iPad Device Research Articles

Abstract A134: Overcoming barriers to prostate cancer screening: A tethered educational video and mobile screening program

Abstract Background: Prostate cancer (PC) is the most commonly diagnosed cancer in men. One in 8 White and 1 in 6 Black men will be diagnosed with PC in their lifetime. The current prostate cancer screening (PCS) guidelines recommend shared decision making to discuss the advantages and disadvantages of PCS. In Philadelphia, among men over 40 years of age, only 39% and 18% have discussed the advantages and disadvantages of PCS with a provider, respectively. Among men over 50 years of age, only 47% have had a Prostate Specific Antigen (PSA) test. This research evaluated an educational video designed to increase awareness of the advantages and disadvantages of PCS and provided access to mobile PSA screening among the diverse men in Philadelphia. Methods: Between April-May 2024, we enrolled men aged 40+ at community events within and around the city of Philadelphia and excluded men who previously participated in the study. Screening events were advertised through social media, printed flyers, emails, and text messages disseminated by labor union administrators to union members. Participants completed a questionnaire which examined PC and PCS knowledge, decisional conflict, and likelihood to screen before and after viewing a 12-minute educational video on an iPad or personal device. The video consisted of a conversation between a local pastor, who is a Black PC survivor, and a urologist. The video included the pastor’s personal experience with PC and allowed him and the urologist to have the opportunity to address common PC misconceptions and myths. After the video, participants provided video feedback. A $10 gift card and giveaways were offered before presenting the option for on-site PSA draws by a licensed phlebotomist. Results: A total of 133 men (38% Black; 56% White, 10% Hispanic; mean age of 53 years old (s.d.=10.4)) completed the pre and post questionnaires. A total of 61% of participants had never had a PSA test. Twenty-two percent did not know blood testing was an option, and 28% did not know they needed a PSA test. Thirty-two percent of participants would have been somewhat or very unlikely to get screened without this program. Having the screening option come to their community or place of work was the determining factor for 81% of screened participants. After watching the video, PC knowledge improved in 6 of 10 items (overall knowledge score pre vs. post p<.01). Post video, decisional conflict was reduced in 9 of the 10 questionnaire items (each item had a p≤.001). A total of 95% of participants stated ‘yes’, they would undergo PCS after watching the video versus 69% being either somewhat or very likely to get screened before watching the video (p<0.001). All 95% were screened on-site. The video information was deemed useful to 99% and credible by 97% of respondents. Conclusion: This educational video increased PCS awareness, intention to screen for PC, and completion of PCS. When coupled with an educational video, mobile PSA screening initiatives are an effective and efficient way to increase access to PSA screening for diverse men. Citation Format: Mallorie C. Jones, William Buckley, Alexandra Cordoba, Suji Kim, David Barreto, Debanjan Pain, Vivian Nguyen, Blane Newberry, Daniel Lee, Carmen E. Guerra. Overcoming barriers to prostate cancer screening: A tethered educational video and mobile screening program [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A134.

A Health-Related Quality of Life Measure for Patients Who Undergo Minimally Invasive Glaucoma Surgery

PurposeTo develop a standardized patient-reported outcome measure to assess the impact of glaucoma and treatment, including minimally invasive glaucoma surgery (MIGS), on health-related quality of life (HRQOL). DesignObservational study before and after concomitant cataract and FDA-approved implantable MIGS device surgery to provide information on the measure's performance in assessing HRQOL. Methods SettingSurvey administration was done by electronic patient-reported outcomes (ePRO) application to patients at multiple sites on a computer, iPad, or similar device. Patient PopulationOne hundred eighty-four adults completed a baseline survey, 124 completed a survey 3 months after surgery, and 106 completed the 1-month test-retest reliability survey. The age range was 37-89, and the average age was 72. Most of the respondents were female (57%), non-Hispanic White (81%), and had a college degree (56%). Main Outcome MeasuresThe Glaucoma Outcomes Survey (GOS) includes 42 questions assessing functional limitations (27 items), vision-related symptoms (7 items), psychosocial issues (7 items) and satisfaction with microinvasive glaucoma surgery (1 item). The three multiple-item scales were scored on a 0-100 range, with a higher score indicating worse health. ResultsInternal consistency reliability estimates ranged from 0.75 (vision-related symptoms) to 0.93 (functional limitations) and one-month test-retest intraclass correlations ranged from 0.65 (PROMIS global mental health) to 0.92 (functional limitations). Product-moment correlations among the GOS scales ranged from 0.56 to 0.60. Improvement in visual acuity in the study eye from baseline to the 3-month follow-up was significantly related to improvements in GOS functional limitations (r =0.18, p =0.0485), vision-related symptoms (r = 0.19, p = 0.0386), and psychosocial concerns (r = 0.18, p =0.0503). The highest proportion of responders to treatment was seen for the GOS functional limitations scale (48%), followed by GOS psychosocial issues (21%) and GOS vision-related symptoms (17%). ConclusionsThis study provides initial support for using the GOS instrument in ophthalmic procedures such as MIGS. Further evaluation of the GOS in other samples, including different patient subgroups and clinical settings, will be valuable. The instrument may be useful for evaluations of other treatments for glaucoma.

