Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 5 appraisals
JMIR mHealth and uHealth
Wearable Devices for Monitoring and Management of Comorbid Obstructive Sleep Apnea and Hypertension: Scoping Review
BACKGROUND: As an established driver of hypertension, obstructive sleep apnea (OSA) generates a significant cardiovascular burden when both disorders are present. This intersection not only compromises nocturnal hemodynamics but also hampers long-term clinical management. Yet, current health care delivery rarely integrates the simultaneous and continuous tracking of these dual burdens. While wearable technology provides a noninvasive, pragmatic toolset for synchronized physiological monitoring, research remains largely siloed within single-disease frameworks. Consequently, clinical evidence supporting wearable applications specifically for comorbid populations remains sparse. OBJECTIVE: In this scoping review, we summarized the current applications of wearable technology for comorbid OSA and hypertension. The analysis primarily outlines device categories, monitored physiological indicators, prevalent clinical scenarios, and existing challenges. METHODS: The search for relevant literature spanned PubMed, Web of Science, Embase, and IEEE Xplore, covering the period from January 2015 to February 2026. Eligible studies included adults and used wearable or portable technologies to objectively track sleep- or respiratory-related indicators and cardiovascular/blood pressure metrics. Study selection, data charting, and evidence synthesis were conducted using a 2-reviewer process and descriptive and narrative approaches. RESULTS: Our initial search yielded 739 records. Following title and abstract screening, we reviewed 54 full texts, ultimately finalizing a cohort of 13 eligible studies. Published between 2015 and 2026 across 9 countries, these articles capture data from 5596 participants. Most were observational studies and device validation studies. Evaluated device types included wrist-worn devices, fingertip contact devices, patch and single-lead devices, and multiparameter portable monitoring systems. The clinical applications mainly focused on screening and risk stratification for comorbid OSA and hypertension, monitoring of abnormal nocturnal blood pressure and hemodynamic changes, and cardiovascular risk assessment and remote longitudinal management. However, research remains sparse, and different devices vary greatly in reference standards, diagnostic thresholds, and validation pathways; therefore, their clinical translational value still requires further validation. CONCLUSIONS: Wearable devices may complement traditional assessment by providing continuous nocturnal and longitudinal data. However, at present, they are more suitable as auxiliary monitoring and risk warning tools in comorbidity management and cannot yet replace standard sleep studies or standard blood pressure monitoring. Future research should further shift from feasibility validation to large-sample, prospective, multicenter clinical studies in comorbid populations.
1 Aug 2026
Read appraisal →JMIR human factors
Japanese Health Information Technology Usability Evaluation Scale for Sexually Transmitted Infection-Related Chatbots: Development and Psychometric Validation Study
BACKGROUND: The rapid expansion of mobile technology has accelerated the integration of health applications and conversational AI into clinical and public health practices. To ensure these tools are effective and sustainable, usability evaluations and early user engagement during development are essential. The Health Information Technology Usability Evaluation Scale (Health-ITUES) is a validated and flexible usability assessment instrument that is available in multiple languages and applicable across diverse contexts. However, a Japanese version of this scale has not yet been developed. OBJECTIVE: This study aimed to translate and validate a Japanese version of the Health-ITUES, customized for a sexually transmitted infection (STI)-related chatbot, and to support the usability assessment of emerging mobile health tools in Japan. METHODS: We developed a Japanese version of the Health-ITUES using a chatbot under development as a consultation tool for young women regarding STIs. First, the original scale was customized to reflect the chatbot's specific purpose and intended usage context. Following established translation guidelines, we conducted forward translation from English to Japanese, back translation, expert review, and reconciliation. We then evaluated the reliability and validity of the Japanese version in a sample of 301 young women. RESULTS: The Japanese version of the Health-ITUES demonstrated high internal consistency (Cronbach α=0.85-0.98). Confirmatory factor analysis supported acceptable construct validity (root mean square error of approximation is 0.10, comparative fit index>0.90). Additionally, the Health-ITUES scores showed strong correlations with satisfaction and usage intention for the tool (r=0.779 and 0.797, respectively). CONCLUSIONS: The Japanese version of the Health-ITUES provides initial evidence of reliability and validity in an STI-related scenario among young women and may facilitate more rigorous usability evaluations of mHealth and conversational AI tools in Japan.
