{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:47:50Z","timestamp":1782841670799,"version":"3.54.5"},"reference-count":61,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Digital health tools integrating electronic patient-reported outcome and experience measures (ePROMs\/ePREMs) enable longitudinal monitoring of health-related quality of life (HRQoL), psychological well-being, and treatment satisfaction in pre-exposure prophylaxis (PrEP) users. However, determinants of sustained engagement with digital follow-up platforms remain insufficiently characterized.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To describe the feasibility of the Naveta-Phemium digital platform for longitudinal monitoring of safety, HRQoL, and treatment satisfaction among PrEP users, and to develop and internally validate a machine learning framework to characterize and predict engagement with digital follow-up.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A prospective observational study was conducted using the Naveta digital follow-up platform. HIV-negative adults at high risk of HIV infection received tenofovir disoproxil fumarate (245 mg) plus emtricitabine (200 mg). Clinical safety, HRQoL, and satisfaction were assessed using laboratory parameters and validated ePROMs\/ePREMs (Hospital Anxiety and Depression Scale, Patient-Reported Outcome Measurement Information System Profile-29, Treatment Satisfaction Questionnaire for Medication, and Person-Centered Coordinated Care Experience Questionnaire). Engagement was defined at the questionnaire level and analyzed using the ALGOPROMIA-Classification framework with repeated stratified cross-validation. Model explainability was assessed using permutation-based Shapley Additive Explanations.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 81 participants contributed repeated questionnaire-level observations (mean PrEP duration 689 d). PrEP was well tolerated, with no moderate or severe adverse events; mild transient symptoms were mainly gastrointestinal (31\/45, 68.9%) and neurological (26\/45, 57.8%). Renal function remained stable (creatinine: 0.86 [SD 0.13] mg\/dL; estimated glomerular filtration rate:\n P<\/jats:italic>\n =.498). Psychological well-being and HRQoL remained stable (Hospital Anxiety and Depression Scale<7; Patient-Reported Outcome Measurement Information System Profile-29 near population norms). Treatment satisfaction was consistently high (Treatment Satisfaction Questionnaire for Medication\u224885\u201087), and satisfaction with the NAVETA telemedicine model remained stable (8\/10). Engagement showed clear sociodemographic and behavioral gradients. Ensemble-based machine learning models achieved good discrimination in predicting engagement (area under the curve\u22480.82) across \u224812,300 questionnaire-level observations. Random forest was retained for robustness and consistency. Shapley Additive Explanations analysis highlighted lifestyle-related variables as the most influential predictors, with heterogeneous individual-level effects.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Naveta enabled feasible telemedicine-based PrEP follow-up with preserved HRQoL, high satisfaction, and stable safety. Combining longitudinal ePROMs\/ePREMs with explainable machine learning allowed detailed characterization of digital engagement, supporting digitally supported PrEP care optimization and informing future comparative and cost-effectiveness studies.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/87592","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T10:20:09Z","timestamp":1772533209000},"page":"e87592-e87592","source":"Crossref","is-referenced-by-count":0,"title":["Digital Monitoring of Pre-Exposure Prophylaxis Users Through Electronic Patient-Reported Outcome Measures and Electronic Patient-Reported Experience Measures: Multicenter Prospective Study on Feasibility, Safety, and Predictive Modeling of Digital Engagement"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7304-458X","authenticated-orcid":false,"given":"Gabriel","family":"Mercadal-Orfila","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0142-1205","authenticated-orcid":false,"given":"Joaqu\u00edn Ignacio","family":"Serrano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3619-6634","authenticated-orcid":false,"given":"Tilman","family":"Mijares","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9002-8158","authenticated-orcid":false,"given":"Llu\u00eds","family":"Vidal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1263-0814","authenticated-orcid":false,"given":"Adrian","family":"Curran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0491-3718","authenticated-orcid":false,"given":"Salvador","family":"Herrera-P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinsp.2024.100419","article-title":"Impact