internet.
Bartlett C, Simpson K, Turner AN.
Department Health Sciences, University of York, York, YO10 5ZZ, UK.
BACKGROUND: Access to medical records on the Internet has been reported to be
acceptable and popular with patients, although most published evaluations have
been of primary care or office-based practice. We tested the feasibility and
acceptability of making unscreened results and data from a complex chronic
disease pathway (renal medicine) available to patients over the Internet in a
project involving more than half of renal units in the UK.
METHODS: Content and presentation of the Renal PatientView (RPV) system was
developed with patient groups. It was designed to receive information from
multiple local information systems and to require minimal extra work in units.
After piloting in 4 centres in 2005 it was made available more widely. Opinions
were sought from both patients who enrolled and from those who did not in a paper
survey, and from staff in an electronic survey. Anonymous data on enrollment and
usage were extracted from the webserver.
RESULTS: By mid 2011 over 17,000 patients from 47 of the 75 renal units in the UK
had registered. Users had a wide age range (<10 to >90 yrs) but were younger and
had more years of education than non-users. They were enthusiastic about the
concept, found it easy to use, and 80% felt it gave them a better understanding
of their disease. The most common reason for not enrolling was being unaware of
the system. A minority of patients had security concerns, and these were reduced
after enrolling. Staff responses were also strongly positive. They reported that
it aided patient concordance and disease management, and increased the quality of
consultations with a neutral effect on consultation length. Neither patient nor
staff responses suggested that RPV led to an overall increase in patient anxiety
or to an increased burden on renal units beyond the time required to enroll each
patient.
CONCLUSIONS: Patient Internet access to secondary care records concerning a
complex chronic disease is feasible and popular, providing an increased sense of
empowerment and understanding, with no serious identified negative consequences.
Security concerns were present but rarely prevented participation. These are
powerful reasons to make this type of access more widely available.
PMCID: PMC3438097
PMID: 22867441 [PubMed - indexed for MEDLINE]
22. Otolaryngol Head Neck Surg. 2012 Nov;147(5):855-7. doi: 10.1177/0194599812456153.
Epub 2012 Jul 31.
The digital divide in Internet-based patient education materials.
Sun GH.
University of Michigan, Ann Arbor, MI, USA. gordonsu@med.umich.edu
The ubiquity of the Internet has led to the widespread availability of
health-related information to the public, and the subsequent empowerment of
13. 28. BMJ Qual Saf. 2012 Jul;21(7):600-5. doi: 10.1136/bmjqs-2012-000906. Epub 2012 Apr
20.
Associations between Internet-based patient ratings and conventional surveys of
patient experience in the English NHS: an observational study.
Greaves F, Pape UJ, King D, Darzi A, Majeed A, Wachter RM, Millett C.
Department of Primary Care and Public Health, Reynolds Building, Charing Cross
Campus, Imperial College London, London, UK. felix.greaves08@imperial.ac.uk
OBJECTIVE: Unsolicited web-based comments by patients regarding their healthcare
are increasing, but controversial. The relationship between such online patient
reports and conventional measures of patient experience (obtained via survey) is
not known. The authors examined hospital level associations between web-based
patient ratings on the National Health Service (NHS) Choices website, introduced
in England during 2008, and paper-based survey measures of patient experience.
The authors also aimed to compare these two methods of measuring patient
experience.
DESIGN: The authors performed a cross-sectional observational study of all
(n=146) acute general NHS hospital trusts in England using data from 9997 patient
web-based ratings posted on the NHS Choices website during 2009/2010. Hospital
trust level indicators of patient experience from a paper-based survey (five
measures) were compared with web-based patient ratings using Spearman's rank
correlation coefficient. The authors compared the strength of associations among
clinical outcomes, patient experience survey results and NHS Choices ratings.
RESULTS: Web-based ratings of patient experience were associated with ratings
derived from a national paper-based patient survey (Spearman �=0.31-0.49, p<0.001
for all). Associations with clinical outcomes were at least as strong for online
ratings as for traditional survey measures of patient experience.
CONCLUSIONS: Unsolicited web-based patient ratings of their care, though
potentially prone to many biases, are correlated with survey measures of patient
experience. They may be useful tools for patients when choosing healthcare
providers and for clinicians to improve the quality of their services.
PMID: 22523318 [PubMed - indexed for MEDLINE]
29. Am J Med Qual. 2012 Nov-Dec;27(6):494-502. doi: 10.1177/1062860611436246. Epub
2012 Apr 18.
Consistency of patient preferences about a secure internet-based patient
communications portal: contemplating, enrolling, and using.
Wakefield DS, Kruse RL, Wakefield BJ, Koopman RJ, Keplinger LE, Canfield SM, Mehr
DR.
University of Missouri, Columbia, MO, USA. wakefielddo@health.missouri.edu
Internet-based secure communication portals (portal) have the potential to
enhance patient care via improved patient-provider communications. This study
examines differences among primary care patients' perceptions when contemplating
using, enrolling to use, and using a portal for health care purposes. A total of
3 groups of patients from 1 Midwestern academic medical center were surveyed at
different points in time: (1) Waiting Room survey asking about hypothetical
interest in using a portal to communicate with their physicians; (2) patient
portal Enrollment survey; and (3) Follow-up postenrollment experience survey.