A Beta-Prototype Chatbot for Increasing Health Literacy of Patients With Decompensated Cirrhosis: Usability Study.

Health literacy is low among patients with chronic liver disease (CLD) and associated with poor health outcomes and increased health care use. Lucy LiverBot, an artificial intelligence chatbot was created by a multidisciplinary team at Monash Health, Australia, to improve health literacy and self-efficacy in patients with decompensated CLD. The aim of this study was to explore users' experience with Lucy LiverBot using an unmoderated, in-person, qualitative test. Lucy LiverBot is a simple, low cost, and scalable digital intervention, which was at the beta prototype development phase at the time of usability testing. The concept and prototype development was realized in 2 phases: concept development and usability testing. We conducted a mixed methods study to assess usability of Lucy LiverBot as a tool for health literacy education among ambulatory and hospitalized patients with decompensated CLD at Monash Health. Patients were provided with free reign to interact with Lucy LiverBot on an iPad device under moderator observation. A 3-part survey (preuser, user, and postuser) was developed using the Unified Acceptance Theory Framework to capture the user experience. There were 20 participants with a median age of 55.5 (IQR 46.0-60.5) years, 55% (n=11) of them were female, and 85% (n=17) of them were White. In total, 35% (n=7) of them reported having difficulty reading and understanding written medical information. Alcohol was the predominant etiology in 70% (n=14) of users. Participants actively engaged with Lucy LiverBot and identified it as a potential educational tool and device that could act as a social companion to improve well-being. In total, 25% (n=5) of them reported finding it difficult to learn about their health problems and 20% (n=4) of them found it difficult to find medical information they could trust. Qualitative interviews revealed the conversational nature of Lucy LiverBot was considered highly appealing with improvement in mental health and well-being reported as an unintended benefit of Lucy LiverBot. Patients who had been managing their liver cirrhosis for several years identified that they would be less likely to use Lucy LiverBot, but that it would have been more useful at the time of their diagnosis. Overall, Lucy LiverBot was perceived as a reliable and trustworthy source of information. Lucy LiverBot was well received and may be used to improve health literacy and address barriers to health care provision in patients with decompensated CLD. The study revealed important feedback that has been used to further optimize Lucy LiverBot. Further acceptability and validation studies are being undertaken to investigate whether Lucy LiverBot can improve clinical outcomes and health related quality of life in patients with decompensated CLD.

A Streamlined Algorithmic Process for Creating Three-dimensional Printed Forearm Casts.

Three-dimensional (3D) printing is a rapidly evolving field that has found its way into the medical field, providing unsurpassed contributions to the provision of patient-centered care. Its utilization lies in optimizing preoperative planning, the creation and customization of surgical guides and implants, and the designing of models that can be used to augment patient counseling and education. We integrate a simple yet effective method of scanning the forearm using an iPad device with Xkelet software to obtain a 3D printable stereolithography file, which is then incorporated to our suggested algorithmic model for designing a 3D cast, utilizing Rhinocerus design software and Grasshopper plugin. The algorithm implements a stepwise process of retopologizing the mesh, division of the cast model, creating the base surface, applying proper clearance and thickness to the mold, and creating a lightweight structure through the addition of ventilation holes to the surface with a joint connector between the two plates. In our experience, scanning and design of the patient-specific forearm cast using Xkelet and Rhinocerus, alongside implementing an algorithmic model through Grasshopper plugin has dramatically reduced the designing process from 2 to 3 hours to 4-10 minutes, further increasing the number of patient scans that can be sequenced in a short duration. In this article, we introduce a streamlined algorithmic process for the use of 3D scanning and processing software to create forearm casts that are tailored to the patients' dimensions. We emphasize the implementation of computer-aided design software for a quicker and more accurate design process.

