Smart Contract-based Consensus Building for Collaborative Medical Decision-Making

Medical decision-making is moving away from the traditional one-off dyadic encounter between the patient and physician, and transitioning towards a more inclusive, shared decision-making process that also considers the inputs from other stakeholders. This ensures that a patient's decision is not only based on a medical opinion, but also includes other considerations such as impact on family members, legal and financial implications, and experiences of patients in similar situations. However, given the sensitive nature of health data and decisions, there are several challenges associated with safeguarding the privacy, security and consent of all contributors and assuring the integrity of the process. We propose a collaborative medical decision-making platform that uses a consensus building mechanism implemented using Blockchain-based Smart Contracts to address some of the above challenges, thereby giving the participants confidence that both the decision-making process and the outcome(s) can be trusted. We also present a proof-of-concept implementation using the private Ethereum Blockchain to demonstrate practicability

Precision health in behaviour change interventions: A scoping review

Precision health seeks to optimise behavioural interventions by delivering personalised support to those in need, when and where they need it. Conceptualised a decade ago, progress toward this vision of personally relevant and effective population-wide interventions continues to evolve. This scoping review aimed to map the state of precision health behaviour change intervention research. This review included studies from a broader precision health review. Six databases were searched for studies published between January 2010 and June 2020, using the terms ‘precision health’ or its synonyms, and including an intervention targeting modifiable health behaviour(s) that was evaluated experimentally. Thirty-one studies were included, 12 being RCTs (39 %), and 17 with weak study design (55 %). Most interventions targeted physical activity (27/31, 87 %) and/or diet (24/31, 77 %), with 74% (23/31) targeting two to four health behaviours. Interventions were personalised via human interaction in 55 % (17/31) and digitally in 35 % (11/31). Data used for personalising interventions was largely self-reported, by survey or diary (14/31, 45 %), or digitally (14/31, 45 %). Data was mostly behavioural or lifestyle (20/31, 65 %), and physiologic, biochemical or clinical (15/31, 48 %), with no studies utilising genetic/genomic data. This review demonstrated that precision health behaviour change interventions remain dependent on human-led, low-tech personalisation, and have not fully considered the interaction between behaviour and the social and environmental contexts of individuals. Further research is needed to understand the relationship between personalisation and intervention effectiveness, working toward the development of sophisticated and scalable behaviour change interventions that have tangible public health impact

The Psychosocial Impacts of COVID-19 on a Sample of Australian Adults: Cross-sectional Survey and Sentiment Analysis

BackgroundThe COVID-19 pandemic has had enormous impacts on people’s lives, including disruptions to their normal ways of behaving, working, and interacting with others. Understanding and documenting these experiences is important to inform the ongoing response to COVID-19 and disaster preparedness efforts. ObjectiveThe aim of this study was to examine the psychosocial impacts of COVID-19 on a sample of Australian adults. MethodsThe data analyzed were derived from a larger cross-sectional survey of Australian adults that was administered during the month of May 2020. Participants (N=3483) were asked in which ways COVID-19 had most greatly impacted them; the responses produced a text data set containing 1 COVID-19 impact story for each participant, totaling 86,642 words. Participants also completed assessments of their sociodemographic characteristics (sex, age, financial stress), level of concern related to COVID-19, personality trait profile, and satisfaction with life. Impact stories were analyzed using sentiment analysis and compared against the Theoretical Domains Framework to determine the most frequently impacted life domains. Finally, a multinomial regression analysis, stratified by participant sex, was conducted to identify the associations of psychological and demographic socializations with sentiment toward COVID-19. ResultsIn total, 3483 participants completed the survey, the majority of whom were female (n=2793, 80.2%). Participants’ impact stories were most commonly categorized as neutral (1544/3483, 44.3%), followed by negative (1136/3483, 32.6%) and positive (802/3483, 23.1%). The most frequently impacted life domains included behavioral regulation, environmental context and resources, social influences, and emotions, suggesting that the COVID-19 pandemic was impacting these areas of participants’ lives the most. Finally, the regression results suggested that for women, lower satisfaction with life and higher financial stress were associated with increased likelihood of negative, rather than positive, sentiment (P<.001); however, the proportion of variance in the sentiment that was explained was very small (<5%). ConclusionsParticipant sentiment toward COVID-19 varied. High rates of neutral and negative sentiment were identified. Positive sentiment was identified but was not as common. Impacts to different areas of people’s lives were identified, with a major emphasis on behavioral regulation and related domains such as social influences, environmental context and resources, and emotions. Findings may inform the development of mental health and social support resources and interventions to help alleviate the psychosocial consequences of disaster response measures

Defining precision health: a scoping review protocol

Introduction Precision health is a nascent field of research that would benefit from clearer operationalisation and distinction from adjacent fields like precision medicine. This clarification is necessary to enable precision health science to tackle some of the most complex and significant health problems that are faced globally. There is a pressing need to examine the progress in human precision health research in the past 10 years and analyse this data to first, find similarities and determine discordances in how precision health is operationalised in the literature and second, identify gaps and future directions for precision health research.Methods and analysis To define precision health and map research in this field, a scoping review will be undertaken and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Scoping Review Extension guidelines. Systematic searches of scientific databases (Medline, Embase, Scopus, Web of Science and PsycINFO) and grey literature sources (Google Scholar, Google Patents) identified 8053 potentially eligible articles published from 1 January 2010 to 30 June 2020. Following removal of duplicates, a total of 3190 articles were imported for screening. Article data will be extracted using a customised extraction template on Covidence and analysed descriptively using narrative synthesis.Ethics and dissemination Ethics approval is not required. Findings will be disseminated through professional networks, conference presentations and publication in a scientific journal

Trends and gaps in precision health research: a scoping review

10.1136/bmjopen-2021-056938BMJ OPEN111