Those who enroll and use a patient portal have different demographic
characteristics and interest levels in selected portal functions (eg, e-mailing
providers, viewing medical records online, making appointments) and initially
perceive only limited improvements in care because of the portal. These
differences have potential market implications and provide insight into selecting
17. University of Pittsburgh School of Medicine, Pittsburgh; Drexel University
College of Medicine; Department of Radiation Oncology, Jefferson Medical College
of Thomas Jefferson University, Kimmel Cancer Center, Philadelphia, PA; Bruce and
Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology,
Haifa, Israel.
PURPOSE: A wiki is a collaborative Web site, such as Wikipedia, that can be
freely edited. Because of a wiki's lack of formal editorial control, we
hypothesized that the content would be less complete and accurate than that of a
professional peer-reviewed Web site. In this study, the coverage, accuracy, and
readability of cancer information on Wikipedia were compared with those of the
patient-orientated National Cancer Institute's Physician Data Query (PDQ)
comprehensive cancer database.
METHODS: For each of 10 cancer types, medically trained personnel scored PDQ and
Wikipedia articles for accuracy and presentation of controversies by using an
appraisal form. Reliability was assessed by using interobserver variability and
test-retest reproducibility. Readability was calculated from word and sentence
length.
RESULTS: Evaluators were able to rapidly assess articles (18 minutes/article),
with a test-retest reliability of 0.71 and interobserver variability of 0.53. For
both Web sites, inaccuracies were rare, less than 2% of information examined. PDQ
was significantly more readable than Wikipedia: Flesch-Kincaid grade level 9.6
versus 14.1. There was no difference in depth of coverage between PDQ and
Wikipedia (29.9, 34.2, respectively; maximum possible score 72). Controversial
aspects of cancer care were relatively poorly discussed in both resources (2.9
and 6.1 for PDQ and Wikipedia, respectively, NS; maximum possible score 18). A
planned subanalysis comparing common and uncommon cancers demonstrated no
difference.
CONCLUSION: Although the wiki resource had similar accuracy and depth as the
professionally edited database, it was significantly less readable. Further
research is required to assess how this influences patients' understanding and
retention.
PMCID: PMC3170066
PMID: 22211130 [PubMed - in process]
36. Online J Public Health Inform. 2012;4(1). pii: ojphi.v4i1.3684. doi:
10.5210/ojphi.v4i1.3684. Epub 2012 May 17.
Appraisal Skills, Health Literacy and the Patient-Provider Relationship:
Considerations as the Health Care Consumer Turns to the Internet to Inform their
Care.
O'Dell R.
A. T. Still University, Arizona, USA.
Health care consumers increasingly obtain health information from the Internet to
inform their health care; the health care consumer, who also has the role of
patient, maintains the right to access information from sources of their choosing
for this purpose. However, noteworthy considerations exist including information
appraisal skills, health literacy and the patient-provider relationship.
Awareness and education are warranted to assist the health care consumer in
achieving proficiency as they turn to the Internet for health information.
PMCID: PMC3615802
PMID: 23569625 [PubMed]
37. Dis Colon Rectum. 2012 Jan;55(1):85-9. doi: 10.1097/DCR.0b013e3182351eec.
18. Assessment of the quality of patient-orientated Internet information on surgery
for diverticular disease.
Yeung TM, Mortensen NJ.
Stanford University School of Medicine, Stanford, California, USA.
trevoryeung@doctors.org.uk
BACKGROUND: The Internet is a vast resource available for patients to obtain
health information.
OBJECTIVE: This study examines the quality of Web sites that provide information
on diverticular disease, treatment options, and surgery.
DESIGN: Two search engines (Google and Yahoo) and the search terms "surgery and
diverticular disease" and "surgery and diverticulitis" were used. The first 50
sites of each search were assessed. Sites that fulfilled the inclusion criteria
were evaluated for content and scored by using the DISCERN instrument, which
evaluates the quality of health information on treatment choices.
RESULTS: Two hundred sites were examined, of which 60 (30%) provided
patient-orientated information. 50 sites (25%) were duplicated, 7 (3.5%) were
links, 10 (5%) were advertisements, 14 (7%) were resources for clinicians, 9
(4.5%) were message forums, 27 (13.5%) were articles, and 15 (7.5%) were dead
links. Of the 60 Web sites that provided patient information, only 10 (16.7%) had
been updated within the past 2 years. Seventeen (28.3%) sites were affiliated
with hospitals and clinics, but another 17 (28.3%) sites were associated with
private companies with commercial interests. Although most Web sites contained
information on symptoms, complications, investigations, and treatment options of
diverticular disease, 20 (33.3%) did not describe any of the risks of surgery,
and 45 (75%) did not provide information on the timescale of recovery
postoperatively. Eighteen sites did not provide balanced information on treatment
options; of these, 7 were biased toward medical treatment and 6 focused on
laparoscopic surgery. Overall, only 22 (36.7%) were identified as being "good" or
"excellent" with the use of the DISCERN criteria.
