@Article{info:doi/10.2196/med20.2014,
author="Elias, Pierre
and Rajan, O. Nithin
and McArthur, Kara
and Dacso, C. Clifford",
title="InSpire to Promote Lung Assessment in Youth: Evolving the Self-Management Paradigms of Young People With Asthma",
journal="Med 2.0",
year="2013",
month="May",
day="21",
volume="2",
number="1",
pages="e1",
keywords="pediatric asthma",
keywords="chronic disease management",
keywords="mobile phones",
keywords="spirometry",
keywords="gamification",
abstract="Background: Asthma is the most common chronic disease in childhood, disproportionately affecting urban, minority, and disadvantaged children. Individualized care plans supported by daily lung-function monitoring can reduce morbidity and mortality. However, despite 20 years of interventions to increase adherence, only 50\% of US youth accurately follow their care plans, which leads to millions of preventable hospitalizations, emergency room visits, and sick days every year. We present a feasibility study of a novel, user-centered approach to increasing young people's lung-function monitoring and asthma self-care. Promoting Lung Assessment in Youth (PLAY) helps young people become active managers of their asthma through the Web 2.0 principles of participation, cocreation, and information sharing. Specifically, PLAY combines an inexpensive, portable spirometer with the motivational power and convenience of mobile phones and virtual-community gaming. Objective: The objective of this study was to develop and pilot test InSpire, a fully functional interface between a handheld spirometer and an interactive game and individualized asthma-care instant-messaging system housed on a mobile phone. Methods: InSpire is an application for mobile smartphones that creates a compelling world in which youth collaborate with their physicians on managing their asthma. Drawing from design-theory on global timer mechanics and role playing, we incentivized completing spirometry maneuvers by making them an engaging part of a game young people would want to play. The data can be sent wirelessly to health specialists and return care recommendations to patients in real-time. By making it portable and similar to applications normally desired by the target demographic, InSpire is able to seamlessly incorporate asthma management into their lifestyle. Results: We describe the development process of building and testing the InSpire prototype. To our knowledge, the prototype is a first-of-its kind mobile one-stop shop for asthma management. Feasibility testing in children aged 7 to 14 with asthma assessed likability of the graphical user interface as well as young people's interest in our incentivizing system. Nearly 100\% of children surveyed said they would play games like those in PLAY if they involved breathing into a spirometer. Two-thirds said they would prefer PLAY over the spirometer alone, whereas 1/3 would prefer having both. No children said they would prefer the spirometer over PLAY. Conclusions: Previous efforts at home-monitoring of asthma in children have experienced rapid decline in adherence. An inexpensive monitoring technology combined with the computation, interactive communication, and display ability of a mobile phone is a promising approach to sustainable adherence to lung-function monitoring and care plans. An exciting game that redefines the way youth conduct health management by inviting them to collaborate in their health better can be an incentive and a catalyst for more far-reaching goals. ",
doi="10.2196/med20.2014",
url="http://www.medicine20.com/2013/1/e1/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25075232"
}


@Article{info:doi/10.2196/jmir.1987,
author="Nordfeldt, Sam
and {\"A}ngarne-Lindberg, Teresia
and Berter{\"o}, Carina",
title="To Use or Not to Use -- Practitioners' Perceptions of an Open Web Portal for Young Patients With Diabetes",
journal="J Med Internet Res",
year="2012",
month="Nov",
day="09",
volume="14",
number="6",
pages="e154",
keywords="Internet",
keywords="Web 2.0",
keywords="Health knowledge",
keywords="childhood chronic disease",
keywords="health professionals",
keywords="practice",
keywords="attitudes",
keywords="participation",
keywords="type 1 diabetes",
keywords="health information",
keywords="blog",
keywords="discussion forum",
abstract="Background: Health care professionals' attitudes can be a significant factor in their acceptance and efficient use of information technology, so they need to have more knowledge about this resource to enhance their participation. Objective: We explored practitioners' perceptions of using an open-access interactive Web portal tailored to young diabetes type 1 patients and their guardians or significant others. The portal offered discussion forums, blog tools, self-care and treatment information, research updates, and news from local practitioners. Methods: Eighteen professionals who were on pediatric diabetes care teams each wrote an essay on their experience using the portal. For their essays, they were asked to describe two situations, focusing on positive and negative user