A protein-based biosensor measures cortisol with high accuracy. Smartphone compatibility makes stress testing more accessible. Cortisol plays a key role in regulating essential body functions such as...

Learn how to turn your smartphone into a health monitor to track heart rate, sleep, and fitness using simple apps and built-in features.

Background: Increasing life expectancy has increased focus on the health-related consequences of aging, such as sarcopenia and frailty. Given the prevalence of these conditions among older individuals and the frequent resulting long-term care needs, early detection and intervention are crucial. Objective: This study aimed to validate a novel smartphone-based system measuring acceleration during the sit-to-stand movement to detect sarcopenia and frailty. Methods: Participants were 587 individuals from the Otassha study cohort who underwent health assessments in 2023, of whom 569 (96.9%) completed 2 supervised sit-to-stand trials while holding a smartphone on the lower abdomen. Sarcopenia and frailty were diagnosed using the Asian Working Group for Sarcopenia 2019 criteria and the revised Japanese Cardiovascular Health Study criteria, respectively. Peak force, rising time (T1), and stabilization time (T2) were extracted from acceleration signals, and reproducibility was examined using the intraclass correlation coefficient (ICC(2,1)). Predictive models were developed using elastic net penalized logistic regression, and model performance was evaluated using 500 bootstrap resamples. Benchmark models using age and sex, walking speed, and grip strength were also constructed for comparison. Results: Sarcopenia and frailty were identified in 16.7% (95/569) and 9% (51/569) of the participants, respectively. Peak force demonstrated excellent reliability (ICC=0.863), whereas T1 and T2 showed lower reproducibility (ICC

Background: Targeting automatic approach tendencies toward alcohol-related stimuli has been shown to significantly reduce relapse rates in patients with alcohol use disorder (AUD) when used as an add-on to inpatient treatment. Traditional approach-avoidance task (AAT) training requires a clinical setting and a stationary device. Objective: A mobile app was tested that allowed the training to be conducted outside a clinical environment while capturing actual motion parameters, such as acceleration. Methods: Three proof-of-concept studies assessed the reliability and validity of the mobile app version of the AAT. Study 1 tested technical stability and measurement reliability in 26 university students across 6 home-based sessions. Study 2 examined approach-avoidance tendencies in 15 inpatients with AUD. Study 3 tested 28 soccer fans to determine the modifiability of alcohol-related biases after 3 or 6 training sessions. Results: The app demonstrated high technical stability and measurement reliability in study 1. In study 2, patients showed faster reaction times (RTs) when pushing away alcohol-related images (avoidance tendency) and greater acceleration when pulling them toward themselves (approach tendency). In study 3, participants also exhibited an RT-based alcohol avoidance bias and a small acceleration-based alcohol approach bias. Training effects were observed for RTs after the test, indicating an increase in alcohol avoidance. An increase in acceleration-based alcohol avoidance was only found in participants with risky alcohol consumption. Conclusions: The mobile app version of the AAT appears to produce reliable measures and might have the potential to effectively modify alcohol-related automatic tendencies. The current study serves as a proof of concept, so all results should be treated as exploratory. Future randomized controlled trials are needed to evaluate the app’s potential to change actual alcohol behavior in nonclinical populations.

Leprosy is endemic in many low-income countries, affecting mainly the poorest communities. The disease can lead to sensorimotor functional losses that can predispose patients to reduced independence. In older adults, these losses associated with leprosy are added to those already resulting from natural aging and associated comorbidities, which can contribute to the clinical picture of frailty syndrome in these older adults. Early detection of frailty can reduce several serious consequences for these individuals, preventing loss of quality of life and financial costs to patients and the health care system. Sensors built into smartphones have been proposed as low-cost, and highly sensitive tools for detecting motor loss and could help monitor the risk of some frailty features in older people affected by leprosy.

