Mindfulness-based online intervention on mental health and quality of life among COVID-19 patients in China: an intervention design

Probably not a substantial claim: may not pass S3 (load-bearing).

COVID-19 survivors in other countries have similar psychological status.

“COVID-19 survivors in other countries have similar psychological status [11–13].”

• cites [11] Paz C, Mascialino G, Adana-Díaz L, Rodríguez-Lorenzana A, Simbaña-Rivera K, Gómez-Barreno L, et al. Behavioral and sociodemographic predictors of anxiety and depression in patients under epidemiological surveillance for COVID-19 in Ecuador. PLoS ONE. 2020;15(9):e0240008. https://doi.org/10.1371/journal.pone.0240008 (PMID: 32997705). sourcePartly supported

  The Discussion (page unavailable) says levels of emotional distress during the COVID-19 pandemic were broadly consistent across its Ecuadorian participants and a comparison study. It does not establish similar psychological status specifically among COVID-19 survivors in other countries; its separate mention of survivors concerns MERS. (LLM, conf=0.86)

  Experimental — accuracy not yet measured
• cites [12] Le HT, Lai AJX, Sun J, Hoang MT, Vu LG, Pham HQ, et al. Anxiety and depression among people under the nationwide partial lockdown in Vietnam. Front Public Health. 2020;29(8):589359. https://doi.org/10.3389/fpubh.2020.589359. sourceCould not verify

  The Abstract and Discussion > Key Findings describe psychological symptoms among people surveyed during Vietnam’s partial lockdown, not COVID-19 survivors. The Discussion compares their scores with general-population studies in China, Iran, and Italy, but does not assess whether survivors in other countries have similar psychological status. Searches for survivors and recovered patients found no relevant passage. (LLM, conf=0.75)

  Experimental — accuracy not yet measured
• cites [13] Tee ML, Tee CA, Anlacan JP, Aligam KJG, Reyes PWC, Kuruchittham V, et al. Psychological impact of COVID-19 pandemic in the Philippines. J Affect Disord. 2020;1(277):379–91. https://doi.org/10.1016/j.jad.2020.08.043. sourceDisputed

  The Discussion (page unavailable) compares pandemic-related psychological outcomes in the Philippine general-population survey with reports from elsewhere. It says respondents in China had worse psychological impact, rather than similar status. The paper does not make this comparison among COVID-19 survivors. (LLM, conf=0.79)

  Checked by a reasoning model — may be wrong.

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In Vietnam and the Philippines, 22.6% and 16.3% of respondents reported clinically concerning levels of psychological impact.

“In addition, 22.6% and 16.3% of respondents reported clinically concerning levels of psychological impact in Vietnam and the Philippines, the Asian countries with similar cultural context as China [12, 13].”

• cites [12] Le HT, Lai AJX, Sun J, Hoang MT, Vu LG, Pham HQ, et al. Anxiety and depression among people under the nationwide partial lockdown in Vietnam. Front Public Health. 2020;29(8):589359. https://doi.org/10.3389/fpubh.2020.589359. sourceDisputed

  Table 3 (Results > Tables; page unavailable) reports 4.9% of Vietnamese respondents as ‘concerned’ and 6.8% as ‘extremely concerned’ on the IES-R—a combined 11.7%, not 22.6%. The paper does not report a Philippine respondent group; its figure of 16.3 is a mean IES-R score, not a percentage of Philippine respondents. (LLM, conf=0.88)

  Checked by a reasoning model — may be wrong.

  Experimental — accuracy not yet measured
• cites [13] Tee ML, Tee CA, Anlacan JP, Aligam KJG, Reyes PWC, Kuruchittham V, et al. Psychological impact of COVID-19 pandemic in the Philippines. J Affect Disord. 2020;1(277):379–91. https://doi.org/10.1016/j.jad.2020.08.043. sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In Wuhan, China, a March 2020 survey found 45.9% of patients had depression symptoms, 38.8% anxiety, and 54.1% insomnia.

“In addition, a survey conducted in March, 2020 showed that 45.9% of patients had symptoms of depression, 38.8% had anxiety and 54.1% had insomnia in Wuhan, China [10].”