experiences. The essays were analyzed using qualitative content analysis. Results: Based on our analysis of the respondents essays, we identified three categories that describe perceptions of the Web portal. The first category - to use or not to use - included the different perspectives of the practioners; those who questioned the benefits of using the Web portal or showed some resistance to using it. The frequency of use among the practitioners varied greatly. Some practitioners never used it, while others used it on a daily basis and regularly promoted it to their patients. Some respondents in this category reflected on the benefits of contributing actively to online dialogues. In the second category - information center for everyone -- practitioners embraced the site as a resource for scientifically sound information and advice. As part of their practice, and as a complement to traditional care, practitioners in this category described sending information through the portal to patients and their significant others. Practitioners felt safe recommending the site because they knew that the information provided was generated by other practitioners. They also assumed that their patients benefited from actively using the Web portal at home: peers brought the site to life by exchanging experiences through the discussion forums. In the third category -- developing our practice -- practitioners reflected upon the types of information that should be given to patients and how to give it (ie, during in-person appointments or through the Web portal). They perceived meeting with various professionals at other hospitals to update information on the portal and develop content policies as constructive teamwork. Practitioners expressed interest in reading patients' dialogues online to learn more about their views. They also thought about how they could use the portal to adapt more to patients' needs (eg, creating functions so patients could chat with the diabetes nurses and doctors). Conclusions: Practitioners expressed positive perceptions toward a tailored open Web portal. They suggested that future benefits could be derived from systems that integrate factual information and online dialogues between practitioners and patients (ie, exchanging information for everyone's benefit). ",
doi="10.2196/jmir.1987",
url="http://www.jmir.org/2012/6/e154/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23137767"
}


@Article{info:doi/10.2196/jmir.2002,
author="Ressler, Katz Pamela
and Bradshaw, S. Ylisabyth
and Gualtieri, Lisa
and Chui, Ho Kenneth Kwan",
title="Communicating the Experience of Chronic Pain and Illness Through Blogging",
journal="J Med Internet Res",
year="2012",
month="Oct",
day="23",
volume="14",
number="5",
pages="e143",
keywords="Blogging",
keywords="narrative medicine",
keywords="disease management",
keywords="Internet",
keywords="pain",
keywords="chronic illness",
keywords="survey",
keywords="psychosocial support systems",
keywords="holistic health",
keywords="selfcare",
abstract="Background: Although more individuals are sharing their experiences with chronic pain or illness through blogging (writing an Internet web log), research on the psychosocial effects and motivating factors for initiating and maintaining a blog is lacking. Objective: The objective was to examine via online questionnaire the perceived psychosocial and health benefits of blogging among patients who use this media to communicate their experience of chronic pain or illness. Methods: A 34-item online questionnaire was created, tested, and promoted through online health/disease forums. The survey employed convenience sampling and was open from May 5 to July 2, 2011. Respondents provided information regarding demographics, health condition, initiation and upkeep of blogs, and dynamics of online communication. Qualitative data regarding respondents' blogging experiences, expectations for blogging, and the perceived effects from blogging on the blogger's health, interpersonal relationships, and quality of life were collected in the form of written narrative. Results: Out of 372 respondents who started the survey, 230 completed the entire questionnaire. Demographic data showed survey respondents to be predominantly female (81.8\%) and highly educated (97.2\% > high school education and 39.6\% with graduate school or professional degrees). A wide spectrum of chronic pain and illness diagnoses and comorbidities were represented. Respondents reported that initiating and maintaining an illness blog resulted in increased connection with others, decreased isolation, and provided an opportunity to tell their illness story. Blogging promoted accountability (to self and others) and created opportunities for making meaning and gaining insights from the experience of illness, which nurtured a sense of purpose and furthered their understanding of their illness. Conclusions: Results suggest that blogging about chronic pain and illness may decrease a sense of isolation through the establishment of online connections with others and increases a sense of purpose to help others in similar situations. Further study involving a larger sample size, a wider range of education levels, and respondents with different types and magnitudes of illnesses will be needed to better elucidate the mechanism of the observed associations in this understudied area. ",
