Bibliographic record
Abstract
Ideas and Opinions17 November 2020Connecting With Older Adults via TelemedicineCarrie L. Nieman, MD, MPH and Esther S. Oh, MD, PhDCarrie L. Nieman, MD, MPHJohns Hopkins University School of Medicine and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (C.L.N., E.S.O.) and Esther S. Oh, MD, PhDJohns Hopkins University School of Medicine and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (C.L.N., E.S.O.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-1322 Annals Author Insight Video - Carrie L. Nieman, MD, MPH, and Esther S. Oh, MD, PhD In this video, Carrie L. Nieman, MD, MPH, and Esther S. Oh, MD, PhD, offer additional insight into the article, "Connecting With Older Adults via Telemedicine." (Duration 3:21) SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Routine outpatient visits have rapidly transitioned to telemedicine because of the evolving coronavirus pandemic. In the rush toward telemedicine, our older adults may be at particular risk for missing out or misunderstanding their providers. Hearing loss is almost universal among older adults: Approximately two thirds of persons aged 70 years or older have clinically significant hearing loss (1). Age-related hearing loss occurs gradually and frequently leaves older patients with the sense that their hearing is adequate but that clarity is the issue and others mumble. Clinic-based visits, which are generally face to face in a quiet environment, allow hearing loss ...References1. Lin FR, Thorpe R, Gordon-Salant S, et al. Hearing loss prevalence and risk factors among older adults in the United States. J Gerontol A Biol Sci Med Sci. 2011;66:582-90. [PMID: 21357188] doi:10.1093/gerona/glr002 CrossrefMedlineGoogle Scholar2. Yueh B, Shapiro N, MacLean CH, et al. Screening and management of adult hearing loss in primary care: scientific review. JAMA. 2003;289:1976-85. [PMID: 12697801] CrossrefMedlineGoogle Scholar3. Stronge AJ, Rogers WA, Fisk AD. Human factors considerations in implementing telemedicine systems to accommodate older adults. J Telemed Telecare. 2007;13:1-3. [PMID: 17288650] CrossrefMedlineGoogle Scholar4. Goman AM, Lin FR. Prevalence of hearing loss by severity in the United States. Am J Public Health. 2016;106:1820-2. [PMID: 27552261] doi:10.2105/AJPH.2016.303299 CrossrefMedlineGoogle Scholar5. Martin-Khan M, Wootton R, Gray L. A systematic review of the reliability of screening for cognitive impairment in older adults by use of standardised assessment tools administered via the telephone. J Telemed Telecare. 2010;16:422-8. [PMID: 21030488] doi:10.1258/jtt.2010.100209 CrossrefMedlineGoogle Scholar6. Pendlebury ST, Welch SJ, Cuthbertson FC, et al. Telephone assessment of cognition after transient ischemic attack and stroke: modified telephone interview of cognitive status and telephone Montreal Cognitive Assessment versus face-to-face Montreal Cognitive Assessment and neuropsychological battery. Stroke. 2013;44:227-9. [PMID: 23138443] doi:10.1161/STROKEAHA.112.673384 CrossrefMedlineGoogle Scholar7. Swenor BK, Ramulu PY, Willis JR, et al. The prevalence of concurrent hearing and vision impairment in the United States [Letter]. JAMA Intern Med. 2013;173:312-3. [PMID: 23338042] doi:10.1001/jamainternmed.2013.1880 CrossrefMedlineGoogle Scholar8. Anderson M, Perrin A. Tech adoption climbs among older adults. 17 May 2017. Accessed at www.pewresearch.org/internet/2017/05/17/tech-adoption-climbs-among-older-adults on 25 March 2020. Google Scholar9. Nieman CL, Marrone N, Szanton SL, et al. Racial/ethnic and socioeconomic disparities in hearing health care among older Americans. J Aging Health. 2016;28:68-94. [PMID: 25953816] doi:10.1177/0898264315585505 CrossrefMedlineGoogle Scholar10. Mamo SK, Nieman CL, Lin FR. Prevalence of untreated hearing loss by income among older adults in the United States. J Health Care Poor Underserved. 2016;27:1812-1818. [PMID: 27818440] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Johns Hopkins University School of Medicine and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (C.L.N., E.S.O.)Grant Support: In part by funding from the National Institutes of Health (NIA K23AG059900 [Dr. Nieman] and NIA R01AG057725 [Dr. Oh]) and the Roberts Family Fund (Dr. Oh).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-1322.Corresponding Author: Carrie L. Nieman, MD, MPH, Cochlear Center for Hearing & Public Health, Johns Hopkins Bloomberg School of Public Health, 2024 East Monument Street, Suite 2-700, Baltimore, MD 21205; e-mail, [email protected]edu.Current Author Addresses: Dr. Nieman: Cochlear Center for Hearing & Public Health, Johns Hopkins Bloomberg School of Public Health, 2024 East Monument Street, Suite 2-700, Baltimore, MD 21205.Dr. Oh: Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, Room 1B.76, Baltimore, MD 21224.Author Contributions: Conception and design: C.L. Nieman, E.S. Oh.Drafting of the article: C.L. Nieman, E.S. Oh.Critical revision of the article for important intellectual content: C.L. Nieman, E.S. Oh.Final approval of the article: C.L. Nieman, E.S. Oh.Administrative, technical, or logistic support: C.L. Nieman.This article was published at Annals.org on 11 August 2020. PreviousarticleNextarticle Advertisement Annals Author Insight Video - Carrie L. Nieman, MD, MPH, and Esther S. Oh, MD, PhD In this video, Carrie L. Nieman, MD, MPH, and Esther S. Oh, MD, PhD, offer additional insight into the article, "Connecting With Older Adults via Telemedicine." 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ResponseConsulta telemática de cardiología para ancianos. La regla de las 5 M puede ser una ayuda. RespuestaHearing LossCarrie L. Nieman, MD, MPH and Esther S. Oh, MD, PhD 17 November 2020Volume 173, Issue 10Page: 831-832KeywordsCognitive impairmentComputersDisclosureElderlyGeriatricsHearingInternetPrevention, policy, and public healthTelemedicineVision ePublished: 11 August 2020 Issue Published: 17 November 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.004 | 0.005 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.174 | 0.057 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".