Vestibular contribution to path integration deficits in 'at-genetic-risk' for Alzheimer's disease.

Path integration changes may precede a clinical presentation of Alzheimer's disease by several years. Studies to date have focused on how spatial cell changes affect path integration in preclinical AD. However, vestibular input is also critical for intact path integration. Here, we developed the vestibular rotation task that requires individuals to manually point an iPad device in the direction of their starting point following rotational movement, without any visual cues. Vestibular features were derived from the sensor data using feature selection. Machine learning models illustrate that the vestibular features accurately classified Apolipoprotein E ε3ε4 carriers and ε3ε3 carrier controls (mean age 62.7 years), with 65% to 79% accuracy depending on task trial. All machine learning models produced a similar classification accuracy. Our results demonstrate the cross-sectional role of the vestibular system in Alzheimer's disease risk carriers. Future investigations should examine if vestibular functions explain individual phenotypic heterogeneity in path integration among Alzheimer's disease risk carriers.

IPad’s contributed to enhance inclusion of students with visual impairment in public schools

This study aimed to identify the extent iPad’s contributed to enhance inclusion of students with visual impairment (partially) in public schools. The study used the descriptive and analytical approach. The population consisted of (160) students who received iPad device within the “vision project” implemented at UNRWA schools in Gaza strip. The study used a questionnaire prepared and adapted by the researcher, to measure degree of iPad’s contribution to inclusion in general and at three dimensions: academic, psychological, and behavioral. Results showed the level of iPad’s contribution to enhance inclusion among students with visual impairment was high, with an average of 2.70 and a relative weight 90%. Concerning the three dimensions, results showed the academic attained as average of 2.77 with relative weight 88.6%, however in the second dimension (psychological) the mean was 2.98 with relative weight 99.3%, lastly for the third dimension (behavioral), the mean was 2.67 with relative weight 89.0%. This indicated high level of iPad’s contribution to enhance inclusion of students with visual impairment at public schools specifically at UNRWA schools. The study recommended use iPads for best inclusive practices.

Evaluation and refinement of a handheld health information technology tool to support the timely update of bedside visual cues to prevent falls in hospitals.

To evaluate clinicians' perspectives, before and after clinical implementation (i.e. trial) of a handheld health information technology (HIT) tool, incorporating an iPad device and automatically generated visual cues for bedside display, for falls risk assessment and prevention in hospital. This pilot study utilized mixed-methods research with focus group discussions and Likert-scale surveys to elicit clinicians' attitudes. The study was conducted across three phases within two medical wards of the Queen Elizabeth Hospital. Phase 1 (pretrial) involved focus group discussion (five staff) and surveys (48 staff) to elicit preliminary perspectives on tool use, benefits and barriers to use and recommendations for improvement. Phase 2 (tool trial) involved HIT tool implementation on two hospital wards over consecutive 12-week periods. Phase 3 (post-trial) involved focus group discussion (five staff) and surveys (29 staff) following tool implementation, with similar themes as in Phase 1. Qualitative data were evaluated using content analysis, and quantitative data using descriptive statistics and logistic regression analysis, with subgroup analyses on user status (P ≤ 0.05). Four findings emerged on clinicians' experience, positive perceptions, negative perceptions and recommendations for improvement of the tool. Pretrial, clinicians were familiar with using visual cues in hospital falls prevention. They identified potential benefits of the HIT tool in obtaining timely, useful falls risk assessment to improve patient care. During the trial, the wards differed in methods of tool implementation, resulting in lower uptake by clinicians on the subacute ward. Post-trial, clinicians remained supportive for incorporating the tool into clinical practice; however, there were issues with usability and lack of time for tool use. Staff who had not used the tool had less appreciation for it improving their understanding of patients' falls risk factors (odds ratio 0.12), or effectively preventing hospital falls (odds ratio 0.12). Clinicians' recommendations resulted in subsequent technological refinement of the tool, and provision of an additional iPad device for more efficient use. This study adds to the limited pool of knowledge about clinicians' attitudes toward health technology use in falls avoidance. Clinicians were willing to use the HIT tool, and their concerns about its usability were addressed in ongoing tool improvement. Including end-users in the development and refinement processes, as well as having high staff uptake of new technologies, is important in improving their acceptance and usage, and in maximizing beneficial feedback to further inform tool development.