CONCLUSIONS: The quality of patient information on surgery for diverticular
disease is highly variable, and Web sites that are sponsored by private companies
may be biased in discussing treatment options. There is potential for the
Internet to provide valuable information, and clinicians should guide patients to
access high-quality Web sites.
PMID: 22156872 [PubMed - indexed for MEDLINE]
38. J Gen Virol. 2012 Mar;93(Pt 3):526-30. doi: 10.1099/vir.0.037259-0. Epub 2011 Nov
23.
A naturally occurring human/hepatitis E recombinant virus predominates in serum
but not in faeces of a chronic hepatitis E patient and has a growth advantage in
cell culture.
Nguyen HT, Torian U, Faulk K, Mather K, Engle RE, Thompson E, Bonkovsky HL,
Emerson SU.
Molecular Hepatitis Section, Laboratory of Infectious Diseases, National
Institute of Allergy and Infectious Diseases, National Institutes of Health,
Bethesda, MD 20892, USA.
Hepatitis E virus is the aetiological agent of acute hepatitis E, a self-limiting
disease prevalent in developing countries. Molecular analysis of viral genomic
RNA from a chronically infected patient confirmed the recent discovery that
chronic infection correlated with extensive diversification of the virus
quasispecies: the hypervariable region of some virus genomes in this USA patient
contained large continuous deletions and a minor proportion of genomes in faeces
and serum had acquired a mammalian sequence that encoded 39 aa of S19 ribosomal
19. protein fused to the virus non-structural protein. Genomes with this insert were
selected during virus passage in cultured cells to become the predominant
species, suggesting that the inserted sequence promoted virus growth. The results
demonstrated that hepatitis E virus can mutate dramatically during a prolonged
infection and suggests it may be important to prevent or cure chronic infections
before new variants with unpredictable properties arise.
PMCID: PMC3352352
PMID: 22113007 [PubMed - indexed for MEDLINE]
39. Hum Reprod Update. 2012 Mar-Apr;18(2):211-27. doi: 10.1093/humupd/dmr045. Epub
2011 Nov 22.
Patient-focused internet interventions in reproductive medicine: a scoping
review.
Aarts JW, van den Haak P, Nelen WL, Tuil WS, Faber MJ, Kremer JA.
Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical
Centre, 6500 HB Nijmegen, The Netherlands.
BACKGROUND: The Internet has revolutionized fertility care since it became a
popular source of information and support for infertile patients in the last
decade. The aim of this scoping review is to map (i) the main categories of
patient-focused Internet interventions within fertility care, (ii) the detailed
composition of the interventions and (iii) how these interventions were
evaluated.
METHODS: A literature search used various 'Internet' and 'Infertility' search
terms to identify relevant studies published up to 1 September 2011. The selected
studies had to include patients facing infertility and using an
infertility-related Internet intervention. We charted data regarding categories
of interventions, components of interventions and evaluation methodology. We
categorized the stages of research using the UK's Medical Research Council
framework for evaluating complex interventions.
RESULTS: We included 20 studies and identified 3 educational interventions, 2
self-help interventions, 1 human-supported therapeutic intervention, 9 online
support groups and 2 counselling services. Information provision, support and
mental health promotion were common aims. Few interactive online components were
present in the online programmes. Three studies were in the pilot phase and 17
were in the evaluation phase.
CONCLUSIONS: Several categories of patient-focused Internet-based interventions
in fertility care are primarily applied to provide support and education and
promote mental health. The interventions could be improved by using more
interactive and dynamic elements as their key components. Finally, more emphasis
on methodological standards for complex interventions is needed to produce more
rigorous evaluations. This review shows where further development or research
into patient-focused Internet interventions in fertility-care practice may be
warranted.
PMID: 22108381 [PubMed - in process]
40. HDA Now. 2011 Summer:11.
Patient reviews on the Internet.
Lombardi G.
Officite, USA.
PMID: 22096840 [PubMed - indexed for MEDLINE]
21. Internet and e-mail use in ENT: a survey of patient usage and satisfaction.
Shaw B, Farboud A, Trinidade A, Kothari P.
University College London, Gower Street, London, WC1E 6BT, UK.
Nowadays, internet and e-mail are important modes of communication and
information. This paper seeks to determine internet usage as a source of health
information amongst ENT patients and to investigate whether patients prefer to
communicate primarily with the hospital via e-mail. The method used is a
questionnaire study and 201 patients attending an ENT clinic completed
questionnaires over 2 weeks in December 2010. Of those with internet access
(85%), 37% had used it for health information prior to their appointment; 90%
rated the information between average and excellent; over half stated they would
like doctor-recommended websites. Overall, 8% had previously used e-mail to
communicate with healthcare professionals, but 50% stated that they wished to use
e-mail in the future. ENT patients are becoming increasingly computer-literate.
As healthcare professionals, we must do more to incorporate the internet as a
source of reliable healthcare information. Properly implemented, e-mail can
become an invaluable method of communication with patients.
