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Journal Description

i-JMR is a general medical journal with a focus on innovation in health, health care, and medicine - through new medical techniques and innovative ideas and/or research, including—but not limited to—technology, clinical informatics, sociotechnical and organizational health care innovations, or groundbreaking research.

i-JMR is indexed in PubMed and archived in PubMed Central.

i-JMR is also indexed in Clarivate Analytics (formerly the IP and Science Division of Thomson Reuters) new Emerging Sources Citation Index (ESCI).

 

Recent Articles:

  • Source: Shutterstock; Copyright: SewCream; URL: https://www.shutterstock.com/image-photo/adult-child-hands-holding-purple-ribbons-1487364179?id=1487364179&irgwc=1&utm_medium=Affiliate&utm_campaign=Eezy%2C%20LLC&utm_source=38919&utm_term=photopin; License: Licensed by the authors.

    Parental Knowledge, Attitudes, and Behaviors Toward Their Epileptic Children at King Abdulaziz University Hospital: Cross-Sectional Study

    Abstract:

    Background: Epilepsy is a chronic disease characterized by periodic seizures that result from abnormal integrated firing impulses in the brain. It is one of the most common neurological disorders. Over the past few years, there has been increasing awareness about the effect that having a child with epilepsy has on parents and the reciprocal impact of parental knowledge and attitudes regarding epilepsy on the affected child. Objective: This study aimed to assess parental knowledge, attitudes, and behavior toward their epileptic children. Methods: A cross-sectional study was conducted in 2018 by the Pediatric Neurology Department of King Abdulaziz University Hospital, Jeddah, the Kingdom of Saudi Arabia. A sample size of 115 of 332 parents who have a child diagnosed with epilepsy and aged 18 years or younger were recruited for this study. Statistical analysis was performed using SPSS version 21. Data analysis was performed using an independent t test, a chi-square test, one-way analysis of variance, and correlation analysis. Results: A total of 115 participants answered the questionnaire; of these, 65 (56.5%) were men, with an average age of 40.3 years, and the mean age of the children was 9.0 years. Overall, 85 (85/115, 73.9%) children were taken care of by both of their parents. The mean parental knowledge score was 7.49 (SD 2.08) out of 12, and it was significantly related to the educational level of the parent (P=.004). The knowledge question that was most frequently answered incorrectly was “Diagnosis of epilepsy is usually made based on at least two unprovoked seizures.” As only 28.7% (33/115) of participants chose the correct answer, mean parental attitude score was 26.51 (SD 4.284) out of 35, and there was no significant relation with the educational level of parents (P=.13); however, it was negatively correlated with the child’s age (P=.045). Mean parental behavioral score was 23.35 (SD 4.121) out of 35, and there was no significant relation with the educational level of the parents (P=.24). The most negatively answered question for the behavior section was “I can leave my child without supervision,” with a mean score of 2.25 (SD 1.09) out of 5. Gender did not play a significant role in parental knowledge, attitudes, or behavior (P=.44, P=.77, and P=.99, respectively). Conclusions: Parental knowledge in our sample still needs improvement. Therefore, more awareness campaigns should be made for the community and for the parents of affected children to create a supportive environment for the children and help them thrive and develop.

  • Source: The Authors / Placeit; Copyright: JMIR Publications; URL: http://www.i-jmr.org/2020/1/e14446/; License: Creative Commons Attribution (CC-BY).

    Defining Symptom Concepts in Chronic Subjective Tinnitus: Web-Based Discussion Forum Study

    Abstract:

    Background: A minimum standard based upon consensus decision making recommends a core set of tinnitus-specific health complaints (outcome domains) that should be assessed and reported in all clinical trials as this enables comparisons to be made across studies as well as data pooling for meta-analysis. Objective: This study aimed to further clarify how the outcome domain concepts should be defined for 5 of the core set: tinnitus intrusiveness, sense of control, acceptance of tinnitus, concentration, and ability to ignore. This step requires a clear and fully elaborated definition for each outcome domain, moving from an abstract or a vague concept to an operationalized and measurable health-related construct, so that a suitable measurement instrument can then be identified. Methods: A series of 5 focus group–style semistructured discussions were conducted via a Web-based discussion forum, each open for 2 weeks and ending with a vote. The participants included 148 tinnitus experts who completed a preceding e-Delphi survey that had generated the original set of minimum standards. The participants were health care users living with tinnitus, health care professionals, clinical researchers, commercial representatives, and funders. Results: The Web discussions led to a revision of all 5 original plain language definitions that had been used in the preceding e-Delphi survey. Each revised definition was voted by 8 to 53 participants and reached the prespecified threshold of 70% consensus for all except tinnitus intrusiveness. Although a single definition was not agreed upon for tinnitus intrusiveness, the majority of participants shared the view that the concept should be sufficiently broad to encapsulate a range of subdomains. The examples included tinnitus awareness, unpleasantness, and impact on different aspects of everyday life. Thematic analysis of the 5 Web-based discussion threads gave important insights into expert interpretations of each core outcome domain, generating an operationalized and measurable health construct in each case. Conclusions: The qualitative data gathered during the Web-based discussion forum provided an important in-depth understanding of the health concepts that had raised a debate during earlier face-to-face meetings. The descriptive summaries and definitions provide sufficient operationalization of those concepts to proceed to the second stage of core outcome set development that is to identify and evaluate suitable measurement instruments. This study supports the use of Web-based peer discussion forums in defining health concepts.

  • Driver talking on a mobile phone while drinking coffee and working on a laptop. Source: iStock by Getty Images; Copyright: tommaso79; URL: https://www.istockphoto.com/ca/photo/stressed-businessman-working-seated-in-car-gm903701712-249237902; License: Licensed by the authors.

    Quality and Accuracy of Information Available on Websites for Distracted Driving: Qualitative Analysis

    Abstract:

    Background: Distracted driving has become alarmingly widespread, and its prevalence continues to increase despite efforts by government and nongovernment organizations to educate the public about this pervasive problem. Every year, 1.35 million people die, and nearly 80 million people get injured in road traffic incidents. Motor vehicle crashes are the leading cause of death among young people, and distracted driving plays a huge role in road traffic fatalities and injuries. Considering that most people now use the internet as an information source and Google is the most visited website and number one online search engine in the world, we performed a qualitative analysis of information available through Google on distracted driving and its outcomes. Objective: The goal of this study was to analyze the quality and accuracy of the information on distracted driving and its consequences available to the general public when using Google as a search engine for distracted driving. Methods: In November 2018, a nonregional Google search on distracted driving was conducted. The first two pages of the Google search results were selected for analysis. Data were collected on the type of website, type of distraction, consequences of distracted driving described, presence and referencing of statistics, and orthopedic and nonorthopedic injuries described, with their acute and chronic sequelae. Results: In total, we analyzed 25 websites: 12 websites (48%) were from government bodies, which were the most common type of websites; 19 (76%) of the sites provided statistics; and 15 (60%) referenced the source of the statistic. Mobile phones were the most frequently cited type of distraction, with 17 (68%) sites discussing it, while death was the most commonly mentioned consequence of distracted driving, quoted in 15 (60%) of the websites. Additionally, 52% of the sites provided tips on how to avoid distracted driving. Only one website mentioned orthopedic injuries. Conclusions: The prevalence of distracted driving is increasing, and so are the consequences associated with it. Nevertheless, the information available online does not accurately describe the current circumstances regarding this issue. The National Highway Traffic Safety Administration attributed 391,000 injuries and 3477 deaths to distracted driving in 2015, which are 5000 more injuries and almost 150 more fatalities compared to 2011. However, despite these figures, most of the websites discussed death as a consequence of distracted driving and often overlooked injuries, even though injuries are over 100 times more likely to occur in distraction-affected crashes. The websites also largely fail to address other forms of driving distractions, like daydreaming or talking to a passenger, and mostly focus on mobile phone–related activities as distractions. More specific information on the dangers of distracted driving and nonlethal trauma may support an overall cultural shift to curb this behavior.