Developing a “Fun Fraction” Website of Virtual Manipulatives and the Effects of Explicit and Systematic Instruction With the Virtual-Representational-Abstract Instructional Sequence for Elementary School Students With Mathematics Difficulties

초등학교 수학부진학생은 분수 곱셈 문장제 문제풀이 기술 및 수학적 추론 능력에서 또래 학생들보다 현저한 어려움을 나타낸다. 본 연구는 2부분으로 구성되었다. <연구 1>의 목적은 수학부진학생을 위한 ‘재미난 분수’ 웹사이트를 개발한 후 사용성 검사를 실시하여, 중재 전에 웹사이트에 대한 타당성을 검토하고자 하는 것이었다. 총 53명의 교육분야 대학생 및 전문가가 사용성 평가에 참여하였고, 정보 및 상호작용 체계에 대한 사용성이 인터페이스 측면보다 높게 평가되었다. <연구 2>의 목적은 초등학교 고학년 수학부진학생 2명을 대상으로 ‘재미난 분수’ 웹을 기반으로 한 가상조작물-반구체물-추상기호의 명시적이고, 순차적인 교수에 대한 중재 효과를 검증하는 것이었다. 기초선과 비교했을 때 중재 구간에서 현우와 민재의 분수 곱셈 문장제 문제풀이 정확도 및 수학적 추론은 유의미하게 증가하였지만(p < .05), 수학적 추론보다는 문제풀이 정확도의 향상 점수가 더 높았다. 대상자간 중다간헐기초선설계의 적용 결과, 민재는 아이패드, 컴퓨터, 모바일 기기를 활용하여 가상조작물을 이용하였을 때 유의미한 중재 효과를 보였고(p < .05), 현우는 컴퓨터와 모바일을 이용하였을 때만 유의미한 중재 효과를 보였다. 평가 질문 유형에 따른 분석 결과, 현우와 민재 모두 연산 문제보다 표상 문제를 어려워하였다. 중재에 대한 사회적 타당도를 평가한 결과, 두 학생 모두 모바일 기기보다는 컴퓨터와 아이패드 기기로 가상조작물을 활용하는 것을 선호하였다. 본 연구의 제한점 및 향후 연구에 관한 제언점을 논의하였다.Elementary school students with mathematics difficulties experience significantly more complications in word problem-solving and mathematical reasoning of multiplying fractions than their peers. This study was conducted in two segments. The purpose of <Study 1> was to develop a “fun fraction” website for these students and test its usability before conducting an intervention. Altogether 53 college students and educational experts participated in the usability testing, rating the website’s instructional and interactive design features higher than its interface design. The purpose of <Study 2> was to investigate the intervention effect of explicit and systematic instruction with the virtual representational-abstract instructional sequence on two students with mathematics difficulties in upper elementary school grades. Although their word problem-solving accuracy and mathematical reasoning of multiplying fractions significantly improved (p < .05), their improvement score in word problem-solving accuracy was higher than mathematical reasoning. As a result of implementing a multiple-probe design across participants, Minjae displayed a significant intervention effect when using virtual manipulatives via an iPad, computer, or mobile device (p < .05), but Hyunwoo demonstrated significant effects only when using a computer or mobile device. Results of evaluation questions revealed that both experienced more difficulty in solving representative problems than arithmetic problems. Both students preferred using computers and iPads to mobile devices. This paper also discussed limitations, recommendations for future research, and educational implications.

