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PubMed2002

What is digital medicine?

Changes in health care are a fundamental part of social and intellectual evolution. The modern practice of scientific medicine depends on the existence of the written and printed word to store medical information. Because computers can transform information as well as store it, new digital tools cannot only record clinical data, they can also generate medical knowledge. In doing so, they make it possible to develop "digital medicine" that is potentially more precise, more effective, more experimental, more widely distributed, and more egalitarian than current medical practice. Critical steps in the creation of digital medicine are careful analysis of the impact of new technologies and coordinated efforts to direct technological development towards creating a new paradigm of medical care.

Delivery of Health Care↗

PubMed2026

Use of wearable technologies for physical activity promotion in older adults: A systematic review.

This systematic review, conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251055299), examined the use of wearable technologies for promoting physical activity (PA) in adults aged 60 years and older. Searches across five databases (PubMed, Scopus, Web of Science, CINAHL, Cochrane) identified 2438 records, of which only six randomized controlled trials published between 2021 and 2025 met inclusion criteria, with sample sizes ranging from 36 to 551 participants and mean ages between 65 and 79 years. Given the small number of included studies, findings should be interpreted as preliminary. The studies ranged from the standalone use of commercial trackers (Fitbit, Polar, ActiGraph) to multicomponent interventions combining wearables with physiotherapist feedback, telephone counseling, web-based platforms, or interactive cognitive-motor training. Wearables used alone, as in the REACT trial, produced small or non-significant PA effects. In contrast, interventions integrating devices with personalized feedback, professional support, or digital platforms, such as PROMOTE and TASMANIA, were associated with more consistent improvements in PA, physical function, and cognitive outcomes. Multicomponent programs, such as PEER and ICMT, reported broader benefits, including cognition, balance, and reductions in sedentary behavior, though these findings derive from individual trials and require replication. Risk of bias, assessed with the Cochrane Risk of Bias tool version 2 (RoB 2.0), was rated as "some concerns" for five studies and low for only one, mainly due to gaps in randomization reporting, missing data, and lack of preregistration. Tentatively, and based on a very limited evidence base, wearables may have greater impact when embedded within broader behavioral systems, incorporating feedback, coaching, or interactive components, rather than when used in isolation as passive monitoring tools. Adherence and psychosocial outcomes appeared related to comfort and perceived usefulness among older adults, though larger and more robust trials are needed to confirm these patterns.

Humans↗

PubMed2026

Privacy, security, and reliability risks of artificial intelligence in healthcare: a systematic review of empirical evidence.

BACKGROUND: Artificial intelligence (AI) is increasingly integrated into healthcare information systems, supporting clinical decision-making, imaging analysis, and predictive modeling. While these applications offer operational and clinical benefits, they also introduce emerging risks to patient privacy, data security, and system reliability. OBJECTIVE: To systematically review empirical evidence on privacy breaches, security vulnerabilities, and misuse associated with AI applications in healthcare settings. METHODS: PubMed, Embase, Web of Science, Scopus, IEEE Xplore, and ACM Digital Library were searched for empirical studies published between January 2015 and November 2025 that evaluated AI use or misuse in clinical diagnosis, treatment, or decision-making. Two reviewers independently screened studies and extracted data using a standardized form. Findings were synthesized narratively due to heterogeneity in study designs, AI methods, and reported outcomes. RESULTS: Of 7,285 records identified through database searches and 205 through citation screening, 22 empirical studies met the inclusion criteria, spanning multiple clinical domains and data modalities, predominantly medical imaging applications. Five recurring threat categories were identified: patient re-identification, membership inference, unauthorized access and adversarial exploitation, input manipulation, and misuse or overinterpretation of AI outputs. Across studies, AI models were shown to encode latent biometric signals across diverse data types, limiting the effectiveness of traditional anonymization and synthetic data approaches. Adversarial attacks and input manipulation were also shown to compromise diagnostic performance and system integrity. CONCLUSION: This systematic review provides empirical evidence suggesting that contemporary AI systems in healthcare introduce privacy and security risks that may challenge traditional assumptions about data protection. These findings underscore the need for privacy- and security-by-design approaches and governance frameworks that address risks across the AI lifecycle.