doi="10.2196/jmir.2002",
url="http://www.jmir.org/2012/5/e143/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23092747"
}


@Article{info:doi/10.2196/jmir.2034,
author="Feil, G. Edward
and Sprengelmeyer, G. Peter
and Davis, Betsy
and Chamberlain, Patricia",
title="Development and Testing of a Multimedia Internet-Based System for Fidelity and Monitoring of Multidimensional Treatment Foster Care",
journal="J Med Internet Res",
year="2012",
month="Oct",
day="16",
volume="14",
number="5",
pages="e139",
keywords="Mental health",
keywords="fidelity",
keywords="clinical supervision",
keywords="multidimensional treatment foster care",
keywords="multimedia",
abstract="Background: The fields of mental health, child welfare, and juvenile justice are jointly faced with the challenge of reducing the prevalence of antisocial behavior among adolescents. In the last 20 years, conduct disorders have moved from being considered intractable difficulties to having complex but available solutions. The treatments for even long-standing offending behavior among adolescents are now well documented and supported by a growing and compelling body of evidence. These empirically validated interventions are being widely disseminated, but the replication of the results from clinical trials in community settings has yet to be documented. The treatments, which produced impressive effects in a research context, are difficult to replicate without intensive monitoring of fidelity by the developers. Such monitoring is a barrier toward adoption; as the distance between the adopter and developer increases, so does cost. At the same time, states, communities, and agencies are under increasing pressure to implement those intervention services that have been shown to be most effective. The use of the Internet offers a potential solution in that existing reporting and data collection by clinicians can be subject to remote supervision. Such a system would have the potential to provide dissemination teams with more direct access to higher-quality data and would make adopters more likely to be able to implement services at the highest possible conformity to research protocols. Objective: To create and test such an innovative system for use with the Multidimensional Treatment Foster Care (MTFC) program, which is an in-home treatment (alternative to a residential- or group-home setting) for antisocial youths. This research could advance the knowledge base about developing innovative infrastructures in community settings to disseminate empirically validated treatments. Methods: The fidelity system was used and reviewed by parent and professional users: 20 foster parent users of the Parent Daily Report function, 9 professional MTFC program supervisors, and 4 MTFC consultants. All participants rated the system's ease of use, quality of the website, and observational videos recorded at agency meetings. In addition, foster parents entered data on child behavior. Results: All professionals and foster parents rated the system as very easy to use. We found particularly high levels of use by parents. Professionals rated the computer-collected videos of clinical meetings as being of high quality and easily codeable. Conclusions: The project developed a user-friendly and secure Web-based system using state-of-the-art computer-based protocols for recording questionnaire and observational data generated by community-based MTFC staff and foster parents, with positive satisfaction and utilization results. ",
doi="10.2196/jmir.2034",
url="http://www.jmir.org/2012/5/e139/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23073495"
}


@Article{info:doi/10.2196/jmir.1989,
author="Whittaker, Robyn",
title="Issues in mHealth: Findings From Key Informant Interviews",
journal="J Med Internet Res",
year="2012",
month="Oct",
day="02",
volume="14",
number="5",
pages="e129",
keywords="Cellular phone",
keywords="mobile health",
keywords="mobile phone",
abstract="Background: mHealth is enjoying considerable interest and private investment in the United States. A small but growing body of evidence indicates some promise in supporting healthy behavior change and self-management of long-term conditions. The unique benefits mobile phones bring to health initiatives, such as direct access to health information regardless of time or location, may create specific issues for the implementation of such initiatives. Other issues may be shared with general health information technology developments. Objective: To determine the important issues facing the implementation of mHealth from the perspective of those within the US health system and those working in mHealth in the United States. Methods: Semistructured interviews were conducted with 27 key informants from across the health and mHealth sectors in the United States. Interviewees