Planned Observational Study of Hearing Loss and the Effects of Statin Drugs in Head and Neck Squamous Cell Carcinoma Patients Treated With Chemoradiation

The incidence of hearing loss in head and neck squamous cell carcinoma (HNSCC) patients treated with cisplatin chemoradiation has not been well-established, particularly for low-dose, weekly (40 mg/m2) regimens. Preclinical and retrospective clinical data suggest that statin drugs may partially mitigate cisplatin-induced hearing loss. Barriers to study of hearing loss in cancer patients include limited access to audiology services during the short window of time between cancer diagnosis and initiation of treatment. We hypothesize that a substantial proportion of HNSCC patients treated with low-dose, weekly cisplatin, and concurrent radiation therapy will develop clinically relevant hearing loss, which will be of lower magnitude in patients taking statin drugs for hyperlipidemia. We sought to design an observational study that would facilitate the comparison of pretreatment and posttreatment audiograms on HNSCC patients treated with chemoradiation. Eligible patients will include patients with confirmed HNSCC of the oral cavity, oropharynx, larynx, or hypopharynx for whom definitive or adjuvant chemoradiation with weekly cisplatin is planned. A tympanogram and audiogram will be obtained prior to treatment and at 1 month and 6 months posttreatment. An FDA-approved software will be used with calibrated headphones for self-administered audiograms on a tablet (iPad) device. Medications, including statin drugs, will be tracked throughout treatment. This prospective observational study has been IRB approved, and preliminary results will be presented. Despite lower overall toxicity, low-dose, weekly cisplatin chemoradiation regimens for HNSCC continue to cause clinically significant hearing loss. Information on the incidence and severity of the resulting hearing loss would be helpful for the counseling of patients. Statin drugs have shown promise in preliminary studies as a possible preventive intervention, but prospective clinical data are needed.

A Randomized Trial of a Binocular iPad Game Versus Part-Time Patching in Children Aged 13 to 16 Years With Amblyopia

To compare visual acuity (VA) improvement in teenagers with amblyopia treated with a binocular iPad game vs part-time patching. One hundred participants aged 13 to <17 years (mean 14.3 years) with amblyopia (20/40 to 20/200, mean ∼20/63) resulting from strabismus, anisometropia, or both were enrolled into a randomized clinical trial. Participants were randomly assigned to treatment for 16weeks of either a binocular iPad game prescribed for 1 hour per day (n= 40) or patching of the fellow eye prescribed for 2 hours per day (n= 60). The main outcome measure was change in amblyopic eye VA from baseline to 16weeks. Mean amblyopic eye VA improved from baseline by 3.5 letters (2-sided 95% confidence interval [CI]: 1.3-5.7 letters) in the binocular group and by 6.5 letters (2-sided 95% CI: 4.4-8.5 letters) in the patching group. After adjusting for baseline VA, the difference between the binocular and patching groups was-2.7 letters (95% CI:-5.7 to 0.3 letters, P= .082) or 0.5 lines, favoring patching. In the binocular group, treatment adherence data from the iPad device indicated that only 13% of participants completed >75% of prescribed treatment. In teenagers aged 13 to <17 years, improvement in amblyopic eye VA with the binocular iPad game used in this study was not found to be better than patching, and was possibly worse. Nevertheless, it remains unclear whether the minimal treatment response to binocular treatment was owing to poor treatment adherence or lack of treatment effect.

Recommendations for professional development necessary for iPad integration

With the recent adoptions of 1:1 technology initiatives, such as the iPads in schools, it is urgent to provide appropriate professional development opportunities for teachers to maximize student use of the technology. This study provides vital information on the professional development needs of teachers for initial integration of technology with the iPad device and what is needed beyond the first year to sustain use in classrooms. One hundred and ninety-one teachers from 10 school districts participated in the study. The results of this study indicate that successful professional development occurs when teachers are allowed time to collaborate with colleagues and learn from peers on how they integrated curriculum with the technology. Collaboration with peers and work time was more important to teachers than one-on-one coaching or large group professional development. Teachers also voiced a need for ongoing, differentiated professional development due to the wide range of teacher expertise and learning levels with technology.

An Investigation into the Role of Tablet Devices in Facilitating Collaborative Learning in EFL Language Course

The following paper outlines research concerning the ways in which learners use tablet devices, namely the iPad device, to learn English both in and outside of the classroom and how students’ interdependence and collaborative learning may be fostered by such an approach.&#x0D; &#x0D; The study comprised of 21 Saudi university students at Dammam University, who were provided with the iPad device over a 12-week period. The potential use of the device as a mediating learning tool, in order to develop students’ collaboration and interaction, is discussed with reference to data compiled from students’ learning diaries, focus group interviews, and online log files. &#x0D; &#x0D; The results suggest tablet devices aid learning by providing meaningful opportunities to use the target language in context and encouraging collaborative interaction. The findings also indicate that various types of teacher support, as well as interaction with the teacher and other students, remain necessary alongside tablet-assisted language learning.