PMID: 21968629 [PubMed - indexed for MEDLINE]
44. Can J Surg. 2011 Oct;54(5):339-43. doi: 10.1503/cjs.011910.
Information on the Internet about colorectal cancer: patient attitude and
potential toward Web browsing. A prospective observational study.
Sajid MS, Shakir AJ, Baig MK.
Department of Colorectal Surgery, Worthing Hospital, Worthing. West Sussex,
United Kingdom. surgeon1wrh@hotmail.com
BACKGROUND: Patients with colorectal cancer who seek to improve their knowledge
of health and treatment options can now access in a few seconds data that would
previously have required hours of research. Our aim was to evaluate the attitudes
of patients toward Web browsing for information on colorectal cancer.
METHODS: We surveyed all patients attending a colorectal cancer follow-up clinic
between January and August 2007 on their use of the Internet to obtain
information on colorectal cancer.
RESULTS: In all, 439 patients with mean age of 68.6 years participated in the
study. Of these, 24% reported using the Internet to obtain colorectal cancer
information. Most participants used the Google search engine. Only 13% of
participants confirmed that colorectal cancer information on the Internet was
helpful in decision-making. Patients under the age of 65 years were more likely
to have Internet access (p < 0.001), more likely to use the Internet to find
colorectal cancer information (p = 0.005) and more likely to access a site
recommended by a colorectal specialist (p = 0.002). Among Internet users, men
were slightly more likely than women to use the Internet, although the difference
was not significant (p = 0.20).
CONCLUSION: The Internet is a useful tool for disseminating information about
colorectal cancer. The best sites are still difficult for patients to distinguish
from the thousands of sites returned by search engines. This study demonstrates
that the level of potential interest is sufficient to justify the development of
a departmental or regional colorectal cancer network of websites and indicates
areas of interest for patients.
PMCID: PMC3195665
PMID: 21933528 [PubMed - indexed for MEDLINE]
22. 45. Healthc Q. 2011;14(2):101-5.
Patient relations office facilitate community engagement: using Internet-based
correspondence to encourage discussion at the University Health Network.
Rogers S, Sedge E.
University Health Network, in Toronto, Ontario, Canada.
PMID: 21841402 [PubMed - indexed for MEDLINE]
46. Int J Qual Stud Health Well-being. 2011;6(3). doi: 10.3402/qhw.v6i3.5907. Epub
2011 Jul 12.
Support through patient internet-communities: Lived experience of Russian in
vitro fertilization patients.
Isupova OG.
Institute of Demography High School of Economics, Moscow, Russian Federation.
The article is concerned with the life experiences of infertile women going
through infertility treatment and their need for social and psychological
support, which they try to find in their immediate social environment. The
Internet has become one place where everyone can find "people like oneself." The
best support is received from these people who are in the same life situation and
are able and willing to share their lived experiences with each other.
Communication via the Internet and the formation of a virtual community of
patients has both positive and negative aspects, all of which are examined in the
article. On the one hand, it creates a psychologically favorable atmosphere and
might potentially increase the success rate of IVF treatment. On the other, this
leads to the seclusion of patients within the circle of "similar people" and
sometimes to negative attitudes towards people outside the circle. The article is
based on the author's "netnography" research of a virtual community of Russian
In-Vitro Fertilization (IVF)(1) patients.
PMCID: PMC3136244
PMID: 21760835 [PubMed]
47. Comput Inform Nurs. 2011 Dec;29(12):714-8; quiz 719-20. doi:
10.1097/NCN.0b013e318224b597.
Patient-provider internet portals--patient outcomes and use.
Shaw RJ, Ferranti J.
Duke University School of Nursing, Durham, NC 27710, USA. ryan.shaw@duke.edu
An important emerging information technology tool is the electronic health record
with a patient-provider Internet portal. Patient-provider Internet portals offer
a venue for providing patient access to personal health data. In this study, we
conducted a cross-sectional secondary data analysis to describe the types of
diabetes patients who utilize the patient-provider Internet portal and examine
any preliminary differences in patient outcomes. Data from this study suggest
that a significant portion of patients (29.7%) with diabetes utilize the portal.
Clinical outcome results indicated that portal use was not a significant
predictor of low-density lipoprotein and total cholesterol levels. However,
portal use was a statistically significant predictor of glycosylated hemoglobin
(HbA1c) (P < .001). As patient-provider Internet portals are increasingly
24. their relationship with their doctor.
METHODS: A cross-sectional survey was conducted among a convenience sample of
patients visiting 10 primary care clinics in central Israel using a questionnaire
developed for this survey. The survey examined attitudes to using the internet
for health-related information and attitudes to sharing this information with
doctors. Associations between demographic variables, internet use and patient
satisfaction with the doctor's response were tested using the chi-square
statistic and t-tests.
RESULTS: Completed questionnaires were received from 138 patients; the response
rate was 69%. Patients in the study sample had a high rate of internet access
(87%), with many using the internet as a source of health information (41%)
although most patients using the internet never share this information with their
doctor (81%). Among those who share information with the doctor, most felt that
this has a positive effect on the relationship (870/%). Few patients reported
being referred to websites by the doctor (28%).
