Translating Games Into Effective Health Results Using Digital Tools

2022 ◽  
pp. 53-74
Author(s):  
Duarte Vital Brito ◽  
Hernâni Zão Oliveira
Keyword(s):  
Health Professionals ◽  
Scientific Evidence ◽  
Risk Of Bias ◽  
Future Research ◽  
Randomized Control Trials ◽  
Randomized Control ◽  
Barriers And Opportunities ◽  
Compliance To Treatment ◽  
Study Designs

The use of gamification in the health context, especially to trigger behavior change, has assumed a particular relevance. However, the scientific evidence that supports the effectiveness of gamified methodologies has constituted a barrier to the implementation of projects. This chapter draws on a review of this theme, identifying barriers and opportunities for using gamification mechanisms. Results show that digital games are often considered as more enjoyable, engaging, and interesting solutions that are able to increase access, autonomy, self-efficacy, compliance to treatment, and knowledge acquisition. However, most studies reported a high risk of bias due to small-sized samples, short follow-up times, and lack of randomized control trials or more robust study designs. Therefore, future research should target older adults, ensure longer periods of follow-up, bigger samples, and include randomized control trials. Involvement of patients and health professionals is also a key component to ensure a more effective and regulated delivery of such solutions within the healthcare system.

scholarly journals Active Vision Therapy for Anisometropic Amblyopia in Children: A Systematic Review

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Carlos J. Hernández-Rodríguez ◽  
David P. Piñero
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Scientific Evidence ◽  
Active Vision ◽  
Risk Of Bias ◽  
Randomized Control Trials ◽  
Double Blind ◽  
Anisometropic Amblyopia ◽  
Randomized Control ◽  
Vision Therapy

Purpose. The aim of the study was evaluation of the scientific evidence about the efficacy of vision therapy in children and teenagers with anisometropic amblyopia by performing a systematic literature review. Methods. A search was performed using 3 searching strategies in 4 different databases (PubMed, Web of Science, Scopus, and PruQuest). The quality of the included articles was evaluated using two tools for the risk of bias assessment, ROBINS-I for nonrandomized studies of intervention (NRSI), and ROB 2.0 for randomized clinical trials. Results. The search showed 1274 references, but only 8 of them passed the inclusion criteria after the complete text review. The articles that were finally included comprised 2 randomized control trials and 6 nonrandomized studies of intervention. These articles provided evidence supporting the efficacy of vision therapy for the treatment of anisometropic amblyopia in children and teenagers. Assessment of the risk of bias showed an appropriate risk of bias for the randomized control trials, but a high risk of bias for nonrandomized studies of intervention (NRSI). A main source of risk of bias for NRSI was the domain related to the measurements of the outcomes, due to a lack of double-blind studies. Conclusion. Vision therapy is a promising option for the treatment of anisometropic amblyopia in children and teenagers. However, the level of scientific evidence provided by the studies revised is still limited, and further randomized clinical trials are necessary to confirm the results provided to date and to optimize the vision therapy techniques by knowing the specific neural mechanisms involved.

scholarly journals Challenges in treatment of renal echinococcosis with gross hydatiduria and unsalvageable kidney: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Sameera Shuaibi ◽  
Abdelrahman AlAshqar ◽  
Munirah Alabdulhadi ◽  
Wasl Al-Adsani
Keyword(s):  
Clinical Decision Making ◽  
Scientific Evidence ◽  
Renal Involvement ◽  
Clinical Decision ◽  
Response To Treatment ◽  
Standards Of Care ◽  
Future Research ◽  
Positive Serology ◽  
Grape Skin

Abstract Introduction Renal echinococcosis is of rare occurrence, and although often asymptomatic, it can present with various mild to drastic presentations, of which hydatiduria is pathognomonic. Diagnosis can be preliminarily established by imaging, and treatment is primarily surgical. We present a patient with renal echinococcosis treated successfully with exclusive antiparasitic pharmacotherapy after refusing surgery despite extensive renal involvement. We hope through this report to help establish future solid guidelines regarding this uncommon therapeutic approach. Case presentation This is a case of a 49-year-old Syrian shepherd presenting with flank pain and passage of grape-skin-like structures in urine. A diagnosis of renal echinococcosis with hydatiduria and significant parenchymal destruction was established based on exposure history, positive serology, imaging findings, and renal scintigraphy. After proper counseling, the patient refused nephrectomy and was therefore started on dual pharmacotherapy (albendazole and praziquantel) and is having an uneventful follow-up and a satisfactory response to treatment. Conclusion This case embodies the daily challenges physicians navigate as they uphold the ethical principles of their practice and support their patients’ autonomy while delivering the best standards of care and consulting the scientific evidence. Although surgery is the cornerstone of renal echinococcosis treatment, treating physicians should be prepared to tackle situations where surgery cannot be done and offer the best next available option for patients who refuse surgery. As data on exclusive pharmacotherapy are limited, future research should thoroughly investigate the efficacy of this uncommon approach and outline reliable recommendations, facilitating future clinical decision-making in this avenue.