  • Source: freepik; Copyright: freepik; URL: https://www.freepik.com/free-photo/close-up-female-doctor-using-digital-tablet-medical-report-desk_4435676.htm#page=1&query=doctor%20screening&position=29; License: Licensed by JMIR.

    Dermatologists’ Adherence to the Latest Recommendations for Screening of Hydroxychloroquine Retinopathy in Saudi Arabia: Cross-Sectional Study

    Abstract:

    Background: Hydroxychloroquine (HCQ) has been used to manage many inflammatory skin conditions. Nevertheless, retinopathy continues to be its most significant adverse effect. The American Academy of Ophthalmology (AAO) recommends baseline ophthalmologic screening in the first year of HCQ treatment. However, a recent study found an inadequate awareness of the recommendations. Furthermore, limited data are available regarding the implementation of the recommendations among dermatologists. Objective: The aim of this study was to assess dermatologists’ adherence to recommendations pertaining to their current practice regarding HCQ toxicity detection. Methods: A self-administrated questionnaire was distributed between February 2 and May 4, 2018, among members of the Saudi Society of Dermatology. The questionnaire comprised demographic-related questions and questions pertaining to each physician’s routine practice about the follow-up of HCQ-treated patients. Results: A total of 76 dermatologists completed the questionnaire. We achieved a response rate of 62.54%. More than half (43/76, 56%) of the dermatologists were male. Furthermore, more than half (41/76, 53%) of them reported treating 1 to 3 patients with HCQ during the last year. Furthermore, two-thirds (47/76, 61%) of them reported screening patients before initiating HCQ treatment. Regarding follow-up recommendations, 59% (45/76) of dermatologists reported yearly after starting treatment for no-risk patients, whereas 94% (72/76) reported “yearly within 5 years of treatment” for at-risk patients. Data were considered significant at P<.05. All analyses were performed using SPSS, version 20 (IBM). Conclusions: Dermatologists in Saudi Arabia are not well informed about some aspects of the latest recommendations regarding screening for HCQ toxicity in terms of tests, follow-up timing, cessation of the drug, and causative agents. Therefore, we recommend conducting more studies in Saudi Arabia to determine the adherence of more physicians to the AAO recommendations. Furthermore, patient education regarding HCQ toxicity and increased patient awareness are recommended for effective and safe HCQ use.

  • Source: Flickr; Copyright: Brian McKechnie; URL: https://www.flickr.com/photos/bamcat/50675771/in/photolist-5tJ9c-pZujuY-pxpe3o-aujoCz-aun2rh-PmfxB-ziXwAL-phWZhA-8V1oNQ-8UXjQ2-8V1oL7-8pr85w-aun4FL-aujpdt-aujo7r-8vfoLG-8vckHt-8vckMe-8UXjM8-7bJ1hM-aun2F1-8vcmaF-aun3Uh-8vcm2k-aun4yW-nd1rz-PkEim-aun4Ny-PkEm; License: Creative Commons Attribution (CC-BY).

    Racial Disparities in Mortality Among American Film Celebrities: A Wikipedia-Based Retrospective Cohort Study

    Abstract:

    Background: In the United States, well-documented racial disparities in health outcomes are frequently attributed to racial bias and socioeconomic inequalities. However, it remains unknown whether racial disparities in mortality persist among those with higher socioeconomic status (SES) and occupational prestige. Objective: As the celebrity population is generally characterized by high levels of SES and occupational prestige, this study aimed to examine survival differences between black and white film celebrities. Methods: Using a Web-based, open-source encyclopedia (ie, Wikipedia), data for 5829 entries of randomly selected American film actors and actresses born between 1900 and 2000 were extracted. A Kaplan-Meier survival curve was conducted using 4356 entries to compare the difference in survival by race. A Cox semiparametric regression analysis examined whether adjusting for year of birth, gender, and cause of death influenced differences in survival by race. Results: Most celebrities were non-Hispanic white (3847/4352, 88.4%), male (3565/4352, 81.9%), and born in the United States (4187/4352, 96.2%). Mean age at death for black celebrities (64.1; 95% CI 60.6-67.5 years) was 6.4 years shorter than that for white celebrities (70.5; 95% CI 69.6-71.4 years; P<.001). Black celebrities had a faster all-cause mortality rate using Kaplan-Meier survival function estimates and a log-rank test. However, in a Cox semiparametric regression, there was no longer a significant difference in survival times between black and white celebrities (hazard ratio 1.07; 95% CI 0.87-1.31). Conclusions: There is some evidence that racial disparities in all-cause mortality may persist at higher levels of SES, but this association was no longer significant in adjusted analyses. Further research is needed to examine if racial disparities in mortality are diminished at higher levels of SES among more representative populations.

