Prioritization of Quality Principles for Health Apps Using the Kano Model: Survey Study

Background Health apps are often used without adequately taking aspects related to their quality under consideration. This may partially be due to inadequate awareness about necessary criteria and how to prioritize them when evaluating an app. Objective The aim of this study was to introduce a method for prioritizing quality attributes in the mobile health context. To this end, physicians were asked about their assessment of nine app quality principles relevant in health contexts and their responses were used as a basis for designing a method for app prioritization. Ultimately, the goal was to aid in making better use of limited resources (eg, time) by assisting with the decision as to the specific quality principles that deserve priority in everyday medical practice and those that can be given lower priority, even in cases where the overall principles are rated similarly. Methods A total of 9503 members of two German professional societies in the field of orthopedics were invited by email to participate in an anonymous online survey over a 1-month period. Participants were asked to rate a set of nine app quality principles using a Kano survey with functional and dysfunctional (ie, positively and negatively worded) questions. The evaluation was based on the work of Kano (baseline), supplemented by a self-designed approach. Results Among the 9503 invited members, 382 completed relevant parts of the survey (return rate of 4.02%). These participants were equally and randomly assigned to two groups (test group and validation group, n=191 each). Demographic characteristics did not significantly differ between groups (all P>.05). Participants were predominantly male (328/382, 85.9%) and older than 40 years (290/382, 75.9%). Given similar ratings, common evaluation strategies for Kano surveys did not allow for conclusive prioritization of the principles, and the same was true when using the more elaborate approach of satisfaction and dissatisfaction indices following the work of Timko. Therefore, an extended, so-called “in-line-of-sight” method was developed and applied for this evaluation. Modified from the Timko method, this approach is based on a “point of view” (POV) metric, which generates a ranking coefficient. Although the principles were previously almost exclusively rated as must-be (with the exception of resource efficiency), which was not conducive to their prioritization, the new method applied from the must-be POV resulted in identical rankings for the test and validation groups: (1) legal conformity, (2) content validity, (3) risk adequacy, (4) practicality, (5) ethical soundness, (6) usability, (7) transparency, (8) technical adequacy, and (9) resource efficiency. Conclusions Established survey methodologies based on the work of Kano predominantly seek to categorize the attributes to be evaluated. The methodology presented here is an interesting option for prioritization, and enables focusing on the most important criteria, thus saving valuable time when reviewing apps for use in the medical field, even with otherwise largely similar categorization results. The extent to which this approach is applicable beyond the scenario presented herein requires further investigation.

Slow Medicine and Choosing Wisely: a synergistic alliance

Choosing Wisely® is an initiative of the American Board of Internal Medicine Foundation to help physicians and patients engage in conversations about the overuse of tests and procedures and support physician efforts to help patients make smart and effective care choices. Choosing Wisely campaigns are now active and present in 25 countries around the world, on five continents. Italy is the only country where a Choosing Wisely campaign was launched, and it is currently steered by a Nationwide association (Slow Medicine), creating a synergistic alliance. The Slow Medicine Association was founded in 2011 when a group of health professionals and citizens shared a new paradigm of values, methodology, and interventions and decided to establish an association with the mission of working for a health system driven by ethics and quality principles. Three keywords summarize the philosophy of Slow Medicine: measured because it acts with moderation, gradualness, and without waste; respectful because it is attentive to the dignity of individuals recognizing their values; and equitable because it is committed to ensuring appropriate care based on the best available evidence. Slow Medicine allowed the spread of Choosing Wisely in Italy involving several professional societies and participating at the National meetings of the Societies as well as numerous other meetings, in which the mission of the Association is combined with the principle of the ‘do not’ recommendations. Numerous other initiatives were carried out, and new projects were planned in synergy with Choosing Wisely.