CONCLUSIONS: Internet use is prevalent in this population, though physicians may
be unaware of this. Future study could examine the effects of doctors who ask
patients actively about their internet use and inform them of relevant health
information sources online.
PMID: 21598810 [PubMed - indexed for MEDLINE]
51. Lakartidningen. 2011 Mar 30-Apr 5;108(13):727-9.
[Social media change the professional-patient relation. Clarification of ethical
guidelines concerning social networking on the Internet is necessary].
[Article in Swedish]
Chenik M, Bolinder G, Juth N.
Karolinska universitetssjukhuset, Stockholm. marie.chenik@karolinska.se
PMID: 21574413 [PubMed - indexed for MEDLINE]
52. Arch Pediatr Adolesc Med. 2011 May;165(5):405-11. doi:
10.1001/archpediatrics.2011.55.
Variation in use of Internet-based patient portals by parents of children with
chronic disease.
Byczkowski TL, Munafo JK, Britto MT.
Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center,
University of Cincinnati College of Medicine, 3333 Burnet Ave., Cincinnati, OH
45229-3039, USA. terri.byczkowski@cchmc.org
OBJECTIVES: To assess the use of Internet-based portals among families of
children with chronic diseases and to describe characteristics of portal
registrants and users.
DESIGN: Retrospective observational study.
SETTING: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, using
data from September 1, 2003, through February 29, 2008. Patients/
PARTICIPANTS: Parents of children with diabetes mellitus, juvenile idiopathic
arthritis, or cystic fibrosis.
INTERVENTIONS: Parents of children with a chronic disease were given the
opportunity to access health-related information for their children via an
Internet-based portal.
OUTCOME MEASURES: Percentage of families who obtained a portal account
(registered), used the portal for the first time within 3 months and again 3 to 6
25. months after registration, number of times logged in, and session length.
RESULTS: Of 1900 families, 27.9% obtained a portal account. Of those, 47.8% used
the portal within 3 months of registration and 15.9% continued to use the portal
3 to 6 months after registration. Families of African American patients and of
patients insured by Medicaid were less likely to obtain a portal account. More
outpatient visits and having private health insurance coverage were associated
with increased portal registration and use.
CONCLUSIONS: Understanding the feasibility of portal use by parents is an
important first step to using portals for improving self-management,
patient-provider interactions, and outcomes for children with chronic diseases.
Subsequent studies should address parent perceptions of the value portals add to
the management of the chronic disease of their child and ways to increase that
value. Barriers to using portals among racial minorities and publicly insured
families should also be studied to address disparities.
PMID: 21536954 [PubMed - indexed for MEDLINE]
53. Sultan Qaboos Univ Med J. 2010 Aug;10(2):169-79. Epub 2010 Jul 19.
"I Found it on the Internet": Preparing for the e-patient in Oman.
Masters K, Ng'ambi D, Todd G.
ITHealthEd, Austria.
In the Information Age, the communication patterns between doctor and patient are
changing. Using Everett Rogers' theory of Diffusion of Innovations, this paper
begins by examining the diffusion of the Internet in the world and in Oman. It
then considers the emergence of e-patients. The characteristics of e-patients are
described in some detail. The paper ends by describing steps that should be taken
when teaching medical students in Oman so that they can be prepared for
e-patients.
PMCID: PMC3074705
PMID: 21509226 [PubMed]
54. Sultan Qaboos Univ Med J. 2011 Feb;11(1):129-31. Epub 2011 Feb 12.
Re: I found it on the Internet": Preparing for the e-patient in Oman.
Alwahaibi N.
Department of Pathology, College of Medicine & Health Sciences, Sultan Qaboos
University, Muscat, Oman.
PMCID: PMC3074694
PMID: 21509223 [PubMed]
55. J Sex Med. 2011 Jul;8(7):2038-47. doi: 10.1111/j.1743-6109.2011.02263.x. Epub
2011 Apr 7.
The ability of the general male public to assess their suitability to take 50-mg
sildenafil: an assessment of the comprehension of patient information materials
via internet survey.
Symonds T, Coyne KS, Margolis MK, Schnetzler G.
Pfizer Ltd., Sandwich, Kent, UK United BioSource Corporation, Bethesda, MD, USA.
tara.symonds@pfizer.com
28. PMID: 21402299 [PubMed - indexed for MEDLINE]
59. Cogn Behav Ther. 2011;40(1):57-64. doi: 10.1080/16506073.2010.529457.
Can the patient decide which modules to endorse? An open trial of tailored
internet treatment of anxiety disorders.
Andersson G, Estling F, Jakobsson E, Cuijpers P, Carlbring P.