were approached directly following an environmental scan of mHealth in the United States or recommendation by those working in mHealth. Results: The most common issues were privacy and data security, funding, a lack of good examples of the efficacy and cost effectiveness of mHealth in practice, and the need for more high-quality research. The issues are outlined and categorized according to the environment within which they predominantly occur: policy and regulatory environments; the wireless industry; the health system; existing mHealth practice; and research. Conclusions: Many of these issues could be addressed by making the most of the current US health reform environment, developing a strategic and coordinated approach, and seeking to improve mHealth practice. ",
doi="10.2196/jmir.1989",
url="http://www.jmir.org/2012/5/e129/",
url="http://www.ncbi.nlm.nih.gov/pubmed/23032424"
}


@Article{info:doi/10.2196/med20.1996,
author="Moick, Martina
and Terlutter, Ralf",
title="Physicians' Motives for Professional Internet Use and Differences in Attitudes Toward the Internet-Informed Patient, Physician--Patient Communication, and Prescribing Behavior",
journal="Med 2.0",
year="2012",
month="Jul",
day="06",
volume="1",
number="2",
pages="e2",
keywords="Physician",
keywords="Internet use",
keywords="attitude",
keywords="Internet-informed patient",
keywords="communication",
keywords="prescribing behavior",
keywords="physician-patient relationship",
keywords="motivation research",
abstract="Background: Physicians have differing motives for using the Internet and Internet-related services in their professional work. These motives may affect their evaluation of patients who bring with them health-related information from the Internet. Differing motives may also affect physician--patient communication and subsequent prescribing behavior. Objectives: To segment physicians into types based on their motives for using the Internet in connection with professional activities and to analyze how those segments differ in their attitudes in three areas: toward patients who bring along Internet-sourced information; in their own subsequent prescribing behavior; and in their attitudes toward using the Internet to communicate with patients in future. Methods: We surveyed 287 German physicians online from three medical fields. To assess physicians' motives for using the Internet for their professional activities, we asked them to rate their level of agreement with statements on a 7-point scale. Motive statements were reduced to motive dimensions using principal component analysis, and 2-step cluster analysis based on motive dimensions identified different segments of physicians. Several statements assessed agreement or disagreement on a 7-point scale physicians' attitudes toward patients' bringing Internet information to the consultation and their own subsequent prescribing behavior. Further, we asked physicians to indicate on a 7-point scale their valuation of the Internet for physician--patient communication in the future. Data were then subjected to variance and contingency analyses. Results: We identified three motive dimensions for Internet use: (1) being on the cutting edge and for self-expression (Cronbach alpha = .88), (2) efficiency and effectiveness (alpha = .79), and (3) diversity and convenience (alpha = .71). These three factors accounted for 71.4\% of the variance. Based on physicians' motives for using the Internet, four types of physician Internet user were identified: (1) the Internet Advocate (2), Efficiency-Oriented, (3) Internet Critic, and (4) Driven Self-expressionist. Groups differed significantly concerning (1) their attitude toward informed patients in general (F1234 = 9.215, P < .001), (2) perceived improvement in the physician--patient relationship Internet information brings (F1234 = 5.386, P < .001), (3) perceived accuracy of information the patient brings (F1234 = 3.658, P = .01), and (4) perceived amount of time needed to devote to an Internet-informed patient (F1234 = 3.356, P = .02). Physician segments did not differ significantly in reported prescribing behavior (F1234 = 1.910, P = .13). However, attitudes toward using the Internet to communicate with patients in future differed significantly (F1234 = 23.242, P < .001). Conclusions: Based on self-reporting by German physicians of their motives for professional Internet use, we identified four types of Internet users who differ significantly in their attitude toward patients who bring along Internet information and their attitudes toward using the Internet to communicate with patients in future. ",
doi="10.2196/med20.1996",
url="http://www.medicine20.com/2012/2/e2/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25075230"
}


@Article{info:doi/10.2196/jmir.1976,
author="Ahlers-Schmidt, Rose Carolyn
and Chesser, K. Amy
and Paschal, M. Angelia
and Hart, A. Traci
and Williams, S. Katherine
and Yaghmai, Beryl
and Shah-Haque, Sapna",
title="Parent Opinions About Use of Text Messaging for Immunization Reminders",
journal="J Med Internet Res",
year="2012",
month="Jun",
