Mobile and tablet apps, ubiquitous and pervasive computing, wearable computing and domotics for health.

There are limited data on racial and ethnic disparities related to quality of life (QoL) and health literacy in adults with multiple cardiac conditions. This article evaluates the relationship between health literacy and QoL among patients with cardiac conditions in a multiethnic community in New York City.

Background: The Palliative Performance Scale (PPS) has been widely used for survival prediction among patients with cancer; however, few studies have reviewed PPS scores in heterogeneous palliative care populations across multiple care settings. Objective: The aim of this systematic review was to determine how the PPS tool has been used to estimate survival at the end of life. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, and the Cochrane Library were searched for the existing literature published from 2008 to 2017. We synthesized study characteristics, the PPS scores at baseline, and primary outcomes, and explored differences in survival estimates by diagnosis. The quality of the studies was assessed using the Good ReseArch for Comparative Effectiveness (GRACE) checklist. Results: Seventeen studies were included in this review (nine with cancer and eight with mixed diagnoses). All included studies reported that the PPS exhibited a significant association with survival. Survival estimates ranged from 1 to 3 days for patients with PPS scores of 10% compared with 5 to 36 days for those with scores of 30%. The categorical cut-points for the PPS scores were not consistently reported across studies. Conclusion: This review provides a broad overview on the prognostic value of the PPS tool for survival among multiple patient populations across care settings. Consistent reporting of PPS scores would facilitate the comparison of survival estimates across end-of-life diagnoses.

Patients increasingly use patient-reported outcomes (PROs) to self-monitor their health status. Visualizing PROs longitudinally (over time) could help patients interpret and contextualize their PROs. The study sought to assess hospitalized patients' objective comprehension (primary outcome) of text-only, non-graph, and graph visualizations that display longitudinal PROs. We conducted a clinical research study in 40 hospitalized patients comparing 4 visualization conditions: (1) text-only, (2) text plus visual analogy, (3) text plus number line, and (4) text plus line graph. Each participant viewed every condition, and we used counterbalancing (systematic randomization) to control for potential order effects. We assessed objective comprehension using the International Organization for Standardization protocol. Secondary outcomes included response times, preferences, risk perceptions, and behavioral intentions. Overall, 63% correctly comprehended the text-only condition and 60% comprehended the line graph condition, compared with 83% for the visual analogy and 70% for the number line (P = .05) conditions. Participants comprehended the visual analogy significantly better than the text-only (P = .02) and line graph (P = .02) conditions. Of participants who comprehended at least 1 condition, 14% preferred a condition that they did not comprehend. Low comprehension was associated with worse cognition (P < .001), lower education level (P = .02), and fewer financial resources (P = .03). The results support using visual analogies rather than text to display longitudinal PROs but caution against relying on graphs, which is consistent with the known high prevalence of inadequate graph literacy. The discrepancies between comprehension and preferences suggest factors other than comprehension influence preferences, and that future researchers should assess comprehension rather than preferences to guide presentation decisions.