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Comment & Response
February 2014

Technical Difficulties and Evaluating e-Health Interventions

Author Affiliations
  • 1Center for Genome Sciences, Washington University School of Medicine in St Louis, St Louis, Missouri
JAMA Intern Med. 2014;174(2):304. doi:10.1001/jamainternmed.2013.12759

To the Editor In their Research Letter, Kakkar and Jacobson1 report low patient viewership of an online instructional video describing colonoscopy preparation. Their analysis is significantly confounded by technical challenges with viewing the video. The authors mention that “[t]here were no technical problems reported by those instructed to watch the video, although we did not inquire as to why they did not view the video.”1(p1375) At the time of writing, the training video (at http://www.bmc.org/digestivedisorders.htm) is provided as a “.wsx” file, which is not a valid file extension for any current video format. This video will not open in Windows Media Player (as the authors suggest) on any operating system, without being manually renamed to “.asf.” Only users accessing this site in Internet Explorer on Windows will have the filename automatically corrected to the “.asf” extension. It seems unlikely that other patients in the authors’ study had the technical wherewithal to determine the correct file format and rename the video accordingly.

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