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Comment & Response
February 2014

Technical Difficulties and Evaluating e-Health Interventions—Reply

Author Affiliations
  • 1Hallmark Health Medical Associates, Malden, Massachusetts
  • 2Boston University Medical Center, Boston, Massachusetts
JAMA Intern Med. 2014;174(2):305. doi:10.1001/jamainternmed.2013.12734

In Reply Mr Semenkovich raises concerns that patients asked to view our instructional video may not have been able to view it because the video appears as a .wsx file on his computer. This suggests he is trying to view the video on an Apple product, with a Mac operating system. He is correct to point out that someone with such an operating system would need to determine a correct file format and rename the video. It was for this reason that a transcript of the video was also provided on our website in PDF format, enabling anyone with technical problems to access the information provided in the video. However, the videos (in English and Spanish) appear as windows media viewer (.wmv) files when viewed on a personal computer (PC) with Microsoft Windows and Internet Explorer. Recent statistics show that Windows is the operating system on more than 78% of all PCs sold, while Apple’s Macs represent approximately 4% of the market.1 During the course of the study (2010-2011), PCs outsold Macs by a ratio of 20:1.1 We therefore doubt that technical difficulties adequately account for failure of 95% of our patients to view the video.

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