Surveillance and Digital Health

Martinez-Martin, Nicole; Char, Danton

doi:10.1080/15265161.2018.1498954

Cited by 9 publications

(6 citation statements)

References 9 publications

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“…Beyond surgery, the concept of digital phenotyping has been extensively applied in the mental health arena for objective continuous generation of data points representing activities, cognitions, and behaviors (e.g., self-evaluated mood, daily steps, call durations, text frequency, psychosocial PROMs) in the management of a conditions including depression, anxiety, bipolar disease, schizophrenia and monitoring suicidal risk [ 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

Digital Phenotyping and Patient-Generated Health Data for Outcome Measurement in Surgical Care: A Scoping Review

Jayakumar

Lin

Galea

et al. 2020

JPM

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Digital phenotyping—the moment-by-moment quantification of human phenotypes in situ using data related to activity, behavior, and communications, from personal digital devices, such as smart phones and wearables—has been gaining interest. Personalized health information captured within free-living settings using such technologies may better enable the application of patient-generated health data (PGHD) to provide patient-centered care. The primary objective of this scoping review is to characterize the application of digital phenotyping and digitally captured active and passive PGHD for outcome measurement in surgical care. Secondarily, we synthesize the body of evidence to define specific areas for further work. We performed a systematic search of four bibliographic databases using terms related to “digital phenotyping and PGHD,” “outcome measurement,” and “surgical care” with no date limits. We registered the study (Open Science Framework), followed strict inclusion/exclusion criteria, performed screening, extraction, and synthesis of results in line with the PRISMA Extension for Scoping Reviews. A total of 224 studies were included. Published studies have accelerated in the last 5 years, originating in 29 countries (mostly from the USA, n = 74, 33%), featuring original prospective work (n = 149, 66%). Studies spanned 14 specialties, most commonly orthopedic surgery (n = 129, 58%), and had a postoperative focus (n = 210, 94%). Most of the work involved research-grade wearables (n = 130, 58%), prioritizing the capture of activity (n = 165, 74%) and biometric data (n = 100, 45%), with a view to providing a tracking/monitoring function (n = 115, 51%) for the management of surgical patients. Opportunities exist for further work across surgical specialties involving smartphones, communications data, comparison with patient-reported outcome measures (PROMs), applications focusing on prediction of outcomes, monitoring, risk profiling, shared decision making, and surgical optimization. The rapidly evolving state of the art in digital phenotyping and capture of PGHD offers exciting prospects for outcome measurement in surgical care pending further work and consideration related to clinical care, technology, and implementation.

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Section: Discussionmentioning

confidence: 99%

Digital Phenotyping and Patient-Generated Health Data for Outcome Measurement in Surgical Care: A Scoping Review

Jayakumar

Lin

Galea

et al. 2020

JPM

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“…On the one hand, studies discuss that the objective of DP is to foster self-care and reduce dependency on (and contacts with) healthcare professionals. On the other hand, it is also claimed that DP would require more interventions by health professionals, whose role seems to be idealisedas if they were practically capable of constantly monitoring patients' medication-taking data, to then promptly intervene whenever needed [18]. The presence of this dichotomy suggests that it is not clear whether DP entail an increase or a reduction of workload for doctors in the everyday provision of care.…”

Section: Discussionmentioning

confidence: 99%

“…The idea that traditional drugs are integrated into DP in order to automatically collect and share patients' data has also generated a great number of ethical concerns. It has been argued that collecting data through DP might affect individuals' autonomy [17], represent an unpleasant form of surveillance [18], introduce elements of coercion in the treatment of patients [19], impact on the doctor-patient relationship [18,20], compromise privacy [21] and over-enhance the idea of responsibility for health [22]. Some authors have even compared taking DP to "swallowing a spy", which would collect and upload a huge amount of sensitive data without bringing any substantial therapeutic benefit to the patients [23].…”

Section: Introductionmentioning

confidence: 99%

Digital pills: a scoping review of the empirical literature and analysis of the ethical aspects

et al. 2020

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Background: Digital Pills (DP) are an innovative drug-device technology that permits to combine traditional medications with a monitoring system that automatically records data about medication adherence as well as patients' physiological data. Although DP are a promising innovation in the field of digital medicine, their use has also raised a number of ethical concerns. These ethical concerns, however, have been expressed principally from a theoretical perspective, whereas an ethical analysis with a more empirically oriented approach is lacking. There is also a lack of clarity about the empirical evidence available concerning the application of this innovative digital medicine. Methods: To map the studies where DP have been tested on patients and discuss the ethically relevant issues evident therein, we performed a scoping review of the empirical literature concerning DP. Results: Our search allowed us to identify 18 papers reporting on studies where DP were tested on patients. These included studies with different designs and involving patients with a variety of conditions. In the empirical literature, a number of issues with ethical relevance were evident. At the patient level, the ethical issues include users' interaction with DP, personal sphere, health-related risks and patients' benefits. At the provider level, ethically relevant issues touch upon the doctor-patient relationship and the question of data access. At the societal level, they concern the benefits to society, the quality of evidence and the dichotomy device-medicine. Conclusions: We conclude that evidence concerning DP is not robust and that more research should be performed and study results made available to evaluate this digital medicine. Moreover, our analysis of the ethically relevant aspects within empirical literature underscores that there are concrete and specific open questions that should be tackled in the ethical discussion about this new technological solution.

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“…On the other, FRT medication adherence monitoring might not be sufficiently effective in improving adherence to outweigh the risk of undermining trust in the patient-physician relationship. 42…”

Section: Ethical Dimensions Of Frt In Health Carementioning

confidence: 99%

What Are Important Ethical Implications of Using Facial Recognition Technology in Health Care?

Martinez-Martin¹

2019

AMA Journal of Ethics

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Applications of facial recognition technology (FRT) in health care settings have been developed to identify and monitor patients as well as to diagnose genetic, medical, and behavioral conditions. The use of FRT in health care suggests the importance of informed consent, data input and analysis quality, effective communication about incidental findings, and potential influence on patient-clinician relationships. Privacy and data protection are thought to present challenges for the use of FRT for health applications.

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Surveillance and Digital Health

Cited by 9 publications

References 9 publications

Digital Phenotyping and Patient-Generated Health Data for Outcome Measurement in Surgical Care: A Scoping Review

Digital Phenotyping and Patient-Generated Health Data for Outcome Measurement in Surgical Care: A Scoping Review

Digital pills: a scoping review of the empirical literature and analysis of the ethical aspects

What Are Important Ethical Implications of Using Facial Recognition Technology in Health Care?

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