Use of Tablets and Smartphones to Support Medical Decision Making in US Adults: Cross-Sectional Study.

BACKGROUND: Tablet and smartphone ownership have increased among US adults over the past decade. However, the degree to which people use mobile devices to help them make medical decisions remains unclear. OBJECTIVE: The objective of this study is to explore factors associated with self-reported use of tablets or smartphones to support medical decision making in a nationally representative sample of US adults. METHODS: Cross-sectional data from participants in the 2018 Health Information National Trends Survey (HINTS 5, Cycle 2) were evaluated. There were 3504 responses in the full HINTS 5 Cycle 2 data set; 2321 remained after eliminating respondents who did not have complete data for all the variables of interest. The primary outcome was use of a tablet or smartphone to help make a decision about how to treat an illness or condition. Sociodemographic factors including gender, race/ethnicity, and education were evaluated. Additionally, mobile health (mHealth)- and electronic health (eHealth)-related factors were evaluated including (1) the presence of health and wellness apps on a tablet or smartphone, (2) use of electronic devices other than tablets and smartphones to monitor health (eg, Fitbit, blood glucose monitor, and blood pressure monitor), and (3) whether people shared health information from an electronic monitoring device or smartphone with a health professional within the last 12 months. Descriptive and inferential statistics were conducted using SAS version 9.4. Weighted population estimates and standard errors, univariate odds ratios, and 95% CIs were calculated, comparing respondents who used tablets or smartphones to help make medical decisions (n=944) with those who did not (n=1377), separately for each factor. Factors of interest with a P value of <.10 were included in a subsequent multivariable logistic regression model. RESULTS: Compared with women, men had lower odds of reporting that a tablet or smartphone helped them make a medical decision. Respondents aged 75 and older also had lower odds of using a tablet or smartphone compared with younger respondents aged 18-34. By contrast, those who had health and wellness apps on tablets or smartphones, used other electronic devices to monitor health, and shared information from devices or smartphones with health care professionals had higher odds of reporting that tablets or smartphones helped them make a medical decision, compared with those who did not. CONCLUSIONS: A limitation of this research is that information was not available regarding the specific health condition for which a tablet or smartphone helped people make a decision or the type of decision made (eg, surgery, medication changes). In US adults, mHealth and eHealth use, and also certain sociodemographic factors are associated with using tablets or smartphones to support medical decision making. Findings from this study may inform future mHealth and other digital health interventions designed to support medical decision making.

Are vitamin D levels affected by acute bacterial infections in children?

AIMS: Vitamin D deficiency is associated with infectious diseases; however, it is not known whether vitamin D levels are affected by acute infection. Our aim was to establish whether 25-hydroxyvitamin D (25OHD) levels taken during an acute bacterial infection are representative of baseline levels. METHODS: Thirty children between 6 months and 15 years of age with proven bacterial infections presenting to a tertiary paediatric referral centre had 25OHD levels taken during their acute infection and again 1 month later provided that they had recovered from their infection, had no subsequent infections and had not been taking vitamin supplements. 25OHD levels were measured by liquid chromatography mass spectrometry. RESULTS: Mean 25OHD at enrolment was 67.5 nmol/L (standard deviation (SD) 22.0), and mean 25OHD at 1 month follow up was 72.7 nmol/L (SD 25.8) (paired t-test P = 0.25). C-reactive protein levels were recorded in 29/30 patients at enrolment (mean 85.1 mg/L, SD 83.5) and 25/30 patients at follow-up (mean 4.0 mg/L, SD 3.3) (paired t-test P = 0.002). The ethnicity of the participants was New Zealand European or European Other, 26; Samoan, 2; Maori, 1; and Chinese, 1. CONCLUSIONS: In children, 25OHD levels are not affected by acute bacterial infections; 25OHD levels taken during acute bacterial infection are representative of baseline levels. 25OHD levels collected during acute bacterial infection provide reliable information for case-control studies.