Humans↗

PubMed2002

A brief telephone interview to identify lesbian and bisexual women in random digit dialing sampling.

Lesbian health research has most often relied on nonprobability samples that are biased and restrict generalizability. Random sampling could reduce bias, but requires development of a method for fast and reliable screening of a large number of women. We tested the feasibility of using a brief telephone interview to assess sexual attraction, behavior, and identity. Using Random Digit Dialing in a neighborhood of Boston with a high density of lesbian residents, we interviewed 202 women aged 18 to 59. Of the respondents, 33% reported some sexual attraction to other women, 20% reported sex with women since age 18, and 14% identified as a lesbian. The high level of cooperation with the study among eligible women (94%) and the high proportion of women who disclosed homosexual attraction, behavior, or identity show that it is feasible to use a brief screening questionnaire about sexuality of women over the telephone even without building special rapport with the respondents.

Adult↗

PubMedDate not supplied

[Organization of lung digital X-ray fluorography and its introduction into the health care services of Russia].

Based on comprehensive study of the capacities of digital X-ray fluorography (DXRF), the authors give their views on two main aspects of its use. These are firstly the most acceptable organizational forms of lung DXRF into the health care services of Russia and, secondly, its place in the diagnosis of pulmonary tuberculosis, lung cancer, chronic nonspecific lung diseases, and mediastinal tumors. As for its organization and introduction, the authors are against the fact that film fluorography should be rapidly replaced by DXRF. They give recommendations based on the reasonable and stepwise introduction of DXRF, which may rule out their negative perception versus the present attitude to the so-called prophylactic film fluorography. In the part dealing with diagnosis that analyzes 955 cases of various lung diseases (from over 8000 DXRFs) verified by different studies (morphological, cytological, etc.) and chest X-ray computed tomography, the authors show the results of monitoring imaging, by demonstrating all its potentialities. At the same time they recommend that image printing fixing should be also rather widely employed. In the authors' opinion, DXRF may become the method of choice in detecting pulmonary tuberculosis, lung cancer, chronic nonspecific lung diseases, and mediastinal tumors.

Delivery of Health Care↗

PubMed1995

Techniques and tools for digitizing analog video for use in CD-ROM-based health education programs.

This presentation is designed to familiarize medical educators with the techniques and tools for converting analog video into digital video for use in CD-ROM based multimedia programs. Recent advances in computer processing, CD-ROM storage, and digital video enable personal computers to be used for creating and presenting digital adaptations of videodisc and videotape based instructional programs. These digital multimedia programs are being used for training health care providers, for patient and family health education, and for health information kiosks. Repurposing existing analog video is a cost effective approach for creating high quality multimedia instructional programs. The presentation will cover the process of digitally capturing and manipulating video segments for playback from CD-ROM. Procedures from initial digital capture to transcoding will be discussed and illustrated. Strengths and limitations of alternative procedures will be discussed. Two CD-ROM development projects, the digital conversion of The Anatomy Project videodiscs and the creation of a patient education program on spinal cord injury, will be used as examples of techniques.

Analog-Digital Conversion↗

PubMed2006

A community-based participatory health information needs assessment to help eliminate diabetes information disparities.

This article describes the participatory research process, results, action plan, and implications of the community health information needs assessment conducted within the African American community in two South Carolina counties. The REACH 2010: Charleston and Georgetown Diabetes Coalition library program is a partnership among community organizations, public and health sciences libraries, and lay community health advisors. A planning committee studied digital divide issues related to health information, designed and implemented a survey, held focus groups, analyzed data, identified needs and assets, and formulated an action plan to increase the dissemination of diabetes information. Key survey findings show that older (older than 60) and less educated (fewer than 12 years of education) African Americans in Charleston and Georgetown counties lack skills to access Internet and library services and suffer disparities in health information. Based on assessment evidence, the community plans to increase Internet access points and provide a train-the-trainer program to teach people skills for using Internet and library resources to get high-quality information about diabetes and its complications. This process taps community resources, builds local capacities and technical skills, educates about health, and empowers participants as active partners in their own health and their community's health.

