Tracking Greenhouse Gas Emission Initiatives Across a Large Academic Health System Utilizing Innovative Dashboards

Journal of Medical Systems · 2026-03-18

Why Clinical Trials Will Fail to Ensure Safe AI

Journal of Medical Systems · 2025-07-17 · 3 citations

Longitudinal Data Collection via Consumer-Grade Wearable Sensors in Adolescent Student-Athletes: Feasibility and Potential (Preprint)

2025-02-27

<sec> <title>BACKGROUND</title> Recent advancements in sports medicine have been fueled by innovative technologies, particularly consumer-grade wearable devices like Fitbit, Apple Watch, and Garmin. These devices offer physiological and biomechanical data and hold promise for personalized, real-time, and remote assessment of athlete recovery. However, few studies have been conducted with these devices in adolescent student athletes. </sec> <sec> <title>OBJECTIVE</title> The primary objective of this study was to assess the feasibility of integrating consumer-grade wearable technology into injury recovery monitoring of adolescent student-athletes. </sec> <sec> <title>METHODS</title> The study included 34 high school student-athletes aged 14-18 diagnosed with either concussion or orthopedic injury, enrolled within 10 days of injury. Participants were equipped with a Fitbit Sense for continuous monitoring of physiological markers, including cardiovascular metrics, physical activity levels, and sleep patterns. Data collection extended 4-6 weeks beyond injury clearance, during which adherence rates were assessed at both hourly and daily intervals. Hourly adherence was defined as the proportion of participants with at least one recorded heart rate data point per hour, while daily adherence was defined as the proportion of participants with at least one recorded heart rate data point per 24-hour period. </sec> <sec> <title>RESULTS</title> The study demonstrated high participant adherence to wearing the device. The orthopedic injury cohort exhibited a median adherence rate of 95%, with individual rates ranging from 82% to 100%. Similarly, the concussion cohort demonstrated a median adherence rate of 93%, with adherence rates spanning from 37% to 100%. Notably, the study encountered minimal issues related to device functionality, with only one participant necessitating a device replacement. </sec> <sec> <title>CONCLUSIONS</title> These findings demonstrate successful integration of wearable technology in data collection for adolescent student-athletes recovering from sports-related injuries. However, it is important to consider current limitations, including factors that may influence data accuracy and precision. Conclusions: In conclusion, this feasibility study demonstrates the practicality of employing consumer-grade wearable technology for the collection of physiological and biomechanical parameters in adolescent student-athletes recovering from sport-related injuries. The high level of adherence highlights the potential applicability of consumer-grade wearable devices in this population. Study findings lay the foundation for future investigations with larger and more diverse cohorts to identify the utility of device metrics in identifying unique patterns of injury-specific recovery (i.e., sport-related concussion). Consumer-grade wearable devices offer promise for optimizing assessment and management of injured athletes through wearable technology integration into standard clinical protocols. </sec>

Monitoring Adolescent Sport-Related Concussion Recovery Using Consumer-Grade Wearables: A Pilot Study

Journal of Head Trauma Rehabilitation · 2025-12-26 · 1 citations

OBJECTIVE: To evaluate whether consumer-grade wearable devices (CGWDs) can detect physiological differences between adolescent athletes recovering from sport-related concussion (SRC) versus musculoskeletal (MSK) injury, and to examine whether wearable-derived physiological markers are associated with symptom burden during the acute post-injury phase. SETTING: Outpatient sports medicine clinic at a pediatric academic medical center. PARTICIPANTS: High school student-athletes aged 14-18 years were eligible if they presented within 10 days of SRC or acute, nonsurgical MSK injury and had internet access and willingness to comply with study procedures. Thirty-eight participants were enrolled; four were excluded due to protocol deviations. The final analytic sample included 34 participants (SRC: n = 17; MSK: n = 17). DESIGN: Prospective observational cohort study conducted from September 2021 to April 2022. All participants were issued a Fitbit Sense to passively monitor sleep, activity, and heart rate for up to 6 weeks post-injury. No randomization or blinding occurred, as this was an observational study. MAIN MEASURES: The primary outcome was group differences in CGWD-derived physiological metrics (sleep patterns and architecture, physical activity, heart rate) across 3 post-enrollment time intervals (Days 1-14, 15-28, 29-42). Secondary outcomes included correlations between physiological data and symptom burden based on the Post-Concussion Symptom Inventory, Second Edition (PCSI-2). RESULTS: Compared to MSK peers, participants with SRC showed significantly more light sleep, more nocturnal wake time, and lower daily step counts during the first 4 weeks post-injury (P <.0038). No significant differences were observed in REM sleep, deep sleep, or heart rate. In SRC participants, greater nocturnal wake time and lower resting heart rate were modestly associated with higher cognitive symptom ratings; emotional symptoms were modestly associated with step counts. No adverse events occurred. CONCLUSIONS: CGWDs may capture recovery-specific physiological disruptions in adolescent SRC, particularly in sleep and physical activity. These findings support the potential for wearable technology to inform individualized, objective approaches to concussion monitoring in clinical practice.