day="06",
volume="14",
number="3",
pages="e83",
keywords="Provider-patient communication",
keywords="child immunizations",
keywords="text message",
abstract="Background: Adherence to childhood immunization schedules is a function of various factors. Given the increased use of technology as a strategy to increase immunization coverage, it is important to investigate how parents perceive different forms of communication, including traditional means and text-message reminders. Objective: To examine current forms of communication about immunization information, parents' satisfaction levels with these communication modes, perceived barriers and benefits to using text messaging, and the ideal content of text messages for immunization reminders. Methods: Structured interviews were developed and approved by two Institutional Review Boards. A convenience sample of 50 parents was recruited from two local pediatric clinics. The study included a demographics questionnaire, the shortened form of the Test of Functional Health Literacy for Adults (S-TOFHLA), questions regarding benefits and barriers of text communication from immunization providers, and preferred content for immunization reminders. Content analyses were performed on responses to barriers, benefits, and preferred content (all Cohen's kappas > 0.70). Results: Respondents were mostly female (45/50, 90\%), white non-Hispanic (31/50, 62\%), between 20--41 years (mean = 29, SD 5), with one or two children (range 1--9). Nearly all (48/50, 96\%) had an S-TOFHLA score in the ``adequate'' range. All parents (50/50, 100\%) engaged in face-to-face contact with their child's physician at appointments, 74\% (37/50) had contact via telephone, and none of the parents (0/50, 0\%) used email or text messages. Most parents were satisfied with the face-to-face (48/50, 96\%) and telephone (28/50, 75\%) communication. Forty-nine of the 50 participants (98\%) were interested in receiving immunization reminders by text message, and all parents (50/50, 100\%) were willing to receive general appointment reminders by text message. Parents made 200 comments regarding text-message reminders. Benefits accounted for 63.5\% of comments (127/200). The remaining 37.5\% (73/200) regarded barriers; however, no barriers could be identified by 26\% of participants (13/50). Parents made 172 comments regarding preferred content of text-message immunization reminders. The most frequently discussed topics were date due (50/172, 29\%), general reminder (26/172, 26\%), and child's name (21/172, 12\%). Conclusions: Most parents were satisfied with traditional communication; however, few had experienced any alternative forms of communication regarding immunizations. Benefits of receiving text messages for immunization reminders far outweighed the barriers identified by parents. Few barriers identified were text specific. Those that were, centered on cost if parents did not have unlimited texting plans. ",
doi="10.2196/jmir.1976",
url="http://www.jmir.org/2012/3/e83/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22683920"
}


@Article{info:doi/10.2196/jmir.1983,
author="Archambault, Michel Patrick
and Bilodeau, Andrea
and Gagnon, Marie-Pierre
and Aubin, Karine
and Lavoie, Andr{\'e}
and Lapointe, Jean
and Poitras, Julien
and Croteau, Sylvain
and Pham-Dinh, Martin
and L{\'e}gar{\'e}, France",
title="Health Care Professionals' Beliefs About Using Wiki-Based Reminders to Promote Best Practices in Trauma Care",
journal="J Med Internet Res",
year="2012",
month="Apr",
day="19",
volume="14",
number="2",
pages="e49",
keywords="Wiki",
keywords="Collaborative writing applications",
keywords="Web 2.0",
keywords="traumatic brain injury",
keywords="interprofessional collaboration",
keywords="reminders",
keywords="computerized clinical decision-support system",
keywords="knowledge translation",
keywords="evidence-based medicine",
keywords="theory of planned behavior",
abstract="Background : Wikis are knowledge translation tools that could help health professionals implement best practices in acute care. Little is known about the factors influencing professionals' use of wikis. Objectives : To identify and compare the beliefs of emergency physicians (EPs) and allied health professionals (AHPs) about using a wiki-based reminder that promotes evidence-based care for traumatic brain injuries. Methods : Drawing on the theory of planned behavior, we conducted semistructured interviews to elicit EPs' and AHPs' beliefs about using a wiki-based reminder. Previous studies suggested a sample of 25 EPs and 25 AHPs. We purposefully selected participants from three trauma centers in Quebec, Canada, to obtain a representative sample. Using univariate analyses, we assessed whether our participants' gender, age, and level of experience were similar to those of all eligible individuals. Participants viewed a video showing a clinician using a wiki-based reminder, and we interviewed participants about their behavioral, control, and normative beliefs---that is, what they saw as advantages, disadvantages, barriers, and facilitators to their use