Developing Consumer Consensus on Remote Assessment and Management of Physical Function in Older Adults (RAMP): International Modified Delphi Process Background: Remote health care delivery, including the use of digital health interventions, is emerging as a tool for assessing and managing physical function, but its design and implementation often overlook the needs and preferences of older adult end users. Objective: The primary aim of this modified Delphi process was to develop consumer consensus on preferences for remote assessment and management of physical function in older adults. Methods: Research and consumer experts of the Remote Assessment and Management of Physical Function in Older Adults (RAMP) Working Group co-developed the Round 1 Delphi survey, which was advertised to consumers (adults aged ≥60 years) via international clinical and research networks and social media between August and November 2023. The online survey presented 23 Delphi statements for which respondents reported their level of agreement using an 11-point Likert scale (0-10; scores ≥7 indicated agreement). Statements were classified as having “strong agreement” and achieving consensus if ≥80% of participants indicated agreement. Statements classified as having “moderate” (70%-80% of participants indicated agreement) or “low” (

New in JMIR Aging: Developing Consumer Consensus on Remote Assessment and Management of Physical Function in Older Adults (RAMP): International Modified Delphi Process #RemoteHealth #DigitalHealth #ElderlyCare #PhysicalFunction #HealthResearch

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#feasibility and Acceptability of Remotely Accessed Compensatory Cognitive Training for Japanese People With Schizophrenia: Pilot Study Background: Compensatory cognitive training (CCT) is an evidence-based treatment for improving cognitive function in patients with schizophrenia. However, the need for patients to commute to treatment sites hinders its widespread use. Using a remote device to conduct CCT could improve its accessibility, making it easier for participants to adjust their schedules and reducing their burden. Objective: The purpose of this study was threefold: to investigate the creation and participant acceptability of CCT using a remote device (r-CCT); to determine the #feasibility of implementing the developed intervention; and to collect preliminary data for future studies of the effectiveness of r-CCT in Japan. Methods: To reduce participant movement during training, CCT was conducted remotely in real time, using borrowed iPads. The training was conducted in a group format via video conferencing once a week for 2 h, for a total of 12 sessions. Four patients with schizophrenia who underwent r-CCT were recruited to determine participation or dropout rates across 12 training sessions. In addition, their diagnostic assessment,(the Scale of Positive Symptoms and the Scale of Negative Symptoms), cognitive function (e.g., the Japanese version of the Trail Making Test Part A (TMT-A) and Part B (TMT-B), digit span, digit symbol), social functioning (Social Functioning Scale Japanese version; SFS-J), and quality of life (Japanese Schizophrenia Quality of Life Scale; JSQLS) were assessed before, immediately after, and three months after implementation. Results: The average participation rate of the three participants (a male in his thirties was excluded) was high at 92%. Immediately after the r-CCT, positive trends were observed in cognitive function―excluding prospective memory. For example, the TMT-A scores improved for all three participants: Mr. A (58s→56s), Mr. B (52s→49s), and Ms. C (65s→49s). The Japanese Verbal Learning Test (JVLT) immediate scores also increased: Mr. A (16→19), Mr. B (13→14), Ms. C (14→21). Functional outcomes, assessed using the SFS-J, showed limited improvement immediately postintervention but tended to return to or fell below preintervention levels at the three-month follow-up. Quality of Life (QOL) scores, measured using the JSQLS, remained relatively stable or improved immediately following the r-CCT and at the three-month follow-up. Conclusions: Despite this study’s small number of participants and lack of randomization, it suggests that the accessibility and implementation potential of r-CCT may be high. The ability to participate in training from any location could be expected to increase participation rates or reduce dropout rates. In the future, the authors will develop the implementation method further and increase the sample size to demonstrate the training’s effectiveness.

