7 articles found

A Cryptographic Method for Reproducible, Transparent Randomization of Clinical Trial Design

Original Research

23 December 2024

There remains difficulty in creating adequate and equitable protocols and mechanisms to guide the use of randomization to assign participants to different treatment arms in a randomized clinical trial. A trustworthy randomization system should be correct, reproducible, confidential, and transparent, to ensure fairness, secure public trust, and protect both the recruited participants and the trial supervisors. We propose the design and implementation of an accountable and trustworthy randomization approach using a verifiable pseudorandom shuffling mechanism for the purposes of simple randomization in clinical trials. The solution has been deployed in the form of a user-accessible, no-download website for ready access to the public.

Ian Miers

David Chen

Colin McSwiggen

Yan yan

Sammer Marzouk

Deborah Lai

Matthew Green

Norawit Kijpaisalratana

Abdul Badih El Ariss

Ali Raja

Jarone Lee

A Scoping Review of Health AI Controversies in the Grey Literature from 2013-2022

Original Research

22 February 2025

Objective This study aimed to 1) quantify the number of controversies related to health artificial intelligence (AI) development and deployment over the past 10 years, and 2) categorize health AI controversies by theme. Materials and Methods This study is a scoping review. We queried GoogleNews for articles meeting pre-specified inclusion and exclusion criteria related to health AI controversies. A total of 7508 articles were queried, with 76 articles ultimately meeting criteria. Articles were quantitatively evaluated for timing and coded according to both organizational involvement and the themes of the controversies described in the article. Results Of the 76 articles, 55% were published in 2019 and 2022. No articles were published before 2016. Privacy, AI accuracy, and AI bias were the most common themes. Oversight and conflict of interest were the least common themes. Google, Babylon, and Optum were the most discussed companies. Conclusions The results demonstrate concrete evidence for many of the theoretical concerns highlighted by patient and physician surveys as well as scholarly ethics research. However, the volume of articles over the past 10 years was small. It is possible that this study was too narrow in scope, that health AI has actually not yielded a large volume of controversial events, or that news organizations have insufficiently investigated potential health AI controversies. Further research is required to develop a more complete understanding of controversial activities in health AI.

Joshua M Faber

Chad Teven

Arturo Francisco Balaguer Townsend

Broadband Access and Health Outcomes in FCC Priority Counties: A Longitudinal Analysis

Original Research

24 February 2025

Background: The relationship between broadband access and health outcomes is an emerging field of interest within public health research. In an increasingly digital world, it is important to understand how to best allocate broadband resources to maximize health impact and decrease health disparities. This study specifically investigates how levels of broadband connectivity are associated with health metrics for conditions such as diabetes, obesity, and preventable hospitalizations in counties identified as ‘priority’ by the Federal Communications Commission (FCC) due to their low broadband access and high rates of chronic disease. Objective: To understand the longitudinal relationship between broadband access and health outcomes in priority counties, specifically focusing on diabetes, obesity, and preventable hospitalizations. Methods: This study analyzes data from 171 FCC priority counties from 2013-2020. Using regression models, we explore how broadband metrics, including broadband subscriptions and download speed, along with county characteristics such as rurality and persistent poverty, predict health outcomes. Health outcomes of interest include diabetes prevalence, obesity rates, and preventable hospitalizations. Results: A 1 percentage point increase in broadband subscriptions was associated with a 0.5% decrease in the odds of diabetes prevalence (odds ratio [OR] 0.995, 95% Confidence Interval [CI] 0.992-0.997). No significant relationship was found between broadband and obesity rates and preventable hospitalizations. County disparities were evident, with counties experiencing persistent poverty showing a 10% increase in the odds of diabetes prevalence (OR 1.100, 95% CI 1.062-1.140) and a 20.3% increase in preventable hospitalizations (β=1.203, 95% CI 1.131-1.280, P<.001). Rural counties were predicted to have a 17.6% increase in the odds of obesity prevalence (OR 1.176, 95% CI 1.127-1.228) and a 15.1% increase in the odds of diabetes prevalence (OR 1.151, 95% CI 1.111-1.191). Conclusions: Our data suggests that increased access to broadband may be correlated with decreased rates of diabetes in FCC priority counties. The study highlights the variable relationship between broadband access and health outcomes and acknowledges health disparities in rural, persistent poverty counties. This analysis provides a baseline for understanding the dynamics between broadband and health in critical need areas. Such insights highlight how expanding broadband infrastructure, especially rural and impoverished regions where disease burden is high, may help reduce health disparities and improve healthcare service access. Future data can be incorporated to clarify causality and model how the adoption of broadband infrastructure may take time to facilitate telehealth usage and ultimately support improved health outcomes, and how these dynamics may differ depending on county characteristics.

Reese Green

Max von Franque

Melissa Martinez

Alister Martin

Utilization of Structured Data to Improve Visibility of Digital Health Websites

Original Research

24 February 2025

Objective This article proposes a framework to design, organize, and implement structured data, a standardized format to embed metadata into websites, to improve visibility of information from digital health websites. Methods We described the utility of structured data to improve visibility of websites and a proposed framework to design and evaluate context-specific structured data using existing structured data schemas. Results To motivate the increased use of structured data of health websites, we 1) highlight the considerations of implementing structured data in websites, 2) outline a framework and case study to build structured data, and 3) describe practical methods to implement structured data into healthcare websites. Discussion The use of structured data in healthcare websites can increase the visibility of health resources through search engine optimization (SEO), show rich, personalized results to target users, and allow the website to serve as a living digital directory of resource information for patients. Conclusion Further quality improvement and implementation science research is needed to promote the systematic uptake of structured data as a tool to deliver personalized healthcare information to patients.