The effectiveness of Lee Silverman Voice Treatment therapy issued interactively through an iPad device: A non-inferiority study

Introduction This study compared the differences in recorded speech variables between people treated with conventional ‘in person’ Lee Silverman Voice Treatment (LSVT) and those treated remotely via iPad-based ‘Facetime’. Method Eight participants were selected for the iPad LSVT, and 21 similarly matched subjects were selected from existing data to form the ‘in person’ group. Participants in both groups had diagnosed idiopathic Parkinson’s disease and moderate hypokinetic dysarthria. Eighteen sessions of prescribed LSVT comprising a pre-treatment assessment, 16 treatment sessions, and a six months’ post-treatment assessment were administered for each person. In both groups, pre- and post-treatment assessments were conducted face-to-face. Performance measures were recorded during assessment and treatment. Average measures were determined for all tasks at all time points and a summary outcome variable was composed from across-task performance. Results Non-inferiority testing confirmed that iPad LSVT was non-inferior in treating all LSVT task 3 variables except generating words, with the 90% upper confidence intervals (CI) lying between the non-inferiority margin of ± 2.25 and zero. The iPad was superior in treating the task 3 rainbow reading passage and describing motor task variables with upper and lower 90% CI values being negative. The improvement in the summary outcome variable score was also superior in the iPad group. Discussion Non-inferiority testing implies that the iPad LSVT is non-inferior in treating task three variables when compared to traditional LSVT. The study supports further development of remote delivery solutions involving the Apple iPad and ‘Facetime’ system as a means of improving access to services and the participant’s experience.

Abstract A11: Assessment of family cancer history in a pancreatic cancer clinic: A pilot study of a web-based survey

Abstract Introduction: Approximately 5-10% of pancreatic cancer diagnoses are associated with inherited cancer syndromes and family cancer history assessment is a critical component of identifying these high risk families. We developed and validated a comprehensive web-based family history survey, which collects cancer type and age of diagnosis for first and second degree relatives directly from patients, generating a summary and cancer risk model scores for medical care teams in real-time. We tested feasibility and performance of this tool in an outpatient pancreatic cancer clinic setting. Methods: 161 patients age 18 years and older, with appointments at the University of Michigan Multidisciplinary Pancreatic Tumor Clinic between September 2015 and February 2016 were approached during their clinic visit to complete the web-based survey on an iPad device. Responses were compared to the clinic’s current family history collection method with medical assistants entering data from paper forms into the electronic medical record (EMR) during the intake process. Data completeness, and proportion of patients identified as meeting criteria for genetic referral were compared between the two survey modalities. Results: 92.5% of patients approached agreed to take the iPad survey. Time to complete the survey ranged from 2-50 minutes (mean 12 minutes). Patient ages ranged from 24 to 87 years, with a median age of 64. Patients who were unfamiliar with the iPad technology and/or had difficulty recalling ages of diagnoses of relatives accounted for a greater amount of time taken to complete the survey. Only 6.0% of patients were unable to complete the survey prior to the end of their visit. Of the 128 patients that completed the iPad survey, 82 (64.1%) had a personal history of pancreatic cancer; the remaining 46 (35.9%) presented with a personal or family history suggestive of increased pancreatic cancer risk. Based on clinical criteria for genetic referral for known inherited syndromes related to increased pancreatic cancer risk, we determined that 53.7% of patients with a pancreatic cancer diagnosis met criteria for genetic counseling by iPad survey vs 41.4% by the paper form. Of patients without a pancreatic cancer diagnosis, 23.9% met genetic referral criteria using the iPad tool vs 21.7% using the paper form. Among patients with pancreatic cancer, the most common reasons for meeting high risk criteria were having another family member with pancreatic cancer (12.2%) or having two or more relatives on the same side of the family with cancers associated with increased pancreatic cancer risk (e.g., breast, ovarian, melanoma; 17.1%). Among those without a personal history of pancreatic cancer, the most common reasons for meeting high risk criteria were family history of ovarian cancer (6.5%), and having three or more related family members with the aforementioned cancers (13.0%). Conclusions: Assessment of family history using a web-based tool is feasible, as demonstrated by high participation and completion rates among all age groups. Both iPad and paper surveys identified a significant percentage of patients for genetic referral. Improvements in obtainment of cancer relevant family history and better inclusion of such data in the EMR may play an important role in better screening of high risk individuals for pancreatic and other types of hereditable cancers. Citation Format: Kara Anne Schradle, Heather Gail Cameron, Riya Kumar, Erika Koeppe, Elana Leflein, Cristina Moisa, Matthew Demerath, Elena Martinez Stoffel, Diane M. Simeone.{Authors}. Assessment of family cancer history in a pancreatic cancer clinic: A pilot study of a web-based survey. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2016 May 12-15; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2016;76(24 Suppl):Abstract nr A11.