Adult↗

PubMed2002

Opinions of Illinois voters about coordinated school health programs.

A random-digit dialed telephone survey was conducted in Illinois to determine support for coordinated school health programs (CSHP). Survey data were obtained from 469 registered voters in June and July 2000. Results demonstrated that most Illinois registered voters: 1) supported the concept and practice of CSHP; 2) were uncertain if current school health education and services were adequate; 3) believed Illinois schools should set a goal of creating a "healthier state;" and 4) although supportive of concept, were not familiar with term CSHP. Characteristics of supportive and nonsupportive registered voters are reported. Results of this study may assist in developing educational and marketing strategies to build support for coordinated school health programs in Illinois.

Adolescent↗

PubMedDate not supplied

Physician executives straddle the digital divide.

e-Health is here to stay and experts predict that the Internet will become the hub of health care. Rapid advancements in biotechnology and medical research, increasingly curious patients who surf the Internet for medical information, and pressures from managed care companies to contain costs and speed treatments are the central components driving e-health. Despite physician reluctance to embrace the e-revolution, many hospitals and medical groups are employing the Internet and information technology to improve their customer interface, as well as to reduce business costs. This article offers seven e-strategies for health care performance improvement: (1) Supply chain management; (2) e-transactions; (3) care management; (4) improving quality; (5) boosting revenues; (6) outsourcing; and (7) provider networks (Intranets). By helping to incorporate these key e-solutions, physician executives can position their organizations for success in the new millennium.

Attitude of Health Personnel↗

PubMed1995

The potential of computerized representations of anatomy in the training of health care providers.

The purpose of anatomy education is to develop the skills for anatomical reasoning, which is a requirement for performing a number of clinical tasks. Anatomical reasoning integrates an understanding of the three-dimensional (3-D) geometry of the body and its parts (the spatial domain of anatomical information) with an understanding of functional, developmental, pathological, and other relationships among anatomic entities (the symbolic domain of anatomical information). Traditional methods in anatomy have substantial shortcomings for representing and integrating these two information domains. Computer-based methods of knowledge representation have a great potential for overcoming the shortcomings and for promoting anatomical reasoning. To realize this potential, there is a need for (1) establishing 3-D electronic atlases of the human body; (2) generating models of symbolic anatomical information, and (3) developing computer programs (user interfaces) that integrate these knowledge sources and serve the needs of trainees and practitioners in different fields of the health sciences. The Digital Anatomist Program at the University of Washington has begun to build such a client-server framework for anatomical information, and its application for biomedical education is being evaluated.

Anatomy↗

PubMed2003

A novel way of distributing medical practice guidelines using Personal Digital Assistants (PDA).

With the rapid growth in medical knowledge, physicians' ability to keep up to date has become increasingly difficult. Although the Internet brought significant improvements in access to medical knowledge, there are still problems remaining, particularly for the mobile physician who is unable to perform time-consuming on-line searches, even with wireless access to the Internet. The goal of this project was to develop a novel way of distributing medical knowledge from the Internet to health professionals' Personal Digital Assistants (PDAs). This model delivers targeted information and provides access to that information at the point of care.

Computers, Handheld↗

PubMed2002

The digital portfolio: a tool for human resource management in health care?

This article discusses the current situation of human resource management (HRM) in Finnish health care and charts the views of nurse directors (ward sisters and clinical nurse managers, n = 47) on the digital portfolio as a tool of HRM. The study is part of an evaluation research project; this article reports on the findings from nurse directors' perspective. The data were collected from three organizations in eastern Finland: a University Hospital, a Central Hospital and a Social and Health Centre. The nurse directors indicated a need for information on their staff's skills and competencies, but the area on which they had most information was on staff's formal education. They did not have access to systematic tools and methods for monitoring the continuous education of staff members. The digital portfolio can be used as a tool for HRM in health care, although the nurse directors did not realize it could provide a tool for sharing expertise through the units or wards.

Adult↗

PubMedDate not supplied

Assessing the value of the internet in health improvement.