• cites [10] Hu Y, Chen Y, Zheng Y, You C, Tan J, Hu L, et al. Factors related to mental health of inpatients with COVID-19 in Wuhan, China. Brain Behav Immun. 2020. https://doi.org/10.1016/j.bbi.2020.07.016. sourceSupported

May combine two claims.

In Shanghai, China, immediately after the outbreak, more than 33.0% of COVID-19 patients reported PTSD, 60.2% depression, and 55.3% anxiety symptoms.

“Immediately after the outbreak, a considerable proportion of patients with COVID-19 reported post-traumatic stress disorder (PTSD) (more than 33.0%), depression (60.2%), and anxiety (55.3%) symptoms in Shanghai, China [9].”

• cites [9] Guo Q, Zheng Y, Shi J, Wang J, Li G, Li C, et al. Immediate psychological distress in quarantined patients with COVID-19 and its association with peripheral inflammation: a mixed-method study. Brain Behav Immun. 2020;88:17–27. https://doi.org/10.1016/j.bbi.2020.05.038. sourcePartly supported

  The Results (Demographic and clinical characteristics; page unavailable) report depression symptoms in 60.2% and anxiety symptoms in 55.3% of patients. They report that only 1.0% exceeded the PTSD screening cutoff, not more than 33.0%. The Methods (Design and participants; page unavailable) place recruitment primarily in Shanghai during February 2020. (LLM, conf=0.90)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

As of March 22, 2021, there are 97,716 COVID-19 survivors cured and discharged in China, about one-third (32,572) may be suffering from mental illness as reported by survey results in Wuhan.

“As of March 22, 2021, there are 97 716 COVID-19 survivors cured and discharged from hospital in China, about one-third of them (i.e. 32 572 patients) may be suffering from mental illness as reported by the survey results in Wuhan, China [3, 10].”

• cites [3] National Health Commission of the People’s Republic of China. March 23: Daily briefing on novel coronavirus cases in China. http://en.nhc.gov.cn/2021-03/23/c_83286.htm. Accessed 22 Mar 2021.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [10] Hu Y, Chen Y, Zheng Y, You C, Tan J, Hu L, et al. Factors related to mental health of inpatients with COVID-19 in Wuhan, China. Brain Behav Immun. 2020. https://doi.org/10.1016/j.bbi.2020.07.016. sourcePartly supported

  The Discussion reports substantial depression, anxiety and insomnia symptoms among COVID-19 inpatients in Wuhan, supporting concern about their mental health. But the survey assessed 85 patients before discharge, not survivors after discharge; the approximately one-third post-discharge figure in the Discussion concerns SARS survivors. This paper does not establish that 32,572 of the 97,716 discharged COVID-19 patients in China had mental illness. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

This study protocol is reported in accordance with SPIRIT reporting guidelines.

“This study protocol is reported in accordance with SPIRIT reporting guidelines [22]”

• cites [22] Chan AW, Tetzlaff JM, Gøtzsche PC, Altman DG, Mann H, Berlin JA, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013;346:e7586. https://doi.org/10.1136/bmj.e7586. sourceSupported
  Experimental — accuracy not yet measured

Classified as probably not a substantial claim. May combine two claims.

The current study will use RCT, double-blind, evidence-based meditation design, and a longer period of intervention and follow-up, which may ensure more solid conclusions compared to similar studies.

“The current study will use RCT, double-blind, evidence-based meditation design, and a longer period of intervention and follow-up, which may ensure more solid conclusions compared to similar studies [18, 47].”

• cites [18] Wei N, Huang BC, Lu SJ, Hu JB, Zhou XY, Hu CC, et al. Efficacy of internet-based integrated intervention on depression and anxiety symptoms in patients with Covid-19. J Zhejiang Univ Sci B. 2020;21(5):400–4. https://doi.org/10.1631/jzus.B2010013. sourceSupported
• cites [47] Guo L, Wu M, Zhu Z, Zhang L, Peng S, Li W, et al. Effectiveness and influencing factors of online education for caregivers of patients with eating disorders during COVID-19 pandemic in China. Eur Eat Disord Rev. 2020. https://doi.org/10.1002/erv.2783.10.1002/erv.2783. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Mindfulness-based interventions help patients cope with anxiety and depression by enhancing stress management and reducing negative coping behaviors, and are more adaptive and persistent than behavioral therapy.

