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Health care Experiences of Educated Young Adults With Blindness in the Digital Age: Qualitative Study

Background: The rapid advancement of digital health technologies (DHTs) offers substantial potential for improving healthcare access, yet it simultaneously risks exacerbating existing inequities for marginalized populations. Previous research on the digital divide has often treated individuals with blindness as a homogenous group, primarily focusing on barriers related to digital access and skills. However, less is known about the nuanced experiences of specific subgroups, such as educated and digitally literate young adults. This study focuses on this demographic to understand how their advanced digital capabilities interact with systemic and infrastructural barriers in healthcare. Objective: This qualitative study aimed to explore the lived healthcare experiences of educated young adults with blindness in China, specifically identifying how DHTs simultaneously contribute to their empowerment and exclusion. Methods: Eligible participants were educated young adults with blindness in China (aged 18-30 years, Mandarin speakers, smartphone users, and holding or pursuing higher education). A total of 12 semi-structured interviews were conducted in Mandarin during September 2024. All interviews were audio-recorded and transcribed verbatim. An inductive thematic analysis was employed to interpret the data and identify key themes. Results: Participants’ experiences highlighted an “empowered but excluded” dynamic. Seven key themes emerged, categorized into empowerment and exclusion. Empowerment themes included: (1) digital platforms empowering self-management and healthcare access, where DHTs enabled independent appointment booking and access to comprehensive health information; and (2) digital platforms empowering for finding medical visit companions, facilitating the discovery of companions for physical and emotional support. Exclusion themes comprised: (3) inaccessible online appointment systems, due to non-inclusive designs; (4) inaccessible healthcare environments and information formats, stemming from non-accessible self-service machines and written materials; (5) lack of provider competencies in respecting patient autonomy, as providers often assumed digital incompetence; (6) data privacy and security concerns, heightened by increased digitalization and reliance on assistive tools; and (7) challenges related to the quality and consistency of online companion support, highlighting the limitations of platform-based assistance. Conclusions: Our findings reveal an “empowered but excluded” dynamic: the potential for digital empowerment and enhanced independence is often curtailed by systematic barriers. Addressing this necessitates a multifaceted approach: enhancing technological accessibility through robust standards adherence and inclusive co-design processes; improving healthcare provider competencies in patient-centered care via targeted training; and empowering educated young blind adults by building their capacity for self-determination to achieve equitable healthcare access.

Impact of Digital Interventions on the Treatment Burden of Patients With Chronic Conditions: Systematic Review

Background: Digital interventions can provide cost-effective, quality health care for patients with chronic conditions. Patients with chronic conditions often are burdened by a substantial load of adhering to a treatment regimen and suffer from impacts on their function and well-being. This treatment burden has consequences for treatment adherence and disease outcomes. Digital interventions have the potential to alleviate the burden, but they also may cause new challenges and an increased workload for the patient. Previous reviews have examined digital interventions or treatment burden separately, but there is a lack of systematic reviews on the intersection of digital interventions, treatment burden, and chronic conditions. Objective: This systematic review aimed to evaluate the evidence of how digital interventions impact the treatment burden experienced by people with chronic conditions, and to assess the quality of this evidence. Methods: We searched databases PubMed, Scopus, Web of Science, ACM, PubMed Central, and CINAHL for articles published between January 1, 2013, and June 17, 2025. We included studies that had key topics related to chronic conditions, treatment burden, and digital interventions. A total of 2 reviewers independently screened the articles in 2 stages, extracted data on study design, participant characteristics, intervention type, and treatment burden outcomes from included articles, and assessed their quality using the Critical Appraisal tools from the Joanna Briggs Institute. A convergent integrated approach was used for data synthesis and integration, where quantitative data were converted into qualitative data, and the qualitative and quantitative evidence were analyzed and categorized together. Results: We included 46 relevant studies in total. We categorized the interventions into 4 types: Telehealth, informational resources, self-management tools, and facilitated tools. The results of this study indicate that digital interventions mostly support patients with chronic conditions with their treatment burden, with minor concerns of increasing treatment burden. The main benefits are support with self-management, informational support, and easier ways to contact health care professionals. The main concerns were accessibility issues, time-consuming tools, and causing fear and anxiety. Conclusions: Our findings demonstrate how treatment burden is a relevant concept for future digital health care research and practice. Digital interventions can help patients with their treatment burden by supporting self-management, improving access to health care, improving patients’ experience, and addressing relevant concerns. More research is needed about conditions with low or medium initial treatment burden.

Considerations for Patient Privacy of Large Language Models in Health Care: Scoping Review

Background: The application of large language models (LLMs) in health care holds significant potential for enhancing patient care and advancing medical research. However, the protection of patient privacy remains a critical issue, especially when handling patient health information (PHI). Objective: This scoping review aims to evaluate the adequacy of current approaches and identify areas in need of improvement to ensure robust patient privacy protection in the existing studies about PHI-LLMs within the health care domain. Methods: A search of the literature published from January 1, 2022, to July 20, 2025, was performed on July 20, 2025, using 2 databases (PubMed and Embase). This scoping review focused on the following three research questions: (1) What studies on the development and application of LLMs using PHI currently exist within the health care domain? (2) What patient privacy considerations are addressed in existing PHI-LLMs research, and are these measures sufficient? (3) How can future research on the development and application of LLMs using PHI better protect patient privacy? Studies were included if they focused on the development and application of LLMs within health care using PHI, encompassing activities such as model construction, fine-tuning, optimization, testing, and performance comparison. Eligible literature comprised original research articles written in English. Conversely, studies were excluded if they used publicly available datasets, under the assumption that such data have been adequately deidentified. Additionally, non-English publications, reviews, abstracts, incomplete reports, and preprints were excluded from the review due to the lack of rigorous peer review. Results: This study systematically identified 9823 studies on PHI-LLM and included 464 studies published between 2022 and 2025. Among the 464 studies, (1) a small number of studies neglected ethical review (n=45, 9.7%) and patient informed consent (n=148, 31.9%) during the research process, (2) more than a third of the studies (n=178, 38.4%) failed to report whether to implement effective measures to protect PHI, and (3) there was a significant lack of transparency and comprehensive detail in anonymization and deidentification methods. Conclusions: We propose comprehensive recommendations across 3 phases—study design, implementation, and reporting—to strengthen patient privacy protection and transparency in PHI-LLM. This study emphasizes the urgent need for the development of stricter regulatory frameworks and the adoption of advanced privacy protection technologies to effectively safeguard PHI. It is anticipated that future applications of LLMs in the health care field will achieve a balance between innovation and robust patient privacy protection, thereby enhancing ethical standards and scientific credibility.

Clinical validation of a three-marker methylation panel to detect CIN3+ in vaginal self-samples in the Dutch population-based screening programme

The use of vaginal self-sampling for cervical cancer screening is promising and increasing. However, triage cytology cannot be performed on vaginal self-sampling material after a high-risk human papilloma viru...
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