{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:33:20Z","timestamp":1786120400413,"version":"build-2736575974"},"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 The medical black bag is synonymous with physicians, especially general practitioners, who are expected to be ready to provide care across settings. The content of the devices they use will likely expand due to the proliferation of digital tools. As portable diagnostics diversify, guidance is increasingly needed on which tools clinicians should choose and what this shift may mean for the physical examination and point-of-care assessment.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to map the current, the possible, and the future content of the medical black bag using anticipatory methods, and to provide a general, practice-oriented outline of how portable diagnostic technologies may evolve in primary care.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n National equipment lists and the World Health Organization\u2019s MeDevIS database were compiled and filtered to define a contemporary reference set of reusable portable diagnostic instruments relevant to generalist practice. A 1-year trend analysis using major professional and medical technology news sources was conducted to identify possible additions, screening for devices with diagnostic relevance, portability, digital capability, market presence, and evidence visibility. To extend the outlook to the next decade, we performed a horizon-scanning exercise using the same review period. These devices were grouped into thematic categories.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n National equipment recommendations and World Health Organization lists yielded a stable core set of diagnostic tools used in routine primary care practice. Trend analysis and horizon scanning expanded this set by identifying possible and future additions of portable medical devices that can be used at the point of care. Overall, the identified technologies were increasingly digital, diverse, connected, and in some cases, AI-supported, reflecting a trajectory toward more integrated and data-enabled diagnostics.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The medical black bag is likely to evolve from a stable set of familiar instruments toward a broader toolbox of portable and connected diagnostic devices. While these tools may expand the scope of bedside assessment and enable more reproducible and shareable clinical signs, their value depends on appropriate validation, usability, workflow integration, training, and supportive financial and organizational conditions. Regular evidence-informed updates of equipment recommendations, alongside practical implementation support, may help primary care systems adopt useful innovations while preserving the human dimensions of clinical care.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/93861","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T17:40:09Z","timestamp":1783618809000},"page":"e93861-e93861","source":"Crossref","is-referenced-by-count":0,"title":["The Digital Evolution of the Medical Black Bag: Environmental Scan With Trend Analysis and Horizon Scanning"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5699-8199","authenticated-orcid":false,"given":"Gell\u00e9rt","family":"Katonai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8292-4859","authenticated-orcid":false,"given":"Nora","family":"Arvai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7005-7083","authenticated-orcid":false,"given":"Bertalan","family":"Mesko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"issue":"4","key":"R1","doi-asserted-by":"publisher","first-page":"196","DOI":"10.3109\/02813432.2011.629153","article-title":"The earliest mention of a black bag","volume":"29","author":"Tsoucalas","journal-title":"Scand J Prim Health Care"},{"issue":"9","key":"R2","first-page":"636","volume":"45","author":"Dammery","journal-title":"Aust Fam Physician"},{"issue":"4","key":"R3","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1080\/028134302321004917","article-title":"Do general practitioners use what\u2019s in their doctor\u2019s bag?","volume":"20","author":"Devroey","journal-title":"Scand J Prim Health Care"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.2147\/CA.S361304","article-title":"General practice doctors bag and emergency bag audit \u2013 a quality improvement project (QIP) in a Rural Irish general practice","volume":"Volume 14","author":"Hutch","journal-title":"CA"},{"issue":"2","key":"R5","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1038\/s41371-022-00693-x","article-title":"Automated \u2018oscillometric\u2019 blood pressure measuring devices: how they work and what they measure","volume":"37","author":"Sharman","journal-title":"J Hum Hypertens"},{"issue":"4","key":"R6","doi-asserted-by":"publisher","first-page":"e279","DOI":"10.1016\/S2589-7500(21)00276-4","article-title":"Effectiveness and safety of pulse oximetry in remote patient monitoring of patients with COVID-19: a systematic review","volume":"4","author":"Alboksmaty","journal-title":"Lancet Digit Health"},{"key":"R7","unstructured":"Standards for general practices (5th edition): criterion GP5.3 \u2013 doctor\u2019s bag. Royal Australian College of General Practitioners. 