Browsing by Author "Steinhubl, Steven R"
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- ItemCan mobile health technologies transform health care?(2013-12-11) Steinhubl, Steven R; Muse, Evan D; Topol, Eric J
- ItemDigital recruitment and enrollment in a remote nationwide trial of screening for undiagnosed atrial fibrillation: Lessons from the randomized, controlled mSToPS trial.(0000-00-00) Baca-Motes, Katie; Edwards, Alison M; Waalen, Jill; Edmonds, Shawn; Mehta, Rajesh R; Ariniello, Lauren; Ebner, Gail S; Talantov, Dimitri; Fastenau, John M; Carter, Chureen T; Sarich, Troy C; Felicione, Elise; Topol, Eric J; Steinhubl, Steven RObjectives The advent of large databases wearable technology and novel communications methods has the potential to expand the pool of candidate research participants and offer them the flexibility and convenience of participating in remote research However reports of their effectiveness are sparse We assessed the use of various forms of outreach within a nationwide randomized clinical trial being conducted entirely by remote means Methods Candidate participants at possibly higher risk for atrial fibrillation were identified by means of a large insurance claims database and invited to participate in the study by their insurance provider Enrolled participants were randomly assigned to one of two groups testing a wearable sensor device for detection of the arrhythmia Results Over 10 months the various outreach methods used resulted in enrollment of 2659 participants meeting eligibility criteria Starting with a baseline enrollment rate of 0 8 in response to an email invitation the recruitment campaign was iteratively optimized to ultimately include website changes and the use of a five step outreach process three short personalized emails and two direct mailers that highlighted the appeal of new technology used in the study resulting in an enrollment rate of 9 4 Messaging that highlighted access to new technology outperformed both appeals to altruism and appeals that highlighted accessing personal health information Conclusions Targeted outreach enrollment and management of large remote clinical trials is feasible and can be improved with an iterative approach although more work is needed to learn how to best recruit and retain potential research participants Trial registration Clinicaltrials govNCT02506244 Registered 23 July 2015
- ItemIdentification of paroxysmal atrial fibrillation subtypes in over 13,000 individuals.(0000-00-00) Wineinger, Nathan E; Barrett, Paddy M; Zhang, Yunyue; Irfanullah, Ikram; Muse, Evan D; Steinhubl, Steven R; Topol, Eric JBACKGROUND Paroxysmal atrial fibrillation PAF is broadly defined despite high variability in the occurrence and duration of PAF episodes OBJECTIVE We aimed to identify rhythm patterns in a large cohort of individuals with PAF who wore an ambulatory single lead ECG patch sensor as part of standard clinical care METHODS We performed a retrospective analysis of longitudinal rhythm data obtained from 13 293 individuals with PAF RESULTS In this study 7 934 men and 5 359 women with PAF wore an ambulatory single lead ECG patch sensor for 11 4 days on average experiencing 1 041 504 PAF episodes The median daily rate of PAF was 1 21 episodes per day IQR 0 31 4 99 and the median maximum duration per individual was 7 5 hours IQR 2 4 18 6 hours There was an inverse relationship between the duration of PAF episodes and the frequency in which they occurred which became pronounced at moderate and high overall burden of AF This produced a spectrum of PAF flanked by two distinct subtypes of the disease the staccato subtype characterized by many short AF episodes and the legato subtype characterized by fewer longer episodes Longer but less frequent episodes became more common with increasing age Only 49 4 of individuals experienced an episode in the first 24 hours of monitoring increasing to 89 7 after 1 week of monitoring CONCLUSIONS We identified subtypes of the disease that we labeled staccato and legato Although further study is required these subtypes may result from differing elements of pathophysiology and disease progression and may confer differing stroke risks
- ItemImplementation of mobile health tools--reply.(2014-04-09) Steinhubl, Steven R; Muse, Evan D; Topol, Eric J