Background: Telerehabilitation involves the delivery of rehabilitation services over a distance through communication technologies. In contrast to traditional in-person rehabilitation, telerehabilitation can help overcome barriers including geographic distance and facility use. There is evidence to suggest that telerehabilitation can lead to increased patient engagement and adherence to treatment plans. However, limited research exists on the association of telerehabilitation with adverse events, potentially hindering its broader adoption and use in health care. Objectives: This systematic review of randomized controlled trials aims to summarize existing research on adverse events related to telerehabilitation delivery. Methods: This review was conducted according to the methodological framework outlined by the Joanna Briggs Institute. Studies were identified from MEDLINE ALL, Embase, APA PsycINFO, CENTRAL, and CINAHL. Included studies were randomized controlled trials published between 2013 and 2023, written in English, and had no geographic or delivery mode restrictions. Data extraction used the TIDieR (Template for Intervention Description and Replication) framework, along with authors, publication year, sample size, specific telerehabilitation modes, and the incidence, type, severity, and relatedness of reported adverse events. Methodological quality was assessed using the Cochrane risk of bias tool, and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation tool. Results: Search results identified 9022 references, of which 37 randomized controlled trials met the criteria for inclusion. There were a total of 3166 participants, with a mean age of 57.4 (SD 11.3) years, and 1023 (32.3%) being female participants. Various delivery modes were used, with videoconferencing emerging as the most frequently used method. A total of 201 adverse events were recorded during 65,352 sessions (0.31% or 3.1 per 1000 sessions). These events were predominantly physical (eg, falls and palpitations), nonserious or mild, and not directly attributed to the telerehabilitation intervention. Additionally, 34 (92%) of included studies implemented various safety practices including vital sign monitoring, safety checklists, and scheduled check-ins with study personnel. Conclusions: This review demonstrates that telerehabilitation exhibits a generally safe profile as an alternative to in-person rehabilitation, with most reported adverse events being rare, nonserious or mild, and unrelated to telerehabilitation protocols. However, more extensive research with detailed reporting on adverse event characteristics is needed. Moreover, future research should evaluate the effectiveness of different safety practices and their association with adverse events. An enhanced understanding of potential risks in telerehabilitation can foster broader adoption while ensuring its safe implementation among health care providers and patients.

Background: Chordomas are rare ectodermal bone malignancies derived from transformed notochordal remnants. Histologic variants include conventional (80%–90%), chondroid (5%–15%), and dedifferentiated (2%–8%). Because chordomas are relatively resistant to chemotherapy and radiotherapy, novel targeted agents are needed to expand treatment approaches and improve outcomes. This study analyzes the genomic landscape of chordoma and identifies potential pathogenic and druggable targets.Methods: Eighty‐six tumor samples derived from chordoma patients treated at Massachusetts General Hospital, University of California, Los Angeles, and the University of Miami were included. Tumor specimens were sent for comprehensive molecular profiling using next‐generation sequencing. The most frequently mutated genes were identified and categorized by subtype, and microsatellite instability and programmed death ligand‐1 (PD‐L1) staining were assessed.Results: Histologic subtypes included 70 conventional (81.4%), nine chondroid (10.5%), and seven dedifferentiated chordomas (8.1%). The most common mutations were cyclin‐dependent kinase inhibitor 2A/B (CDKN2A/B) (28 of 86, 33%), low‐density lipoprotein receptor‐related protein 1B (10 of 86, 12%), polybromo‐1 (9 of 86, 11%), and epidermal growth factor receptor (EGFR) (8 of 86, 9%). By subtype, CDKN2A/B mutation was most common in conventional chordoma (24 of 70, 34%), and chondroid chordoma (3 of 9, 33%). CDKN2A/B and EGFR mutations were most common in dedifferentiated chordoma (2/7, 29%). Microsatellite instability was not detected in seven of 69 (10.1%) samples. PD‐L1 staining of tumor and immune cells was scarce, with scores <1 in 38 of 41 (92.7%) and 22 of 25 (88%) patients, respectively.Conclusions: This study provides a robust, high‐dimensional sequencing assessment from 86 chordoma tissue samples and a descriptive overview of the genomic landscape of this rare, difficult to treat malignancy. Future studies should include in vitro assessment of gain and loss of function of frequently altered pathways to validate these findings.