The internet is a powerful tool that provides easy access to information. Many people access it for health information and bring the material gathered to health appointments. However, the information may not always be correct or adequately monitored for quality. This could lead to some of it being harmful. This article examines whether or not the internet will enable us to lead healthier lives. The need for a quality label, how professionals must become adept at using the internet, the possibility of a digital divide exacerbating health inequalities and the dangers of misusing the internet's interactive elements are examined.

Computer Literacy↗

PubMed2000

Postnatal pelvic floor screening clinics: a pilot study.

Information regarding the importance of pelvic floor muscle (PFM) exercises during and after pregnancy is now available to most pregnant women and to women who have just given birth. However, despite the apparent availability of this information, there are many women who do not perform these exercises following childbirth, and many who only practice them occasionally. A survey of 48 postnatal women in Bolton revealed that although they had all heard about pelvic floor exercises, less than 50% practised them post-delivery and of those that did only 10% continued with regular daily exercises for more than 2 weeks after the birth of their child. Of greater concern was the wide variety in exercise techniques. It was decided to address this problem by offering informative postnatal education on PFM exercises and by training health visitors to digitally assess the pelvic floor and run screening clinics for women 3-12 months post-delivery. This article discusses the results of a pilot study that includes data on the first 28 women to attend the clinic.

Adult↗

PubMed2006

A site of communication among enterprises for supporting occupational health and safety management system.

The occupational health and safety management constitutes a field of increasing interest. Institutions in cooperation with enterprises make synchronized efforts to initiate quality management systems to this field. Computer networks can offer such services via TCP/IP which is a reliable protocol for workflow management between enterprises and institutions. A design of such network is based on several factors in order to achieve defined criteria and connectivity with other networks. The network will be consisted of certain nodes responsible to inform executive persons on Occupational Health and Safety. A web database has been planned for inserting and searching documents, for answering and processing questionnaires. The submission of files to a server and the answers to questionnaires through the web help the experts to make corrections and improvements on their activities. Based on the requirements of enterprises we have constructed a web file server. We submit files in purpose users could retrieve the files which need. The access is limited to authorized users and digital watermarks authenticate and protect digital objects. The Health and Safety Management System follows ISO 18001. The implementation of it, through the web site is an aim. The all application is developed and implemented on a pilot basis for the health services sector. It is all ready installed within a hospital, supporting health and safety management among different departments of the hospital and allowing communication through WEB with other hospitals.

Communication↗

PubMed1998

The effect of transdermal nicotine on digital perfusion in reformed habitual smokers.

The effects of transdermal nicotine-assisted smoking cessation on digital perfusion and health-related quality of life were assessed in 10 chronic smokers. Components of digital blood flow were evaluated by digital temperature and laser Doppler fluxmetry before, during, and after a standardized cold challenge. Nutritional flow was measured by vital capillaroscopy; a quantitative perfusion profile was obtained by laser Doppler perfusion imaging. A battery of validated measures were used to evaluate health-related quality of life. The microvascular response of smokers was evaluated before smoking cessation and at 2 and 7 days after smoking cessation and was compared with the response of nonsmoking controls. Results demonstrated that a (1) cutaneous microvascular perfusion was lower in smokers than nonsmokers, (2) the acute administration of transdermal nicotine did not decrease cutaneous perfusion, (3) smoking cessation and transdermal nicotine normalized digital microvascular perfusion by 7 days, and (4) transdermal nicotine and smoking cessation did not negatively impact health-related quality of life.

Administration, Cutaneous↗

PubMed2026

Teaching Acute Coronary Syndrome High-Risk ECG Interpretation and Clinical Decision-Making Through FOAMed Videos and Podcast Versus Print-Based Materials Among Emergency Care Providers: Randomized Controlled Mixed Methods Trial.