Suhanee Mitragotri

David Chen

Jarone Lee

Removing Barriers to Government Benefits: Link Health’s Role in Advancing Health Equity Through Expanded Enrollment

Original Research

27 March 2025

Objectives. To evaluate Link Health’s role in improving federal benefit program enrollment by analyzing application trends and impact from 2022-2024. Methods. Link Health connects eligible populations to federal benefits through in-person and digital ethods. Using data from clinics in Massachusetts and Texas and digital sign-ups, we analyze enrollment trends, funding disbursed, and demographics. Results. From 2022-2024, Link Health supported 2,362 applicants, disbursing over $2.8 million to eligible families. Application methods differed significantly by language (𝛸2=97.4, P<0.001, v=0.4), age (W=589819, P=0.03, r=0.05), state (𝛸2=11.5, P<0.001, v=0.1), and race (𝛸2=138.1, P<0.001). Conclusions. Link Health’s hybrid approach and community partnerships may reduce barriers and optimize benefit enrollment, supporting marginalized communities across several health determinants. In the context of diminishing federal support and the postpandemic benefits cliff era, organizations like Link Health are critical to help individuals access resources. Policy Implications. Targeted, community-based digital enrollment models like Link Health’s could be applied to enhance access to vital resources across the country.

Reese Joy Fields Green

Timothy Scheinert

Sudarshan Krishnamurthy

Nicole Nyamongo

Steven Lauterwasser

Alister Martin

Innovating Emergency Medicine: Generative AI, Narrative Medicine, and Human-Centered Design

Original Research

26 April 2025

Introduction: Emergency medicine in less resourceful areas struggles with the rising burden of disease and disability. Recognizing the limitations of conventional problem-solving has prompted reevaluating our approach to leverage AI capabilities. This article presents the introduction of a masterclass called ‘Create to Innovate’ (C2i) built using Human Centered Design Thinking. We explore narrative medicine through storytelling as an innovative method of promoting emotional engagement and clinical decision making in emergency medicine. Methods: The 'C2i' masterclasses were held at Aga Khan University Hospital in Karachi, Pakistan in December 2023 and at Evercare Hospital in Lagos, Nigeria in March 2024. This study used an explanatory mixed methods approach, collecting quantitative data from a post-intervention 'MoodBoard' survey and qualitative data from the AI-generated children's stories, with a total sample size of 60 participants. Results: The pilot study included 22 participants from the Karachi cohort and 38 from the Lagos cohort. A five-point validated visual analog scale, the MoodBoard, assessed the impact of the masterclasses. A significant difference was observed in the overall mean score between the two cohorts (Karachi 3.74 vs. Lagos 3.96; p < 0.05, C.I: -0.42 to -0.01). Qualitative analysis revealed three specific themes within the generated stories: prosocial behavior, resourcefulness and health awareness. Conclusion: The masterclass achieved its goal of fostering innovative solutions through storytelling. The MoodBoard survey highlighted its effectiveness and enjoyment. The imaginative stories offered educational insights into healthcare challenges, highlighting their potential for broader applications in healthcare education and professional training, while enhancing problem-solving and emotional engagement.

Syed Waqas

Zunaira Namal

Ahmed Raheem

Asad I Mian

HackAway! Innovating Mental Wellness for Students of Higher Education through a Comprehensive Brain-Mind Hackathon

Original Research

15 May 2025

Background The growing recognition of mental health challenges has prompted the need for appropriate and sustainable technologies to address these issues. Among vulnerable populations, students face unique stressors, making their mental well-being a pressing concern. Recognizing the urgent need to address these issues, we organized 'The Brain and Mind Institute: Student Mental Health Hackathon.' This event aimed to foster innovative solutions and multidisciplinary engagement in the field of student mental health. Methods: The study utilized a quantitative analysis to examine the impact and outcomes of the seventh Hackathon, the "Brain-Mind Hackathon" held at Aga Khan University in Pakistan in October 2021. Participants from diverse backgrounds collaborated to devise innovative solutions for medical education. Data analysis involved descriptive statistics, to assess the hackathon's effectiveness in fostering collaboration and generating practical solutions. Results: In the BMI Hackathon event, 74 participants took part, with a majority being females (62.16%) and falling within the age range of 21 to 30 years (64.86%). Over half were students (70.27%), with 59.4% from healthcare backgrounds. The evaluations provided by hackers were positive overall with a mean score of 4.41 out of 5 on a Likert Scale. Participants' feedback revealed that the hackathon positively impacted empathy towards student mental health issues and provided valuable opportunities for progress and incubation-related activities. Time constraints were noted as a significant challenge. Conclusion: This dynamic Hackathon offered innovative solutions for pressing student mental health challenges, promoting collaboration, and fostering empathy. Despite time constraints, practical ideas emerged, highlighting the importance of interdisciplinary interactions and the need for more incubation time. The event underscores the significance of hackathons in driving positive change in student mental health and paves the way for future research and interventions in this critical area

Ume-e-Aiman Chhipa

Ayesha Memon

Zeeshan Ahsan Allana

Hasan N Tahir

Sidra Kamal

Kendi Muchungi

Zul Merali

Diana MacKay

Asad I Mian

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