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BACKGROUND: Smartphones are often equipped with inertial sensors that measure individuals' physical activity (PA). However, their role in remote monitoring of the patients' PAs in telemedicine needs to be adequately explored.OBJECTIVE: This study aimed to explore the correlation between a participant's actual daily step counts and the daily step counts reported by their smartphone. In addition, we inquired about the usability of smartphones for collecting PA data.METHODS: This prospective observational study was conducted among patients undergoing lower limb orthopedic surgery and a group of nonpatients as control. The data from the patients were collected from 2 weeks before surgery until 4 weeks after the surgery, whereas the data collection period for the nonpatients was 2 weeks. The participant's daily step count was recorded by PA trackers worn 24/7. In addition, a smartphone app collected the number of daily steps registered by the participants' smartphones. We compared the cross-correlation between the daily steps time series obtained from the smartphones and PA trackers in different groups of participants. We also used mixed modeling to estimate the total number of steps, using smartphone step counts and the characteristics of the patients as independent variables. The System Usability Scale was used to evaluate the participants' experience with the smartphone app and the PA tracker.RESULTS: Overall, 1067 days of data were collected from 21 patients (n=11, 52% female patients) and 10 nonpatients (n=6, 60% female patients). The median cross-correlation coefficient on the same day was 0.70 (IQR 0.53-0.83). The correlation in the nonpatient group was slightly higher than that in the patient group (median 0.74, IQR 0.60-0.90 and median 0.69, IQR 0.52-0.81, respectively). The likelihood ratio tests on the models fitted by mixed effects methods demonstrated that the smartphone step count was positively correlated with the PA tracker's total number of steps (χ 2 1=34.7, PCONCLUSIONS: Considering the ubiquity, convenience, and practicality of smartphones, the high correlation between the smartphones and the total daily step count time series highlights the potential usefulness of smartphones in detecting changes in the number of steps in remote monitoring of a patient's PA.

Objective This study aimed to develop a clinical decision-support tool (The MAP-Knee Tool) to improve the management of adolescents with non-traumatic knee pain.Methods This multi-step study consisted of five steps ((1-4) initial development and (5) end-user testing with adolescents with or without non-traumatic knee pain and medical doctors). It ended with the first version of the MAP-Knee Tool for the six most common non-traumatic knee pain conditions. The tool includes four components: 1) tool for diagnosing, 2) credible explanations of the diagnoses based on two systematic literature searches and an Argumentative Delphi process with international experts, 3) prognostic factors based on an individual participant data meta-analysis, and 4) option grid including an unbiased presentation of management options based on the available evidence.Results We included seven children/adolescents (8-15 years old) and seven medical doctors for the end-user testing. All four components were revised accordingly, and the text was condensed as the initial draft was too comprehensive.Conclusion We developed a clinical decision-support tool for clinicians and adolescents with non-traumatic knee pain to support the consultation in clinical practice. ObjectiveThis study aimed to develop a clinical decision-support tool (The MAP-Knee Tool) to improve the management of adolescents with non-traumatic knee pain. MethodsThis multi-step study consisted of five steps ((1-4) initial development and (5) end-user testing with adolescents with or without non-traumatic knee pain and medical doctors). It ended with the first version of the MAP-Knee Tool for the six most common non-traumatic knee pain conditions. The tool includes four components: 1) tool for diagnosing, 2) credible explanations of the diagnoses based on two systematic literature searches and an Argumentative Delphi process with international experts, 3) prognostic factors based on an individual participant data meta-analysis, and 4) option grid including an unbiased presentation of management options based on the available evidence. ResultsWe included seven children/adolescents (8-15 years old) and seven medical doctors for the end-user testing. All four components were revised accordingly, and the text was condensed as the initial draft was too comprehensive. ConclusionWe developed a clinical decision-support tool for clinicians and adolescents with non-traumatic knee pain to support the consultation in clinical practice. Practice ImplicationsThe tool targets clinicians and adolescents with four components that may decrease diagnostic uncertainty and increase shared decision-making.

The objective of this scoping review is to identify and map the extent of peer-reviewed literature within intramedullary nails and the results of their use on the physis.