Mobile app validation: a digital health scorecard approach

AbstractWhile digital health solutions continue to grow in number and in complexity, the ability for stakeholders in healthcare to easily discern quality lags far behind. This challenge is in part due to the lack of a transparent and standardized approach to validation. Evaluation of mobile health applications (apps) is further burdened by low barriers to development and direct-to-user marketing, leading to a crowded and confusing landscape. In this context, we investigated the pragmatic application of a previously described framework for digital health validation, the Digital Health Scorecard, in a cohort of 22 popular mobile health oncology apps. The apps evaluated using this framework performed poorly, scoring 49.4% across all evaluation criteria as a group. Performance across component domains varied considerably with cost scoring highest at 100%, usability at 56.7%, technical at 37.3%, and clinical at 15.9%. satisfaction of prospectively determined end-user requirements derived from patient, family, and clinician consensus scored 37.2%. While cost outperformed consistently and usability was adequate, the results also suggested that apps suffered from significant technical limitations, were of limited clinical value, and generally did not do what end users wanted. These large gaps further support the need for transparent and standardized evaluation to help all stakeholders in healthcare improve the quality of mobile health.

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The Functionality, Quality and Consistency with International Guidelines of Asthma Mobile Health Applications: Protocol for a Systematic Review. (Preprint)

10.2196/preprints.32617 ◽

2021 ◽

Author(s):

Billy Robinson ◽

Enying Gong ◽

Brian Oldenburg ◽

Katharine See

Keyword(s):

Systematic Review ◽

Mobile Health ◽

Airflow Limitation ◽

Significant Variable ◽

Assessment Framework ◽

Mobile Health Applications ◽

Gina Guidelines ◽

Mhealth Apps ◽

Health Applications

BACKGROUND Asthma is a chronic respiratory disorder defined clinically as a combination of typical respiratory symptoms, and significant variable reversible airflow limitation. In addition to pharmacotherapy, a key aspect of asthma management is empowering patients to manage their condition and recognise and respond to asthma exacerbations. Mobile health applications (mHealth apps) represent a potential medium through which patients could improve the ability to self-manage their asthma. Few studies have conducted a systematic evaluation of both free and paid asthma mobile applications for the quality and functionality of the apps using a validated tool and to our knowledge none have systematically assessed these applications for the quality of information that they provide compared to available international best practice guidelines. This represents the first study that will undertake both of these evaluations for all available mHealth Apps in Australia targeted towards adult asthmatics. The Global Initiative for Asthma (GINA) guidelines represent a regularly updated guideline based on reviews of the available scientific literature by an international panel of experts. This review will examine the functionality and quality of available asthma mobile health applications and the consistency of these available applications with recommendations from the GINA guidelines. OBJECTIVE The objective of this study is to conduct a systematic review of adult-targeted asthma mobile health applications on the Australian market. As part of this review the potential for an mHealth app to improve asthma self-management and the overall quality of the application will be evaluated, using the Mobile App Rating Scale (MARS) framework, and the quality of the information within an app, using the current GINA guidelines as a reference, will be assessed. METHODS A methodological stepwise approach was taken in creating this review. First the most recent GINA guidelines were independently reviewed by two authors to identify key recommendations that could feasibly be incorporated into a mHealth app. These identified recommendations were then compared to a previously developed asthma application assessment framework. A modified assessment framework was created, ensuring all of these identified recommendations were included. Two popular App stores were then reviewed to identify potential mHealth Apps and then a screening process based on pre-defined inclusion and exclusion criteria occurred to establish what mHealth Apps would be evaluated. Application evaluation then occurred. Technical information was obtained from publicly available information on the application store or within the app itself. The next step was to perform an application quality assessment using the validated MARS framework to objectively determine the quality of the application. Application functionality was then assessed using the IMS Institute for Health Informatics Functionality Scoring system. Finally, the mHealth applications will be assessed using a checklist that we have developed based on what was identified from the international GINA guidelines. RESULTS To date, funding has been received for the project from the Respiratory Department at Northern Health, Victoria. Three reviewers have been recruited to systematically evaluate the applications. Results for this study are expected by the end of this year. CONCLUSIONS Nil as protocol CLINICALTRIAL PROSPERO 269894

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Relationships between the Older Adult’s Cognitive Decline and Quality of Life: The Mediating Role of the Assistive Mobile Health Applications

International Journal of Interactive Mobile Technologies (iJIM) ◽

10.3991/ijim.v13i10.11288 ◽

2019 ◽

Vol 13 (10) ◽

pp. 42

Author(s):

