ABSTRACT
BACKGROUND: Telehealth use has increased considerably in the last years and evidence suggests an overall positive sentiment towards telehealth. Twitter has a wide userbase and can enrich our understanding of telehealth use by users expressing their personal opinions in an unprompted way. This study aimed to explore Twitter users' experiences, perceptions and expectations about telehealth over the last 5 years. METHODS: Mixed-methods study with sequential complementary quantitative and qualitative phases was used for analysis stages comprising (1) a quantitative semiautomated analysis and (2) a qualitative research-led thematic analysis. A machine learning model was used to establish the data set with relevant English language tweets from 1 September 2017 to 1 September 2022 relating to telehealth using predefined search words. Results were integrated at the end. RESULTS: From the initial 237,671 downloaded tweets, 6469 had a relevancy score above 0.8 and were input into Leximancer and 595 were manually analysed. Experiences, perceptions and expectations were categorised into three domains: experience with telehealth consultation, telehealth changes over time and the purpose of the appointment. The most tweeted experience was expectations for telehealth consultation in comparison to in-person consultations. Users mostly mentioned the hope that waiting times for the consultations to start to be less than in-person, more telehealth appointments to be available and telehealth to be cheaper. Perceptions around the use of telehealth in relation to healthcare delivery changes brought about by the COVID-19 pandemic were also expressed. General practitioners were mentioned six times more than other healthcare professionals. CONCLUSION/IMPLICATIONS: This study found that Twitter users expect telehealth services to be better, more affordable and more available than in-person consultations. Users acknowledged the convenience of not having to travel for appointments and the challenges to adapt to telehealth. PATIENT OR PUBLIC CONTRIBUTION: An open data set with 237,671 tweets expressing users' opinions in an unprompted way was used as a source for telehealth service users, caregivers and members of the public experiences, perceptions and expectations of telehealth.
ABSTRACT
BACKGROUND: Atypical cries have been identified in infants with neurological dysfunction. The aim of this study was to conduct a systematic review and meta-analysis to appraise existing evidence for associations between acoustic cry characteristics and neurological dysfunction in infants aged 18 months or less. METHODS: PubMed/MEDLINE, PsycINFO, CINAHL, and Embase were searched for original, peer-reviewed studies published in English reporting cry variables in infants aged 18 months or less with or at risk of neurological dysfunction. Studies without a nonneurologically impaired control sample were excluded. Pooled effect sizes were estimated using standardized mean difference (SMD) and odds ratio (OR). I2 indicated study heterogeneity, and the risk of bias was assessed using the Newcastle-Ottawa Scale. RESULTS: From March 2018 to February 2019, 28,294 studies were retrieved. Eight were meta-analyzed. Infants with or at risk of neurological dysfunction exhibited higher mean (SMD = 0.11 [95% confidence interval, 0.00 to 0.23]) and minimum (SMD = 0.93 [0.64 to 1.23]) fundamental frequency; higher odds of hyperphonation (OR = 13.17 [1.05 to 165.87]), biphonation (OR = 10.62 [1.53 to 73.59]), rise-fall-rise melodies (OR = 4.66 [1.16 to 18.66]), and flat melodies (OR = 4.47 [1.27 to 15.68]); and lower odds of fall-rise-fall melodies (OR = 0.21 [0.05 to 0.83]). CONCLUSIONS: Infants with underlying neuropathology have unique cries characterized by higher fundamental frequency, dysphonation, and atypical melodies, although study heterogeneity and imprecision of effect size estimates limited our interpretation. Assessment of acoustic cry characteristics offers the potential for noninvasive, rapid, point-of-care screening for neurologically high-risk infants.
