J. Med. Internet Res. - How can research keep up with eHealth? Ten strategies for increasing the timeliness and usefulness of eHealth research.

Tópicos

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Resumo

CKGROUND: eHealth interventions appear and change so quickly that they challenge the way we conduct research. By the time a randomized trial of a new intervention is published, technological improvements and clinical discoveries may make the intervention dated and unappealing. This and the spate of health-related apps and websites may lead consumers, patients, and caregivers to use interventions that lack evidence of efficacy.OBJECTIVE: This paper aims to offer strategies for increasing the speed and usefulness of eHealth research.METHODS: The paper describes two types of strategies based on the authors' own research and the research literature: those that improve the efficiency of eHealth research, and those that improve its quality.RESULTS: Efficiency strategies include: (1) think small: conduct small studies that can target discrete but significant questions and thereby speed knowledge acquisition; (2) use efficient designs: use such methods as fractional-factorial and quasi-experimental designs and surrogate endpoints, and experimentally modify and evaluate interventions and delivery systems already in use; (3) study universals: focus on timeless behavioral, psychological, and cognitive principles and systems; (4) anticipate the next big thing: listen to voices outside normal practice and connect different perspectives for new insights; (5) improve information delivery systems: researchers should apply their communications expertise to enhance inter-researcher communication, which could synergistically accelerate progress and capitalize upon the availability of "big data"; and (6) develop models, including mediators and moderators: valid models are remarkably generative, and tests of moderation and mediation should elucidate boundary conditions of effects and treatment mechanisms. Quality strategies include: (1) continuous quality improvement: researchers need to borrow engineering practices such as the continuous enhancement of interventions to incorporate clinical and technological progress; (2) help consumers identify quality: consumers, clinicians, and others all need to easily identify quality, suggesting the need to efficiently and publicly index intervention quality; (3) reduce the costs of care: concern with health care costs can drive intervention adoption and use and lead to novel intervention effects (eg, reduced falls in the elderly); and (4) deeply understand users: a rigorous evaluation of the consumer's needs is a key starting point for intervention development.CONCLUSIONS: The challenges of distinguishing and distributing scientifically validated interventions are formidable. The strategies described are meant to spur discussion and further thinking, which are important, given the potential of eHealth interventions to help patients and families.

Resumo Limpo

ckground ehealth intervent appear chang quick challeng way conduct research time random trial new intervent publish technolog improv clinic discoveri may make intervent date unapp spate healthrel app websit may lead consum patient caregiv use intervent lack evid efficacyobject paper aim offer strategi increas speed use ehealth researchmethod paper describ two type strategi base author research research literatur improv effici ehealth research improv qualityresult effici strategi includ think small conduct small studi can target discret signific question therebi speed knowledg acquisit use effici design use method fractionalfactori quasiexperiment design surrog endpoint experiment modifi evalu intervent deliveri system alreadi use studi univers focus timeless behavior psycholog cognit principl system anticip next big thing listen voic outsid normal practic connect differ perspect new insight improv inform deliveri system research appli communic expertis enhanc interresearch communic synergist acceler progress capit upon avail big data develop model includ mediat moder valid model remark generat test moder mediat elucid boundari condit effect treatment mechan qualiti strategi includ continu qualiti improv research need borrow engin practic continu enhanc intervent incorpor clinic technolog progress help consum identifi qualiti consum clinician other need easili identifi qualiti suggest need effici public index intervent qualiti reduc cost care concern health care cost can drive intervent adopt use lead novel intervent effect eg reduc fall elder deepli understand user rigor evalu consum need key start point intervent developmentconclus challeng distinguish distribut scientif valid intervent formid strategi describ meant spur discuss think import given potenti ehealth intervent help patient famili

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