Department of Behavioural Sciences and Learning, Swedish Institute for Disability
Research, Linkoping University, Sweden. Gerhard.Andersson@liu.se
Internet-delivered cognitive behaviour therapy commonly consists of
disorder-specific modules that are based on face-to-face manuals. A recent
development in the field is to tailor the treatment according to patient profile,
which has the potential to cover comorbid conditions in association with anxiety
and mood disorders. However, it could be that the patients themselves are able to
decide what modules to use. The authors tested this in an open pilot trial with
27 patients with mixed anxiety disorders. Modules were introduced with a brief
description, and patients could choose which modules to use. The exception was
the two first modules and the last, which involved psychoeducation and relapse
prevention. The treatment period lasted for 10 weeks. Results showed large
within-group effect sizes, with an average Cohen's d of 0.88. In a structured
clinical interview, a majority (54%) had significantly improved 10 weeks after
commencing treatment. Only one person dropped out. On the basis of results of
this preliminary study, the authors suggest that the role of choice and tailoring
should be further explored in controlled trials and that patient choice could be
incorporated into Internet-delivered treatment packages.
PMID: 21337215 [PubMed - indexed for MEDLINE]
60. Ugeskr Laeger. 2011 Feb 21;173(8):572-7.
[The Internet influences the patient-physician relationship].
[Article in Danish]
Riiskjær E, Ammentorp J, Nielsen JF, Kofoed PE.
Institut for Økonomi, Aarhus Universitet, Universitetsparken, Bygning 1322,
Aarhus C, Denmark. eriiskjaer@econ.au.dk
So far, we have only limited knowledge on how the patients' use of the Internet
affects consultations. A review of 36 empirically based articles from 1999 to
2009 demonstrates that patients' Internet search for health information is
widespread. However, there are signs that the impact of Internet searches on
consultations is limited as a number of factors reduce the probability of an
effect on the dialogue between physician and patient. Results are discussed with
reference to three classic consultation models: the paternalistic, the
partnership and the consumer model.
PMID: 21333257 [PubMed - indexed for MEDLINE]
61. J Am Med Inform Assoc. 2011 May 1;18(3):318-21. doi: 10.1136/jamia.2010.006015.
Epub 2011 Jan 24.
Social disparities in internet patient portal use in diabetes: evidence that the
digital divide extends beyond access.
29. Sarkar U, Karter AJ, Liu JY, Adler NE, Nguyen R, López A, Schillinger D.
Center for Vulnerable Populations at San Francisco General Hospital, University
of California San Francisco, San Francisco, California, USA.
usarkar@medsfgh.ucsf.edu
The authors investigated use of the internet-based patient portal, kp.org, among
a well-characterized population of adults with diabetes in Northern California.
Among 14,102 diverse patients, 5671 (40%) requested a password for the patient
portal. Of these, 4311 (76%) activated their accounts, and 3922 (69%), logged on
to the patient portal one or more times; 2990 (53%) participants viewed
laboratory results, 2132 (38%) requested medication refills, 2093 (37%) sent
email messages, and 835 (15%) made medical appointments. After adjustment for
age, gender, race/ethnicity, immigration status, educational attainment, and
employment status, compared to non-Hispanic Caucasians, African-Americans and
Latinos had higher odds of never logging on (OR 2.6 (2.3 to 2.9); OR 2.3 (1.9 to
2.6)), as did those without an educational degree (OR compared to college
graduates, 2.3 (1.9 to 2.7)). Those most at risk for poor diabetes outcomes may
fall further behind as health systems increasingly rely on the internet and limit
current modes of access and communication.
PMCID: PMC3078675
PMID: 21262921 [PubMed - indexed for MEDLINE]
62. Ann Oncol. 2011 Feb;22(2):490-1. doi: 10.1093/annonc/mdq746. Epub 2011 Jan 19.
Internet to boost patient accrual in oncology trials? A multiinstitutional AERIO
study.
Rodrigues MJ, Haberer S, Dionysopoulos D, Barrière J, Wassermann J, Tazi Y,
Rajpar S, Giroux J, Bidard FC, Loriot Y; AERIO Group.
PMID: 21248065 [PubMed - indexed for MEDLINE]
63. Patient Prefer Adherence. 2010 Nov 3;4:397-406. doi: 10.2147/PPA.S14477.
Multinational Internet-based survey of patient preference for newer oral or
injectable Type 2 diabetes medication.
Dibonaventura MD, Wagner JS, Girman CJ, Brodovicz K, Zhang Q, Qiu Y, Pentakota
SR, Radican L.
Health Sciences Practice, Kantar Health, New York;
BACKGROUND: The prevalence of Type 2 diabetes mellitus continues to rise.
Although glucagon-like peptide-1 (GLP-1) analog and dipeptidyl peptidase-4
(DPP-4) inhibitor medications are effective, there are differences between these
products, including method of administration (injectable versus oral). The
objective of this study was to examine patient preferences (and predictors of
preferences) for two different medication profiles, one similar to a GLP-1 analog
(liraglutide) and another similar to a DPP-4 inhibitor (sitagliptin).
METHODS: Internet survey data were collected in two waves (wave 1, n = 2402; wave
2, n = 1340) using patients from the US and Europe. Patients were presented with
two hypothetical medication profiles ("drug A" and "drug B", resembling
sitagliptin and liraglutide, respectively) and asked to report their preferences.
