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      Effects of a Smartphone Application on Breast Self-Examination: A Feasibility Study

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          Abstract

          Objectives

          The aims of this study were to develop a smartphone application to encourage breast self-examination (BSE), and to evaluate the effects of this application in terms of modifying BSE behavior.

          Methods

          A smartphone application, based on the Android OS, was developed with functions including a BSE date alarm, a reminder to encourage mother and daughter to practice BSE together, record keeping, and educational content with video clips. Females aged 19 and over were enrolled to evaluate the effectiveness of the application. Two series of questionnaires were carried out (before and after use of the application) by e-mail, telephone, and face-to-face interviews between July and September 2012.

          Results

          Forty-five subjects were enrolled in the study (age 29.5-5.9 years). Of the participants, only 28 (62.2%) had ever practiced BSE and only one of these (2.2%) was carried out at the appropriate time, based on the results of the baseline survey. After using the application, the number of participants practicing BSE increased from 28 to 32 (62.2% to 71.1%, p = 0.503). In subgroup analysis (age < 30 years), the number of participants using BSE increased from 8 to 18 (36.4% to 81.8%, p = 0.002), and the number of those using it at the appropriate time rose from 1 to 15 (2.2% to 33.3%, p < 0.001).

          Conclusions

          The use of the developed smartphone application increased BSE in females younger than 30 years. To confirm the long-term benefits of the mobile application, additional studies must be carried out.

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          Most cited references23

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          Effect of mobile phone intervention for diabetes on glycaemic control: a meta-analysis.

            To assess the effect of mobile phone intervention on glycaemic control in diabetes self-management. We searched three electronic databases (PubMed, EMBASE and Cochrane Library) using the following terms: diabetes or diabetes mellitus and mobile phone or cellular phone, or text message. We also manually searched reference lists of relevant papers to identify additional studies. Clinical studies that used mobile phone intervention and reported changes in glycosylated haemoglobin (HbA(1c) ) values in patients with diabetes were reviewed. The study design, intervention methods, sample size and clinical outcomes were extracted from each trial. The results of the HbA(1c) change in the trials were pooled using meta-analysis methods.   A total of 22 trials were selected for the review. Meta-analysis among 1657 participants showed that mobile phone interventions for diabetes self-management reduced HbA(1c) values by a mean of 0.5% [6 mmol/mol; 95% confidence interval, 0.3-0.7% (4-8 mmol/mol)] over a median of 6 months follow-up duration. In subgroup analysis, 11 studies among Type 2 diabetes patients reported significantly greater reduction in HbA(1c) than studies among Type 1 diabetes patients [0.8 (9 mmol/mol) vs. 0.3% (3 mmol/mol); P=0.02]. The effect of mobile phone intervention did not significantly differ by other participant characteristics or intervention strategies.   Results pooled from the included trials provided strong evidence that mobile phone intervention led to statistically significant improvement in glycaemic control and self-management in diabetes care, especially for Type 2 diabetes patients. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.
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            Features of Mobile Diabetes Applications: Review of the Literature and Analysis of Current Applications Compared Against Evidence-Based Guidelines