  • Source: Image created by the Authors; Copyright: The Authors; URL: http://www.i-jmr.org/2019/4/e14607/; License: Creative Commons Attribution (CC-BY).

    Osteopathic Considerations for Peripheral Neuropathy Due to Concomitant Diffuse Idiopathic Skeletal Hyperostosis Syndrome and Lumbar Epidural Lipomatosis:...

    Abstract:

    Background: Diffuse idiopathic skeletal hyperostosis (DISH) syndrome and lumbar epidural lipomatosis are relatively asymptomatic neurological conditions, with findings often seen incidentally on radiological studies. Objective: The aim of this paper is to present unique findings of concomitant, symptomatic DISH syndrome and lumbar epidural lipomatosis and to discuss the osteopathic diagnosis and treatment implications. Methods: Concomitant, symptomatic variants are rare and present challenges to treatment and management, as seen with a 60-year-old African American woman who presented with worsening disequilibrium and new-onset bilateral fingertip numbness. Past medical history was significant for alcohol abuse disorder, hypertension, hyperlipidemia, and multiple episodes of self-resolving vertigo and lower extremity neuropathy. Results: The patient was referred to the neurology department for stroke workup, which was negative. Osteopathic structural exam revealed thoracolumbar and sacral dysfunctions. Magnetic resonance imaging revealed findings consistent with thoracic DISH syndrome and lumbar epidural lipomatosis in the areas of somatic dysfunctions. Conclusions: Due to minimal information on osteopathic manipulative treatment in rare neurological diseases, only gentle techniques of myofascial release, balanced ligamentous tension, and muscle energy were performed with resultant minimal improvement, thus highlighting the necessity for better guidelines and further research.

  • Source: Flickr; Copyright: Joshua Ganderson; URL: https://www.flickr.com/photos/jganderson/3630957159/in/photolist-6wRB4D-aodyiN-4okkdS-4U1Y6H-4RY4G-4qBM6z-9qtPUV-5gmygK-fYny1i-3QR65q-mSMWrP-9sL6CC-8MkG26-2NZybc-pGzAcZ-6ZFtE6-pGTBS7-6cYPju-PxGAb-J5Ys9N-bVCpCK-4qFRpU-4qFRp1-6DV2Zo-9t16e2-6Fga3d-7Nnagk-ktf; License: Creative Commons Attribution (CC-BY).

    Quality of Life Among Informal Caregivers of Patients With Degenerative Cervical Myelopathy: Cross-Sectional Questionnaire Study

    Abstract:

    Background: Degenerative cervical myelopathy (DCM) is a common, chronic neurological condition that severely affects individuals by causing a range of disabling symptoms, frequently at a time around the peak of their careers. Subsequently, individuals with DCM often become dependent on informal care arrangements. The significant economic contribution of informal care and its burden on care providers are becoming increasingly recognized. Objective: This study aimed to measure the quality of life of DCM informal caregivers and provide preliminary insight into possible contributing factors. Methods: Carers of individuals with DCM completed a Web-based survey hosted by Myelopathy.org, an international DCM charity. Carer quality of life was assessed in the form of caregiver happiness and 7 dimensions of carer burden using the Care-Related Quality of Life (CarerQol) instrument. The relationships between patient disease severity, patient pain, and carer quality of life were investigated. Differences in carer quality of life were assessed across patient and carer demographic groups, including between UK and US carers. Results: DCM caregivers experienced substantial burden as a result of their caregiving (mean CarerQol-7D=64.1; 95% CI 58.8-69.5) and low happiness (mean CarerQol-VAS [Visual Analog Scale]=6.3; 95% CI 5.7-6.9). Burden was high and happiness was low in DCM carers when compared with a large, mixed-disease study of adult informal carers where CarerQol-7D was 79.1 and CarerQol-VAS was 7.1. No significant relationship was found between DCM carer quality of life and patient disease severity and pain scores. DCM carer quality of life appeared uniform across all patient and carer demographic groups. Conclusions: Caring for individuals with DCM is associated with reduced quality of life in the form of significant burden and reduced happiness. Reductions appear greater in DCM than in other diseases investigated. However, no simple relationship was identified between individual patient or carer factors and carer quality of life.

