A randomized trial to determine the impact on compliance of a psychophysical peripheral cue based on the Elaboration Likelihood Model

Objective: Non-compliance in clinical studies is a significant issue, but causes remain unclear. Utilizing the Elaboration Likelihood Model of persuasion, this study assessed the psychophysical peripheral cue ‘Interactive Voice Response System (IVRS) call frequency’ on compliance. Methods: 71 participants were randomized to once daily (OD), twice daily (BID) or three times daily (TID) call schedules over two weeks. Participants completed 30-item cognitive function tests at each call. Compliance was defined as proportion of expected calls within a narrow window (± 30 min around scheduled time), and within a relaxed window (− 30 min to + 4 h). Data were analyzed by ANOVA and pairwise comparisons adjusted by the Bonferroni correction. Results: There was a relationship between call frequency and compliance. Bonferroni adjusted pairwise comparisons showed significantly higher compliance (p = 0.03) for the BID (51.0%) than TID (30.3%) for the narrow window; for the extended window, compliance was higher (p = 0.04) with OD (59.5%), than TID (38.4%). Conclusion: The IVRS psychophysical peripheral cue call frequency supported the ELM as a route to persuasion. The results also support OD strategy for optimal compliance. Models suggest specific indicators to enhance compliance with medication dosing and electronic patient diaries to improve health outcomes and data integrity respectively

Artificial Neural Network for Predicting COVID 19 Using JNN

Abstract: The emergence of the novel coronavirus (COVID-19) in 2019 has presented the world with an unprecedented global health crisis. The rapid and widespread transmission of the virus has strained healthcare systems, disrupted economies, and challenged societies. In response to this monumental challenge, the intersection of technology and healthcare has become a focal point for innovation. This research endeavors to leverage the capabilities of Artificial Neural Networks (ANNs) to develop an advanced predictive model for forecasting the spread of COVID-19. It involves the collection, analysis, and integration of diverse datasets encompassing epidemiological, clinical, and social factors that influence the virus's dissemination

Pilot study of an interactive voice response system to improve medication refill compliance

<p>Abstract</p> <p>Background</p> <p>Sub-optimal adherence to prescribed medications is well documented. Barriers to medication adherence include medication side effects, cost, and forgetting to take or refill medications. Interactive Voice Response (IVR) systems show promise as a tool for reminding individuals to take or refill medications. This pilot study evaluated the feasibility and acceptability of using an IVR system for prescription refill and daily medication reminders. We tested two novel features: personalized, medication-specific reminder messages and communication via voice recognition.</p> <p>Methods</p> <p>Patients enrolled in a study of electronic prescribing and medication management in Quebec, Canada who were taking chronic disease-related drugs were eligible to participate. Consenting patients had their demographic, telephone, and medication information transferred to an IVR system, which telephoned patients to remind them to take mediations and/or refill their prescriptions. Facilitators and barriers of the IVR system use and acceptability of the IVR system were assessed through a structured survey and open-ended questions administered by telephone interview.</p> <p>Results</p> <p>Of the 528 eligible patients who were contacted, 237 refused and 291 consented; 99 participants had started the pilot study when it was terminated because of physician and participant complaints. Thirty-eight participants completed the follow-up interview. The majority found the IVR system's voice acceptable, and did not have problems setting up the time and location of reminder calls. However, many participants experienced technical problems when called for reminders, such as incorrect time of calls and voice recognition difficulties. In addition, most participants had already refilled their prescriptions when they received the reminder calls, reporting that they did not have difficulties remembering to refill prescriptions on their own. Also, participants were not receptive to speaking to an automated voice system.</p> <p>Conclusion</p> <p>IVR systems designed to improve medication compliance must address key technical and performance issues and target those individuals with reported memory difficulties or complex medication regimens in order to improve the utility of the system. Future research should also identify characteristics of medication users who are more likely to be receptive to IVR technology.</p

The Palestinian primary ciliary dyskinesia population: first results of the diagnostic, and genetic spectrum