of a reminder, and how they felt important referents would perceive their use of a reminder. Two reviewers independently analyzed the content of the interview transcripts. We considered the 75\% most frequently mentioned beliefs as salient. We retained some less frequently mentioned beliefs as well. Results : Of 66 eligible EPs and 444 eligible AHPs, we invited 55 EPs and 39 AHPs to participate, and 25 EPs and 25 AHPs (15 nurses, 7 respiratory therapists, and 3 pharmacists) accepted. Participating AHPs had more experience than eligible AHPs (mean 14 vs 11 years; P = .04). We noted no other significant differences. Among EPs, the most frequently reported advantage of using a wiki-based reminder was that it refreshes the memory (n = 14); among AHPs, it was that it provides rapid access to protocols (n = 16). Only 2 EPs mentioned a disadvantage (the wiki added stress). The most frequently reported favorable referent was nurses for EPs (n = 16) and EPs for AHPs (n = 19). The most frequently reported unfavorable referents were people resistant to standardized care for EPs (n = 8) and people less comfortable with computers for AHPs (n = 11). The most frequent facilitator for EPs was ease of use (n = 19); for AHPs, it was having a bedside computer (n = 20). EPs' most frequently reported barrier was irregularly updated wiki-based reminders (n = 18); AHPs' was undetermined legal responsibility (n = 10). Conclusions : We identified EPs' and AHPs' salient beliefs about using a wiki-based reminder. We will draw on these beliefs to construct a questionnaire to measure the importance of these determinants to EPs' and AHPs' intention to use a wiki-based reminder promoting evidence-based care for traumatic brain injuries. ",
doi="10.2196/jmir.1983",
url="http://www.jmir.org/2012/2/e49/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22515985"
}


@Article{info:doi/10.2196/jmir.1960,
author="Kadry, Bassam
and Chu, F. Larry
and Kadry, Bayan
and Gammas, Danya
and Macario, Alex",
title="Analysis of 4999 Online Physician Ratings Indicates That Most Patients Give Physicians a Favorable Rating",
journal="J Med Internet Res",
year="2011",
month="Nov",
day="16",
volume="13",
number="4",
pages="e95",
keywords="Doctor ratings",
keywords="patient satisfaction",
keywords="online physician reviews",
keywords="consumer health",
keywords="physician rating",
abstract="Background: Many online physician-rating sites provide patients with information about physicians and allow patients to rate physicians. Understanding what information is available is important given that patients may use this information to choose a physician. Objectives: The goals of this study were to (1) determine the most frequently visited physician-rating websites with user-generated content, (2) evaluate the available information on these websites, and (3) analyze 4999 individual online ratings of physicians. Methods: On October 1, 2010, using Google Trends we identified the 10 most frequently visited online physician-rating sites with user-generated content. We then studied each site to evaluate the available information (eg, board certification, years in practice), the types of rating scales (eg, 1--5, 1--4, 1--100), and dimensions of care (eg, recommend to a friend, waiting room time) used to rate physicians. We analyzed data from 4999 selected physician ratings without identifiers to assess how physicians are rated online. Results: The 10 most commonly visited websites with user-generated content were HealthGrades.com, Vitals.com, Yelp.com, YP.com, RevolutionHealth.com, RateMD.com, Angieslist.com, Checkbook.org, Kudzu.com, and ZocDoc.com. A total of 35 different dimensions of care were rated by patients in the websites, with a median of 4.5 (mean 4.9, SD 2.8, range 1--9) questions per site. Depending on the scale used for each physician-rating website, the average rating was 77 out of 100 for sites using a 100-point scale (SD 11, median 76, range 33--100), 3.84 out of 5 (77\%) for sites using a 5-point scale (SD 0.98, median 4, range 1--5), and 3.1 out of 4 (78\%) for sites using a 4-point scale (SD 0.72, median 3, range 1--4). The percentage of reviews rated ?75 on a 100-point scale was 61.5\% (246/400), ?4 on a 5-point scale was 57.74\% (2078/3599), and ?3 on a 4-point scale was 74.0\% (740/1000). The patient's single overall rating of the physician correlated with the other dimensions of care that were rated by patients for the same physician (Pearson correlation, r = .73, P < .001). Conclusions: Most patients give physicians a favorable rating on online physician-rating sites. A single overall rating to evaluate physicians may be sufficient to assess a patient's opinion of the physician. The optimal content and rating method that is useful to patients when visiting online physician-rating sites deserves further study. Conducting a qualitative analysis to compare the quantitative ratings would help validate the rating instruments used to evaluate physicians. ",
doi="10.2196/jmir.1960",
url="http://www.jmir.org/2011/4/e95/",
url="http://www.ncbi.nlm.nih.gov/pubmed/22088924"
}