  • Checking for quality. Source: Unsplash.com; Copyright: Joao Silas; URL: https://unsplash.com/photos/UGQoo2nznz8; License: Licensed by JMIR.

    How Do Publicly Available Allergy-Specific Web-Based Training Programs Conform to the Established Criteria for the Reporting, Methods, and Content of...

    Abstract:

    Background: Allergic diseases, such as allergic asthma, rhinitis, and atopic eczema, are widespread, and they are a considerable burden on the health care system. For patients and health care professionals, Web-based training programs (WTPs) may be helpful to foster self-management and provide allergy-specific information, given, for instance, their good accessibility. Objective: This study aimed to assess an exploratory sample of publicly available allergy-specific WTPs—that is, interactive, feedback-oriented Web-based training platforms promoting health behavior change and improvement of personal skills—with regard to (1) general characteristics, aims, and target groups and (2) the extent to which these tools meet established criteria for the reporting, methods, and content of evidence-based (digital) health information and education. Methods: WTPs were identified via an initial Google search and a search of English and German language websites of medical and public health services, such as the European Centre for Allergy Research Foundation (German), Asthma UK, and Anaphylaxis Canada. We developed a checklist from (1) established guidelines for Web-based health information (eg, the Journal of the American Medical Association benchmarks, DISCERN criteria, and Health On the Net code) and (2) a database search of related studies. The checklist contained 44 items covering 11 domains in 3 areas: (1) content (completeness, transparency, and evidence), (2) structure (data safety and qualification of trainers and authors), and (3) impact (effectiveness, user perspective, and integration into health care). We rated the WTPs as completely, partly, or not satisfying each checklist item and calculated overall and domain-specific scores for each WTP using SPSS 23.0 (SPSS Inc). Results: The 15 identified WTPs covered an average of 37% of the items (score 33 out of 88). A total of 7 WTPs covered more than 40% (35/88; maximum: 49%; 43/88). A total of 5 covered 30% (26/88) to 40% (35/88) of all rated items and the rest covered fewer (n=3; lowest score 24%; 21/88). Items relating to intervention (58%; 10/18), content (49%; 9/18), and data safety (60%; 1/2) were more often considered, as opposed to user safety (10%; 0.4/4), qualification of staff (10%; 0.8/8), effectiveness (16%; 0.4/2), and user perspective (45%; 5/12). In addition, in 13 of 15 WTPs, a minimum of 3 domains were not covered at all. Regarding evidence-based content, 46% of all WTPs (7/15) scored on use of scientific research, 53% on regular information update (8/15), and 33% on provision of references (5/15). None of 15 provided details on the quality of references or the strength of evidence. Conclusions: English and German language allergy-specific WTPs, addressing lay audiences and health care professionals, conform only partly to established criteria for the reporting, methods, and content of evidence-based (digital) health information and education. Particularly, well-conducted studies on their effectiveness are missing.

  • Source: Freepik; Copyright: Freepik; URL: https://www.freepik.com/free-photo/woman-blanket-coughing_3143785.htm; License: Licensed by JMIR.

    Modern Innovative Solutions in Improving Outcomes in Chronic Obstructive Pulmonary Disease (MISSION COPD): Mixed Methods Evaluation of a Novel Integrated...

