The Potential of Clinical Decision Support Systems for Prevention, Diagnosis, and Monitoring of Allergic Diseases.

Clinical decision support systems (CDSS) aid health care professionals (HCP) in evaluating large sets of information and taking informed decisions during their clinical routine. CDSS are becoming particularly important in the perspective of precision medicine, when HCP need to consider growing amounts of data to create precise patient profiles for personalized diagnosis, treatment and outcome monitoring. In allergy care, several CDSS are being developed and investigated, mainly for respiratory allergic diseases. Although the proposed solutions address different stakeholders, the majority aims at facilitating evidence-based and shared decision-making, incorporating guidelines, and real-time clinical data. We offer here an overview on existing tools, new developments and novel concepts and discuss the potential of digital CDSS in improving prevention, diagnosis and monitoring of allergic diseases.

Evidence on User-Led Innovation in Diabetes Technology (The OPEN Project): Protocol for a Mixed Methods Study.

BACKGROUND: Digital innovations in health care have traditionally followed a top-down pathway, with manufacturers leading the design and production of technology-enabled solutions and those living with chronic conditions involved only as passive recipients of the end product. However, user-driven open-source initiatives in health care are becoming increasingly popular. An example is the growing movement of people with diabetes, who create their own "Do-It-Yourself Artificial Pancreas Systems" (DIYAPS). OBJECTIVE: The overall aim of this study is to establish the empirical evidence base for the clinical effectiveness and quality-of-life benefits of DIYAPS and identify the challenges and possible solutions to enable their wider diffusion. METHODS: A research program comprising 5 work packages will examine the outcomes and potential for scaling up DIYAPS solutions. Quantitative and qualitative methodologies will be used to examine clinical and self-reported outcome measures of DIYAPS users. The majority of members of the research team live with type 1 diabetes and are active DIYAPS users, making Outcomes of Patients' Evidence With Novel, Do-It-Yourself Artificial Pancreas Technology (OPEN) a unique, user-driven research project. RESULTS: This project has received funding from the European Commission's Horizon 2020 Research and Innovation Program, under the Marie Sklodowska-Curie Action Research and Innovation Staff Exchange. Researchers with both academic and nonacademic backgrounds have been recruited to formulate research questions, drive the research process, and disseminate ongoing findings back to the DIYAPS community and other stakeholders. CONCLUSIONS: The OPEN project is unique in that it is a truly patient- and user-led research project, which brings together an international, interdisciplinary, and intersectoral research group, comprising health care professionals, technical developers, biomedical and social scientists, the majority of whom are also living with diabetes. Thus, it directly addresses the core research and user needs of the DIYAPS movement. As a new model of cooperation, it will highlight how researchers in academia, industry, and the patient community can create patient-centric innovation and reduce disease burden together. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/15368.

Using temporally aligned event-related potentials for the investigation of attention shifts prior to and during saccades.

According to the pre-motor theory of attention, attention is shifted to a saccade's landing position before the saccade is executed. Such pre-saccadic attention shifts are usually studied in psychophysical dual-task conditions, with a target-discrimination task before saccade onset. Here, we present a novel approach to investigate pre-saccadic attention shifts with the help of event-related potentials (ERPs). Participants executed one or two saccades to color-defined targets while ERPs and eye-movements were recorded. In single-target blocks participants executed a single saccade. In two-targets blocks participants made either a single saccade to one of the targets, or two successive saccades to both targets. Importantly, in two-targets blocks, targets could appear on the same or on opposite sides of the vertical midline. This allowed us to study contra-to-ipsilateral ERP differences (such as the N2pc or PCN) that reflect attention shifts to the targets, prior to saccade onset and during saccades. If pre-saccadic attention shifts to saccade target locations are necessary for saccade execution and if searched-for saccade targets capture attention, there should be enhanced attentional competition (1) between two targets compared to single targets; (2) between two opposite-sides targets compared to two same-side targets; and (3) in two saccades rather than one saccade conditions: More attentional competition was expected to delay saccade latency and to weaken pre-saccadic laterality effects in ERPs. Hypotheses were tested by means of temporally aligned ERPs that were simultaneously time-locked to stimulus onsets, saccade onsets, and saccade offsets. Predictions (1) and (2) were partly and fully confirmed, respectively, but no evidence was found for (3). We explain the implications of our results for the role of attention during saccade preparation, and we point out how temporally aligned ERPs compare to ICA-based electroencephalogram (EEG) artifact correction procedures and to psychophysical dual-task approaches.