Background: Clinical decision support systems (CDSSs) are widely used in various health care settings. In Japan, pressure ulcers are becoming a major concern in an aging society due to their increasing prevalence. However, management is often handled by nonspecialists in wound care due to regional disparities in specialist availability. Objective: To provide support for nonspecialists in wound care, we developed a prototype smartphone-based CDSS for pressure ulcer management. The system prompts users to answer questions about the wound's condition and recommends appropriate ointments and wound dressings by using a safety-first approach. This study aims to evaluate the utility of this system. Methods: We conducted a randomized crossover pilot study involving 28 general internal medicine (GIM) physicians. Participants were randomly assigned to group A (intervention-control) or group B (control-intervention). Participants evaluated 10 standardized pressure ulcer photographs and selected the most appropriate ointment and wound dressing for each. The unit of analysis was the individual response to each question (N=280 total observations). We used generalized estimating equations with an exchangeable correlation structure to account for within-subject clustering and adjust for potential period and sequence effects. Results: The overall correct response rate during the intervention phase was significantly higher than that during the control phase (49.3% vs 4.3%, respectively). After adjusting for clustering and crossover biases, the use of CDSS was associated with a 29.1-fold increase in the odds of a correct response (95% CI 8.2-103; P

Background: Methamphetamine use disorder is a growing public health crisis with limited access to effective treatment. Contingency management (CM) has demonstrated efficacy for stimulant use disorders, but is typically delivered in person. Smartphone-based CM may overcome barriers such as limited access, but its effectiveness and real-world application remain understudied. This study explores patient and clinician experiences with a fully remote, smartphone-based CM intervention for methamphetamine use. Objective: This exploratory, descriptive qualitative study analyzes interviews with patients and clinicians involved in a previously published single-arm trial in which smartphone-based CM was offered to individuals using methamphetamine through primary care or specialty addiction treatment clinics within a large health system. The study aims to identify and describe key facilitators, barriers, and perspectives related to engagement of both groups with the intervention, providing actionable insights to inform optimization and implementation of digital CM in health care settings. Methods: We conducted a qualitative analysis of semistructured interviews with 14 patients and 14 clinicians from a prior pilot study of a fully remote, smartphone-based CM intervention for methamphetamine use. Interviews were analyzed using grounded theory in a 5-step process: transcript review, codebook development, coding, thematic reduction, and generation of overarching themes. The analysis focused on a priori themes related to facilitators, barriers, and suggestions for improvement. Results: Patients and clinicians identified many benefits, viewing the program as valuable for individuals using methamphetamine. Patients appreciated the flexibility, accessibility, and motivational incentives. Clinicians saw CM as a low-risk, evidence-based strategy that could enhance engagement, especially among patients less responsive to traditional approaches. Common challenges included technological issues such as problems with video-based testing, app navigation, and internet access. Patients had mixed views about educational modules and described difficulty with correct substance test procedures and a lack of human connection. Clinicians expressed concerns for patients with significant psychosocial instability. Differences emerged in the types of concerns raised: patients focused on day-to-day engagement, while clinicians emphasized broader themes of equity, sustainability, and a preference for models rewarding improvement even without full abstinence. Conclusions: Smartphone-based CM shows promise for addressing methamphetamine use disorder, especially in settings lacking traditional treatment access. However, optimizing implementation requires addressing challenges related to technology, accessibility, and equity. Recommendations include integrating CM with clinical infrastructure, expanding rewardable behaviors beyond abstinence, enhancing user experience, and improving technological access. Future research should explore flexible models that incorporate broader recovery goals and strengthen both technical and human support.

Background: The widespread adoption of smartphones and tablet devices, along with advancements in data communication technology, has resulted in a paradigm shift in the treatment of dizziness. External factors, such as the spread of #covid19, have accelerated this transformation in recent years. We have been pursuing telemedicine and online medical care for treating dizziness and have developed different products and services necessary for each treatment process stage. Several patients face difficulties in accessing medical facilities during severe vertigo episodes. Furthermore, clinical findings, such as nystagmus or other symptoms, may be absent when symptoms subside by the time of their appointment. Objective: Creating a smartphone application development designed to capture eye movements during vertigo attacks, enabling recordings at any location, including home or work. Methods: We developed an application named “iCapNYS” that leverages the iPhone’s front camera and gyro sensor to record eye movements and head positions. This application uses features that encourage spontaneous eye movements to reduce nystagmus suppression caused by fixation. Additionally, we designed lightweight, recyclable cardboard goggles that would securely hold the smartphone and block ambient light, thereby optimizing the recording conditions. Results: The “iCapNYS” system successfully captured subtle peripheral vestibular nystagmus in a patient with vertigo. The recorded nystagmus characteristics are comparable to those obtained using traditional infrared CCD cameras. Conclusions: This application is an effective tool for treating vertigo and is easy for the elderly to use, as it can be recorded with only three taps. We expect that the introduction of this nystagmus-monitoring system will improve vertigo treatment quality, promote medical collaboration, and provide patients with peace of mind in their care.

