JMIR Research Protocols

Virtual health care has become increasingly popular worldwide since the COVID-19 pandemic. Immigrant populations in Canada face significant barriers to, and disparities in, access to and use of virtual care. South Asian immigrants in particular often face intersectional impediments to health care access. Compassionate and equitable health care is a fundamental patient right and should be provided at all levels of the health care system; however, patients frequently report a lack of compassionate, respectful, and caring health services.

Cancer-related pain remains highly prevalent and frequently undertreated despite advances in oncological therapies and analgesic strategies. Multidisciplinary approaches are recommended to optimize complex cancer pain management and integrate supportive care; however, robust real-world evidence evaluating their measurable clinical and patient-reported impact remains limited. Structured multidisciplinary cancer pain committees may be associated with changes in pain outcomes, quality of life, and patient experience, but prospective evaluations in routine clinical practice are scarce.

Hypertension is a leading contributor to stroke and cardiovascular disease in underserved populations.

Dog bites represent a significant global public health concern, particularly among children and adolescents. Approximately 330,000 emergency department visits occur annually in the United States alone due to dog-bite injuries, with pediatric populations bearing a disproportionate burden. Despite this, existing systematic reviews remain fragmented, focusing on isolated aspects such as breed-specific risk, educational interventions, or legislative measures, without comprehensively addressing the global incidence, prevalence, and multifactorial risk profile in pediatric cohorts.

Non–small cell lung cancer (NSCLC) is the leading cause of cancer-related mortality worldwide and continues to have poor survival outcomes, with most patients diagnosed at advanced stages of disease. In New Zealand, NSCLC contributes substantially to cancer inequities, with Māori communities experiencing disproportionately high incidence and mortality rates. Although low-dose computed tomography screening can improve early detection, major limitations remain, including false-positive findings, overdiagnosis, high infrastructure costs, and limited accessibility for rural and underserved populations. Liquid biopsy approaches using circulating tumor DNA (ctDNA), particularly DNA methylation profiling, have emerged as promising, minimally invasive strategies for improving cancer detection, treatment monitoring, and precision oncology.

Cleft lip and palate is a complex congenital defect that can present functional and esthetic challenges, particularly in patients with large alveolar clefts for which surgical management is indicated. In contrast to traditional treatment techniques such as autologous bone grafting, newer techniques include unilateral Le Fort I osteotomy advancement and dentoalveolar transport distraction osteogenesis and have been shown to be useful in the treatment of maxillary hypoplasia and large alveolar clefts. These techniques may help improve both esthetic and function in patients with substantial tissue deficiencies as well as in patients with scarring.

A 1-session virtual reality (VR) exposure for public speaking anxiety has been found to be effective in reducing public speaking anxiety. Previous meta-analyses comparing 1-session to several sessions of in vivo exposure for specific phobias did not find a difference in effectiveness. However, due to the specificity of VR exposure and public speaking anxiety, it is unclear how dividing the same amount of exposure tasks into 3 shorter sessions instead of one long session would affect the effectiveness of VR exposure for public speaking.

Systemic lupus erythematosus (SLE) presents substantial life challenges, reflecting the complex and heterogeneous nature of the disease. Pain is common and often one of the earliest manifestations. Skill-based behavioral pain treatments are often inaccessible to patients with SLE, and no SLE-specific evidence exists to guide patient and clinician treatment choices. To fill a pressing evidence gap for SLE pain treatment, the Lupus PROGRESS (Pain Relief With Online Groups That Empower Skill-Based Symptom Reduction) trial will compare a lower-burden evidence-based behavioral pain treatment with online multisession cognitive behavioral therapy (CBT; the gold standard behavioral treatment for chronic pain) while also enhancing diversity and representativeness among patient advisors and study participants.

Breast cancer screening through mammography is essential for early detection and improved survival; however, pain and discomfort during the procedure remain major barriers to women’s participation. Pain perception during mammography is influenced not only by technical factors but also by psychological variables such as anxiety, depression, pain catastrophizing, and personality traits. Despite growing evidence, findings on the role of psychological factors remain inconsistent, and the contribution of personality traits remains largely unexplored, highlighting the need for further investigation.

In India, hanging is the leading method of suicide, and survivors of near-hanging often present with altered sensorium due to cerebral edema from cervical vascular compression and hypoxia. Management typically involves supportive care and antiedema measures, such as mannitol, hypertonic saline, and dexamethasone. Dexamethasone, a corticosteroid that crosses the blood-brain barrier, is commonly used for presumed cerebral edema. However, evidence supporting its efficacy is limited, and there are no clinical guidelines that recommend its routine use. A randomized controlled trial is therefore essential to establish the real-world efficacy of dexamethasone in this setting.

Placental dysfunction underlies major obstetric complications, including preeclampsia, fetal growth restriction, preterm birth, and stillbirth. While early identification of pregnancies at high risk of complications enables preventive interventions, current screening methods based on traditional risk factors have limited accuracy.

Wounds are common and clinically consequential, and consistent assessment is essential for communication, monitoring, and decision-making. Although multiple wound assessment instruments exist, there is no agreement among specialists on which criteria to prioritize during validation processes and evidence synthesis remains insufficient within the Brazilian context.