RESULTS: Most patients in wave 1 and wave 2 reported that overall they would
prefer a drug with the sitagliptin-like profile (81.9% and 84.4%, respectively)
over a drug with the liraglutide-like profile (18.1% and 15.6%, respectively),
and >80% of patients reported that they would be able to take a drug with the
sitagliptin-like profile as directed by their physician for a longer period. The
30. likelihood of preferring the sitagliptin-like profile significantly increased as
age (odds ratio [OR] = 1.02) and importance placed on method of administration
(OR = 1.32) increased (P < 0.05). Although the sitagliptin-like profile was
preferred by the majority of patients in all subgroups, a lower proportion of
patients with obesity, with weight gain, with A1C values above target, and who
exercised preferred the sitagliptin-like profile compared with those without
obesity (77.0% versus 87.9%), without weight gain (77.8% versus 86.7%), with A1C
values at or below target (79.0% versus 86.5%), and who did not exercise (81.6%
versus 86.4%), respectively (P < 0.05).
CONCLUSIONS: This research suggests that patients (across geographies) prefer an
oral medication with a profile resembling sitagliptin to an injectable medication
with a profile resembling liraglutide.
PMCID: PMC3003606
PMID: 21206515 [PubMed]
64. J Health Commun. 2010;15 Suppl 3:186-99. doi: 10.1080/10810730.2010.522691.
The role of provider-patient communication and trust in online sources in
Internet use for health-related activities.
Hou J, Shim M.
Grady College of Journalism & Mass Communication, University of Georgia, 120
Hooper Street, Athens, GA 30602-3018, USA. jiranhou@uga.edu
Provider-patient communication is an important factor influencing patients'
satisfaction and health outcomes. This study draws upon the uses and
gratification theory to examine how individuals' perception of communication with
healthcare providers is associated with their Internet use for health-related
activities. Using the data from the 2007 Health Information National Trends
Survey (HINTS), we found that as individuals perceived their communication with
providers to be less patient-centered, they were more likely to engage in various
types of online health activities, such as using websites for healthy lifestyles,
searching for healthcare providers, and seeking health information. Trust in
online health information was also found to be a significant predictor of online
health activities. The results of this study emphasized the important role of
provider-patient communication in motivating individuals to turn to the Internet
for health purposes.
PMID: 21154093 [PubMed - indexed for MEDLINE]
65. Implement Sci. 2010 Nov 17;5:87. doi: 10.1186/1748-5908-5-87.
The QUIT-PRIMO provider-patient Internet-delivered smoking cessation referral
intervention: a cluster-randomized comparative effectiveness trial: study
protocol.
Houston TK, Sadasivam RS, Ford DE, Richman J, Ray MN, Allison JJ.
Division of Health Informatics and Implementation Science, Quantitative Health
Sciences and Medicine, University of Massachusetts Medical School, Worcester, MA,
USA. Rajani.Sadasivam@umassmed.edu.
BACKGROUND: Although screening for tobacco use is increasing with electronic
health records and standard protocols, other tobacco-control activities, such as
referral of patients to cessation resources, is quite low. In the QUIT-PRIMO
study, an online referral portal will allow providers to enter smokers' email
addresses into the system. Upon returning home, the smokers will receive
automated emails providing education about tobacco cessation and encouragement to
![#web2salute
100 Abstracts of E-patient
1. Head Neck. 2013 Apr 2. doi: 10.1002/hed.23282. [Epub ahead of print]
Internet-mediated physician-patient interaction focusing on extracranial hemangiomas and vascular malformations.
Wiegand S, Marggraf J, Wilhelm T, Eivazi B, Werner JA.
Department of Otolaryngology, Head and Neck Surgery, University Hospital Giessen
& Marburg, Marburg, Germany.
BACKGROUND: Internet-mediated communication in health care is becoming increasingly important. The purpose of
this study was to analyze internet-mediated physician-patient interaction in an angioma center.
METHODS: Patient-related e-mails received between January 2002 and June 2009 were retrospectively analyzed
regarding the diagnosis of hemangiomas or vascular malformations. Additionally, the visitors' statistics of the
corresponding website ''www.angiome.de" was evaluated.
RESULTS: Five hundred forty-eight e-mails matched the criteria of the study. From 2002 to 2008, the number of
messages registered annually increased by a factor of 20 and the average number of e-mails per patient tripled. The
number of new patients contacting the center via e-mail increased from 12 to 72 per year. The website
''www.angiome.de" was visited 8490 times in 2008 and 13,291 times in 2009.
CONCLUSION: The presence of the internet is relevant to get in touch with new patients and to provide information
for nonprofessionals and experts especially in diseases with low incidence.
© 2013 Wiley Periodicals, Inc. Head Neck, 2013. Copyright © 2013 Wiley Periodicals, Inc., A Wiley Company.
PMID: 23554096 [PubMed - as supplied by publisher]
2. BMJ. 2013 Apr 2;346:f1990. doi: 10.1136/bmj.f1990.
How the e-patient community helped save my life: an essay by Dave deBronkart.
Debronkart D.
Nashua, New Hampshire, USA.
PMID: 23550048 [PubMed - in process]
3. BMC Med Inform Decis Mak. 2013 Mar 5;13:33. doi: 10.1186/1472-6947-13-33.
Internet-enabled pulmonary rehabilitation and diabetes education in group settings at home: a preliminary study of
patient acceptability.