            Background Interest in mobile health (mHealth) applications for self-management of diabetes is growing. In July 2009, we found 60 diabetes applications on iTunes for iPhone; by February 2011 the number had increased by more than 400% to 260. Other mobile platforms reflect a similar trend. Despite the growth, research on both the design and the use of diabetes mHealth applications is scarce. Furthermore, the potential influence of social media on diabetes mHealth applications is largely unexplored. Objective Our objective was to study the salient features of mobile applications for diabetes care, in contrast to clinical guideline recommendations for diabetes self-management. These clinical guidelines are published by health authorities or associations such as the National Institute for Health and Clinical Excellence in the United Kingdom and the American Diabetes Association. Methods We searched online vendor markets (online stores for Apple iPhone, Google Android, BlackBerry, and Nokia Symbian), journal databases, and gray literature related to diabetes mobile applications. We included applications that featured a component for self-monitoring of blood glucose and excluded applications without English-language user interfaces, as well as those intended exclusively for health care professionals. We surveyed the following features: (1) self-monitoring: (1.1) blood glucose, (1.2) weight, (1.3) physical activity, (1.4) diet, (1.5) insulin and medication, and (1.6) blood pressure, (2) education, (3) disease-related alerts and reminders, (4) integration of social media functions, (5) disease-related data export and communication, and (6) synchronization with personal health record (PHR) systems or patient portals. We then contrasted the prevalence of these features with guideline recommendations. Results The search resulted in 973 matches, of which 137 met the selection criteria. The four most prevalent features of the applications available on the online markets (n = 101) were (1) insulin and medication recording, 63 (62%), (2) data export and communication, 61 (60%), (3) diet recording, 47 (47%), and (4) weight management, 43 (43%). From the literature search (n = 26), the most prevalent features were (1) PHR or Web server synchronization, 18 (69%), (2) insulin and medication recording, 17 (65%), (3) diet recording, 17 (65%), and (4) data export and communication, 16 (62%). Interestingly, although clinical guidelines widely refer to the importance of education, this is missing from the top functionalities in both cases. Conclusions While a wide selection of mobile applications seems to be available for people with diabetes, this study shows there are obvious gaps between the evidence-based recommendations and the functionality used in study interventions or found in online markets. Current results confirm personalized education as an underrepresented feature in diabetes mobile applications. We found no studies evaluating social media concepts in diabetes self-management on mobile devices, and its potential remains largely unexplored.
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              Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2009

              Purpose This study overviews nationwide cancer statistics, including incidence, mortality, survival, and prevalence, and their trends in Korea based on 2009 cancer incidence data. Materials and Methods Incidence data from 1993-2009 were obtained from the Korea National Cancer Incidence Database, and vital status was followed through 31 December 2010. Mortality data from 1983-2009 were obtained from Statistics Korea. Crude rates and age-standardized rates for incidence, mortality, and prevalence; and relative survival were calculated. Results In total, 192,561 cancer cases and 69,780 cancer deaths were observed during 2009, and 808,503 10-year cancer prevalent cases occurred in Korea as of 1 January 2010. The incidence rate for all cancers combined showed an annual increase of 3.3% from 1999 to 2009. Conclusion Stomach, liver and cervical cancers have been decreasing and thyroid, breast and colorectal cancers have been increasing at large. In particular, in 2009, colorectal cancer became the third most common cancer in females and for the first time ranked higher than stomach cancer, which had been the long-standing common cancer in Korea. While overall cancer incidence has been rapidly increasing in Korea, age-standardized cancer mortality rates have been declining since 2002, and cancer survival has been improving.
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                Author and article information

                Journal
                Healthc Inform Res
                Healthc Inform Res
                HIR
                Healthcare Informatics Research
                Korean Society of Medical Informatics
                2093-3681
                2093-369X
                December 2013
                31 December 2013
                : 19
                : 4
                : 250-260
                Affiliations
                [1 ]Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea.
                [2 ]Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea.
                [3 ]Center for Clinical Epidemiology and Biostatistics/Department of Biostatistics & Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
                [4 ]Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
                Author notes
                Corresponding Author: Rae Woong Park, MD, PhD. Department of Biomedical Informatics, Ajou University School of Medicine, 206, World cup-ro, Yeongtong-gu, Suwon 443-721, Korea. Tel: +82-31-219-5342, Fax: +82-31-219-4472, veritas@ 123456ajou.ac.kr
                Article
                10.4258/hir.2013.19.4.250
                3920037
                24523989
                1fd1eea6-f13c-4edb-9e46-040ce6ced64d
                © 2013 The Korean Society of Medical Informatics

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 October 2013
                : 22 December 2013
                : 24 December 2013
                Funding
                Funded by: National Research Foundation
                Award ID: 2010-0028631
                Funded by: Ministry of Health and Welfare
                Award ID: A112022
                Categories
                Original Article

                Bioinformatics & Computational biology
                breast cancer,breast self-examination,cellular phone

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