24 July 2026
Read appraisal →PloS one
AI-based color vision screening and educational counseling for high school students: An experimental study
Color vision deficiency (CVD) can negatively affect students' learning experiences and career choices; however, combined screening and educational counseling remain challenging in school settings, particularly in low-resource contexts. Conventional paper-based color vision tests are time-consuming, difficult to standardize, and rarely linked to individualized educational or career guidance. This study aimed to design, implement, and validate an Android-based mobile application that integrates CVD screening with artificial intelligence (AI)-assisted educational and career counseling for high school students. A cross-sectional study was conducted with 527 high school students in Danang, Viet Nam. The application incorporated a digital Ishihara-based screening module and an AI-assisted counseling component. Screening outcomes were compared with conventional Ishihara testing to evaluate agreement, while students' perceptions of usability, usefulness, and counseling relevance were assessed using a validated questionnaire. Statistical analyses included descriptive statistics, independent-samples t-tests, reliability analysis using Cronbach's alpha, and exploratory factor analysis. Seventeen students (3.23%) were identified as having CVD, including red-green, protan, deutan, and achromatopsia (complete CVD). The mobile application demonstrated high concordance with conventional screening results. No statistically significant differences were observed between students with and without CVD in overall system evaluation scores (p > 0.05). The questionnaire showed good internal consistency (Cronbach's alpha = 0.857) and a clear multi-factor structure reflecting students' acceptance of AI-assisted educational and career counseling. These findings indicate that the proposed mHealth application offers a feasible and scalable approach for school-based CVD screening combined with personalized educational and career guidance. The system may serve as a supportive decision-making tool for students and counselors, while further validation under diverse real-world conditions and across different mobile devices is recommended.
24 July 2026
Read appraisal →Journal of behavioral addictions
Efficacy of a mobile-based approach-avoidance task training (PROTECTapp) for problematic usage of the internet in young adults: A randomized controlled trial
BACKGROUND AND AIMS: Problematic usage of the internet (PUI) has been linked to impaired mental health and academic functioning in young adults. This randomized controlled trial evaluated the efficacy of a 3-week mobile-based approach-avoidance task (AAT) training (PROTECTapp) for reducing PUI in university students. METHODS: Ninety-two participants (Mage = 22.00 years, 69.6% women) with elevated levels of PUI were randomized to the PROTECTapp intervention (n = 45) or a waitlist control group (n = 47). Primary outcomes were PUI severity and internet-related craving. Secondary outcomes included motivation to change, psychopathological symptoms and academic functioning. Participants were assessed at baseline and postintervention; the intervention group completed additional 3- and 12-week follow-ups. RESULTS: Intention-to-treat analyses indicated greater reductions in PUI following the PROTECTapp intervention compared to the waitlist (p = .003; d = -0.80, 95% CI [-1.23, -0.38]). No significant effects emerged for craving or broader psychological outcomes (ps > .05), though favorable effects were observed on motivation to change (ambivalence: p = .020; d = -0.24, 95% CI [-0.65, 0.17]; taking steps: p = .002; d = 0.45 [0.04, 0.87]). Satisfaction with the intervention was moderate (M = 18.32 of 32), and participants completed on average 35.52 training sessions. Adverse events were reported infrequent (7.1%). DISCUSSION AND CONCLUSIONS: PROTECTapp is a promising mobile-based intervention to reduce PUI and enhance motivation to change in young adults. Its brevity, scalability, and safety profile highlight its potential as a low-threshold preventive or adjunctive intervention for young individuals at-risk.
18 July 2026
Read appraisal →JMIR nursing
WeChat-Based Nursing Interventions in Women's Mobile Health: Systematic Review
BACKGROUND: Mobile health (mHealth) technology offers new approaches to improve women's health by providing personalized monitoring and real-time guidance. As one of the most widely used social media platforms in China, WeChat has shown great potential in mHealth practice, yet systematic evidence on its application in women's health care remains insufficient. OBJECTIVE: This study aims to systematically review WeChat-based nursing interventions in women's mHealth in order to clarify the application status, intervention modalities, target populations, and effectiveness outcomes. METHODS: Searches were conducted in IEEE Xplore, Web of Science, PubMed, Scopus, ACM Digital Library, and Cochrane Central Register of Controlled Trials between January 2011 and December 2024. Two independent reviewers screened studies; extracted data on study design, intervention forms, target diseases, and outcome indicators; and assessed methodological quality. The Cohen κ coefficient was used to evaluate interreviewer agreement. Publication trends, institutional collaborations, author contributions, and research hotspots were analyzed using VOSviewer (Leiden University) and InCites (Clarivate) for bibliometric analysis. RESULTS: A total of 31 eligible studies published from 2014 to 2024 were included. Most studies were randomized controlled trials (n=27). Intervention modalities mainly included WeChat groups (n=22), official accounts (n=18), applets (n=4), and private chats (n=9), mostly used in combination. The top focused health issues were prenatal care (n=5), breast cancer (n=5), gynecological cancer (n=5), and gestational diabetes mellitus (n=4). Six studies adopted multidisciplinary teams. Cohen κ was 0.71, indicating substantial agreement. Publications grew rapidly after 2018, peaking in 2021 and 2024. A total of 40 institutions participated, with Xi'an Jiaotong University having the highest citation impact. Most studies were at high risk of bias due to a nonblinding design. CONCLUSIONS: WeChat-based nursing interventions improve personalized health information access, self-management ability, treatment compliance, and real-time doctor-patient communication for women. This is the first systematic review to evaluate WeChat mHealth interventions in women's health, filling the research gap. Future research should focus on improving methodological quality, exploring cross-cultural adaptability, conducting long-term follow-up, and integrating wearable devices and electronic health records to further optimize WeChat-based women's health services.
7 July 2026
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