“Unlike behavioral therapy, which involves relaxation techniques and changing the schedule of daily activities, mindfulness-based interventions help patients cope with anxiety and depression by enhancing their ability to manage stress and reducing negative coping behaviors, hence are more adaptive and persistent [20].”

• cites [20] Ho CS, Chee CY, Ho RC. Mental health strategies to combat the psychological impact of COVID-19 beyond paranoia and panic. Ann Acad Med Singap. 2020;49(3):155–60. sourcePartly supported

  The 'Mode and Content of Psychological Intervention' section says mindfulness-based cognitive therapy can alleviate stress in people with physical conditions. It attributes improved stress management and reduced maladaptive coping behaviours to cognitive behavioural therapy, not mindfulness-based therapy, and does not say mindfulness-based interventions are more adaptive or persistent than behavioural therapy. (LLM, conf=0.87)

  Experimental — accuracy not yet measured

May combine two claims.

This study will mainly use questionnaires to measure psychiatric symptoms and will not make clinical diagnosis through structured clinical interview and functional neuroimaging, which may result in measurements inconsistent with clinical examinations.

“However, it should be noted that, this study will mainly use questionnaires to measure psychiatric symptoms and do not make clinical diagnosis through structured clinical interview and functional neuroimaging, which may result in measurements that are inconsistent with clinical examinations [50, 51].”

• cites [50] Husain SF, Yu R, Tang TB, Tam WW, Tran B, Quek TT, et al. Validating a functional near-infrared spectroscopy diagnostic paradigm for Major Depressive Disorder. Sci Rep. 2020;10(1):9740. https://doi.org/10.1038/s41598-020-66784-2. sourcePartly supported

  Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured
• cites [51] Ho CSH, Lim LJH, Lim AQ, Chan NHC, Tan RS, Lee SH, et al. Diagnostic and predictive applications of functional near-infrared spectroscopy for major depressive disorder: a systematic review. Front Psychiatry. 2020;6(11):378. https://doi.org/10.3389/fpsyt.2020.00378. sourcePartly supported

  Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In Ecuador, among 759 confirmed or suspected COVID-19 patients, 20.3% had moderate to severe depressive symptoms and 22.5% moderate to severe anxiety.

“In Ecuador, one of the most affected countries by the COVID-19 pandemic in Latin America, of the 759 confirmed or suspected COVID-19 patients, 20.3% showed moderate to severe depressive symptoms, while 22.5% showed moderate to severe anxiety [11].”

• cites [11] Paz C, Mascialino G, Adana-Díaz L, Rodríguez-Lorenzana A, Simbaña-Rivera K, Gómez-Barreno L, et al. Behavioral and sociodemographic predictors of anxiety and depression in patients under epidemiological surveillance for COVID-19 in Ecuador. PLoS ONE. 2020;15(9):e0240008. https://doi.org/10.1371/journal.pone.0240008 (PMID: 32997705). sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

The online MLWC intervention is inexpensive and portable, so it can be more easily implemented in harder-to-reach but internet-accessible populations.

“Furthermore, given the inexpensive and portable features of the online MLWC intervention, it can be more easily implemented in harder-to-reach but internet-accessible populations.”

Classified as probably not a substantial claim.

Currently, WeChat App and its small programs have become an integral part of everyday life for the majority of the population in China.

“Currently, the WeChat App and its small programs have become an integral part of everyday life for the majority of the population in China [21].”

• cites [21] Tencent. Tencent announces 2018 first quarter results. https://www.tencent.com/en-us/articles/15000691526464720.pdf. Accessed 18 Nov 2020.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

Participants who meet eligibility criteria will be randomly assigned in a 1:1 ratio to the online MLWC intervention group or waitlist control group by computer-generated numbers.

“Participants who meet the eligibility criteria will be randomly assigned (in a 1:1 ratio) to the online MLWC intervention group or waitlist control group.”

Classified as probably not a substantial claim.

Adherence to the intervention will be examined through documentation of completed sessions and platform records of logins and time spent on mindfulness training.

“Adherence to the intervention was examined through documentation of completed sessions. Firstly, the internet-based intervention platform can automatically record which participant has logged into each session and how much time they spend on mindfulness training per week.”