Burkow TM, Vognild LK, Ostengen G, Johnsen E, Risberg MJ, Bratvold A, Hagen T,
Brattvoll M, Krogstad T, Hjalmarsen A.
Norwegian Centre for Integrated Care and Telemedicine, University Hospital of
North Norway, P,O, Box 35, Tromsø, N-9038, Norway. Tatjana.m.burkow@telemed.no.
BACKGROUND: The prevalence of major chronic illnesses, such as chronic obstructive pulmonary disease (COPD)
and diabetes, is increasing. Pulmonary rehabilitation and diabetes self-management education are important in the
management of COPD and diabetes respectively. However, not everyone can participate in the programmes offered at a
hospital or other central locations, for reasons such as travel and transport. Internet-enabled home-based programmes
have the potential to overcome these barriers.This study aims to assess patient acceptability of the delivery form and
components of Internet-enabled programmes based on home groups for comprehensive pulmonary rehabilitation and
for diabetes self-management education.](https://image.slidesharecdn.com/100abstractsofe-patient-130424160050-phpapp02/85/100-abstracts-of-e-patient-Fattori-1-320.jpg)
![METHODS: We have developed Internet-enabled home programmes for comprehensive pulmonary rehabilitation and
for diabetes self-management education that include group education, group exercising (COPD only), individual
consultations, educational videos and a digital health diary. Our prototype technology platform makes use of each
user's own TV at home, connected to a computer, and a remote control. We conducted a six-week home trial with 10
participants: one group with COPD and one with diabetes. The participants were interviewed using semi-structured
interviews.
RESULTS: Both home-based programmes were well accepted by the participants. The group setting at home made it
possible to share experiences and to learn from questions raised by others, as in conventional group education. In the
sessions, interaction and discussion worked well, despite the structure needed for turn taking. The thematic educational
videos were well accepted although they were up to 40 minutes long and their quality was below TV broadcasting
standards. Taking part in group exercising at home under the guidance of a physiotherapist was also well accepted by
the participants. Participants in the COPD group appreciated the social aspect of group education sessions and of
exercising together, each in their own home. The digital health diary was used as background information in the
individual consultations and by some participants as a self-management tool. Participant retention was high, with no
dropouts. None of the participantsreported that the six-week duration of the home programmes was too long.
CONCLUSIONS: The Internet-enabled programmes for home-based groups in pulmonary rehabilitation and diabetes
education were generally well accepted by the participants. Our findings indicate that conventional programmes have
the potential to be delivered in socially supportive group settings at home.
PMCID: PMC3599897
PMID: 23496829 [PubMed - in process]
4. J Clin Nurs. 2013 Apr;22(7-8):1016-25. doi: 10.1111/jocn.12007.
The impact of an empowering Internet-based Breast Cancer Patient Pathway program on breast cancer patients' clinical
outcomes: a randomised controlled trial.
Ryhänen AM, Rankinen S, Siekkinen M, Saarinen M, Korvenranta H, Leino-Kilpi H.
Department of Nursing Science, Turku Social and Health Services, Turku City
Hospital, University of Turku, Turku, Finland. anne.ryhanen@turku.fi
AIMS AND OBJECTIVES: To evaluate the effect of the Breast Cancer Patient Pathway program on breast cancer
patient's empowerment process.
BACKGROUND: The results of earlier studies indicate that the use of tailored Internet-based patient education
programs increased patient's knowledge level; however, other outcome measures differed.
DESIGN: This randomised control trial studied the effect of the Internet-based patient educational program on breast
cancer patients' empowerment. In this study, we measured the quality of life, anxiety and managing with treatment-
related side effects as the outcomes of breast cancer patients' empowering process.
METHODS: Breast cancer patients who were Internet users in one Finnish university hospital during 2008-2010 were
randomised to the control group (n=43) and the intervention group (n=47). Baseline data were collected first in the
hospital and the following data seven times during the treatment process, the last time one year after breast cancer
diagnosis.
RESULTS: There were no statistically significant differences in the quality of life, anxiety or side effects of treatment
between the groups. The amount of treatment-related side effects was connected to both physical and psychological
well-being.
CONCLUSIONS: In this study, the Breast Cancer Patient Pathway program did not decrease anxiety level or treatment-
related side effects among breast cancer patients or improve subscales of quality of life when compared with controls.
RELEVANCE TO CLINICAL PRACTICE: There is a need to relieve the side effects caused by patients' care with the
help of patient education. Internet-based patient education programs need more focus when developing new patient
education methods.
© 2013 Blackwell Publishing Ltd.
PMID: 23480498 [PubMed - in process]
5. J Vasc Interv Radiol. 2013 Apr;24(4):469-74. doi: 10.1016/j.jvir.2013.01.006. Epub 2013 Feb 26.
Readability Assessment of Internet-based Patient Education Materials Related to Uterine Artery Embolization.
Shukla P, Sanghvi SP, Lelkes VM, Kumar A, Contractor S.
Department of Radiology, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, 150
Bergen St., UH CC-318, Newark, NJ 07101.](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)