of HIV pre-exposure prophylaxis (PREP) on health-related quality of life (QOL) of patients followed up at a reference center in S\u00e3o Paulo, Brazil","volume":"79","author":"Takada-de-Souza","journal-title":"Clinics (Sao Paulo)"},{"key":"R2","unstructured":"Commission implementing decision c(2016) 5439 final of 18.8.2016 amending the marketing authorisation granted by decision c(2005)456 for \u201ctruvada \u2013 emtricitabine \/ tenofovir disoproxil fumarate\u201d, a medicinal product for human use. European Commission; 2016. URL: https:\/\/ec.europa.eu\/health\/documents\/community-register\/2016\/20160818135700\/dec_135700_en.pdf"},{"issue":"6S","key":"R3","doi-asserted-by":"publisher","first-page":"S33","DOI":"10.1016\/j.jadohealth.2023.09.005","article-title":"Adherence, safety, and feasibility of HIV pre-exposure prophylaxis among adolescent men who have sex with men and transgender women in Brazil (PrEP1519 Study)","volume":"73","author":"Dourado","journal-title":"J Adolesc Health"},{"issue":"5","key":"R4","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1097\/QAI.0000000000001129","article-title":"Preexposure prophylaxis for HIV prevention in a large integrated health care system: adherence, renal safety, and discontinuation","volume":"73","author":"Marcus","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"3","key":"R5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.rr6903a1","article-title":"Preexposure prophylaxis for prevention of HIV acquisition among adolescents: clinical considerations, 2020","volume":"69","author":"Tanner","journal-title":"MMWR Recomm Rep"},{"issue":"3","key":"R6","doi-asserted-by":"publisher","first-page":"E451","DOI":"10.15167\/2421-4248\/jpmh2020.61.3.1352","article-title":"The impact of PrEP: results from a multicenter health technology assessment into the Italian setting","volume":"61","author":"Ferrario","journal-title":"J Prev Med Hyg"},{"issue":"4","key":"R7","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1177\/1060028014520880","article-title":"Systemic preexposure prophylaxis for HIV: translating clinical data to clinical practice","volume":"48","author":"Li","journal-title":"Ann Pharmacother"},{"issue":"5","key":"R8","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1001\/jamaophthalmol.2021.0146","article-title":"A global assessment of eye health and quality of life","volume":"139","author":"Assi","journal-title":"JAMA Ophthalmol"},{"issue":"11","key":"R9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0260168","article-title":"Factors that motivate men who have sex with men in Berlin, Germany, to use or consider using HIV pre-exposure prophylaxis-a multi-methods analysis of data from a multicentre survey","volume":"16","author":"Gaskins","journal-title":"PLoS One"},{"issue":"9","key":"R10","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18094872","article-title":"Persistence as a robust indicator of medication adherence-related quality and performance","volume":"18","author":"Menditto","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"R11","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3463-4","article-title":"A systematic review of adherence to oral pre-exposure prophylaxis for HIV - how can we improve uptake and adherence?","volume":"18","author":"Sidebottom","journal-title":"BMC Infect Dis"},{"issue":"11","key":"R12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0313322","article-title":"Enhancing daily oral PrEP adherence with digital communications: protocol for a systematic review and meta-analysis","volume":"19","author":"Brisson","journal-title":"PLOS ONE"},{"issue":"5","key":"R13","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-048478","article-title":"Oral pre-exposure prophylaxis (PrEP) to prevent HIV: a systematic review and meta-analysis of clinical effectiveness, safety, adherence and risk compensation in all populations","volume":"12","author":"O Murchu","journal-title":"BMJ Open"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.jadohealth.2021.04.001","article-title":"Adherence to pre-exposure prophylaxis in adolescents and young adults: a systematic review and meta-analysis","volume":"70","author":"Allison","journal-title":"J Adolesc Health"},{"issue":"1","key":"R15","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1089\/pop.2021.0031","article-title":"Digital health: unlocking value in a post-pandemic world","volume":"25","author":"D\u2019Anza","journal-title":"Popul Health Manag"},{"issue":"16","key":"R16","doi-asserted-by":"publisher","first-page":"1585","DOI":"10.1056\/NEJMsr1503323","article-title":"Telehealth","volume":"377","author":"Tuckson","journal-title":"N