• AssumptionRests on an assumption: The effectiveness of the MLWC intervention on mental health and quality of life is dependent on adherence.

Probably not a substantial claim: may not pass S4 (based).

The trial will blind all people who might influence outcome assessments, including participants, data analysts, and outcome assessors.

“The trial will blind all people who might influence the outcome assessments, including the participants, data analysts, and outcome assessors.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Before the trial, the principal investigator will organize training on the randomization procedure and ensure each research staff is aware of their responsibilities.

“Before the trial, the principal investigator of the project will organize training on the randomization procedure and ensure that each research staff is clearly aware of their responsibilities.”

Probably not a substantial claim: may not pass S4 (based).

All scales to be used in this study are validated Chinese versions.

“All scales to be used in this study are validated Chinese version.”

Classified as probably not a substantial claim.

In mainland China, WeChat App and its small programs have dominated the browsing time of mobile phone users.

“In the mainland of China, WeChat App and its small programs have dominated the browsing time of mobile phone users [21]”

• cites [21] Tencent. Tencent announces 2018 first quarter results. https://www.tencent.com/en-us/articles/15000691526464720.pdf. Accessed 18 Nov 2020.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim. May combine two claims.

The content of the intervention course will be developed by a team with clinical psychology background and delivered by a psychiatrist with mindfulness training qualification.

“To ensure the efficacy and the quality of the mindfulness intervention, the content of the intervention course will be developed by a team with clinical psychology background and delivered by a psychiatrist with mindfulness training qualification.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

All researchers and support staff will be trained based on the same protocol and are required to have an educational background in medicine or public health.

“All researchers and support staff in this project will be trained based on the same protocol and are required to have an educational background in medicine or public health.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Electronic questionnaires powered by REDCap will be used, and survey questions will be automatically uploaded to a read-only web-based database to ensure authenticity of the data.

“Electronic questionnaires powered by the REDCap software will be used to collect data, hence there will be no formal data monitoring committee. Survey questions filled up by the participants will be automatically uploaded to the read-only web-based database to ensure the authenticity of the data.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

This will affect the normal operation of many families and bring huge health and economic pressure to the country.

“This will undoubtedly affect the normal operation of many families and bring huge health and economic pressure to the country.”

Classified as probably not a substantial claim.

Data will be analyzed based on an intention-to-treat approach.

“Data will be analyzed based on an intention-to-treat approach”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The MLWC intervention will be developed by two psychiatrists, one certified in the Training of Mindfulness Facilitation program at UCLA.

“The MLWC intervention will be developed by two psychiatrists, and one of them has been certified in the Training of Mindfulness Facilitation program at the Mindful Awareness Research Center of University of California, Los Angeles (UCLA).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The mortality rate of COVID-19 has been declining recently, meaning more patients have been released from hospital after being cured.

“It can be seen that the mortality rate of COVID-19 has been declining recently, which means that more and more patients have been released from the hospital after being cured.”

• cites [1] WHO. COVID-19 weekly epidemiological update, 21 March 2021. https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---23-march-2021. Accessed 22 Mar 2021.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [2] World Health Organization. 2020. Coronavirus disease 2019 (COVID-19): Situation report 63. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200323-sitrep-63-Covid-19.pdf?sfvrsn=d97cb6dd_2. Accessed 18 Nov 2020.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [3] National Health Commission of the People’s Republic of China. March 23: Daily briefing on novel coronavirus cases in China. http://en.nhc.gov.cn/2021-03/23/c_83286.htm. Accessed 22 Mar 2021.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Professionals in information technology will design the specific small program for managing questionnaire collection and distribution of embedded video and audio courses to enhance adherence.

“Also, to enhance the adherence of the mindfulness-based intervention, professionals in information technology will design the specific small program for managing the questionnaire collection and distribution of the embedded video and audio courses during the study period.”

Classified as probably not a substantial claim. May combine two claims.

This is a prospective, randomized, parallel-group, double-blind, blank controlled trial involving an online 6-week MLWC intervention with a 3-month follow-up.

“This is a prospective, randomized, parallel-group, double-blind, blank controlled trial involving an online 6-week MLWC intervention with a 3-month follow-up.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Our researchers will promptly check the collected data after each questionnaire survey.

“Moreover, our researchers will promptly check the collected data after each questionnaire survey.”