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      Secondary care provider attitudes towards patient generated health data from smartwatches

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          Abstract

          Wearable devices, like smartwatches, are increasingly used for tracking physical activity, community mobility, and monitoring symptoms. Data generated from smartwatches (PGHD_SW) is a form of patient-generated health data, which can benefit providers by supplying frequent temporal information about patients. The goal of this study was to understand providers’ perceptions towards PGHD_SW adoption and its integration with electronic medical records. In-depth, semi-structured qualitative interviews were conducted with 12 providers from internal medicine, family medicine, geriatric medicine, nursing, surgery, rehabilitation, and anesthesiology. Diffusion of Innovations was used as a framework to develop questions and guide data analysis. The constant comparative method was utilized to formulate salient themes from the interviews. Four main themes emerged: (1) PGHD_SW is perceived as a relative advantage; (2) data are viewed as compatible with current practices; (3) barriers to overcome to effectively use PGHD_SW; (4) assessments from viewing sample data. Overall, PGHD_SW was valued because it enabled access to information about patients that were traditionally unattainable. It also can initiate discussions between patients and providers. Providers consider PGHD_SW important, but data preferences varied by specialty. The successful adoption of PGHD_SW will depend on tailoring data, frequencies of reports, and visualization preferences to correspond with the demands of providers.

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          Interpretive themes in relational communication

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            Use of existing patient-reported outcome (PRO) instruments and their modification: the ISPOR Good Research Practices for Evaluating and Documenting Content Validity for the Use of Existing Instruments and Their Modification PRO Task Force Report.

            Patient-reported outcome (PRO) instruments are used to evaluate the effect of medical products on how patients feel or function. This article presents the results of an ISPOR task force convened to address good clinical research practices for the use of existing or modified PRO instruments to support medical product labeling claims. The focus of the article is on content validity, with specific reference to existing or modified PRO instruments, because of the importance of content validity in selecting or modifying an existing PRO instrument and the lack of consensus in the research community regarding best practices for establishing and documenting this measurement property. Topics addressed in the article include: definition and general description of content validity; PRO concept identification as the important first step in establishing content validity; instrument identification and the initial review process; key issues in qualitative methodology; and potential threats to content validity, with three case examples used to illustrate types of threats and how they might be resolved. A table of steps used to identify and evaluate an existing PRO instrument is provided, and figures are used to illustrate the meaning of content validity in relationship to instrument development and evaluation. RESULTS & RECOMMENDATIONS: Four important threats to content validity are identified: unclear conceptual match between the PRO instrument and the intended claim, lack of direct patient input into PRO item content from the target population in which the claim is desired, no evidence that the most relevant and important item content is contained in the instrument, and lack of documentation to support modifications to the PRO instrument. In some cases, careful review of the threats to content validity in a specific application may be reduced through additional well documented qualitative studies that specifically address the issue of concern. Published evidence of the content validity of a PRO instrument for an intended application is often limited. Such evidence is, however, important to evaluating the adequacy of a PRO instrument for the intended application. This article provides an overview of key issues involved in assessing and documenting content validity as it relates to using existing instruments in the drug approval process.
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              Integrating the use of patient-reported outcomes for both clinical practice and performance measurement: views of experts from 3 countries.

              Policy Points: The patient-reported outcome (PRO) is a standardized method for measuring patients' views of their health status. Our international study showed that experts in clinical practice and performance measurement supported the integrated collection of PRO data for use in both clinical care and performance measurement. The measurement of PROs to support patient-provider decisions and the use of PRO performance measures to evaluate health care providers have developed both separately and in parallel. The use of PROs would benefit from a shared vision by health care providers, purchasers of care, and patients regarding the aims and purposes of the various applications; and the establishment of trust among stakeholders concerning the prudent use of PRO performance measures.
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                Author and article information

                Contributors
                Jordan.alpert@ufl.edu
                Journal
                NPJ Digit Med
                NPJ Digit Med
                NPJ Digital Medicine
                Nature Publishing Group UK (London )
                2398-6352
                3 March 2020
                3 March 2020
                2020
                : 3
                : 27
                Affiliations
                [1 ]ISNI 0000 0004 1936 8091, GRID grid.15276.37, Department of Advertising, College of Journalism and Communications, , University of Florida, ; Gainesville, FL USA
                [2 ]ISNI 0000 0004 1936 8091, GRID grid.15276.37, Department of Aging and Geriatric Research, , University of Florida, ; Gainesville, FL USA
                [3 ]ISNI 0000 0004 1936 8091, GRID grid.15276.37, Computer & Information Science & Engineering, , University of Florida, ; Gainesville, FL USA
                [4 ]ISNI 0000 0004 1936 8091, GRID grid.15276.37, Department of Health Outcomes and Biomedical Informatics, , University of Florida, ; Gainesville, FL USA
                [5 ]ISNI 0000 0004 0481 9574, GRID grid.239186.7, Veterans Health Administration, NF/SG VHS, Geriatrics Research, Education and Clinical Center (GRECC), ; Gainesville, FL USA
                [6 ]ISNI 0000 0004 1936 8091, GRID grid.15276.37, College of Nursing, University of Florida, ; Gainesville, FL USA
                [7 ]ISNI 0000 0004 1936 8091, GRID grid.15276.37, J. Crayton Pruitt Family Department of Biomedical Engineering (BME), , University of Florida, ; Gainesville, FL USA
                Author information
                http://orcid.org/0000-0002-7066-4748
                Article
                236
                10.1038/s41746-020-0236-4
                7054258
                32140569
                372a70af-667e-4d66-967c-b8129bff3d13
                © The Author(s) 2020

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 24 October 2019
                : 24 January 2020
                Funding
                Funded by: Data Science and Applied Technology Core of the Claude D Pepper Older Americans Independence Center at the University of Florida (P30 AG028740) UFII-CTSI Pilot Project Award
                Categories
                Article
                Custom metadata
                © The Author(s) 2020

                health policy,patient education
                health policy, patient education

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