BACKGROUND: Diagnostic testing for primary ciliary dyskinesia (PCD) started in 2013 in Palestine. We aimed to describe the diagnostic, genetic and clinical spectrum of the Palestinian PCD population. METHODS: Individuals with symptoms suggestive of PCD were opportunistically considered for diagnostic testing: nasal nitric oxide (nNO) measurement, transmission electron microscopy (TEM) and/or PCD genetic panel or whole-exome testing. Clinical characteristics of those with a positive diagnosis were collected close to testing including forced expiratory volume in 1 s (FEV1) Global Lung Index z-scores and body mass index z-scores. RESULTS: 68 individuals had a definite positive PCD diagnosis, 31 confirmed by genetic and TEM results, 23 by TEM results alone, and 14 by genetic variants alone. 45 individuals from 40 families had 17 clinically actionable variants and four had variants of unknown significance in 14 PCD genes. CCDC39, DNAH11 and DNAAF11 were the most commonly mutated genes. 100% of variants were homozygous. Patients had a median age of 10.0 years at diagnosis, were highly consanguineous (93%) and 100% were of Arabic descent. Clinical features included persistent wet cough (99%), neonatal respiratory distress (84%) and situs inversus (43%). Lung function at diagnosis was already impaired (FEV1 z-score median −1.90 (−5.0–1.32)) and growth was mostly within the normal range (z-score mean −0.36 (−3.03–2.57). 19% individuals had finger clubbing. CONCLUSIONS: Despite limited local resources in Palestine, detailed geno- and phenotyping forms the basis of one of the largest national PCD populations globally. There was notable familial homozygosity within the context of significant population heterogeneity

Feasibility of Using Interactive Voice Response to Monitor Daily Drinking, Moods, and Relationship Processes on a Daily Basis in Alcoholic Couples

Daily process research on alcohol involvement has used paper-and-pencil and electronic data collection methods, but no studies have yet tested the feasibility of using Interactive Voice Response (IVR) technology to monitor drinking, affective, and social interactional processes among alcoholic (ALC) couples. This study tested the feasibility of using IVR with n  = 54 ALC couples.Participants were n  = 54 couples (probands who met criteria for a past 1-year alcohol use disorder and their partners) recruited from a substance abuse treatment center and the local community. Probands and their partners reported on their daily drinking, marital interactions, and moods once a day for 14 consecutive days using an IVR system. Probands and partners were on average 43.4 and 43.0 years old, respectively.Participants completed a total of 1,418 out of a possible 1,512 diary days for an overall compliance rate of 93.8%. ALC probands completed an average of 13.3 (1.0) diary reports, and partners completed an average of 13.2 (1.0) diary reports. On average, daily IVR calls lasted 7.8 (3.0) minutes for ALC probands and 7.6 (3.0) minutes for partners. Compliance was significantly lower on weekend days (Fridays and Saturdays) compared to other weekdays for probands and spouses. Although today’s intoxication predicted tomorrow’s noncompliance for probands but not spouses, the strongest predictor of proband’s compliance was their spouse’s compliance. Daily anxiety and marital conflict were associated with daily IVR nonresponse, which triggered automated reminder calls.Findings supported that IVR is a useful method for collecting daily drinking, mood, and relationship process data from alcoholic couples. Probands’ compliance is strongly associated with their partners’ compliance, and automated IVR calls may facilitate compliance on high anxiety, high conflict days.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79396/1/j.1530-0277.2009.01115.x.pd

Interactive voice response technology for symptom monitoring and as an adjunct to the treatment of chronic pain

Chronic pain is a medical condition that severely decreases the quality of life for those who struggle to cope with it. Interactive voice response (IVR) technology has the ability to track symptoms and disease progression, to investigate the relationships between symptom patterns and clinical outcomes, to assess the efficacy of ongoing treatments, and to directly serve as an adjunct to therapeutic treatment for chronic pain. While many approaches exist toward the management of chronic pain, all have their pitfalls and none work universally. Cognitive behavioral therapy (CBT) is one approach that has been shown to be fairly effective, and therapeutic interactive voice response technology provides a convenient and easy-to-use means of extending the therapeutic gains of CBT long after patients have discontinued clinical visitations. This review summarizes the advantages and disadvantages of IVR technology, provides evidence for the efficacy of the method in monitoring and managing chronic pain, and addresses potential future directions that the technology may take as a therapeutic intervention in its own right