Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 10 appraisals
Journal of tissue viability
Clinical decision support tools in wound management: A scoping review of existing and emerging tools.
AIM: This scoping review aimed to identify and map clinical decision support tools (both digital and non-digital) used by clinicians for wound management in acute, primary, and community health settings globally, with a focus on the use of artificial intelligence, and the barriers and enablers to implementation. MATERIALS AND METHODS: Studies published between January 2015, and August 2024 were identified through systematic searches of Scopus, Embase, MEDLINE, and CINAHL, conducted in accordance with JBI methodology and reported using the PRISMA-ScR guidelines. Eligible studies included quantitative, qualitative, and mixed-methods research examining non-digital and AI-supported clinical decision support tools for wound management across healthcare settings. RESULTS: Seventeen studies were included, two evaluating AI-supported clinical decision support tools. Most clinical decision support tools had structured wound assessment and treatment planning, though evidence of clinical effectiveness was limited, with only one tool fully validated. Adoption by nurses was influenced by experience, trust, training, and workflow integration, with senior nurses less likely to rely on clinical decision support tools. AI-enabled tools, and a convolutional neural network-based model, improved assessment consistency, documentation, and workflow efficiency. Key barriers included concerns about trust, clinical autonomy, and usability. CONCLUSIONS: Both traditional and AI-supported clinical decision support tools are used for chronic wound management across acute, primary, and community care, but evidence of effectiveness and validation remains limited. The absence of experimental studies highlights the need for rigorous evaluation, clinician education, and strategies to support integration of AI-enabled clinical decision support tool into routine practice.
2 Aug 2026
Read appraisal →Biomedical physics & engineering express
NurtureNest: an IoT-wearable predictive analytics framework for real-time maternal risk assessment
Pregnancy-related complications are increasing globally, necessitating timely and accurate risk prediction for effective clinical intervention. This paper presents NurtureNest, an internet of things-enabled machine learning framework for automated pregnancy risk assessment. The system integrates wearable sensor data from smartwatches with user-provided clinical parameters via a mobile application, enabling continuous remote monitoring. Historical clinical data are used to train multiple machine learning models for multi-class classification of pregnancy risk into low-, medium-, and high-risk categories. Ensemble learning techniques are independently trained and evaluated alongside conventional machine learning classifiers to assess their effectiveness in pregnancy risk prediction. Experimental results show that LightGBM achieves the highest performance with 92.86% test accuracy and 95.04% cross-validation accuracy. Model performance is validated using ROC analysis and feature importance evaluation. The proposed framework enables early risk detection and supports timely clinical decision-making, improving maternal healthcare outcomes.
17 July 2026
Read appraisal →JMIR research protocols
Service Robots as Work Support for Health Personnel in Long-Term Care: Protocol for a Scoping Review
BACKGROUND: Demographic shifts are increasing the global demand for long-term care services, coinciding with a worldwide shortage of health care personnel. Service robots, designed to perform tasks in both professional and personal use, are perceived as a potential solution to alleviate health care personnel's workload and enhance the quality of care. However, the existing literature is fragmented and heterogeneous, with a limited emphasis on the role of service robots in supporting residents rather than health care personnel. Furthermore, there is a lack of consistent definitions of service robotic technologies and a scarcity of studies on implementation models and frameworks. OBJECTIVE: This scoping review aims to map and synthesize evidence regarding the implementation of service robots as work support for health care personnel in long-term care settings. METHODS: A comprehensive 3-step search will be conducted in Embase, MEDLINE, APA PsycInfo, CENTRAL, Scopus, and CINAHL, along with gray literature databases and institutional repositories. Eligible sources encompass empirical studies and gray literature involving service robots, health care personnel, residents aged 65 years or older, and stakeholders such as informal caregivers within institutional long-term care. Exclusions apply to studies on home care, medical or industrial robots, and nonrobotic technologies. Data will be extracted and analyzed using the Joanna Briggs Institute methodology, with findings presented in tables, diagrams, and narrative summaries to identify gaps and inform future research and implementation strategies. RESULTS: The project has been funded for a 4-year period starting in April 2025. This protocol was developed in October 2025 and subsequently registered in November 2025. A comprehensive search strategy was formulated and completely conducted on October 24, 2025. The screening of 4884 titles and abstracts was completed in December 2025, resulting in the retrieval of 64 (1.3%) full-text articles for eligibility assessment. Subsequent phases, including data extraction, analysis, evidence synthesis, and presentation of results, will be conducted sequentially. The scoping review is expected to be finalized by June 2026. CONCLUSIONS: This scoping review is expected to delineate the extent and characteristics of the existing evidence on service robots as work support for health personnel in long-term care settings. It will highlight the key reported outcomes and challenges encountered in implementation studies, as well as the theoretical frameworks, models, and concepts applied to address these issues. TRIAL REGISTRATION: Open Science Framework QWK58; https://osf.io/qwk58/. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/89435.