scholarly journals Positive Technology: Using Mobile Phones for Psychosocial Interventions

2015 ◽  
pp. 871-897 ◽  
Author(s):  
Sara Konrath
Keyword(s):  
Mobile Phones ◽  
Psychosocial Interventions ◽  
Well Being ◽  
Text Messages ◽  
Health Interventions ◽  
Future Research ◽  
Randomized Control Trials ◽  
Advantages And Disadvantages ◽  
Randomized Control ◽  
Mobile Interventions

This article reviews the use of mobile phones in psychosocial interventions. Specifically, it reviews research studies that have used text messages (SMS) or smartphone applications (apps) to improve people's mental health, psychological well-being, or social relationships. Psychosocial interventions are emerging from the larger and more established mobile health (mHealth) literature of physical health interventions. The scientific knowledge of psychosocial interventions is currently quite limited, with only a few published large randomized control trials. Most of those are limited to North American or European participant samples. The advantages and disadvantages of mobile interventions are discussed, along with recommendations for best practices. The success of future research is dependent upon more researcher-friendly tools to implement interventions.

scholarly journals Between-Groups Study Designs Demand Between-Groups Analyses: A Response to Hernandez-Reif, Shor-Posner, Baez, Soto, Mendoza, Castillo, Quintero, Perez, and Zhang

2009 ◽  
Vol 6 (1) ◽  
pp. 49-50 ◽  
Author(s):  
Christopher A. Moyer
Keyword(s):  
Spontaneous Remission ◽  
Clear Understanding ◽  
Randomized Control Trials ◽  
Statistical Regression ◽  
Placebo Effects ◽  
Control Groups ◽  
Dependent Variables ◽  
Randomized Control ◽  
Study Designs ◽  
And Control

The most recent massage therapy (MT) study by Hernandez-Reifet al.displays flaws persistent in this area of research that are attributable to MT researchers’ frequent mistake of using within-group analyses of dependent variables in studies that are purported to be randomized control trials. This practise violates the logic of using randomization to create treatment and control groups, and thereby fails to control for the validity threats of spontaneous remission, placebo effects, and statistical regression. The result is that a clear understanding of what MT can and cannot do is seriously hampered.

scholarly journals The Efficacy of Yoga as a Form of Treatment for Depression

2017 ◽  
Vol 22 (4) ◽  
pp. 1017-1028 ◽  
Author(s):  
Ledetra Bridges ◽  
Manoj Sharma
Keyword(s):  
The United States ◽  
Small Sample ◽  
Randomized Control Trials ◽  
Intervention Period ◽  
Short Term ◽  
Behavioral Theories ◽  
Quasi Experimental ◽  
Randomized Control ◽  
Small Sample Sizes ◽  
Study Designs

The purpose of this article was to systematically review yoga interventions aimed at improving depressive symptoms. A total of 23 interventions published between 2011 and May 2016 were evaluated in this review. Three study designs were used: randomized control trials, quasi-experimental, and pretest/posttest, with majority being randomized control trials. Most of the studies were in the United States. Various yoga schools were used, with the most common being Hatha yoga. The number of participants participating in the studies ranged from 14 to 136, implying that most studies had a small sample. The duration of the intervention period varied greatly, with the majority being 6 weeks or longer. Limitations of the interventions involved the small sample sizes used by the majority of the studies, most studies examining the short-term effect of yoga for depression, and the nonutilization of behavioral theories. Despite the limitations, it can be concluded that the yoga interventions were effective in reducing depression.

scholarly journals Potential treatments in the management of covid-19

2020 ◽  
Vol 12 (9) ◽  
pp. e3963
Author(s):  
Luiza Miranda Marinho de Paula ◽  
Jhonson Tizzo Godoy ◽  
Arthur Alves Baldo ◽  
Henrique Chagas Costa ◽  
Isabela Soares Bôa Morte ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Health Professionals ◽  
Scientific Evidence ◽  
Risk Of Bias ◽  
Low Risk ◽  
Medical Clinic ◽  
Inclusion Criteria ◽  
Future Studies ◽  
Selection Of

Objective: To provide a tool to assist health professionals in the medical clinic regarding treatments still under study to combat COVID-19 and serve as a basis for future studies. Methods: For the development of this systematic review, research was carried out on the Embase, Pubmed databases and on the website clinicaltrials.gov, with the following inclusion criteria: selection of clinical trials carried out in adults, randomized or not, who addressed the discussion on the treatment or development of vaccines for COVID-19. Of the articles found, 22 studies were selected and those with a different methodological design were excluded. Results: The studies cover clinical trials that are divided into double or triple blind and present a low risk of bias. Among the tested interventions, Hydroxychloroquine and antivirals are the drugs that show the most promise in controlling the disease. The final results, however, are not yet available, as studies are ongoing. Final considerations: There is still no scientific evidence to recommend the use of any of the tested drugs, making it necessary to continue and maintain ongoing studies.