Melanoma is one of the most fatal skin cancers, with rising incidence and mortality worldwide. From diagnosis to treatment, patient experiences often involve anxiety, symptom burden, and limited access to information which profoundly impacts health outcomes. This systematic review aims to identify and analyze major barriers melanoma patients face throughout their healthcare journey. Studies were identified from PubMed, Scopus, Web of Science, Embase, and Cochrane Library, supplemented by manual hand-searching. Eligible studies focused on the experiences of melanoma patients, addressed knowledge gaps and barriers to care throughout the patient journey, and were published in English between 2013 and 2023. Screening and extraction were conducted independently and in duplicate. The methodological quality of the included studies was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Out of 2,257 screened articles, 183 met the inclusion criteria. Studies were categorized into four major themes: intersectionality, treatment, diagnosis/prognosis, and patient/societal burden. Commonly explored subcategories included self-examination, risk factors, and drug efficacy. Melanoma patients experience significant gaps throughout their healthcare journey. Identifying areas of improvement in current practices is the first step toward developing targeted solutions that improve the patient experience and quality of life.

Background Melanoma is one of the most fatal skin cancers, with rising incidence and mortality worldwide. From diagnosis to treatment, patient experiences often involve anxiety, symptom burden, and limited access to information which profoundly impacts the quality of overall patient outcomes. Objective This systematic review aims to identify and analyze major barriers melanoma patients face throughout their healthcare journey. Methods Per PRISMA guidelines, studies were identified from PubMed, Scopus, Web of Science, Embase, and Cochrane Library, supplemented by manual hand-searching. Eligible studies focused on the experiences of melanoma patients within Western healthcare systems, addressed knowledge gaps and barriers to care throughout the patient journey, and were published in English between 2013 and 2023. Screening and extraction were conducted independently and in duplicate. Findings were synthesized based on identified themes. The methodological quality of the included studies was assessed using the GRADE criteria. Results Out of 2,257 screened articles, 183 met the inclusion criteria. Studies were categorized into four major themes: intersectionality, treatment, diagnosis/prognosis, and patient/societal burden. Commonly explored subcategories included self-examination, risk factors, and drug efficacy. This focus was driven by the emergence of novel self-examination interventions and knowledge gaps regarding risk factors and prognosis, particularly in relation to newly introduced immune checkpoint inhibitors and targeted therapies. Conclusions Melanoma patients experience significant gaps throughout their healthcare journey. Identifying areas of improvement in current practices is the first step toward developing targeted solutions that improve the patient experience and quality of life.

BACKGROUND Telerehabilitation involves the delivery of rehabilitation services through communication technologies. In contrast to traditional in-person rehabilitation, telerehabilitation can help overcome barriers including geographic distance and facility use. There is evidence to suggest that telerehabilitation can lead to increased patient engagement and adherence to treatment plans. However, limited research exists on the association of telerehabilitation with adverse events, potentially hindering its broader adoption and utilization in healthcare. OBJECTIVE This systematic review of randomized controlled trials aims to summarize existing research on adverse events related to telerehabilitation delivery. METHODS This review was conducted according to the methodological framework outlined by the Joanna Briggs Institute. Studies were identified from MEDLINE ALL, EMBASE, APA PsycINFO, CENTRAL, and CINAHL. Included studies were randomized controlled trials published between 2013 and 2023, written in English, and had no geographic or delivery mode restrictions. Data extraction utilized the Template for Intervention Description and Replication (TIDieR) framework, along with authors, publication year, sample size, specific telerehabilitation modes, and the incidence, type, severity, and relatedness of reported adverse events. Methodological quality was assessed using the Cochrane risk of bias tool. RESULTS Search results identified 9,022 references, of which 37 randomized controlled trials met the criteria for inclusion. There were a total of 3,166 participants, with a mean age of 57.4 years, and 32.3% being female. Various delivery modes were utilized, with videoconferencing emerging as the most frequently employed method. A total of 201 adverse events were recorded during 65,352 sessions (0.31% or 3.1/1000 sessions). These events were predominantly physical (e.g., falls, palpitations), non-serious/mild, and not directly attributed to the telerehabilitation intervention. Additionally, 92.2% of included studies implemented various safety practices including vital signs monitoring, safety checklists, and scheduled check-ins with study personnel. CONCLUSIONS This review demonstrates that telerehabilitation exhibits a generally safe profile as an alternative to in-person rehabilitation, with most reported adverse events being rare, non-serious/mild, and unrelated to telerehabilitation protocols. However, more extensive research with detailed reporting on adverse events characteristics is needed. Moreover, future research should evaluate the effectiveness of different safety practices and their association with adverse events. An enhanced understanding of potential risks in telerehabilitation can foster broader adoption while ensuring its safe implementation among healthcare providers and patients.