BACKGROUND: Accurate interpretation of high-risk acute coronary syndrome (ACS) electrocardiograms (ECGs) is essential for early diagnosis and timely reperfusion, yet substantial deficits persist across health care professions. Digital self-learning formats such as FOAMed (Free Open Access Medical Education) are widely used, but their effectiveness has rarely been evaluated for complex, high-risk ACS ECG patterns. Existing ECG education studies often focus on students or single professional groups and established ST-segment elevation myocardial infarction (STEMI) criteria, leaving newer guideline-recognized STEMI equivalents, selected emerging occlusion myocardial infarction (OMI)-related patterns, and interprofessional emergency care underrepresented. OBJECTIVE: This study aimed to compare the effectiveness of FOAMed podcast and videos versus traditional print-based materials for teaching high-risk ACS ECG patterns and related clinical decision-making in emergency providers. METHODS: We conducted a prospective, interprofessional, controlled mixed methods trial across 5 training sites in Germany. Paramedics, prehospital emergency physicians, and emergency department clinicians received either a FOAMed multimedia module or print-based materials through concealed allocation; deviations from the intended 1:1 ratio resulted from participant no-shows. The intervention consisted of a 30-minute supervised self-learning session. In total, 103 participants were allocated to FOAMed (n=45) or print-based materials (n=58). Two coprimary outcomes were assessed: ECG interpretation accuracy and text-based ACS clinical decision-making. Secondary outcomes included subjective confidence, learning experience, and exploratory qualitative free-text responses. Outcome assessment was automated and blinded; mixed ANOVA was the primary analysis. The study was not prospectively registered because it assessed educational outcomes in health care professionals rather than patient health outcomes. RESULTS: All 103 participants completed the study. Both groups improved, with greater gains in the FOAMed group: ECG interpretation increased from 55% to 65.5% and text-based ACS clinical decision-making from 45% to 68%, versus 57% to 60% and from 47% to 63%, respectively, in the print-based group. Effect sizes were η²=0.055 for ECG interpretation and η²=0.044 for clinical decision-making. Exploratory subgroup analyses provided no evidence of differential effects across age, gender, or professional background and were likely underpowered. Qualitative responses (46 and 37 entries) provided contextual insights into perceived clarity, engagement, and practical relevance supporting the quantitative findings. CONCLUSIONS: This study is innovative in directly comparing a curated FOAMed multimedia module with selected print-based materials in an interprofessional emergency care population. It differs from existing research by focusing on subtle, emerging ischemic patterns and evaluating realistic, time-limited self-learning formats. The findings provide evidence that curated FOAMed resources can produce greater short-term improvements in ECG interpretation and text-based ACS clinical decision-making than traditional print-based materials in this setting. Although implications for clinical performance remain hypothetical, concise, high-quality digital modules may represent a practical supplement to structured continuing education in emergency care.

Humans↗

PubMed2026

Evaluating Patient Satisfaction and Oral Health Impact Profile-14 (OHIP-14): A Multicenter Crossover Study Comparing Selective Pressure Impression Conventional Dentures with Mucostatic Digital Dentures.

PURPOSE: To compare patient satisfaction and oral health impact between individuals receiving complete dentures made by digital methods and those using conventional techniques. MATERIALS AND METHODS: In this randomized crossover clinical trial, 23 patients aged 40 years and older with completely edentulous arches were enrolled at three treatment centers. Each participant received two sets of complete dentures: one set created using conventional methods (selective pressure impression) and the other through digital techniques (mucostatic digital impression). The order of denture placement was randomized, with each set used for 4 weeks. A trained specialist administered treatments alongside research tools, including a general information questionnaire, a denture satisfaction survey, and the OHIP-14 interview tool. Statistical analysis was conducted using Mann-Whitney U test. RESULTS: Participants with digital dentures reported significantly higher satisfaction regarding treatment duration, comfort, confidence, chewing ability, esthetics, and overall satisfaction compared to those with conventional dentures. There were no significant differences in satisfaction concerning speech and pronunciation. Overall, the oral health impact on quality of life was similar between denture types, but participants indicated improved quality of life while using dentures compared to being edentulous. CONCLUSIONS: Patients with digital dentures exhibited greater satisfaction across various domains compared to those with conventional dentures, despite similar satisfaction levels in speech and pronunciation. The impact on quality of life was comparable between both types, as measured by the OHIP-14.

Humans↗