JMIR Research Protocols

Quality indicators in primary care remain predominantly disease-specific and professionally defined, with limited incorporation of what matters most to people living with multiple long-term conditions (MLTCs) and their caregivers. Existing frameworks and quality standards provide important conceptual direction, but few produce a pragmatic set of ready-to-use indicators.

Atopic dermatitis (AD) is a chronic and relapsing skin disorder that significantly impairs patients’ quality of life. Long-term biologic therapy provides durable efficacy for AD, but raises concerns related to costs, safety, and withdrawal-associated relapse. Traditional Chinese medicine (TCM) has a long history in AD treatment and is usually integrated with biologic treatment to achieve complementary benefits and provide comprehensive care for patients with AD. However, high-quality evidence supporting its real-world efficacy remains limited.

Fatigue is a common debilitating symptom of breast cancer (BC), and its treatment may result in a significant symptom burden and affect adherence to treatment. Graded exercise therapy (GET) and cognitive behavioral therapy (CBT) have separately been shown in previous studies to be beneficial for the management of cancer-related fatigue.

Brain natriuretic peptide (BNP) and global longitudinal strain (GLS) are emerging biomarkers used to risk-stratify patients with asymptomatic severe aortic regurgitation (AR) and preserved ejection fraction (EF). Although numerous clinical trials have investigated the efficacy of these biomarkers in patients with aortic stenosis, only a limited number have examined these biomarkers in patients with AR. Therefore, the proposed systematic review and meta-analysis seeks to assess the prognostic value of BNP and/or GLS in patients with severe asymptomatic AR and preserved EF.

Endodontically treated teeth are prone to fractures due to the loss of tooth structure, caries removal, access cavity preparation, and scaling, resulting in compromised strength in the teeth. Posts are used for restoring teeth that have undergone this process, but the role of different fiber posts in resisting fractures in teeth is unclear. Customized carbon fiber posts, customized glass fiber posts, and fiber posts relined with short fiber-reinforced composite (SFRC) are biomechanically efficient. SFRC is used as a relining material around the fiber post to improve adaptation to the root canal.

The use of antidepressants is increasing globally. Despite their obvious benefits, ongoing use of these medications is often not properly monitored or deprescribed when a person returns to better mental health. In addition, providing prescriptions to those who do not have clinical depression leads to personal and societal cost burdens.

Illicit drug use has been rapidly increasing in South Korea, particularly among individuals in their 20s, contributing to a growing burden of substance use disorder (SUD). However, treatment infrastructure remains limited. Nationwide, only a small number of inpatient treatment hospitals are available, and treatment capacity in the Seoul metropolitan area is insufficient to meet growing demand. In addition, community-based addiction services are scarce, creating barriers to continuous care. Digital therapeutics (DTx) have emerged as a promising approach to improve treatment accessibility and continuity of care. In particular, cognitive behavioral therapy (CBT)–based DTx such as RESET-O, developed in the United States and authorized by the US Food and Drug Administration, have demonstrated clinical benefits in supporting addiction recovery. Building on this concept, our team developed D-STOP, a CBT-based DTx intervention designed to support individuals with SUD in the Korean clinical context.

Cardiac rehabilitation (CR) is recommended following valve replacement or repair procedures (VRPs), yet participation remains suboptimal among patients undergoing VRPs. Home-based CR (HBCR), including both fully digital and hybrid (mix of HBCR and center-based CR [CBCR]) models, may improve access and uptake. Although prior systematic reviews have examined HBCR in general populations receiving CR, none have specifically considered HBCR among patients who have undergone VRPs—an expanding but under-studied group with distinct rehabilitation needs.

Young adults aged 18 to 25 years in rural communities face barriers to sexual and reproductive health (SRH) information, including clinician shortages, clinic closures, and privacy concerns in close-knit communities. Many rely on online sources of varying quality; one analysis found that 40% of birth control video content is inaccurate or misleading. AI-enabled conversational health tools (chatbots) may provide scalable SRH information, but implementation may be constrained by low institutional trust, privacy concerns, and rural users’ underrepresentation in AI development. SARHAchat is an AI-enabled SRH conversational health tool developed through prior work. This protocol describes a study to co-design and evaluate SARHAchat with rural young adults, treating trust as a design input rather than a postdeployment outcome.

Continuity of care is essential in psychiatric services due to the chronic, relapsing nature of mental health conditions, yet care pathways remain heavily fragmented at critical transition points. Although advancements in AI and machine learning (ML) offer powerful capabilities to track longitudinal data and automate clinical decision-making, a structured appraisal of their efficacy in supporting continuity of psychiatric care is lacking. This protocol outlines a mixed methods systematic review to evaluate how AI-driven workflows can proactively enhance monitoring, optimize triage and care resource allocation, and address systemic coordination gaps.

The World Health Organization (WHO) launched a Rehabilitation 2030 initiative to call for global action to scale up rehabilitation efforts. Rehabilitation needs are growing, and efforts should be made to strengthen and integrate rehabilitation into all levels of health care, including building research capacity and expanding evidence for rehabilitation. Postdischarge rehabilitation is essential for reducing hospital readmissions and maintaining patients’ health within the community. However, locally, the shift toward community-based rehabilitation is often hampered by long waiting times for admission to day rehabilitation centers (DRCs), cost and logistical barriers, and the lack of a structured program to onboard patients and caregivers to the digital solutions required for rehabilitation in Singapore. Telerehabilitation systems that incorporate wearables within a structured rehabilitation program support inpatient rehabilitation and enable patients to continue with physical rehabilitation after discharge while awaiting admission to a DRC.

Amnestic mild cognitive impairment (aMCI), the predominant subtype of mild cognitive impairment, carries the highest risk of progression to Alzheimer disease among all mild cognitive impairment subtypes. Currently, clinical practice lacks an established, authoritative treatment method for this condition. Prior clinical evidence indicates acupuncture may enhance cognitive function in individuals with mild cognitive impairment. Further clinical evidence suggests Gold Needle therapy demonstrates significant therapeutic effects for challenging and refractory conditions; however, a critical gap exists: no clinical trials currently ascertain whether Gold Needle therapy surpasses conventional acupuncture in treating aMCI. This trial aims to rigorously evaluate the therapeutic efficacy and safety of the Gold Needle “Regulating Spirit” method for clinical symptoms in patients with aMCI, alongside investigating its underlying imaging and biochemical mechanisms.