Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Wearable Fitbit activity trackers are increasingly being used as outcome measurement tools in research and to inform healthcare decisions. However, the accuracy of these devices has not been systematically evaluated. Objective: To quantify Fitbit device measurement accuracy in controlled and free-living settings. Methods: Electronic searches using PubMed, Embase, CINAHL and SportsDiscus databases with a supplementary Google Scholar search. Original research published in English comparing Fitbit device measurements to a gold- or research-standard criterion in adults living with any health, disease or functional status. Risk of bias was assessed using a modified validation subscale in the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN). We identified and synthesized percent measurement error estimates for Fitbit measures of steps, energy expenditure (EE), sleep, distance and time in activity. Results: 67 studies met the inclusion criteria, with 57 incorporated in the quantitative syntheses. Respectively, 40, 21, 8, 6 and 2 studies included measures of steps, EE, time in activity, sleep and distance. Fitbit devices demonstrated acceptable accuracy in controlled settings (Mean % error: +/-3%) for measures of steps taken at normal, jogging and very slow walking speeds when worn on the torso, wrist and ankle respectively, and acceptable accuracy for measures of EE at rest and during very slow walking and for distance measures at normal walking speeds when worn on the wrist. Notable inaccuracies in controlled settings were underestimations of steps during household or sporting activities (Mean: -35.4%; SD: 20.5%) or when using a walking aid (Mean: -20.9%; SD: 22.4%), and underestimations of EE during inclined ambulation (Mean: -18.7%; SD: 22.2%) and overestimations of EE for walking on flat surfaces (Mean: 16.7%; SD: 31.4%). In free-living settings, Fitbit demonstrated acceptable relative accuracy (Mean % error: +/-10%) compared to a research-standard criterion for measures of daily steps when worn on the torso, as well as measures of time in bed and total EE over 15 days. Notable relative inaccuracies in free-living settings were mean error overestimations varying from 30% to 600% for time spent in light through vigorous activity and underestimation of daily steps in mobility-limited older adults (Mean: -24.3%; SD: 9.0%). Conclusions: Other than measures of steps during typical walking activities and EE at rest and across a number of days, the Fitbit activity trackers reviewed showed limited measurement accuracy in both controlled and free-living settings. Given the current limitations of Fitbit’s measurement accuracy, discretion should be exercised when using these devices as an outcome measurement tool in research or to inform healthcare decisions. Clinical Trial: N/A

In the experience of health professionals, it appears that interacting with peers in the workplace fosters learning and information sharing. Informal groups and networks present good opportunities for information exchange. Communities of practice (CoPs), which have been described by Wenger and others as a type of informal learning organization, have received increasing attention in the health care sector; however, the lack of uniform operating definitions of CoPs has resulted in considerable variation in the structure and function of these groups, making it difficult to evaluate their effectiveness.

Since being identified as a concept for understanding knowledge sharing, management, and creation, communities of practice (CoPs) have become increasingly popular within the health sector. The CoP concept has been used in the business sector for over 20 years, but the use of CoPs in the health sector has been limited in comparison.

Pain is a common cause of disability in osteoarthritis. Duloxetine, a serotonin and norepinephrine reuptake inhibitor (SNRI), has demonstrated analgesic effects in diabetic peripheral neuropathy and fibromyalgia. Considering its central mechanism of action, duloxetine may be effective in other pain states with evidence of central sensitization. Herein, we report the results of a 13-week, randomized, double-blind, placebo-controlled trial of duloxetine (60-120 mg/day) versus placebo in the treatment of knee pain in 231 patients meeting clinical and radiographic criteria for osteoarthritis of the knee. Duloxetine was superior to placebo on the primary efficacy measure (weekly mean 24-h pain scores) beginning at Week 1 and continuing through the treatment period (P < or = .05). There was also a significant improvement in the WOMAC physical functioning subscale and several other secondary outcomes. Adverse-event rates did not differ significantly between treatment groups (49.5% for duloxetine 60-120 mg/day, and 40.8% for placebo).

Background: Patient engagement in research (PEIR) is promoted to improve the relevance and quality of health research, but has little conceptualization derived from empirical data.Objective: To address this issue, we sought to develop an empirically based conceptual framework for meaningful PEIR founded on a patient perspective.Methods: We conducted a qualitative secondary analysis of in‐depth interviews with 18 patient research partners from a research centre‐affiliated patient advisory board. Data analysis involved three phases: identifying the themes, developing a framework and confirming the framework. We coded and organized the data, and abstracted, illustrated, described and explored the emergent themes using thematic analysis. Directed content analysis was conducted to derive concepts from 18 publications related to PEIR to supplement, confirm or refute, and extend the emergent conceptual framework. The framework was reviewed by four patient research partners on our research team.Results: Participants’ experiences of working with researchers were generally positive. Eight themes emerged: procedural requirements, convenience, contributions, support, team interaction, research environment, feel valued and benefits. These themes were interconnected and formed a conceptual framework to explain the phenomenon of meaningful PEIR from a patient perspective. This framework, the PEIR Framework, was endorsed by the patient research partners on our team.Conclusions: The PEIR Framework provides guidance on aspects of PEIR to address for meaningful PEIR. It could be particularly useful when patient‐researcher partnerships are led by researchers with little experience of engaging patients in research.