Browsing by Subject "smartphone"
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Item Mobile Health Assessment of Traumatic Dental Injuries Using Smartphone Acquired Photographs: A Multicenter Diagnostic Accuracy Study(In review, 2024) Huang, Boyen; Estai, Mohamed; Pungchanchaikul, Patimaporn; Quick, Karin; Ranjitkar, Sarbin; Fashingbauer, Emily; Askar, Abdirahim; Wang, Josiah; Diefalla, Fatma; Shenouda, Margaret; Seyffer, Danae; Louie, Jeffrey PBackground: Mobile health (mHealth) has an emerging potential for remote assessment of traumatic dental injuries (TDI) and support of emergency care. This study aimed to determine the diagnostic accuracy of TDI detection from smartphone-acquired photographs. Methods: The upper and lower anterior teeth of 153 individuals aged ≥ 6 years were photographed using a smartphone camera app. The photos of 148 eligible participants were reviewed independently by a dental specialist, two general dentists, and two dental therapists, using predetermined TDI classification and criteria. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and inter-rater reliability were estimated to evaluate the diagnostic performance of the photographic method relative to the reference standard established by the dental specialist. Results: Of the 1,870 teeth screened, one-third showed TDI; and one-seventh of the participants had primary or mixed dentitions. Compared between the specialist’s reference standard and four dental professionals’ reviews, the diagnostic sensitivity and specificity for TDI versus non-TDI was 59-95% and 47-93%, respectively, with better performance for urgent types of TDI (78-89% and 99-100%, separately). The diagnostic consistency was also better for the primary/mixed dentitions than the permanent dentition. Conclusion: This study suggested a valid mHealth practice for remote assessment of TDI. A better diagnostic performance in the detection of urgent types of TDI and examination of the primary/mixed dentitions was also reported. Future directions include professional development activities involving dental photography and photographic assessment, incorporation of a machine learning technology to aid photographic reviews, and randomized controlled trials in multiple clinical settings.Item Randomized Controlled Trial of Pacifica, a CBT and Mindfulness-based App for Stress, Depression, and Anxiety Management with Health Monitoring(2018-08) Vu, AnnaMariemHealth smartphone apps have inundated the market. The promise of mHealth apps is that they increase access to psychotherapeutic content while also expanding options beyond face-to-face care. However, information on the quality and efficacy of commercial mHealth apps is sparse. Pacifica, a Cognitive Behavioral Therapy and Mindfulness-based mHealth app, is one of the most popular and publicly endorsed apps on the market. An initial week long pilot study was performed to assess feasibility and acceptability of the Pacifica app and Pacifica Lite, an active control version of the app, in a group of college students (N = 41). Participants generally used the app as intended and rated the aesthetics and functionality positively. The subsequent efficacy study extended the intervention period, added a waitlist control group, and enrolled a greater number of participants. To the best of our knowledge, this study was the first randomized controlled trial designed to examine the feasibility and efficacy of a commercial mHealth app using a smartphone active control app as a comparison. Participants (N=420) were randomly assigned to one of three groups: 1) The Pacifica app that includes the psychotherapy-based components, 2) the active control app “Pacifica Lite” without psychotherapy-based components, and 3) waitlist control. The intervention period was 14 days over the final weeks of a college semester. Participants completed pretest and posttest measures of mental health symptoms and general well-being, state-based affect, perceived stress, and mindfulness prior to and following the intervention period. Regression models with baseline scores as moderators indicated there was an effect of the Pacifica intervention compared to the Waitlist control on negative affect and global mental health. The effect of intervention group on negative affect, global mental health, and perceived stress were all moderated by baseline scores, whereby participants who had higher baseline distress levels reported greater responses to the Pacifica intervention compared to being on the Waitlist. A measure of trait mindfulness showed significant between-group differences, with significantly higher scores in the Pacifica group compared to the waitlist control. There were no effects related to group at posttest for total or subscale scores for symptoms of depression, anxiety, positive state-affect, and mindfulness practice. Overall, the Pacifica app appeared feasible and usable over a high demand final exam period, was significantly more effective than Waitlist on some measures, but it was not significantly more effective than the active control on any measures. Pacifica and the majority of mHealth apps available are not designed as alternatives to face-to-face care but college counseling centers and healthcare systems may choose to include apps like Pacifica as additional resources.