As telehealth plays an even greater role in global health care delivery, it will be increasingly important to develop a strong evidence base of successful, innovative telehealth solutions that can lead to scalable and sustainable telehealth programs. This paper has two aims: (1) to describe the challenges of promoting telehealth implementation to advance adoption and (2) to present a global research agenda for personalized telehealth within chronic disease management. Using evidence from the United States and the European Union, this paper provides a global overview of the current state of telehealth services and benefits, presents fundamental principles that must be addressed to advance the status quo, and provides a framework for current and future research initiatives within telehealth for personalized care, treatment, and prevention. A broad, multinational research agenda can provide a uniform framework for identifying and rapidly replicating best practices, while concurrently fostering global collaboration in the development and rigorous testing of new and emerging telehealth technologies. In this paper, the members of the Transatlantic Telehealth Research Network offer a 12-point research agenda for future telehealth applications within chronic disease management.

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Background Type D personality is an emerging risk factor in cardiovascular disease. We examined the psychometric properties of the Danish version of the Type D Scale (DS14) and the impact of Type D on anxiety and depression in cardiac patients. Method Cardiac patients (n=707) completed the DS14, the Hospital Anxiety and Depression Scale, and the Eysenck Personality Questionnaire. A subgroup (n = 318) also completed the DS14 at 3 or 12 weeks. Results The two-factor structure of the DS14 was confirmed; the subscales negative affectivity and social inhibition were shown to be valid, internally consistent (Cronbach's α=0.87/0.91; mean inter-item correlations= 0.49/0.59), and stable over 3 and 12 weeks (r=0.85/0.78; 0.83/0.79; ps<0.01). Type D was an independent associate of anxiety (β, 0.49; p<0.01) and depression (β, 0.47; p< 0.01) in univariable linear regression analysis and remained a significant independent associate of anxiety (β, 0.26; p< 0.01) and depression (β, 0.17; p < 0.01) in adjusted analyses. Conclusions The Danish DS14 was shown to be a valid and reliable measure associated with increased symptoms of anxiety and depression independent of sociodemographic and clinical risk factors. The DS14 may be used in research and clinical practice to identify high-risk patients.