scholarly journals An Intelligent Individualized Cardiovascular App for Risk Elimination (iCARE) for Individuals With Coronary Heart Disease: Development and Usability Testing Analysis

10.2196/26439 ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. e26439
Author(s):  
Yuling Chen ◽  
Meihua Ji ◽  
Ying Wu ◽  
Qingyu Wang ◽  
Ying Deng ◽  
...  

Background Death and disability from coronary heart disease (CHD) can be largely reduced by improving risk factor management. However, adhering to evidence-based recommendations is challenging and requires interventions at the level of the patient, provider, and health system. Objective The aim of this study was to develop an Intelligent Individualized Cardiovascular App for Risk Elimination (iCARE) to facilitate adherence to health behaviors and preventive medications, and to test the usability of iCARE. Methods We developed iCARE based on a user-centered design approach, which included 4 phases: (1) function design, (2) iterative design, (3) expert inspections and walkthroughs of the prototypes, and (4) usability testing with end users. The usability testing of iCARE included 2 stages: stage I, which included a task analysis and a usability evaluation (January to March 2019) of the iCARE patient app using the modified Health Information Technology Usability Survey (Health-ITUES); and stage II (June 2020), which used the Health-ITUES among end users who used the app for 6 months. The end users were individuals with a confirmed diagnosis of CHD from 2 university-affiliated hospitals in Beijing, China. Results iCARE consists of a patient app, a care provider app, and a cloud platform. It has a set of algorithms that trigger tailored feedback and can send individualized interventions based on data from initial assessment and health monitoring via manual entry or wearable devices. For stage I usability testing, 88 hospitalized patients (72% [63/88] male; mean age 60 [SD 9.9] years) with CHD were included in the study. The mean score of the usability testing was 90.1 (interquartile range 83.3-99.0). Among enrolled participants, 90% (79/88) were satisfied with iCARE; 94% (83/88) and 82% (72/88) reported that iCARE was useful and easy to use, respectively. For stage II usability testing, 61 individuals with CHD (85% [52/61] male; mean age 53 [SD 8.2] years) who were from an intervention arm and used iCARE for at least six months were included. The mean total score on usability testing based on the questionnaire was 89.0 (interquartile distance: 77.0-99.5). Among enrolled participants, 89% (54/61) were satisfied with the use of iCARE, 93% (57/61) perceived it as useful, and 70% (43/61) as easy to use. Conclusions This study developed an intelligent, individualized, evidence-based, and theory-driven app (iCARE) to improve patients’ adherence to health behaviors and medication management. iCARE was identified to be highly acceptable, useful, and easy to use among individuals with a diagnosis of CHD. Trial Registration Chinese Clinical Trial Registry ChiCTR-INR-16010242; https://tinyurl.com/2p8bkrew

2020 ◽  
Author(s):  
Yuling Chen ◽  
Meihua Ji ◽  
Ying Wu ◽  
Qingyu Wang ◽  
Ying Deng ◽  
...  

BACKGROUND Death and disability from coronary heart disease (CHD) can be largely reduced by improving risk factor management. However, adhering to evidence-based recommendations is challenging and requires interventions at the level of the patient, provider, and health system. OBJECTIVE The aim of this study was to develop an Intelligent Individualized Cardiovascular App for Risk Elimination (iCARE) to facilitate adherence to health behaviors and preventive medications, and to test the usability of iCARE. METHODS We developed iCARE based on a user-centered design approach, which included 4 phases: (1) function design, (2) iterative design, (3) expert inspections and walkthroughs of the prototypes, and (4) usability testing with end users. The usability testing of iCARE included 2 stages: stage I, which included a task analysis and a usability evaluation (January to March 2019) of the iCARE patient app using the modified Health Information Technology Usability Survey (Health-ITUES); and stage II (June 2020), which used the Health-ITUES among end users who used the app for 6 months. The end users were individuals with a confirmed diagnosis of CHD from 2 university-affiliated hospitals in Beijing, China. RESULTS iCARE consists of a patient app, a care provider app, and a cloud platform. It has a set of algorithms that trigger tailored feedback and can send individualized interventions based on data from initial assessment and health monitoring via manual entry or wearable devices. For stage I usability testing, 88 hospitalized patients (72% [63/88] male; mean age 60 [SD 9.9] years) with CHD were included in the study. The mean score of the usability testing was 90.1 (interquartile range 83.3-99.0). Among enrolled participants, 90% (79/88) were satisfied with iCARE; 94% (83/88) and 82% (72/88) reported that iCARE was useful and easy to use, respectively. For stage II usability testing, 61 individuals with CHD (85% [52/61] male; mean age 53 [SD 8.2] years) who were from an intervention arm and used iCARE for at least six months were included. The mean total score on usability testing based on the questionnaire was 89.0 (interquartile distance: 77.0-99.5). Among enrolled participants, 89% (54/61) were satisfied with the use of iCARE, 93% (57/61) perceived it as useful, and 70% (43/61) as easy to use. CONCLUSIONS This study developed an intelligent, individualized, evidence-based, and theory-driven app (iCARE) to improve patients’ adherence to health behaviors and medication management. iCARE was identified to be highly acceptable, useful, and easy to use among individuals with a diagnosis of CHD. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR-INR-16010242; https://tinyurl.com/2p8bkrew


Author(s):  
Harukuni Akita ◽  
Miyao Matsubara ◽  
Hitoshi Shibuya ◽  
Hirotoshi Fuda ◽  
Hitoshi Chiba