2020. URL: https:\/\/www.racgp.org.au\/running-a-practice\/practice-standards\/standards-5th-edition [Accessed 01-12-2025]"},{"key":"R8","unstructured":"Foundation standard appendix 1: medical equipment and emergency medicines register. Royal New Zealand College of General Practitioners. 2021. URL: https:\/\/www.rnzcgp.org.nz\/Quality\/Foundation_pages\/Appendix_1.aspx?Appendix1Content=1&WebsiteKey=7623fc84-8f36-4d86-b0c2-150be9e8f9d9&hkey=8c255025-8066-4757-8b79-54fdc919d9ff [Accessed 01-12-2025]"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.2196\/57148","article-title":"Exploring the need for medical futures studies: insights from a scoping review of health care foresight","volume":"26","author":"Mesk\u00f3","journal-title":"J Med Internet Res"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.2196\/82820","article-title":"A practical guide to using futures methods in health care: approaches, applications, and case studies","volume":"27","author":"Mesko","journal-title":"J Med Internet Res"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1016\/j.futures.2024.103326","article-title":"Anticipating emerging medical technologies: the start of an international horizon scanning tool for medical devices","volume":"156","author":"Michels","journal-title":"Futures"},{"key":"R12","unstructured":"Fierce MedTech. Fierce Biotech. URL: https:\/\/www.fiercebiotech.com\/medtech [Accessed 24-07-2026]"},{"key":"R13","unstructured":"Mobi Health News. URL: https:\/\/www.mobihealthnews.com\/ [Accessed 24-07-2026]"},{"key":"R14","unstructured":"Medical technology news. MedTech Dive. 2025. URL: https:\/\/www.medtechdive.com\/ [Accessed 24-07-2026]"},{"key":"R15","unstructured":"Med-Tech Insights. URL: https:\/\/med-techinsights.com\/ [Accessed 24-07-2026]"},{"key":"R16","unstructured":"MassDevice. URL: https:\/\/www.massdevice.com\/ [Accessed 24-07-2026]"},{"key":"R17","unstructured":"Medical Device Network. URL: https:\/\/www.medicaldevice-network.com\/ [Accessed 24-07-2026]"},{"key":"R18","unstructured":"BioWorld. URL: https:\/\/www.bioworld.com\/ [Accessed 24-07-2026]"},{"key":"R19","unstructured":"Digital Health. URL: https:\/\/www.digitalhealth.net\/ [Accessed 24-07-2026]"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i2587","article-title":"Regulatory approval of new medical devices: cross sectional study","volume":"353","author":"Marcus","journal-title":"BMJ"},{"issue":"1","key":"R21","doi-asserted-by":"publisher","DOI":"10.1186\/s13089-019-0145-4","article-title":"Point-of-care ultrasound in primary care: a systematic review of generalist performed point-of-care ultrasound in unselected populations","volume":"11","author":"Sorensen","journal-title":"Ultrasound J"},{"issue":"1","key":"R22","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-023-02128-z","article-title":"Rural family physician use of point-of-care ultrasonography: experiences of primary care providers in British Columbia, Canada","volume":"24","author":"Kornelsen","journal-title":"BMC Prim Care"},{"issue":"4","key":"R23","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1159\/000520474","article-title":"Validation of a market-approved artificial intelligence mobile health app for skin cancer screening: a prospective multicenter diagnostic accuracy study","volume":"238","author":"Sangers","journal-title":"Dermatology"},{"key":"R24","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m127","article-title":"Algorithm based smartphone apps to assess risk of skin cancer in adults: systematic review of diagnostic accuracy studies","volume":"368","author":"Freeman","journal-title":"BMJ"},{"issue":"2","key":"R25","doi-asserted-by":"publisher","first-page":"e117","DOI":"10.1016\/S2589-7500(21)00256-9","article-title":"Point-of-care screening for heart failure with reduced ejection fraction using artificial intelligence during ECG-enabled stethoscope examination in London, UK: a prospective, observational, multicentre study","volume":"4","author":"Bachtiger","journal-title":"Lancet Digit Health"},{"issue":"3","key":"R26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2025.101619","article-title":"Automated detection of reduced ejection fraction using an ECG-enabled digital stethoscope","volume":"4","author":"Guo","journal-title":"JACC Adv"},{"issue":"1","key":"R27","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-023-00899-4","article-title":"Barriers and facilitators to utilizing digital health technologies by healthcare professionals","volume":"6","author":"Borges do Nascimento","journal-title":"NPJ Digit Med"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.1016\/j.smhl.2022.100330","article-title":"Evaluation of challenges for adoption of smart healthcare strategies","volume":"26","author":"Renukappa","journal-title":"Smart Health"},{"issue":"1","key":"R29","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-44676-z","article-title":"Autonomous