Engl J Med"},{"issue":"4","key":"R17","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2022.0326","article-title":"Selecting and implementing patient-reported outcome and experience measures to assess health system performance","volume":"3","author":"Bull","journal-title":"JAMA Health Forum"},{"issue":"1","key":"R18","doi-asserted-by":"publisher","first-page":"12","DOI":"10.35680\/2372-0247.1664","article-title":"Current PROM and PREM use in health system performance measurement: still a way to go","volume":"9","author":"Bull","journal-title":"Patient Exp J"},{"issue":"1","key":"R19","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-025-00733-4","article-title":"Effectiveness of digital health interventions in promoting the pre-exposure prophylaxis (PrEP) care continuum among men who have sex with men (MSM): a systematic review of randomized controlled trials","volume":"22","author":"Du","journal-title":"Curr HIV\/AIDS Rep"},{"issue":"8","key":"R20","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1080\/09540121.2019.1622637","article-title":"Use of technology for delivery of mental health and substance use services to youth living with HIV: a mixed-methods perspective","volume":"32","author":"Saberi","journal-title":"AIDS Care"},{"issue":"1","key":"R21","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1001\/jama.2022.22246","article-title":"Antiretroviral drugs for treatment and prevention of HIV infection in adults: 2022 recommendations of the international antiviral society-USA panel","volume":"329","author":"Gandhi","journal-title":"JAMA"},{"issue":"1","key":"R22","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3203-x","article-title":"A qualitative study examining the benefits and challenges of incorporating patient-reported outcome substance use and mental health questionnaires into clinical practice to improve outcomes on the HIV care continuum","volume":"18","author":"Monroe","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"R23","doi-asserted-by":"publisher","DOI":"10.1186\/s13584-025-00696-2","article-title":"The effect of telemedicine on preventive medicine- a case from Israel","volume":"14","author":"Adler","journal-title":"Isr J Health Policy Res"},{"issue":"10","key":"R24","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0163627","article-title":"Clinical and economic impact of a digital, remotely-delivered intensive behavioral counseling program on medicare beneficiaries at risk for diabetes and cardiovascular disease","volume":"11","author":"Chen","journal-title":"PLoS ONE"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2024.107737","article-title":"A pilot randomized clinical trial of a smartphone-based application to support at-home PSA screening and culturally tailored prostate cancer education for African American men: a study protocol","volume":"147","author":"Neil","journal-title":"Contemp Clin Trials"},{"issue":"5","key":"R26","doi-asserted-by":"publisher","DOI":"10.2196\/15977","article-title":"The effectiveness of electronic health interventions for promoting HIV-preventive behaviors among men who have sex with men: meta-analysis based on an integrative framework of design and implementation features","volume":"22","author":"Xin","journal-title":"J Med Internet Res"},{"issue":"1","key":"R27","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-025-10724-w","article-title":"The role of digital tools in enhancing antiretroviral therapy adherence among adolescents and young adults with HIV: a systematic review of randomized controlled trials","volume":"25","author":"Agbo","journal-title":"BMC Infect Dis"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.2196\/52542","article-title":"Factors associated with digital intervention engagement and adherence in patients with cancer: systematic review","volume":"26","author":"Montalescot","journal-title":"J Med Internet Res"},{"key":"R29","doi-asserted-by":"publisher","DOI":"10.2196\/46116","article-title":"Digital health psychosocial intervention in adult patients with cancer and their families: systematic review and meta-analysis","volume":"10","author":"Zhang","journal-title":"JMIR Cancer"},{"issue":"5","key":"R30","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1016\/j.farma.2024.02.005","article-title":"Salud digital para promover la adherencia al tratamiento antirretroviral en pacientes con VIH\/sida: metarevisi\u00f3n","volume":"48","author":"Ram\u00edrez L\u00f3pez","journal-title":"Farm Hosp"},{"issue":"4","key":"R31","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1007\/s11904-015-0291-7","article-title":"Recent evidence for emerging digital technologies to