OBJECTIVE:Crowdsourcing research allows investigators to engage thousands of people to provide either data or data analysis. However, prior work has not documented the use of crowdsourcing in health and medical research. We sought to systematically review the literature to describe the scope of crowdsourcing in health research and to create a taxonomy to characterize past uses of this methodology for health and medical research. DATA SOURCES: PubMed, Embase, and CINAHL through March 2013. STUDY ELIGIBILITY CRITERIA: Primary peerreviewed literature that used crowdsourcing for health research. STUDY APPRAISAL AND SYNTHESIS METHODS: Two authors independently screened studies and abstracted data, including demographics of the crowd engaged and approaches to crowdsourcing. RESULTS: Twenty-one health-related studies utilizing crowdsourcing met eligibility criteria. Four distinct types of crowdsourcing tasks were identified: problem solving, data processing, surveillance/monitoring, and surveying. These studies collectively engaged a crowd of >136,395 people, yet few studies reported demographics of the crowd. Only one (5 %) reported age, sex, and race statistics, and seven (33 %) reported at least one of these descriptors. Most reports included data on crowdsourcing logistics such as the length of crowdsourcing (n=18, 86 %) and time to complete crowdsourcing task (n=15, 71 %). All articles (n=21, 100 %) reported employing some method for validating or improving the quality of data reported from the crowd. LIMITATIONS: Gray literature not searched and only a sample of online survey articles included. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS:Utilizing crowdsourcing can improve the quality, cost, and speed of a research project while engaging large segments of the public and creating novel science. Standardized guidelines are needed on crowdsourcing metrics that should be collected and reported to provide clarity and comparability in methods. INTRODUCTIONCrowdsourcing is an approach to accomplishing a task by opening up its completion to broad sections of the public. Innovation tournaments, prizes for solving an engineering problem, or paying online participants for categorizing images are examples of crowdsourcing. What ties these approaches together is that the task is outsourced with little restriction on who might participate. Despite the potential of crowdsourcing, little is known about the applications and feasibility of this approach for collecting or analyzing health and medical research data where the stakes are high for data quality and validity.One of the most celebrated crowdsourcing tasks was the prize established in 1714 by Britain's Parliament in the Longitude Act, offered to anyone who could solve the problem of identifying a ship's longitudinal position.1 The Audubon Society's Christmas Bird Count began in 1900 and continues to this day as a way for "citizen scientists" to provide data that can be used for studying bird population trends.2 However, today the world has 2.3 billion Internet users an...

BackgroundRegular physical activity reduces the risk of cardiovascular events, but most ischemic heart disease (IHD) patients do not obtain enough.Methods and ResultsACTIVE REWARD (A Clinical Trial Investigating Effects of a Randomized Evaluation of Wearable Activity Trackers with Financial Rewards) was a 24‐week home‐based, remotely monitored, randomized trial with a 16‐week intervention (8‐week ramp‐up incentive phase and 8‐week maintenance incentive phase) and an 8‐week follow‐up. Patients used wearable devices to track step counts and establish a baseline. Patients in control received no other interventions. Patients in the incentive arm received personalized step goals and daily feedback for all 24 weeks. In the ramp‐up incentive phase, daily step goals increased weekly by 15% from baseline with a maximum of 10 000 steps and then remained fixed. Each week, $14 was allocated to a virtual account; $2 could be lost per day for not achieving step goals. The primary outcome was change in mean daily steps from baseline to the maintenance incentive phase. Ischemic heart disease patients had a mean (SD) age of 60 (11) years and 70% were male. Compared with control, patients in the incentive arm had a significantly greater increase in mean daily steps from baseline during ramp‐up (1388 versus 385; adjusted difference, 1061 [95% confidence interval, 386–1736]; P<0.01), maintenance (1501 versus 264; adjusted difference, 1368 [95% confidence interval, 571–2164]; P<0.001), and follow‐up (1066 versus 92; adjusted difference, 1154 [95% confidence interval, 282–2027]; P<0.01).ConclusionsLoss‐framed financial incentives with personalized goal setting significantly increased physical activity among ischemic heart disease patients using wearable devices during the 16‐week intervention, and effects were sustained during the 8‐week follow‐up.Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT02531022.

Tumor virotherapy has been and continues to be used in clinical trials. One barrier to effective viral oncolysis, consisting of the interferon (IFN) response induced by viral infection, is inhibited by valproic acid (VPA) and other histone deacetylase inhibitors (HDACi). Innate immune cell recruitment and activation have been shown to be deleterious to the efficacy of oncolytic herpes simplex virus (oHSV) infection, and in this report we demonstrate that VPA limits this deleterious response. VPA, administered prior to oHSV inoculation in an orthotopic glioblastoma mouse model, resulted in a decline in NK and macrophage recruitment into tumor-bearing brains at 6 and 24 h post-oHSV infection. Interestingly, there was a robust rebound of recruitment of these cells at 72 h post-oHSV infection. The observed initial decline in immune cell recruitment was accompanied by a reduction in their activation status. VPA was also found to have a profound immunosuppressive effect on human NK cells in vitro. NK cytotoxicity was abrogated following exposure to VPA, consistent with downmodulation of cytotoxic gene expression of granzyme B and perforin at the mRNA and protein levels. In addition, suppression of gamma IFN (IFN-␥) production by VPA was associated with decreased STAT5 phosphorylation and dampened T-BET expression. Despite VPA-mediated immune suppression, mice were not at significantly increased risk for HSV encephalitis. These findings indicate that one of the avenues by which VPA enhances oHSV efficacy is through initial suppression of immune cell recruitment and inhibition of inflammatory cell pathways within NK cells. Despite intense investigations to improve the standard of therapy for glioblastoma (GBM), current regimens result in approximately 15 months of median survival following initial diagnosis, emphasizing the need for new therapies. Oncolytic viruses (OV) are promising biological agents, intensely investigated for nearly 2 decades. These naturally occurring and biologically engineered viruses, which are designed to replicate in a relatively selective manner within tumors and culminate in the destruction of the host's cancer cells (1, 10), have demonstrated effectiveness in preclinical models. Five different clinical trials have tested oncolytic herpes simplex virus (oHSV) (22,35,36,47,50), and a maximum tolerated dose was not achieved and toxicity was not demonstrated. Additionally, oncolytic adenovirus (11), Newcastle disease virus (16), and reovirus (14) have been shown to be safe in dose escalation trials in humans with malignant glioma; moreover, there are ongoing clinical trials with measles virus (24), retrovirus (45), parvovirus H-1, poliovirus, and Seneca Valley virus (see http://www.clinicaltrials.gov/ct2 /results?termϭglioblastomaϩANDϩvirus). However, therapeutic efficacy has been elusive to demonstrate. It is evident that efficacy should depend on the ability of the initially injected oHSV to replicate and distribute within the GBM mass. Identification of both barriers in the host that could li...