artificial intelligence increases screening and follow-up for diabetic retinopathy in youth: the ACCESS randomized control trial","volume":"15","author":"Wolf","journal-title":"Nat Commun"},{"issue":"1","key":"R30","doi-asserted-by":"publisher","DOI":"10.1080\/28338073.2024.2437294","article-title":"Revolutionizing diabetic retinopathy screening: integrating AI-based retinal imaging in primary care","volume":"14","author":"Kummerle","journal-title":"J CME"},{"issue":"1","key":"R31","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1186\/s12875-021-01586-7","article-title":"Barriers and facilitators to diabetic retinopathy screening within Australian primary care","volume":"22","author":"Watson","journal-title":"BMC Fam Pract"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-020-01325-4","article-title":"Tele-ECG consulting and outcomes on primary care patients in a low-to-middle income population: the first experience from Makassar telemedicine program, Indonesia","volume":"21","author":"Mappangara","journal-title":"BMC Fam Pract"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.1017\/S1463423624000057","article-title":"Evaluation of the introduction of a single-lead ECG device and digital cardiologist consultation platform among general practitioners in the Netherlands","volume":"25","author":"Karregat","journal-title":"Prim Health Care Res Dev"},{"issue":"4","key":"R34","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1016\/j.icte.2023.02.007","article-title":"Digitization of healthcare sector: a study on privacy and security concerns","volume":"9","author":"Paul","journal-title":"ICT Express"},{"issue":"1","key":"R35","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-023-02115-5","article-title":"Interoperability of heterogeneous health information systems: a systematic literature review","volume":"23","author":"Torab-Miandoab","journal-title":"BMC Med Inform Decis Mak"},{"issue":"1","key":"R36","doi-asserted-by":"publisher","DOI":"10.1038\/s41533-022-00275-x","article-title":"Accuracy of portable spirometers in the diagnosis of chronic obstructive pulmonary disease A meta-analysis","volume":"32","author":"Zhou","journal-title":"NPJ Prim Care Respir Med"},{"issue":"1","key":"R37","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-025-03690-1","article-title":"Reliability and usability of a portable spirometer compared to a laboratory spirometer","volume":"25","author":"Gao","journal-title":"BMC Pulm Med"},{"issue":"1","key":"R38","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-024-02578-z","article-title":"Is it worth trying? A cross-sectional study on the implementation of point-of-care ultrasound in Hungarian primary care","volume":"25","author":"Kiss-Kov\u00e1cs","journal-title":"BMC Prim Care"},{"issue":"1","key":"R39","doi-asserted-by":"publisher","DOI":"10.1038\/s44325-024-00014-w","article-title":"Global implementation and evaluation of atrial fibrillation screening in the past two decades - a narrative review","volume":"1","author":"Wong","journal-title":"NPJ Cardiovasc Health"},{"issue":"3","key":"R40","doi-asserted-by":"publisher","DOI":"10.3390\/s25030758","article-title":"Clinical validation of a video-otoscopy-based medical device for the remote diagnosis of ear complaints","volume":"25","author":"Pannonhalmi","journal-title":"Sensors (Basel)"},{"key":"R41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2025.112453","article-title":"Digital versus traditional otoscopy in the diagnosis of acute otitis media in the pediatric primary care clinic","volume":"196","author":"Zheng","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"3","key":"R42","doi-asserted-by":"publisher","DOI":"10.2196\/35070","article-title":"Barriers to and facilitators of the use of digital tools in primary care to deliver physical activity advice: semistructured interviews and thematic analysis","volume":"9","author":"Bondaronek","journal-title":"JMIR Hum Factors"},{"issue":"1","key":"R43","doi-asserted-by":"publisher","DOI":"10.1080\/13814788.2023.2273615","article-title":"Direct-to-patient digital diagnostics in primary care: opportunities, challenges, and conditions necessary for responsible digital diagnostics","volume":"29","author":"Villalobos-Quesada","journal-title":"Eur J Gen Pract"},{"key":"R44","unstructured":"Artificial intelligence (AI) technologies for assessing and triaging skin lesions referred to the urgent suspected skin cancer pathway: early value assessment. National Institute for Health and Care Excellence. 2025. URL: https:\/\/www.nice.org.uk\/guidance\/hte24\/resources\/evidence-generation-plan-for-artificial-intelligence-ai-technologies-for-assessing-and-triaging-skin-lesions-referred-to-the-urgent-suspected-skin-cancer-pathway-15309750349\/chapter\/1-Purpose-of-this-document [Accessed 30-07-2026]"},{"key":"R45","unstructured":"Zorginnovatieverhalen: een verkenning van vier innovatievoorbeelden in de zorg [Report in Dutch]. KPMG Health; 2021. URL: https:\/\/www.zorginstituutnederland.nl\/site\/binaries\/site-content\/collections\/documents\/2021\/06\/25\/kpmg-rapport-zorginnovatieverhalen\/KPMG+rapport+Zorginnovatieverhalen.pdf [Accessed 10-05-2025]"},{"key":"R46","unstructured":"Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN). National Institute for Health and Care Excellence. 