Neurocognitive evaluation of adolescents recovering from sports-related concussion: A prospective cohort pilot study utilizing the National Institutes of Health Toolbox cognition Battery

Applied Neuropsychology Child · 2025-06-12 · 1 citations

OBJECTIVE: This study explored NIHTB-CB's utility in assessing cognitive recovery in adolescents with SRC. We hypothesized the NIHTB-CB is sensitive to detecting weaknesses in fluid, but not crystalized, cognition, and adolescents recovering from SRC exhibit greater weaknesses than orthopedically injured (OI) adolescents. METHOD: 12). RESULTS: >.35). CONCLUSIONS: These results did not indicate unique weaknesses in fluid cognition, concerning for NIHTB-CB's sensitivity in detecting post-injury changes using an OI control group. The NIHTB-CB captured preserved crystallized cognition throughout recovery as hypothesized.

A scoping review of human digital twins in healthcare applications and usage patterns

npj Digital Medicine · 2025-09-30 · 24 citations

Digital twins have become increasingly popular across various industries as dynamic virtual models of physical systems. In healthcare, Human Digital Twins (HDTs) serve as virtual counterparts to patients. According to the National Academies of Sciences, Engineering, and Medicine (NASEM), a digital twin must be personalized, dynamically updated, and have predictive capabilities to-in the context of health care-inform clinical decision-making. This scoping review aims to assess the current state of HDTs in healthcare, examining whether the literature aligns with the NASEM definition and identifying trends. A systematic literature search was conducted, covering articles published from January 2017 to July 2024. Only 18 of the 149 included studies (12.08%) fully met the NASEM digital twin criteria. Digital shadows made up 9.4% of studies, general digital models comprised 10.07%, and virtual patient cohorts were another 10.07%. Only two studies mentioned verification, validation, and uncertainty quantification (VVUQ), a critical NASEM standard for model reliability.

Social Network Analysis of Secure Text Messaging Metadata During Clinical Deterioration in an Inpatient Children’s Hospital Setting

Journal of Medical Systems · 2025-09-19

Mitigating clinical deterioration relies upon recognition (afferent limb) and interventions (efferent limb) by a healthcare team. Healthcare provider (HP) communication by text messaging plays a role in facilitating both limbs in the inpatient setting. We sought to quantitatively characterize healthcare provider team communications through the social network analysis (SNA) of secure text messages exchanged in the inpatient setting, and as they relate to a subgroup of patients demonstrating a deterioration during their hospitalization. Messages linked to inpatients exchanged between HPs over a 12-month period, including a cohort of messages linked to patients experiencing deterioration were analyzed using SNA. Subnetworks corresponding to individual patient encounters were constructed, including a series of subnetworks pertaining to patients with an impending clinical deterioration. Network and network participant characteristics were calculated and analyzed. From October 2022 through September 2023 there were 1,065,225 messages delivered by 3,272 HPs, associated with 4,328 inpatient hospital encounters, of which 120 hospital encounters were associated with a deterioration. SNA demonstrated significantly higher measures of eigenvector centrality among frontline providers (FLP) including advanced practice providers and housestaff, relative to attending physician (p < 0.001) and registered nurses (p < 0.001), consistent with greater influence of the FLP on information dissemination through the entire network. Within individual subnetworks associated with the care of patients experiencing a clinical deterioration, FLP participants demonstrated greater overall network influence (p = 0.032) relative to FLP counterparts in networks not associated with a deterioration, despite comparable numbers of participants and connections. Using SNA, we quantitatively characterized a text messaging network within an inpatient hospital setting, demonstrating the importance of FLPs on information dissemination, a finding demonstrated specifically within subnetworks dedicated to the care of individual deteriorating patients. Understanding characteristics of a dynamic communication network of healthcare providers may prove a valuable target in facilitating communication and in mitigating the risks of deterioration.IRB Approval: Johns Hopkins Medicine IRB (#CIR00419339).Clinical trial number: Not applicable.

484 Comparison of Procedural Duration Between Ultrasound-Guided IVs, Midline Catheters, and CVCs

Annals of Emergency Medicine · 2025-08-22

Garbage In, Garbage Out? Negative Impact of Physiological Waveform Artifacts in a Hospital Clinical Data Warehouse

Journal of Medical Systems · 2024-11-25

Precision Anesthesia in 2050

Anesthesia & Analgesia · 2024-01-12 · 12 citations

Over the last few decades, the field of anesthesia has advanced far beyond its humble beginnings. Today's anesthetics are better and safer than ever, thanks to innovations in drugs, monitors, equipment, and patient safety.1-4 At the same time, we remain limited by our herd approach to medicine. Each of our patients is unique, but health care today is based on a one-size-fits-all approach, while our patients grow older and more medically complex every year. By 2050, we believe that precision medicine will play a central role across all medical specialties, including anesthesia. In addition, we expect that health care and consumer technology will continually evolve to improve and simplify the interactions between patients, providers, and the health care system. As demonstrated by 2 hypothetical patient experiences, these advancements will enable more efficient and safe care, earlier and more accurate diagnoses, and truly personalized treatment plans.