INFRAFRONTIER quality principles in systemic phenotyping

Improving reproducibility and replicability in preclinical research is a widely discussed and pertinent topic, especially regarding ethical responsibility in animal research. INFRAFRONTIER, the European Research Infrastructure for the generation, phenotyping, archiving, and distribution of model mammalian genomes, is addressing this issue by developing internal quality principles for its different service areas, that provides a quality framework for its operational activities. This article introduces the INFRAFRONTIER Quality Principles in Systemic Phenotyping of genetically altered mouse models. A total of 11 key principles are included, ranging from general requirements for compliance with guidelines on animal testing, to the need for well-trained personnel and more specific standards such as the exchange of reference lines. Recently established requirements such as the provision of FAIR (Findable, Accessible, Interoperable, Reusable) data are also addressed. For each quality principle, we have outlined the specific context, requirements, further recommendations, and key references.

Design-driven innovation: exploring new product development in the home appliances and furniture industry

PurposeThis paper aims to investigate the phases of new product development within the design-driven innovation (DDI) process, the role of designers and collaborators in the process and how this process relates to some quality principles.Design/methodology/approachThis study adopted a qualitative approach using Gioia methodology. In particular, four Italian manufacturing companies in the home appliances and furniture industry were selected, and data mainly collected through direct interviews were analysed through content analysis.FindingsThe new product development related to DDI includes the following phases: the company brief, the designer research, the concept of the designer, the design, legal protection, prototyping, production and the market launch. Designers play a strategic role in the above phases of DDI, but other actors also cooperate and some quality principles affect positively on the process. This study proposes a model for a DDI process in the home appliances and furniture sector.Research limitations/implicationsAlthough this exploratory study was conducted on only four companies, it advances the DDI research in relation to new product development.Practical implicationsThis study makes recommendations to entrepreneurs and managers on how to innovate successfully and to effectively manage designers and collaborators to ensure competition.Social implicationsThis analysis highlights that design-based innovation contributes to improving the quality of life of consumers.Originality/valueTo the best of the authors' knowledge, this is the first qualitative study to examine the phases of new product development in DDI process, the actors involved and relationship to quality principles for the Italian home appliances and furniture sector.

Teaching Accompaniment in Colombia's Official Educational Institutions

This article presents an analysis of the quality principles for the teaching accompaniment of the official educational institutions of the city of Montería. A questionnaire with 36 reagents (Likert type scale) was applied to 341 teachers and their answers were analyzed through descriptive statistics. Additionally, the chi-square test and V Cramer were used to determine the existence of relationships and their strength. The main results refer to the existence of a relationship between the principles of quality and teacher accompaniment in the official educational institutions of the city of Montería.

Developing effective training and certification schemes for improving on-farm dairy cattle welfare

This chapter discusses developing effective training and certification schemes for improving on-farm dairy cattle welfare. It begins by reviewing the selection of measures that can be used for assessing animal welfare, focusing firstly on animal-based measures, then moves on to review resource and management based measures. The chapter also discusses the four welfare quality principles – feeding, housing, health and behaviour – and how dairy cattle welfare can be affected by the quality these four principles. Training of assessors is also discussed, before a summary of why using a combination of resource-based, management-based and animal-based measures is the best way to ensure good welfare in animals such as dairy cattle.

Excellence in Sustainable Management in a Changing Environment

In the current changing environment, organizations need to evolve from a profitable perspective to a more sustainable focus. To deal with this change, the implementation of specific quality models and principles might help. Thus, the present article aims to study whether sustainable management can be achieved in specific organizations (enterprises, associations, and government institutions) by identifying the EFQM principles. Moreover, it analyses which of these quality principles positively and directly impacts the performances studied (environmental, social, and economic). To achieve these objectives, Ordinal Logistic Regression (ORL) was performed using data corresponding to the sample compiled by the Càtedra Universitària de Responsabilitat Social (RSU) from University of Girona. The research results indicate that implementing specific quality principles all the dimensions improved; thus, the organization becomes more sustainable. The value of this research lies in its contribution to the sustainable management literature; adds knowledge to the ongoing debate about the possible influence of TQM principles on the specific dimensions of sustainable management and highlight the importance of having a clear strategy to obtain the highest sustainable performance.