Teleconsultation has become a vital component of modern healthcare delivery, within which clinical reasoning is a critical determinant of care quality, directly impacting patient outcomes. This qualitative study aimed to explore and validate the key components that constitute effective (accurate, timely and safe) physician-physician clinical reasoning in teleconsultations.

We employed a qualitative design using directed content analysis. The study was conducted within Iran’s national ‘Moein Program’, a structured teleconsultation service providing specialist support for obstetrics and gynaecology. Data collection was conducted between 2023 and 2024.

Semistructured interviews were conducted with 16 purposively sampled obstetrician-gynaecologists (both specialists and residents) who had direct teleconsultation experience. Data collection continued until theoretical saturation was achieved.

The data analysis process was guided by an initial conceptual framework derived from a literature review, and the study’s rigour was ensured through Lincoln and Guba’s trustworthiness criteria, including triangulation and member checking.

The analysis validated and refined the initial framework, culminating in five key components influencing clinical reasoning in teleconsultations: (1) Data collection and sharing, (2) Situation analysis, (3) Ethical and emotional factors, (4) Collaborative decision-making and (5) Resource-related factors.

The study concludes that successful teleconsultation relies not merely on technological infrastructure but critically on a complex interplay of human, cognitive and ethical factors. These findings underscore the necessity for developing integrated teleconsultation systems that are explicitly designed to support both the technical and the collaborative cognitive dimensions of clinical reasoning.

Older adult loneliness is associated with depression, disability and higher mortality rates. As a public health concern, it contributes to increased medical and nursing care costs. Several intervention studies have been conducted to reduce loneliness; however, no universally effective method has been established. We hypothesise that if older adults use their physical abilities to perform petit volunteering, their feelings of loneliness would likely be reduced. This trial aims to investigate the benefits of using petit volunteers for loneliness alleviation (PetitVOLA) application as a sustainable programme to prevent loneliness through the creation of an Ikigai-based volunteer system.

We intend to conduct a randomised controlled trial with a 3-month intervention period to verify the effectiveness of the PetitVOLA programme (sample size, 126 participants; power, 0.8; significance level, 0.05). The primary outcome is loneliness, which we will measure using the UCLA Loneliness Scale (V.3). Secondary outcomes include social isolation (assessed via multicomponent objective criteria), life satisfaction, physical function (gait speed and grip strength), cognitive function, psychological status and lifestyle, each assessed with validated instruments (eg, Mini-Mental State Examination, Geriatric Depression Scale-15 and the Active Mobility Index). The main analysis uses an intention-to-treat approach, while a full analysis set and a per-protocol set are included for sub-analyses.

The trial was approved by the Human Research Ethics Committee of the National Center for Geriatrics and Gerontology, Japan (approval No. 1794). The results of this trial will be disseminated through peer-reviewed journals, conference presentations and reports to the participating community.

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Artificial intelligence (AI) is rapidly evolving, offering an expanding suite of capabilities that go beyond the traditional focus on prediction and classification. Generative AI (GenAI) and agentic AI could create transformative practices to support real-world evidence (RWE) generation for health research by streamlining studies, accelerating insights and improving decision-making. However, there is no published overview available describing the range of applications in RWE generation. This review aims to describe where and how genAI and agentic AI are applied across the domains of healthcare research tasks for RWE generation. Additionally, to map applications by tasks and methods across the product lifecycle continuum, and to identify emerging gaps and opportunities.

This Living Scoping Review (LSR) will include studies reporting an application and/or evaluation of genAI or agentic AI applied to one or more RWE generation research tasks. Searches will be conducted in Embase, MEDLINE and additional sources (eg, grey literature). Citations will be independently screened by two human senior reviewers for a substantive training dataset and a commercially available screening algorithm (Robot Screener) will complete screening with a human reviewer. The LSR will include reports of studies (primary or reviews) describing and/or evaluating the application of any genAI model for RWE generation in healthcare, in English, published from 1 January 2025 to the date of search. Data will be extracted from all studies included in the LSR by one independent senior reviewer using a piloted template, with 10% quality check by a second senior reviewer. Descriptive statistics will be used to summarise the applications of genAI per RWE research task, and the results of genAI evaluations. Thematic analysis will be used to describe genAI application patterns, trends, gaps and opportunities. The LSR protocol and reports will be updated annually, and findings will be published on a publicly available website (eg, ISPE—the International Society for Pharmacoepidemiology).

Ethical approval is not required due to use of previously published data. Planned dissemination includes peer-reviewed publication, presentation and short summaries.

Teleconsultation has gained significant traction due to advancements in information and communication technologies. While much attention has been given to physician-to-patient teleconsultation, the factors influencing physician-to-physician teleconsultation remain underexplored.

This scoping review aims to map and synthesise the existing evidence on the factors influencing physician-to-physician teleconsultation.

We included publications of all methodological designs that specifically addressed factors affecting physician-to-physician teleconsultation. Studies focusing primarily on physician-to-patient teleconsultation without sufficient detail on physician-to-physician components were excluded. The search was limited to articles published in English and Persian between 2014 and 2024.

Eight electronic databases (PubMed, Scopus, Web of Science, etc) were searched from January 2014 to June 2024.

Data extraction was performed by two independent reviewers using a standardised form. Extracted data included study characteristics, key factors influencing teleconsultation and main findings.

From 12 included studies, five key influencing components were identified: ‘patient-related factors’, ‘medical team competencies’, ‘infrastructure and technology’, ‘timing factors’ and ‘planning and programme evaluation’. Among these, infrastructure and technology were the most frequently reported factors across the studies, while patient-related factors were less commonly addressed.

This review identifies a comprehensive set of factors that influence physician-to-physician teleconsultation. The findings provide a foundation for developing effective teleconsultation programmes and highlight the need for more research in diverse healthcare settings.