Background: The widespread adoption of smartphones and tablet devices, along with advancements in data communication technology, has resulted in a paradigm shift in the treatment of dizziness. External factors, such as the spread of #covid19, have accelerated this transformation in recent years. We have been pursuing telemedicine and online medical care for treating dizziness and have developed different products and services necessary for each treatment process stage. Several patients face difficulties in accessing medical facilities during severe vertigo episodes. Furthermore, clinical findings, such as nystagmus or other symptoms, may be absent when symptoms subside by the time of their appointment. Objective: Creating a smartphone application development designed to capture eye movements during vertigo attacks, enabling recordings at any location, including home or work. Methods: We developed an application named “iCapNYS” that leverages the iPhone’s front camera and gyro sensor to record eye movements and head positions. This application uses features that encourage spontaneous eye movements to reduce nystagmus suppression caused by fixation. Additionally, we designed lightweight, recyclable cardboard goggles that would securely hold the smartphone and block ambient light, thereby optimizing the recording conditions. Results: The “iCapNYS” system successfully captured subtle peripheral vestibular nystagmus in a patient with vertigo. The recorded nystagmus characteristics are comparable to those obtained using traditional infrared CCD cameras. Conclusions: This application is an effective tool for treating vertigo and is easy for the elderly to use, as it can be recorded with only three taps. We expect that the introduction of this nystagmus-monitoring system will improve vertigo treatment quality, promote medical collaboration, and provide patients with peace of mind in their care.

Background: The Timed Up and Go Test (TUG) is recommended as an evidence-based tool for measuring physical capacity. Instrumented TUG (iTUG) approaches expand classical supervised clinical applications offering the potential of self-assessment for older adults. Objective: The objectives of this study were to evaluate the concurrent validity and test-retest reliability of a smartphone-based TUG self-assessment (“up&go app”). Methods: Fifty-two community-dwelling older adults (>67 years) were recruited. A validated and medically certified system attached with a belt at the lower back was used as a reference system to validate the “up&go app” algorithm. The participants repeated the TUG five times wearing (1) a smartphone with the “up&go app” in their front trouser pocket and (2) an inertial sensor to test the concurrent validity. A subsample of 37 participants repeated the “up&go app” measurement two weeks later to examine the test-retest reliability. Results: The correlation between the “up&go app” and the reference measurement was r=0.99 for the total test duration and r=0.97 for the five single repetitions. Agreement between the five repetitions was ICC=0.90 [0.84-0.94]. Leaving out the first repetition, the agreement was ICC=0.95 [0.92-0.97]. Test-retest agreement had an ICC = 0.79 [0.53-0.90]. Conclusions: The duration of five repetitions of the TUG test, measured with the pocket-worn “up&go app”, was very consistent with the results of a lower-back sensor system, indicating excellent concurrent validity. Participants walked slower in the first round compared to the other four repetitions within a test run. Test-retest reliability was also excellent. The “up&go app” provides a useful smartphone-based approach to measure five repetitions of the TUG. The app could be used by older adults as a self-screening and monitoring tool of physical capacity at home and thereby help to early identify functional limitations and take interventions when necessary.

Background: Medical services during disasters primarily rely on organized public and mutual aid systems, such as Disaster Medical Assistance Team These systems have been facing challenges owing to recent reductions in disaster response budgets. The…

In this session, Dr. Courtney Beard, PhD, a clinical psychologist and Associate Professor of Psychology at Harvard Medical School, will present the results o...

RE.DOCTOR Vitals: a cutting-edge remote health monitoring solution that leverages the power of digital biomarkers to detect early signs of diabetes.

Background:Young adults have grown up today with mobile phones as an evident part of their lives. Text neck syndrome and SMS thumb may occur due to repetitive use of hand held devices (HHDs)…