support global HIV engagement in care","volume":"12","author":"Jongbloed","journal-title":"Curr HIV\/AIDS Rep"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.2196\/59661","article-title":"Feasibility and acceptability of a digital health portal to improve HIV care engagement among Kenyan youth: mixed methods study","volume":"9","author":"Nturibi","journal-title":"JMIR Form Res"},{"issue":"7","key":"R33","doi-asserted-by":"publisher","DOI":"10.2196\/27861","article-title":"Supporting patient-clinician interaction in chronic HIV care: design and development of a patient-reported outcomes software application","volume":"23","author":"Herrmann","journal-title":"J Med Internet Res"},{"key":"R34","doi-asserted-by":"publisher","DOI":"10.2196\/71817","article-title":"Improving patient engagement in phase 2 clinical trials with a trial-specific patient decision aid: development and usability study","volume":"27","author":"Halilaj","journal-title":"J Med Internet Res"},{"key":"R35","doi-asserted-by":"publisher","DOI":"10.2196\/56196","article-title":"Implementing systematic patient-reported measures for chronic conditions through the Naveta value-based telemedicine initiative: observational retrospective multicenter study","volume":"12","author":"Mercadal-Orfila","journal-title":"JMIR Mhealth Uhealth"},{"key":"R36","doi-asserted-by":"publisher","DOI":"10.2147\/IPRP.S492422","article-title":"Developing a prototype machine learning model to predict quality of life measures in people living with HIV","volume":"14","author":"Mercadal-Orfila","journal-title":"Integr Pharm Res Pract"},{"issue":"3","key":"R37","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.aprim.2020.02.001","article-title":"Profilaxis pre-exposici\u00f3n de la infecci\u00f3n por el VIH y Atenci\u00f3n Primaria (AP)","volume":"52","author":"Mascort","journal-title":"Atenci\u00f3n Primaria"},{"key":"R38","doi-asserted-by":"publisher","DOI":"10.1016\/j.vhri.2020.07.578","article-title":"Treatment satisfaction questionnaire for medication (TSQM version 1.4): ceiling and floor effects, reliability, and known-group validity in Brazilian outpatients with hypertension","volume":"23","author":"Liberato","journal-title":"Value Health Reg Issues"},{"issue":"7","key":"R39","doi-asserted-by":"publisher","first-page":"1885","DOI":"10.1007\/s11136-018-1842-3","article-title":"PROMIS\u00ae-29 v2.0 profile physical and mental health summary scores","volume":"27","author":"Hays","journal-title":"Qual Life Res"},{"issue":"7","key":"R40","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1093\/intqhc\/mzy212","article-title":"Validation of the person-centred coordinated care experience questionnaire (P3CEQ)","volume":"31","author":"Lloyd","journal-title":"Int J Qual Health Care"},{"issue":"1","key":"R41","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1186\/s12931-021-01690-3","article-title":"Development and performance assessment of novel machine learning models to predict pneumonia after liver transplantation","volume":"22","author":"Chen","journal-title":"Respir Res"},{"issue":"1","key":"R42","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-014-0354-0","article-title":"A validation study of the hospital anxiety and depression scale (HADS) in a large sample of French employees","volume":"14","author":"Boc\u00e9r\u00e9an","journal-title":"BMC Psychiatry"},{"issue":"12","key":"R43","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14161","article-title":"Examining the optimal cutoff values of HADS, PHQ-9 and GAD-7 as screening instruments for depression and anxiety in irritable bowel syndrome","volume":"33","author":"Snijkers","journal-title":"Neurogastroenterol Motil"},{"key":"R44","unstructured":"PROMIS\\textsuperscript\u00ae score cut points. HealthMeasures. 2024. URL: https:\/\/www.healthmeasures.net\/score-and-interpret\/interpret-scores\/promis\/promis-score-cut-points [Accessed 28-01-2026]"},{"issue":"5","key":"R45","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0267931","article-title":"Using machine learning to predict health-related quality of life outcomes in patients with low grade glioma, meningioma, and acoustic neuroma","volume":"17","author":"Karri","journal-title":"PLoS ONE"},{"issue":"10","key":"R46","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13101692","article-title":"Impact of cross-validation on machine learning models for early detection of intrauterine fetal demise","volume":"13","author":"Kaliappan","journal-title":"Diagnostics (Basel)"},{"key":"R47","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1465725","article-title":"TELEPROM psoriasis: enhancing patient-centered care and health-related quality of life (HRQoL) in moderate-to-severe plaque