    Abstract:

    Background: Chronic obstructive pulmonary disease (COPD) is the second-leading cause of death in the United Kingdom and accounts for 1.7% of bed days in acute hospitals. An estimated two-third of patients with COPD remain undiagnosed. Objective: Modern Innovative Solutions in Improving Outcomes in Chronic Obstructive Pulmonary Disease (MISSION COPD) aimed to proactively identify patients from primary care who were undiagnosed or had uncontrolled COPD and to provide a comprehensive integrated multidisciplinary clinic to address the needs of this complex group for improving diagnosis, personalizing therapy, and empowering patients to self-manage their condition. Methods: This clinic was led by a respiratory specialist team from Portsmouth Hospitals NHS trust working with five primary care surgeries in Wessex. A total of 108 patients were reviewed, with 98 patients consenting to provide additional data for research. Diagnoses were changed in 14 patients, and 32 new diagnoses were made. Results: Reductions were seen across all aspects of unscheduled care as compared to the prior 12 months, including in emergency general practitioner visits (3.37-0.79 visits per patient, P<.001), exacerbations (2.64-0.56 per patient, P=.01), out-of-hours calls (0.16-0.05 per patient, P=.42), and hospital admissions (0.49-0.12 per patient, P=.48). Improvements were observed in the quality of life and symptom scores in addition to patient activation and patient-reported confidence levels. Conclusions: This pilot demonstrates that the MISSION model may be an effective way to provide comprehensive gold-standard care that is valued by patients and to promote integration across sectors.

  • Source: freepik; Copyright: pressfoto; URL: https://www.freepik.com/free-photo/discussing-x-ray-joint_5402326.htm#page=1&query=x%20ray&position=20; License: Licensed by JMIR.

    Readability and Quality of Online Information on Osteoarthritis: An Objective Analysis With Historic Comparison

    Abstract:

    Background: Osteoarthritis (OA) is the most common cause of disability in people older than 65 years. Readability of online OA information has never been assessed. A 2003 study found the quality of online OA information to be poor. Objective: The aim of this study was to review the readability and quality of current online information regarding OA. Methods: The term osteoarthritis was searched across the three most popular English language search engines. The first 25 pages from each search engine were analyzed. Duplicate pages, websites featuring paid advertisements, inaccessible pages (behind a pay wall, not available for geographical reasons), and nontext pages were excluded. Readability was measured using Flesch Reading Ease Score, Flesch-Kincaid Grade Level, and Gunning-Fog Index. Website quality was scored using the Journal of the American Medical Association (JAMA) benchmark criteria and the DISCERN criteria. Presence or absence of the Health On the Net Foundation Code of Conduct (HONcode) certification, age of content, content producer, and author characteristics were noted. Results: A total of 37 unique websites were found suitable for analysis. Readability varied by assessment tool from 8th to 12th grade level. This compares with the recommended 7th to 8th grade level. Of the 37, 1 (2.7%) website met all 4 JAMA criteria. Mean DISCERN quality of information for OA websites was “fair,” compared with the “poor” grading of a 2003 study. HONcode-endorsed websites (43%, 16/37) were of a statistically significant higher quality. Conclusions: Readability of online health information for OA was either equal to or more difficult than the recommended level.

  • Source: freepik; Copyright: katemangostar; URL: https://www.freepik.com/free-photo/serious-asian-young-female-doctor-using-tablet-computer_2448908.htm#page=2&query=asian+doctor&position=25; License: Licensed by JMIR.

    Physician Decision-Making Patterns and Family Presence: Cross-Sectional Online Survey Study in Japan

    Abstract:

    Background: Due to a low birth rate and an aging population, Japan faces an increase in the number of elderly people without children living in single households. These elderly without a spouse and/or children encounter a lack of caregivers because most sources of care for the elderly in Japan are not provided by private agencies but by family members. However, family caregivers not only help with daily living but are also key participants in treatment decision making. The effect of family absence on treatment decision making has not been elucidated, although more elderly people will not have family members to make surrogate decisions on their behalf. Methods: We conducted a cross-sectional online survey among Japanese physicians using three hypothetical vignettes. The first vignette was about a 65-year-old man with alcoholic liver cirrhosis and the second was about a 78-year-old woman with dementia, both of whom developed pneumonia with consciousness disturbance. The third vignette was about a 70-year-old woman with necrosis of her lower limb. Participants were randomly assigned to either of the two versions of the questionnaires—with family or without family—but methods were identical otherwise. Participants chose yes or no responses to questions about whether they would perform the presented medical procedures. Results: Among 1112 physicians, 454 (40.8%) completed the survey; there were no significant differences in the baseline characteristics between groups. Significantly fewer physicians had a willingness to perform dialysis (odds ratio [OR] 0.55, 95% CI 0.34-0.80; P=.002) and artificial ventilation (OR 0.51, 95% CI 0.35-0.75; P<.001) for a patient from vignette 1 without family. In vignette 2, fewer physicians were willing to perform artificial ventilation (OR 0.59, 95% CI 0.39-0.90; P=.02). In vignette 3, significantly fewer physicians showed willingness to perform wound treatment (OR 0.51, 95% CI 0.31-0.84; P=.007), surgery (OR 0.35, 95% CI 0.22-0.57; P<.001), blood transfusion (OR 0.45, 95% CI 0.31-0.66; P<.001), vasopressor (OR 0.49, 95% CI 0.34-0.72; P<.001), dialysis (OR 0.38, 95% CI 0.24-0.59; P<.001), artificial ventilation (OR 0.25, 95% CI 0.15-0.40; P<.001), and chest compression (OR 0.29, 95% CI 0.18-0.47; P<.001) for a patient without family. Conclusions: Elderly patients may have treatments withheld because of the absence of family, highlighting the potential importance of advance care planning in the era of an aging society with a declining birth rate.

  • People searching for online health information. Source: Image created by the Authors; Copyright: Lars König; URL: https://www.i-jmr.org/2019/3/e13619; License: Creative Commons Attribution (CC-BY).

    Influence of Enthusiastic Language on the Credibility of Health Information and the Trustworthiness of Science Communicators: Insights From a Between-Subject...

    Abstract:

    Background: To decide whether online health information is reliable, information seekers apply 2 stretegies: first, information seekers can make credibility judgments by using their prior knowledge to evaluate the validity of the encountered health claim. Second, instead of evaluating the health claim itself, information seekers can make trustworthiness judgments by evaluating the character of the information source. In recent years, information givers from various professions have begun to use enthusiastic language to disseminate their information and persuade their audiences. Objective: To systematically explore this phenomenon, the goal of this study was to answer the following research questions: (1) does an enthusiastic language style, in comparison with a neutral language style, increase the trustworthiness of a person arguing in an online health forum and the credibility of his or her information? (2) does working for a university, in comparison with working for a lobbying organization, increase the trustworthiness of a person arguing in an online health forum and the credibility of his or her information? (3) does working for a university in combination with using an enthusiastic language style result in especially high trustworthiness and credibility ratings? Methods: In a 2x2 between-subject online experiment, 270 participants read a post from an online health forum and subsequently rated the trustworthiness of the forum post author and the credibility of his information. A total of 2 aspects of the forum post varied, namely the professional affiliation of the forum post author (whether the person introduced himself as a scientist or a lobbyist) and his language style (whether he used a neutral language style or an enthusiastic language style). Results: When the forum post author used an enthusiastic language style, he was perceived as more manipulative (P<.001), less knowledgeable (P<.001), and his information was perceived as less credible (P<.001). Overall, scientists were perceived as less manipulative (P=.04) than lobbyists. Furthermore, language style and professional affiliation interacted: When the forum post author was a lobbyist, language style did not affect integrity (P=.96) and benevolence (P=.79) ratings. However, when the forum post author was a scientist, enthusiastic language led to lower integrity (P=.002) and benevolence (P<.001) ratings than neutral language. Conclusions: The current findings illustrate that health information seekers do not just react to online health information itself. In addition, they are also sensitive to the ways in which health information is presented (“Which langue style is used to communicate health information?”) and who presents it (“Who does the health information source work for?”).

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