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      Smartphone Application WeChat for Clinical Follow-up of Discharged Patients with Head and Neck Tumors: A Randomized Controlled Trial

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          Abstract

          Background:

          Nowadays, social media tools such as short message service, Twitter, video, and web-based systems are more and more used in clinical follow-up, making clinical follow-up much more time- and cost-effective than ever before. However, as the most popular social media in China, little is known about the utility of smartphone WeChat application in follow-up. In this study, we aimed to investigate the feasibility and superiority of WeChat application in clinical follow-up.

          Methods:

          A total of 108 patients diagnosed with head and neck tumor were randomized to WeChat follow-up (WFU) group or telephone follow-up (TFU) group for 6-month follow-up. The follow-ups were delivered by WeChat or telephone at 2 weeks, 1, 2, 3, and 6 months to the patients after being discharged. The study measurements were time consumption for follow-up delivery, total economic cost, lost-to-follow-up rate, and overall satisfaction for the follow-up method.

          Results:

          Time consumption in WFU group for each patient (23.36 ± 6.16 min) was significantly shorter than that in TFU group (42.89 ± 7.15 min) ( P < 0.001); total economic cost in WFU group (RMB 90 Yuan) was much lower than that in TFU group (RMB 196 Yuan). Lost-to-follow-up rate in the WFU group was 7.02% (4/57) compared with TFU group, 9.80% (5/51), while no significance was observed (95% confidence interval [ CI]: 0.176–2.740; P = 0.732). The overall satisfaction rate in WFU group was 94.34% (50/53) compared with 80.43% (37/46) in TFU group (95% CI: 0.057–0.067; P = 0.034).

          Conclusions:

          The smartphone WeChat application was found to be a viable option for follow-up in discharged patients with head and neck tumors. WFU was time-effective, cost-effective, and convenient in communication. This doctor-led follow-up model has the potential to establish a good physician-patient relationship by enhancing dynamic communications and providing individual health instructions.

          Trial Registration:

          Chinese Clinical Trial Registry, ChiCTR-IOR-15007498; http://www.chictr.org.cn/ showproj.aspx?proj=12613.

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          Most cited references 26

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          eHealth Trends in Europe 2005-2007: A Population-Based Survey

          Background In the last decade, the number of Internet users worldwide has dramatically increased. People are using the Internet for various health-related purposes. It is important to monitor such use as it may have an impact on the individual’s health and behavior, patient-practitioner roles, and on general health care provision. Objectives This study investigates trends and patterns of European health-related Internet use over a period of 18 months. The main study objective was to estimate the change in the proportion of the population using the Internet for health purposes, and the importance of the Internet as a source of health information compared to more traditional sources. Methods The survey data were collected through computer-assisted telephone interviews. A representative sample (N = 14,956) from seven European countries has been used: Denmark, Germany, Greece, Latvia, Norway, Poland, and Portugal. The European eHealth Consumer Trends Survey was first conducted in October-November 2005 and repeated in April-May 2007. In addition to providing background information, respondents were asked to rate the importance of various sources of health information. They were also queried as to the frequency of different online activities related to health and illness and the effects of such use on their disposition. Results The percentage of the population that has used the Internet for health purposes increased from an estimated 42.3% (95% CI [Confidence Interval] 41.3 - 43.3) in 2005 to an estimated 52.2% (95% CI 51.3 - 53.2) in 2007. Significant growth in the use of the Internet for health purposes was found in all the seven countries. Young women are the most active Internet health users. The importance of the Internet as a source of health information has increased. In 2007, the Internet was perceived as an important source of health information by an estimated 46.8% (95% CI 45.7 - 47.9) of the population, a significant increase of 6.5 % (95% CI 4.9 - 8.1) from 2005. The importance of all the traditional health information channels has either decreased or remained the same. An estimated 22.7% (95% CI 21.7 - 23.6) are using it for more interactive services than just reading health information. Conclusion The Internet is increasingly being used as a source of health information by the European population, and its perceived importance is rising. Use of the Internet for health purposes is growing in all age groups and for both men and women, with especially strong growth among young women. We see that experienced Internet health users are also using the Internet as an active communication channel, both for reaching health professionals and for communicating with peers.
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            Untangling the Web--the impact of Internet use on health care and the physician-patient relationship.

            The use of Web (i.e. Internet)-derived health information within the health care encounter is rapidly increasing. In this article, an extensive review of the complex effects and sometimes contradictory roles of the Web in regard to health care delivery and the physician-patient relationship is presented. A review of relevant literature was conducted, with key points integrated into a physician guide for effective interaction with Web-activated patients. An emerging consumerist model with "triangulation" of patient-Web-physician can be expected to significantly impact dynamics of the physician-patient relationship. Potential advantages of Web-acquired information include helping patients make informed health care choices (with potential to decrease health care disparities), shared decision-making with a collaborative, teamwork approach, more efficient use of clinical time, augmenting of physician-provided information, online support groups, and/or access to patients' own health information. Alternatively, factors such as misinformation due to highly variable quality of Web information, possible exacerbation of socioeconomic health disparities, and shifting of conventional notions of the physician-patient relationship ("traditional" medical authority) present their own set of challenges for the health care provider. A tangible guide to the integration of patients' use of the Web within a medical practice is thus offered with recommended communication skills. The "net-friendly" clinician can be effective by engendering a genuine partnership with patients, thus contributing to quality health care.
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              Prospective randomized controlled trial using telemedicine for follow-ups in an orthopedic trauma population: a pilot study.

              To compare patient satisfaction between telemedicine and in-person follow-up appointments for orthopedic trauma.
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                Author and article information

                Journal
                Chin Med J (Engl)
                Chin. Med. J
                CMJ
                Chinese Medical Journal
                Medknow Publications & Media Pvt Ltd (India )
                0366-6999
                05 December 2016
                : 129
                : 23
                : 2816-2823
                Affiliations
                [1 ]Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
                [2 ]Department of Otorhinolaryngology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, China
                [3 ]Department of Otorhinolaryngology, Affiliated Futian Hospital of Guangdong Medical College, Shenzhen, Guangdong 518033, China
                Author notes
                Address for correspondence: Prof. Wen-Bin Lei, Department of Otorhinolaryngology, Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-Sen University, National Key Department of Otorhinolaryngology of China, Guangzhou, Guangdong 510080, China E-Mail: leiwb@ 123456mail.sysu.edu.cn
                Article
                CMJ-129-2816
                10.4103/0366-6999.194635
                5146789
                27900995
                Copyright: © 2016 Chinese Medical Journal

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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