Background Lipoprotein(a) [Lp(a)] is a risk factor for atherosclerosis and increases with age. The purpose of this study was to determine the effect of ageing on Lp(a) for three different apo(a) phenotypes. Methods We measured plasma Lp(a) concentrations in 551 unrelated Japanese subjects (20-88 years of age). We performed statistical analyses separately for three apo(a) phenotypes: the low-molecular-weight (LMW) phenotype with the F, B or S1 isoform, the intermediate-molecular-weight (IMW) phenotype with the S2 isoform and the high-molecular-weight (HMW) phenotype with the S3 or S4 isoform. Results For each phenotype, the mean plasma Lp(a) concentration and the frequency of Lp(a) concentrations ≥ 250 mg/L increased with age. Further, a statistically significant difference was always found between the younger subjects (20-39 years of age) and the elderly (over 60 years). The frequency of coronary heart disease increased with age, particularly for the LMW and IMW phenotypes. Conclusions We conclude that ageing elevates plasma Lp(a) concentrations, which may have a role in the prevalence of coronary heart disease in the elderly, especially those with the LMW or IMW phenotypes.


2015 ◽  
Vol 1 (1) ◽  
pp. 29-32
Author(s):  
Mithileshwer Raut ◽  
Prashant Regmi ◽  
Saroj Prasad Ojha ◽  
Bharat Jha

BACKGROUND: Alcohol dependence syndrome (ADS) has become a global public health challenge because of its high prevalence and the concomitant increase in risk of liver disease, cardiovascular disease and premature death. Influence of alcohol use on lipid metabolism is well recognized. Investigations had been carried out in the earlier period on abnormal lipid profile as a risk factor for Coronary Heart disease (CHD). Patients of alcohol dependence usually have a consumption pattern of more heavy use. Therefore it is useful to study the lipid profile in patients of alcohol dependence, to understand the effects of increasing levels of consumption. METHODS: This cross-sectional study was conducted in TU Teaching Hospital. ADS patients were screened by the consultant psychiatrist using the Alcohol Use Disorder Identification Test (AUDIT) questionnaire. A total of 89 patients scored positive on the AUDIT as having alcohol-related problems and were included in the study. 89 ADS patients and 89 healthy controls both male and female were enrolled as participants. Blood Pressure and other anthropometric parameters were measured while fasting blood samples were analyzed for serum lipid profile. SPSS program was used to analyze data, t-test & Spearman's correlation coefficient was used to find correlation. RESULTS: Among the ADS cases 95% were current smokers. Mean age of cases and controls was 35.42±5.6 & 34.53±3.5 years respectively. The mean total cholesterol levels were found to be higher in cases (5.41±0.70) than controls (3.79±0.74) with a strong statistical significance (p<0.001). Also, Mean triglyceride (TG) levels (2.09±0.72), along with the mean HDL-cholesterol (1.66±0.40) and LDL-cholesterol levels (2.79±0.81) were also elevated in cases when compared to the control samples (p<0.001). CONCLUSION: This study has demonstrated definitive lipid profile changes in patients of alcohol dependence, with some correlation to the liver dysfunction. Alcohol causes alteration in various parameters of lipid metabolism including those which predispose to CHD. Low to moderate alcohol use over prolonged periods has been linked to have protective influence for development of coronary heart disease (CHD), through increase in high density lipoprotein cholesterol (HDL-C) levels. DOI: http://dx.doi.org/10.3126/acclm.v1i1.12312 Ann. Clin. Chem. & Lab. Med. 1(1) 2015: 29-32


2019 ◽  
pp. 587-615
Author(s):  
Joseph De Bono ◽  
Anli Yue Zhou

Cardiovascular diseases are one of the leading causes of morbidity and mortality in the UK. Cardiovascular diseases can affect those in employment and can limit working capacity. Multiple considerations should be taken into account when assessing return to work, including psychosocial factors. This chapter provides a comprehensive and up-to-date evidence-based overview of common cardiovascular diseases such as coronary heart disease, valvular disease, congenital heart disease, hypertension, syncope, and implantable cardiac devices including pacemakers (with a special section on implantable devices and electromagnetic fields). Topics of interest also covered within this chapter include travel, firefighters, stress, shift working, hazardous substances, hot conditions, and driving.


2020 ◽  
Vol 118 ◽  
pp. 104706
Author(s):  
Linda L. Magnusson Hanson ◽  
Naja H. Rod ◽  
Jussi Vahtera ◽  
Marianna Virtanen ◽  
Jane Ferrie ◽  
...  

2018 ◽  
Vol 48 (4) ◽  
Author(s):  
Simone Carvalho dos Santos Cunha ◽  
Katia Barão Corgozinho ◽  
Franciele Basso Fernandes Silva ◽  
Kassia Valéria Gomes Coelho da Silva ◽  
Ana Maria Reis Ferreira

ABSTRACT: Our retrospective study evaluated the survival of 24 dogs with unresectable malignant melanoma treated with radiation therapy. Fifteen dogs were treated with radiation therapy (RT) and chemotherapy (CT), five with surgery followed by RT and CT, three with palliative RT, and one with electrochemotherapy associated with RT. All dogs were treated with an orthovoltage Stabilipan I. The protocol used was three or four weekly fractions of 8 Gy. Carboplatin was administered every 21 days, a total of four times. Five percent of dogs were classified as having stage I melanoma, 17% as stage II, 50% as stage III, and 17% as stage IV. Sixty-four percent had a partial response to treatment, 29% achieved complete remission, and 7% remained in a stable disease state. The mean survival time was 390 days for stage I, 286 days for stage II, 159 days for stage III, and 90 days for stage IV. We concluded that radiation therapy can be considered a viable alternative for the palliative treatment of canine oral melanoma.


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