10 July 2026
Read appraisal →Gut
Digital twins in IBD-bridging data, biology and trial innovation
Clinical trials in IBD face difficulties of escalating complexity, high costs and challenges in recruitment. Digital twins are virtual, data-driven replicas of individual patients that model disease trajectories and treatment responses, which offer a potential innovative change in the conduct of clinical trials in IBD. Built from multimodal datasets integrating clinical, molecular, imaging and real-world data, digital twins can generate synthetic control arms, enable adaptive randomisation and predict disease relapse or treatment response. Early studies across oncology, cardiology and endocrinology demonstrate their feasibility and potential to improve statistical power while reducing patient burden. However, the integration of digital twins into clinical trials in IBD will require rigorous validation frameworks, transparent data governance and attention to algorithmic bias and consent. In this review, we explore how digital twins may transform IBD research-from in silico simulation to adaptive, patient-centred trial design-and outline the regulatory, ethical and logistical challenges to be considered in order to successfully integrate them into future trials.
10 July 2026
Read appraisal →International journal of medical informatics
Beyond the conventional: Artificial intelligence in identifying risk factors in sports injuries. A scoping review.
PURPOSE: To map contemporary uses of artificial intelligence (AI) to identify conventional and unconventional risk factors for sports injuries in athletes. METHODS: Following Joanna Briggs Institute guidance and PRISMA-ScR, we conducted an open-access search (January 2015-September 2025) in PubMed/MEDLINE, Scopus, and ScienceDirect using MeSH/DeCS terms for AI and injury risk. Records were managed in Rayyan with de-duplication, independent triple screening, standardized data extraction, and narrative synthesis to address heterogeneity. RESULTS: Fifty-nine studies met inclusion criteria. Frequently modelled predictors included sleep quality and psychological state, external and internal load metrics, and prior injury. AI approaches spanned classical machine learning and deep learning applied to multimodal sensor and clinical data. Across studies, generalizability was limited by heterogeneous populations, outcomes, and measurement/reporting practices; few works reported consistent measurement standards or external validation. Where assessed, observer agreement and classification performance were acceptable but variable. CONCLUSION: AI for sports-injury risk is expanding rapidly, led by classical machine learning on multimodal sensor data. Key gaps are external validity and reproducibility. Progress will require multicenter prospective cohorts, standardized measurement and reporting, sport-specific meta-analyses, transparent model sharing, and deliberate clinical integration into athlete care pathways.
4 July 2026
Read appraisal →Aerospace medicine and human performance
Large Language Models as Behavioral Health Teammates in Long-Duration Spaceflight
INTRODUCTION: Long-duration spaceflight exposes crews to isolated, confined, and extreme environments where chronic stress and limited real-time support heighten interpersonal tensions. Large language models (LLMs) could serve as onboard artificial intelligence teammates for de-escalation, but could also exacerbate tensions by endorsing hostility or exclusion. This study evaluates whether LLMs demonstrate prosocial conflict mediation behaviors vs. failure modes that could elevate interpersonal risk. METHODS: We tested four LLMs (GPT-5, Claude Sonnet 4, Grok 4, Gemini 2.5 Pro) using a Dartmouth PATH Program scenario where one crewmember criticizes an absent teammate and tries to recruit another against him. Models were evaluated across seven test batteries: adversarial framing, backstory manipulation, team role variations, aggressor identity variations, target identity variations, mental health sensitivity, and direct ethics questions. We scored 196 responses using a three-point rubric (defended excluded teammate, neutral, or endorsed exclusion). RESULTS: Claude Sonnet 4 achieved perfect scores (3.0). GPT-5 averaged 2.97. Gemini 2.5 Pro (2.81) showed vulnerability to narrative capture, shifting from defending the excluded crewmember to endorsing criticism when given unfavorable backstory. Grok 4 (2.85) exhibited significant failure under social proof pressure, explicitly endorsing exclusion. All models showed consistent prosocial responses regardless of demographic factors and correctly identified ethical issues when questioned directly. DISCUSSION: LLMs show promise as behavioral health teammates but have critical vulnerabilities. They can be manipulated into endorsing teammate exclusion through backstory reframing, peer pressure, or authority hierarchies, requiring safety protocols before deployment. Dvorak C, Buckey JC Jr. Large language models as behavioral health teammates in long-duration spaceflight. Aerosp Med Hum Perform. 2026; 97(7):516-523.