scholarly journals Telemedicine in Pediatrics: A Systematic Review of Randomized Controlled Trials (Preprint)

2020 ◽  
Author(s):  
Aashaka C. Shah ◽  
Sherif M. Badawy
Keyword(s):  
Type I Diabetes ◽  
Pancreatic Insufficiency ◽  
Health Conditions ◽  
Pediatric Care ◽  
Future Research ◽  
Type I ◽  
Randomized Control Trials ◽  
Eligibility Criteria ◽  
Pubmed Database ◽  
Randomized Control

BACKGROUND Telemedicine modalities, such as video conferencing, are used by healthcare providers to remotely deliver healthcare to patients. The use of telemedicine in pediatrics has increased in recent years to improve healthcare access, optimize disease management, monitor progress of health conditions, and minimize exposure to sick patients during pandemics, such as coronavirus disease-19 (COVID-19). OBJECTIVE To synthesize information from recent randomized control trials regarding the use of telemedicine or telehealth across all health conditions in the pediatric populations. METHODS Studies were identified through PubMed database on May 10, 2020. We followed the guidelines for the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Included studies were randomized control trials from the last ten years that focused on telemedicine or telehealth approaches as a study intervention in general or sub-specialty pediatric care. Title and abstracts were independently screened based on the eligibility criteria. Full texts were retrieved and independently screened based on the eligibility criteria. A standardized form including publication title, first author’s name, publication year, participants’ characteristics, study design, technology approach used, intervention characteristics, study goal, and study findings was used for data extraction. RESULTS Eleven articles met inclusion criteria and were included in this review. All studies were categorized as either randomized control trials (8/11) or cluster randomized trials (3/11). Number of participants in each study ranged from 22 to 400. Health conditions ranged from obesity (3/11), asthma (2/11), mental health (1/11), otitis media (1/11), skin conditions (1/11), type I diabetes (1/11), ADHD (1/11), and cystic fibrosis related pancreatic insufficiency (1/11). Telemedicine approaches used included traditional patient and doctor visits conducted via videoconferencing (5/11), smartphone-based interventions (3/11), telephone counseling (2/11), and telemedicine screening visits (1/11). Telemedicine interventions in all included studies showed comparable or improved outcomes related to symptom management, quality of life, satisfaction, medication adherence, visit completion rates, and disease progression, compared to control groups. CONCLUSIONS Evidence suggests that telemedicine use in general and subspecialty pediatric care is comparable and occasionally more beneficial, compared to in person visits. Patients, healthcare professionals, patients and caregivers may benefit from utilizing telemedicine alongside traditional in person healthcare evaluations. Future research should emphasize improving access to care and cost effectiveness and eliminating barriers of telemedicine use to maximize its potential. CLINICALTRIAL N/A

scholarly journals Systematic Differences in Effect Estimates Between Observational Studies and Randomized Control Trials in Meta-Analyses Combining Both Study Designs in Nephrology

2020 ◽  
Author(s):  
Miho Kimachi ◽  
Akira Onishi ◽  
Aran Tajika ◽  
Kimihiko Kimachi ◽  
Toshi Furukawa
Keyword(s):  
Systematic Reviews ◽  
Observational Studies ◽  
Statistical Significance ◽  
Randomized Control Trials ◽  
Causal Inferences ◽  
Randomized Controlled ◽  
The Past ◽  
Randomized Control ◽  
Meta Analyses ◽  
Study Designs

Abstract The limited availability of randomized controlled trials (RCTs) in nephrology undermines causal inferences in meta-analyses. Systematic reviews of observational studies have grown more common under such circumstances. We conducted systematic reviews of all comparative observational studies in nephrology from 2006 to 2016 to assess the trends in the past decade. We then focused on the meta-analyses combining observational studies and RCTs to evaluate the systematic differences in effect estimates between study designs using two statistical methods: by estimating the ratio of odds ratios (ROR) of the pooled OR obtained from observational studies versus those from RCTs and by examining the discrepancies in their statistical significance. The number of systematic reviews of observational studies in nephrology had grown by 11.7-fold in the past decade. Among 56 records combining observational studies and RCTs, ROR suggested that the estimates between study designs agreed well (ROR: 1.05, 95% confidence interval: 0.90-1.23). However, almost half of the reviews led to discrepant interpretations in terms of statistical significance. In conclusion, the findings based on ROR might encourage researchers to justify the inclusion of observational studies in meta-analyses. However, caution is needed as the interpretations based on statistical significance were less concordant than those based on ROR.

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