2024. URL: www.nice.org.uk\/guidance\/ng245 [Accessed 30-07-2026]"},{"key":"R47","unstructured":"Global strategy for asthma management and prevention. Global Initiative for Asthma; 2024. URL: https:\/\/ginasthma.org\/wp-content\/uploads\/2024\/05\/GINA-2024-Strategy-Report-24_05_22_WMS.pdf [Accessed 30-06-2026]"},{"key":"R48","unstructured":"Lead-I ECG devices for detecting symptomatic atrial fibrillation using single time point testing in primary care. National Institute for Health and Care Excellence. 2019. URL: https:\/\/www.nice.org.uk\/guidance\/dg35\/resources\/leadi-ecg-devices-%20for-detecting-symptomatic-atrial-fibrillation-using-single-time-point-testing-in-primary-care-%20pdf-1053752401861 [Accessed 30-07-2026]"},{"issue":"Supplement_1","key":"R49","doi-asserted-by":"publisher","first-page":"S203","DOI":"10.2337\/dc23-S012","article-title":"12. Retinopathy, neuropathy, and foot care: standards of care in diabetes\u20142023","volume":"46","author":"ElSayed","journal-title":"Diabetes Care"},{"key":"R50","unstructured":"Butterfly IQ+ for diagnostic ultrasound imaging medtech innovation briefing. National Institute for Health and Care Excellence. 2021. URL: https:\/\/www.nice.org.uk\/advice\/mib254 [Accessed 30-07-2026]"},{"key":"R51","unstructured":"Digital technologies to support self-management of COPD: early value assessment health technology evaluation. National Institute for Health and Care Excellence. 2025. URL: https:\/\/www.nice.org.uk\/guidance\/hte19 [Accessed 30-07-2026]"},{"key":"R52","unstructured":"TytoCare and Bradford Teaching Hospitals join forces in NHS \u2018first'. Bradford Teaching Hospitals NHS Foundation Trust. 2019. URL: https:\/\/www.bradfordhospitals.nhs.uk\/tytocare-and-bradford-hospitals-to-join-forces-in-nhs-first [Accessed 01-12-2025]"},{"issue":"3","key":"R53","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.cvdhj.2023.03.002","article-title":"Diagnostic accuracy of the PMcardio smartphone application for artificial intelligence-based interpretation of electrocardiograms in primary care (AMSTELHEART-1)","volume":"4","author":"Himmelreich","journal-title":"Cardiovasc Digit Health J"},{"issue":"11 Pt 2","key":"R54","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2025.101993","article-title":"Automatic diagnosis of left valvular heart disease based on artificial intelligence stethoscope","volume":"4","author":"Zhou","journal-title":"JACC Adv"},{"issue":"21","key":"R55","doi-asserted-by":"publisher","first-page":"2726","DOI":"10.3390\/healthcare13212726","article-title":"Diagnostic accuracy of AI-assisted focused cardiac ultrasound (FOCUS) in primary care","volume":"13","author":"Iacob","journal-title":"Health Care (Don Mills)"},{"issue":"5","key":"R56","doi-asserted-by":"publisher","first-page":"00116","DOI":"10.1183\/23120541.00116-2025","article-title":"Validation of artificial intelligence spirometry diagnostic support software in primary care: a blinded diagnostic accuracy study","volume":"11","author":"Sunjaya","journal-title":"ERJ Open Res"},{"issue":"4","key":"R57","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12040972","article-title":"Smartphone-enabled versus conventional otoscopy in detecting middle ear disease: a meta-analysis","volume":"12","author":"Chen","journal-title":"Diagnostics (Basel)"},{"issue":"3","key":"R58","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1017\/S0022215123001561","article-title":"Novel ENT live telehealth and live video-otoscopy clinics in remote Australia: outcomes and comparisons to traditional clinic models","volume":"138","author":"O\u2019Neil","journal-title":"J Laryngol Otol"},{"issue":"4","key":"R59","doi-asserted-by":"publisher","DOI":"10.1016\/j.patter.2021.100234","article-title":"The medical futurist institute: a vision about the technological future of healthcare","volume":"2","author":"Mesk\u00f3","journal-title":"Patterns (N Y)"},{"issue":"3","key":"R60","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1016\/j.healthpol.2017.01.005","article-title":"The determinants of medical technology adoption in different decisional systems: a systematic literature review","volume":"121","author":"Varabyova","journal-title":"Health Policy"},{"key":"R61","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2013.09.008","article-title":"Technology identity: the role of sociotechnical representations in the adoption of medical devices","volume":"98","author":"Ulucanlar","journal-title":"Soc Sci Med"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T20:44:02Z","timestamp":1786049042000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2026\/1\/e93861"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":61,"URL":"https:\/\/doi.org\/10.2196\/93861","relation":{},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]},"article-number":"v28i4e93861"}}