JMIR Research Protocols

Micronutrient deficiencies, particularly of vitamin D, vitamin B12, and folate, are increasingly recognized as important, yet underexplored contributors to adverse outcomes in oncology care. These micronutrients are essential for immune regulation, DNA synthesis and repair, cell proliferation, and metabolic homeostasis, all of which are frequently disrupted in patients with cancer. Deficiencies may arise due to cancer-related metabolic changes, malabsorption, anorexia, and treatment-related toxicities, potentially influencing therapeutic response, treatment tolerance, survival, and quality of life. Despite growing evidence, findings remain fragmented across cancer types, treatment modalities, and geographical settings.

Cochlear implantation (CI) is a highly effective intervention for adults with severe-to-profound hearing loss, yet uptake across the United Kingdom remains low despite clear National Institute for Health and Care Excellence (NICE 2019) guidance and well-established clinical benefits. The original Cochlear Implant Referral Criteria Audit (CIRCA-1) identified marked inequities in access to CIs in 2022, with lower referral rates among older adults, males, and individuals from socioeconomically deprived areas, alongside individuals from minority ethnic backgrounds being less likely to be informed of their eligibility for referral. Since then, national awareness initiatives and the expansion of the existing local “CI Champions” scheme have aimed to address these inequities, improve awareness of CI candidacy, and improve the quality of discussions with patients about options for CI referral. This repeat assessment aims to assess the success of these interventions to identify improvements in access to CIs as well as persisting barriers.

Recurrent infections are a common concern in pediatric practice and may prompt evaluation for an underlying inborn error of immunity, particularly when infections are severe, persistent, unusual, or recurrent. Recurrent sinopulmonary infections such as pneumonia, sinusitis, and otitis media may indicate a humoral immune defect, as antibody deficiencies are among the most common inborn errors of immunity. Laboratory tests typically include measurement of serum immunoglobulins (immunoglobulin G [IgG], immunoglobulin A [IgA], and immunoglobulin M [IgM]) and IgG subclasses (IgG1, IgG2, IgG3, and IgG4), assessment of vaccine-specific antibody responses, and enumeration of B-cell subsets. Together, these tests assess the quantitative and functional components of humoral immunity. However, pediatric reference intervals for these immunological parameters have not been established in Malaysia.

Older patients with metastatic colorectal cancer (mCRC) are a heterogeneous population with wide variability in functional status, frailty, cognition, nutritional reserve, and comorbidity burden. Treatment decisions are often guided primarily by chronological age and performance status, which may not adequately capture vulnerability or patient-centered outcomes in this population.

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder characterized by impairments in social communication, restricted and repetitive behaviors, and deficits across multiple developmental domains. Although conventional interventions, including speech, behavioral, and occupational therapies, improve functional outcomes, many children continue to experience persistent cognitive and adaptive impairments. Ayurvedic formulations such as and possess neuroprotective, anti-inflammatory, antioxidant, and cognition-enhancing properties, but robust clinical evidence supporting their adjunctive use in ASD is limited.

Standardized metrics such as the numeric rating scale (NRS) provide essential quantitative pain benchmarks but can be augmented by capturing the functional and emotional context of a patient’s lived experience. Adding surveys creates a “contextual disconnect” (increasing data yield with diminishing insights) and adds patient burden. The CONNECT (Collecting Communication Data to Enhance Patient-Physician Interaction) study proposes a structured, multimodal framework integrating patient narratives, drawings, and mobility assessments to capture each patient’s holistic “pain story” and create a comprehensive ground truth dataset for developing digital health tools.

Existing adolescent pregnancy prevention programs have demonstrated modest effects. Evaluation is needed for interventions aimed at improving intermediary outcomes linked to behaviors associated with adolescent pregnancy prevention, including intentions, communication skills, decision-making skills, access to information, and supportive adult relationships. These intermediary outcomes often serve as mechanisms that decrease sexual behaviors associated with unintended pregnancy and sexually transmitted infection risk and enhance understanding of how interventions influence behavior. The US federal government announced a funding cycle aimed at assessing innovative programs for underserved youth. As 1 of the 12 grantees, we will evaluate Using the Connect (UTC), a novel game-based learning intervention offering opportunities to improve participants’ intention to delay sex, skills related to communication, decision-making, and accessing information, and strengthen their connection to a trusted adult.

Antimicrobial resistance poses a growing threat to patient safety worldwide. Nurses are central to antimicrobial management; however, their contribution to formal antimicrobial stewardship (AMS) programs remains poorly characterized. To our knowledge, no previous review has combined evidence on the effectiveness and implementation of nurse-led and nurse-involved AMS interventions, including Gulf Cooperation Council and Middle East and North Africa (GCC/MENA) subgroup analysis.

Stroke is the second leading cause of death worldwide. Cerebrovascular diseases (CVDs), including strokes and transient ischemic attacks (TIAs), cause long-term disabilities and economic burdens. Strokes can be ischemic, caused by blood clots; or hemorrhagic, caused by bleeding in the brain. Immediate diagnosis and treatment are crucial. Proper management of TIAs is essential due to the high risk of subsequent strokes. Currently, wearable sensors, AI-based prediction, and automatic video analysis are not used in CVD diagnosis and recovery estimation.

Chronic pain is a leading cause of disability and requires multidimensional assessment of pain intensity and functioning, yet electronic health records rarely capture these measures systematically. By contrast, surveys collecting patient-reported outcomes can assess pain over multiple dimensions but remain resource-intensive and difficult to scale for continuous population-level monitoring.

Attention-deficit/hyperactivity disorder (ADHD) affects over 366 million adults and 139 million children worldwide, yet diagnosis remains fundamentally subjective, relying on clinical interviews, behavioral observations, and rating scales that yield inconsistent results across practitioners and settings. Artificial intelligence (AI), machine learning (ML), and deep learning (DL) offer a paradigm shift toward objective, data-driven diagnosis by detecting complex patterns across neuroimaging, electrophysiology, and digital biomarkers that elude conventional assessment. Although AI-based ADHD research has grown exponentially, no comprehensive synthesis examines the full spectrum of data modalities, validation practices, and clinical translation readiness. This gap limits our understanding of which approaches are most promising for real-world implementation.

Despite advances in HIV treatment, many people living with HIV fail to achieve or maintain viral suppression. Individuals who experience interruptions in HIV care, adherence challenges, and viral nonsuppression are often underrepresented in clinic-based cohort studies. Virtual cohort methodologies offer opportunities to recruit, engage, and retain these populations while integrating longitudinal behavioral, biomarker, and digital engagement data needed to characterize dynamic changes in HIV care engagement and viral suppression.