Browsing by Author "Topol, Eric J"
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- ItemAdvanced and Accurate Mobile Health Tracking Devices Record New Cardiac Vital Signs.(0000-00-00) Modena, Brian D; Bellahsen, Otmane; Nikzad, Nima; Chieh, Angela; Parikh, Nathan; Dufek, Danielle Marie; Ebner, Gail; Topol, Eric J; Steinhubl, StevenCardiovascular disease remains the leading cause of death and disease worldwide As demands on an already resource constrained healthcare system intensify disease prevention in the future will likely depend on out of office monitoring of cardiovascular risk factors Mobile health tracking devices that can track blood pressure and heart rate in addition to new cardiac vital signs such as physical activity level and pulse wave velocity PWV offer a promising solution An initial barrier is the development of accurate and easily scalable platforms In this study we made a customized smartphone app and used mobile health devices to track PWV blood pressure heart rate physical activity sleep duration and multiple lifestyle risk factors in 250 adults for 17 continual weeks Eligible participants were identified by a company database and then were consented and enrolled using only a smartphone app without any special training given Study participants reported high overall satisfaction and 73 of participants were able to measure blood pressure and PWV Under1 hour apart for at least 14 of 17 weeks The study population s blood pressure PWV heart rate activity levels sleep duration and the interrelationships among these measurements were found to closely match either population averages or values obtained from studies performed in a controlled setting As a proof of concept we demonstrated the accuracy and ease as well as many challenges of using mHealth technology to accurately track PWV and new cardiovascular vital signs at home
- ItemCan mobile health technologies transform health care?(2013-12-11) Steinhubl, Steven R; Muse, Evan D; Topol, Eric J
- ItemDigital medicine and the Scripps Translational Science Institute.(2011-02-25) Topol, Eric J; Schork, Nicholas J; Smith, Joseph M
- 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
- ItemiMedEd: the role of mobile health technologies in medical education.(2014-08-27) Gaglani, Shiv M; Topol, Eric JMobile health mHealth technologies have experienced a recent surge in attention because of their potential to transform the delivery of health care This enthusiasm is partly due to the near ubiquity of smartphones and tablets among clinicians as well as to the stream of mobile medical apps and devices being created While much discussion has been devoted to how these tools will impact the practice of medicine surprisingly little has been written on the role these technologies will play in medical education In this commentary the authors describe the opportunities applications and challenges of mHealth apps and devices in medical education and argue that medical schools should make efforts to integrate these technologies into their curricula By not doing so medical educators risk producing a generation of clinicians underprepared for the changing realities of medical practice brought on by mHealth technologies
- ItemImplementation of mobile health tools--reply.(2014-04-09) Steinhubl, Steven R; Muse, Evan D; Topol, Eric J
- ItemPersonalized medicine: risk prediction, targeted therapies and mobile health technology.(2014-03-03) Hayes, Daniel F; Markus, Hugh S; Leslie, R David; Topol, Eric JPersonalized medicine is increasingly being employed across many areas of clinical practice as genes associated with specific diseases are discovered and targeted therapies are developed Mobile apps are also beginning to be used in medicine with the aim of providing a personalized approach to disease management In some areas of medicine patient tailored risk prediction and treatment are applied routinely in the clinic whereas in other fields more work is required to translate scientific advances into individualized treatment In this forum article we asked specialists in oncology neurology endocrinology and mobile health technology to discuss where we are in terms of personalized medicine and address their visions for the future and the challenges that remain in their respective fields