Understanding Tablet Consumers

This exploratory study surveyed 379 undergraduate students at a southeastern university to investigate the factors that contribute to the consumer ownership of tablets, iPads, and dual adoption of both a tablet and smartphone. It also examines the factors that may predict a consumer’s likelihood to own a tablet in the future, given their current status as a non-owner. The findings consistently demonstrate the importance of perceived tablet usefulness, microblogging social media usage, and computer commerce in affecting tablet, iPad, and dual mobile device ownership.

Building a novel pediatric intensive care iPad handover aid for residents.

There is no consensus on how effective patient handover in the pediatric intensive care unit should occur. Complex patients with rapidly moving clinical trajectories are difficult to summarize and comprehend. We aimed to redesign our current handover instrument to encourage higher-level cognitive interactions, questioning and understanding for pediatric residents. Through an iterative process with five pediatric intensive care unit intensivists, the current hardcopy handover tool was reviewed and compared to other formats published in medical and non-medical domains. Several handover formats on the iPad were created and proposed, but continual feedback from intensive care unit physicians led to a selection, and further revisions were made. A mock handover with completed data fields allowed pediatric residents to provide the final feedback in both a semi-structured group review and a survey with responses on a 1-5 Likert scale (1 = strongly disagree; 2 = disagree; 3 = neither agree or disagree; 4 = agree; 5 = strongly agree). A novel two-axis data grid combining the 'systems' and 'problem list' approach was developed, with read back prompts, and off the shelf applications such as "burn notices". Residents found ease with the organizational format (4.0 ± 0.67 Likert scale response) and the transition to the iPad device (4.3 ± 0.67). Improving physician handovers may be achieved efficiently and economically through physician led iterative processes. Pediatric residents were at ease when the novel handover was combined with newer iPad technologies and applications.

The perceived value of videos in newspapers on iPad

This work sets out to analyse the perceived value of the videos inserted in paid-for editions of tablet newspapers. It is a qualitative investigation centred on a user profile defined by two parameters: regular reading of paid-for journalistic content and familiarisation with the iPad device. The object of this study is the video content inserted in the publication El Mundo in Orbyt. The results demonstrate that the sample subjects find that the videos do not give added journalistic value.

Remote imaging via FaceTime for potential long-distance diagnosis of suspected cardiac structural and shunt anomalies on contrast echocardiography (The RIFLE Study)