JMIR Formative Res: #feasibility and Acceptability of Remotely Accessed Compensatory Cognitive Training for Japanese People With Schizophrenia: Pilot Study #CognitiveTraining #SchizophreniaResearch #RemoteHealth #MentalHealth #Telemedicine

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Remote Photoplethysmography Technology for Blood Pressure and Hemoglobin Level Assessment in the Preoperative Assessment Setting: Algorithm Development Study Background: Various studies have been written about noninvasive, remote photoplethysmography-based measurement of blood pressure (BP) and, to a lesser extent, hemoglobin (Hb) concentration. Widespread applicability has yet to be achieved due to limitations with agreement and correlation. There is also limited data on rPPG BP and Hb measurement evaluation in representative populations at the preoperative evaluation clinic (PEC) setting, such as hypertensive patients and patients with diverse, varying skin tones. Objective: We assessed the accuracy of rPPG technology in noninvasive systolic BP (SBP) and diastolic BP (DBP) measurements compared to automated cuffed blood pressure measuring devices (BPMD). Additionally, we compared the accuracy of rPPG Hb concentration measurement to that of clinical laboratory testing. Methods: Nervotec rPPG telehealth and smartphone software utilizes the principle that reflected light from various skin areas is affected by the volume of blood under the skin, which varies according to arterial pulsations and blood flow. This principle allows for an optical measurement technique that measures these variations. The measurements are then analyzed with signal processing algorithms which generate physiological measurements such as BP and Hb. The study was conducted at Singapore General Hospital (SGH) from 15 February 2023 to 6 December 2024. The participants were recruited in two phases. The first group, used for training and evaluating the algorithm, consisted of 100 patients with a mean age of 52.9 ± 13.1 years. In this group, 59% of patients had concomitant medical diseases such as hypertension (HTN) and diabetes mellitus (DM). The second group, used for validation of the algorithm, consisted of 65 patients with a mean age of 55.15 ± 17.27 years. 43% of the patients had concomitant medical conditions such as HTN, DM and ischemic heart disease (IHD). Both groups had an even distribution of males and females, as well as a diverse range of skin tones (1-10) classified according to the Monk Skin Tone (MST) scale. The primary analysis was focused on assessing the accuracy of rPPG BP measurements compared to BPMD BP measurements. The secondary analysis aimed to evaluate the accuracy of rPPG Hb concentration measurement compared to clinical laboratory testing. Results: Our study demonstrated an accuracy of 83.84% for SBP and 90.55% for DBP, with mean absolute percentage errors (MAPE) of 16.16% for SBP and 9.45% for DBP. Furthermore, the model could predict Hb concentration with an accuracy of 88.41%. MAPE was 11.59%, with an error bias of 0.54 g/dL and an error SD of 1.82 g/dL. Conclusions: Our study is the first to evaluate contactless rPPG BP and Hb concentration measurements in a diverse, heterogeneous study population. The model achieved a DBP accuracy rate of 90.55% with a MAPE of 9.45%. We recorded a MAPE of 16.16% for SBP, and a MAPE of 11.59% for Hb concentration. Quartile evaluation indicated stronger correlations in mid-quartile ranges for DBP (70-74 mmHg) and Hb (13.2 - 14.4 g/dL), confirming the model’s reliability in detecting moderate deviations from normal physiological states. Our current model performance carries potential as a triaging tool within both hospital and population health settings. Clinical Trial: The study was approved by the SingHealth Centralised Institutional Review Board (CIRB Ref: 2023/2042) from 15 February 2023 to 6 December 2024 and is registered on ClinicalTrials.gov (Trial number: NCT06320847).

JMIR Formative Res: Remote Photoplethysmography Technology for Blood Pressure and Hemoglobin Level Assessment in the Preoperative Assessment Setting: Algorithm Development Study #RemoteHealth #Photoplethysmography #BloodPressure #Hemoglobin #NoninvasiveTech

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Determinants of Dropping Out of Remote Patient-Reported Outcome–Based Follow-Up Among Patients With Epilepsy: Prospective Cohort Study Background: Patient-reported outcome (PRO) measures comprise an emerging field in healthcare. In the Central Denmark Region, epilepsy outpatients can participate in remote PRO-based follow-up by completing a questionnaire at home instead of attending a…

JMIR Formative Res: Determinants of Dropping Out of Remote Patient-Reported Outcome–Based Follow-Up Among Patients With Epilepsy: Prospective Cohort Study #Epilepsy #PatientCare #Telemedicine #RemoteHealth #PatientReportedOutcomes