2 July 2026
Read appraisal →Physiotherapy theory and practice
Physical therapists' perspectives on a large language model-powered knowledge translation tool for guideline adherence: A qualitative focus group study.
BACKGROUND: Clinical practice guidelines support healthcare professionals in making evidence-based decisions, yet guideline adherence among physical therapists remains inconsistent. To address this gap, a prototype digital knowledge translation tool powered by a large language model (LLM) was developed, with content based on two exemplary high-quality German national guidelines. OBJECTIVE: To (1) explore the experiences of German physical therapists using the tool, (2) assess their perspectives on its utilization in clinical practice, and (3) compare perceptions between outpatient and inpatient settings. METHODS: Six focus group interviews were conducted: three in a university hospital inpatient setting and three in outpatient physical therapy practices. Discussions were analyzed using qualitative content analysis with inductive and deductive coding. RESULTS: Twenty physical therapists (11 inpatient, 9 outpatient) participated. Overall experiences were positive, though prolonged response times were criticized. Utilization was thought to depend on time availability and workplace digitization. The tool's potential assisting with clinical questions was highlighted. No considerable differences in experiences across settings were noted. Inpatient therapists envisioned using the tool between sessions for personal knowledge enhancement, whereas outpatient therapists anticipated utilization during sessions for patient education. CONCLUSION: LLM-based knowledge translation tools may contribute to improving guideline adherence among physical therapists. Successful implementation requires assessment of digital infrastructure, relevance to clinical needs, and users' digital literacy. Further research should evaluate the quality of LLM-generated summaries to ensure validity and trustworthiness, and optimize the tools' usability regarding speed and content. Development should also prompt ethical considerations about their role in clinical decision-making and patient care.
2 July 2026
Read appraisal →Journal of medical Internet research
Large Language Model Versus Multidisciplinary Team: Feasibility Study of Pancreatic Cancer Management Recommendations
Of 269 pancreatic cancer multidisciplinary team cases, 125 complete structured cases were evaluated. The chat interface model labeled ChatGPT-5.2 matched the multidisciplinary team's broad initial management category in 119 cases (95.2%, 95% CI 89.8%-98.2%). The end point was coarse, and the model was not version controlled, so findings only support supervised exploratory use.
2 July 2026
Read appraisal →International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
Integrated artificial intelligence and omics for prediction and monitoring of pre-eclampsia
Pre-eclampsia is a difficult pregnancy condition that causes high blood pressure and can lead to health complications in both mother and newborn, resulting in a higher fatality rate. It presents with a wide range of symptoms and lacks specific indicators, as the contemporary diagnostic techniques, including proteinuria testing and blood pressure measurements, are not reliable. The current evolution in artificial intelligence (AI) technology tends to show a promising transformation of pre-eclampsia management. AI algorithms are applied to process larger sets of clinical, biochemical, and image data that facilitate timely medical interventions by bringing up the early-onset and severity of pre-eclampsia. By analyzing the red cell distribution width (blood test indicators for pre-eclampsia), it is recognized as a cost-effective way of detecting inflammation. The application of AI technology on non-invasive diagnostic (wearable) devices enables continuous monitoring with imaging techniques for the placenta and retina via cloud-based systems. These developments are not only applied for early detection of pre-eclampsia, but also assist decision making capabilities in both high- and low-resource environments. This article explains how the growing use of AI is changing the way that pre-eclampsia is understood and managed, with the aim of improving accuracy and offering more personalized care for pregnant women.
1 July 2026
Read appraisal →Scientific reports
Classifying mental stress from eye tracking data: deep learning approaches for out-of-the-lab conditions
Eye-tracking signals such as pupil diameter and gaze behavior have been widely used for stress detection, yet most approaches rely on task-specific features, controlled laboratory settings, or multimodal sensor combinations, limiting scalability in less controlled environments. This work investigates whether unimodal eye-tracking time-series data can support task-agnostic stress detection beyond static laboratory tasks. We analyze stress classification across two complementary datasets: a virtual reality goalkeeper task with moderate visuomotor activity and stable recording conditions, and a virtual job interview dataset reflecting less controlled settings with uncalibrated signals. The results show that these signals alone contain informative patterns related to stress-associated autonomic and oculomotor responses. Under favorable conditions, performance reaches up to [Formula: see text] macro-averaged F1-score. At the same time, performance varies substantially across datasets, indicating that effective learning depends strongly on data quality, calibration, signal characteristics, and task design. Overall, the findings demonstrate the potential of unimodal eye tracking as a lower-burden alternative to more complex multimodal systems, while highlighting that reliable stress detection is fundamentally conditioned by the interplay of data, signal representation, and modeling approach.
23 June 2026
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