Certain cardiac anomalies can be missed by standard transthoracic echocardiography and are usually confirmed through contrast echocardiography, a specialized procedure that warrants supervision by a cardiologist with advanced echo training. However, the maldistribution or lack of echo specialists in certain countries, especially in archipelagic settings, deprives many patients of such procedures and probably contributes to delayed diagnosis and treatment. We wanted to find out whether onsite interpretations of contrast echocardiograms of patients with suspected cardiac anomalies are comparable to offsite readings made via the real-time videoconferencing technology of FaceTime. Contrast echocardiograms done on adults or grown-up patients with suspected cardiac structural or shunt anomalies during a one-year period at the Non-invasive Laboratory of the Philippine Heart Center were included in the study. Using the internet-enabled technology of FaceTime, prerecorded echo videos from DVD files were simultaneously viewed and interpreted by two echocardiographers, with the onsite reader using a TV monitor and offsite reader using an Ipad device. Interpretations were compared with respect to 22 pre-specified echocardiographic paramaters, which included chamber size, presence of defect on color Doppler and contrast study, and final diagnosis. Agreement in echo readings was reported as overall agreement rate (% of congruent readings divided by total number of data points for comparison) and Kappa coefficient. The impact of contrast echocardiography on the final diagnosis at both sites was likewise assessed (accuracy rates for pre- and post-contrast diagnoses, with the official test report as reference standard). Video and audio quality were evaluated using a subjective scoring scale, while internet connection was assessed in terms of lag time to transmission (milliseconds), as well as download and upload speeds (Megabytes per second). Sixty-eight (68) videoconferencing sessions were conducted on patients 37 ± 14 years (62% females). Overall reading agreement rate was 89% (1333 congruent readings out of 1496 data points), with most disagreements arising from chamber size evaluation (left ventricle, left atrium and coronary sinus dimensions). Good concordance (kappa > 0.60) was demonstrated between onsite and offsite readings in 14 of 22 parameters. Accuracy rates were comparable for precontrast onsite (51%) and offsite (54%) readings, with a substantial improvement in post-contrast readings (88% onsite and 79% offsite). Only 11 of 68 sessions (16%) had discordant final diagnoses, most of which consisted of overdiagnosis by the offsite reader. Video (3.6) and audio (3.8) quality scores were high (maximum of 4) for both sites, with acceptable lag time (PING < 250 ms), download (2.1 Mbps) and upload (0.3 Mbps) speeds. Onsite interpretations of contrast echocardiograms are comparable to offsite readings made via real-time videoconferencing, with contrast echocardiography enhancing accuracy of diagnosis at both ends. Moreover, FaceTime was feasible, generating acceptable internet speeds as well as obtaining high audio and video quality scores at both ends of the transaction. These findings suggest a role for tele-echocardiography in long-distance, point-of-care diagnosis of patients with structural or shunt anomalies, especially in areas of the country where echocardiographic expertise is very much lacking.

Selection of Touch Gestures for Children’s Applications: Repeated Experiment to Increase Reliability

This paper discusses the selection of touch gestures for children’s applications. This research investigates the gestures that children aged between 2 to 4 years old can manage on the iPad device. Two experiments were conducted for this research. The first experiment was carried out in United Kingdom. The second experiment was carried out in Malaysia. The two similar experiments were carried out to increase the reliability and refine the result. This study shows that children aged 4 years have no problem using the 7 common gestures found in iPad applications. Some children aged 3 years have problem with two of the gestures. A high percentage of children aged 2 years struggled with the free rotate, drag & drop, pinch and spread gestures. This paper also discusses the Additional Criteria for the use of Gestures, Interface Design Components and Research on Children using iPad and Applications.

Interactive Informed Consent: Randomized Comparison with Paper Consents

Informed consent is the cornerstone of human research subject protection. Many subjects sign consent documents without understanding the study purpose, procedures, risks, benefits, and their rights. Proof of comprehension is not required and rarely obtained. Understanding might improve by using an interactive system with multiple options for hearing, viewing and reading about the study and the consent form at the subject’s own pace with testing and immediate feedback. This prospective randomized study compared the IRB-approved paper ICF for an actual clinical research study with an interactive presentation of the same study and its associated consent form using an iPad device in two populations: clinical research professionals, and patients drawn from a variety of outpatient practice settings. Of the 90 participants, 69 completed the online test and survey questions the day after the session (maximum 36 hours post-session). Among research professionals (n = 14), there was a trend (p = .07) in the direction of iPad subjects testing better on the online test (mean correct = 77%) compared with paper subjects (mean correct = 57%). Among patients (n = 55), iPad subjects had significantly higher test scores than standard paper consent subjects (mean correct = 75% vs 58%, p < .001). For all subjects, the total time spent reviewing the paper consent was 13.2 minutes, significantly less than the average of 22.7 minutes total on the three components to be reviewed using the iPad (introductory video, consent form, interactive quiz). Overall satisfaction and overall enjoyment slightly favored the interactive iPad presentation. This study demonstrates that combining an introductory video, standard consent language, and an interactive quiz on a tablet-based system improves comprehension of research study procedures and risks.