psoriasis","volume":"11","author":"Mercadal-Orfila","journal-title":"Front Med"},{"issue":"1","key":"R48","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1038\/s42256-019-0138-9","article-title":"From local explanations to global understanding with explainable AI for trees","volume":"2","author":"Lundberg","journal-title":"Nat Mach Intell"},{"issue":"3","key":"R49","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1007\/s11136-015-1207-0","article-title":"AmbuFlex: tele-patient-reported outcomes (telePRO) as the basis for follow-up in chronic and malignant diseases","volume":"25","author":"Schougaard","journal-title":"Qual Life Res"},{"issue":"18","key":"R50","doi-asserted-by":"publisher","first-page":"3444","DOI":"10.1002\/sim.8183","article-title":"Impact of predictor measurement heterogeneity across settings on the performance of prediction models: a measurement error perspective","volume":"38","author":"Luijken","journal-title":"Stat Med"},{"issue":"546","key":"R51","doi-asserted-by":"publisher","first-page":"1434","DOI":"10.1080\/01621459.2023.2197686","article-title":"Cross-validation: what does it estimate and how well does it do it?","volume":"119","author":"Bates","journal-title":"J Am Stat Assoc"},{"issue":"1","key":"R52","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-022-06082-4","article-title":"Reproducibility of prediction models in health services research","volume":"15","author":"Belbasis","journal-title":"BMC Res Notes"},{"issue":"9","key":"R53","doi-asserted-by":"publisher","DOI":"10.3390\/e26090746","article-title":"Can a transparent machine learning algorithm predict better than its black box counterparts? a benchmarking study using 110 data sets","volume":"26","author":"Peterson","journal-title":"Entropy (Basel)"},{"issue":"1","key":"R54","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-10373-2","article-title":"Age and sex-related comparison of referral-based telemedicine service utilization during the COVID-19 pandemic in Ontario: a retrospective analysis","volume":"23","author":"Wong","journal-title":"BMC Health Serv Res"},{"issue":"4","key":"R55","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1055\/s-0041-1733848","article-title":"Telemedicine adoption during the COVID-19 pandemic: gaps and inequalities","volume":"12","author":"Luo","journal-title":"Appl Clin Inform"},{"key":"R56","doi-asserted-by":"publisher","DOI":"10.2196\/50205","article-title":"Findings from a national survey of older US adults on patient willingness to use telehealth services: cross-sectional survey","volume":"26","author":"Odebunmi","journal-title":"J Med Internet Res"},{"key":"R57","doi-asserted-by":"publisher","DOI":"10.2196\/45057","article-title":"Patterns and predictors of engagement with digital self-monitoring during the maintenance phase of a behavioral weight loss program: quantitative study","volume":"11","author":"Crane","journal-title":"JMIR Mhealth Uhealth"},{"issue":"5","key":"R58","doi-asserted-by":"publisher","DOI":"10.2196\/32006","article-title":"Factors predicting engagement of older adults with a coach-supported ehealth intervention promoting lifestyle change and associations between engagement and changes in cardiovascular and dementia risk: secondary analysis of an 18-month multinational randomized controlled trial","volume":"24","author":"Coley","journal-title":"J Med Internet Res"},{"issue":"1","key":"R59","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.ijsrc.2024.10.002","article-title":"Interpreting machine learning models based on SHAP values in predicting suspended sediment concentration","volume":"40","author":"Lamane","journal-title":"Int J Sediment Res"},{"issue":"1","key":"R60","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-72162-z","article-title":"Engagement analysis of a persuasive-design-optimized eHealth intervention through machine learning","volume":"14","author":"Idrees","journal-title":"Sci Rep"},{"issue":"1","key":"R61","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1001\/jamaophthalmol.2022.4984","article-title":"Longitudinal use of telehealth during the COVID-19 pandemic and utility of asynchronous testing for subspecialty-level ophthalmic care","volume":"141","author":"Mosenia","journal-title":"JAMA Ophthalmol"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2026\/1\/e87592","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:14:48Z","timestamp":1782839688000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2026\/1\/e87592"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,13]]},"references-count":61,"URL":"https:\/\/doi.org\/10.2196\/87592","relation":{},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,13]]},"article-number":"v28i6Se87592"}}