Murtaja Ali Saare ◽

Azham Hussain ◽

Wong Seng Yue

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Cognitive Decline ◽

Mobile Health ◽

Mediating Role ◽

Mobile Health Applications ◽

Conceptual Explanation ◽

Health Applications

This article examines the link between the older adult’s cognitive decline, and Assistive Mobile Health Applications in terms of quality of life as researcher has found scarcity in explaining the mediating role of assistive mobile health applications towards the quality of life of older adults with cognitive decline. Researchers have identified the importance of using assistive mobile health applications in connection of the older adult’s cognitive decline. However, it remained unaddressed in the explaining the mediating role of assistive mobile health application. Therefore, this paper aims to provide an insight that the adoption of assistive m-health applications will provide this population with potential solution to their challenging aging life, hence, enhancing their quality of life. In addition, this paper is only a conceptual explanation, as it aims to identify the possible reasons that influence their Smartphone adoption. Factors were identified using a systematic literature review on relevant peer reviewed papers. The study summarized the empirical evidences which were used to support the conceptual explanation. It is expected that this work will lead towards the empirical findings on the explanation of the mediating role of the assistive mobile health applications to address the relationship of older adult’s cognitive decline and quality of life. This paper providesdirections for future studies in improving the quality of life of older adults.

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Patient Self-Management of Asthma Using Mobile Health Applications: A Systematic Review of the Functionalities and Effects

Applied Clinical Informatics ◽

10.4338/aci-2017-07-r-0116 ◽

2017 ◽

Vol 08 (04) ◽

pp. 1068-1081 ◽

Cited By ~ 33

Author(s):

Mehrdad Farzandipour ◽

Ehsan Nabovati ◽

Reihane Sharif ◽

Marzieh Arani ◽

Shima Anvari

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Mobile Health ◽

Self Management ◽

Cochrane Central Register ◽

Patient Reported ◽

Mobile Health Applications ◽

Mhealth Apps ◽

Health Applications

Objective The aim of this systematic review was to summarize the evidence regarding the effects of mobile health applications (mHealth apps) for self-management outcomes in patients with asthma and to assess the functionalities of effective interventions. Methods We systematically searched Medline, Scopus, and the Cochrane Central Register of Controlled Trials. We included English-language studies that evaluated the effects of smartphone or tablet computer apps on self-management outcomes in asthmatic patients. The characteristics of these studies, effects of interventions, and features of mHealth apps were extracted. Results A total of 10 studies met all the inclusion criteria. Outcomes that were assessed in the included studies were categorized into three groups (clinical, patient-reported, and economic). mHealth apps improved asthma control (five studies) and lung function (two studies) from the clinical outcomes. From the patient-reported outcomes, quality of life (three studies) was statistically significantly improved, while there was no significant impact on self-efficacy scores (two studies). Effects on economic outcomes were equivocal, so that the number of visits (in two studies) and admission and hospitalization-relevant outcomes (in one study) statistically significantly improved; and in four other studies, these outcomes did not improve significantly. mHealth apps features were categorized into seven categories (inform, instruct, record, display, guide, remind/alert, and communicate). Eight of the 10 mHealth apps included more than one functionality. Nearly all interventions had the functionality of recording user-entered data and half of them had the functionality of providing educational information and reminders to patients. Conclusion Multifunctional mHealth apps have good potential in the control of asthma and in improving the quality of life in such patients compared with traditional interventions. Further studies are needed to identify the effectiveness of these interventions on outcomes related to medication adherence and costs.

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ATTITUDES TOWARDS THE USE OF MOBILE HEALTH APPLICATIONS IN BULGARIA

Proceedings of CBU in Medicine and Pharmacy ◽

10.12955/pmp.v1.98 ◽

2020 ◽

Vol 1 ◽

pp. 53-60

Author(s):

Kristina Kilova ◽

Desislava Bakova ◽

Antonia Yaneva ◽

Vanina Mihaylova

Keyword(s):

Mobile Health ◽

Online Survey ◽

Statistical Difference ◽

Graphical Representation ◽

Mobile Health Applications ◽

Quality Of Health Services ◽

Primary Focus ◽

Socially Relevant ◽

Health Applications

Background: The increasing use of mobile phones has offered an opportunity to improve the quality of health services, secure the accessibility of healthcare systems for a larger population and support patients in effective management of their health/chronic conditions. Main Goal: The primary focus of the study in hand is to explore the different attitudes towards the use of mHealth in Bulgaria and to examine the extensive use of mobile health applications for the supervision, prevention and containment of various socially relevant diseases, including the promotion of healthy lifestyles. Materials and methods: An online survey was conducted in the period between July 2019 and February 2020. Amongst the 976 people that were interviewed, 591 (60.6%) were females and 385 (39.4%) were males. The mean age of the respondents was 43.25 ± 0.755. A unique questionnaire was prepared for the collection of information regarding the usage of mobile health applications. Statistical analyses were carried out with the help of IBM SPSS Statistics, version 23. MS Excel 2016 was used for the graphical representation of the results. Results: 89% of the participants possessed a mobile phone and an approximate 84% of them used mHealth applications. Besides this, the results suggested a considerable statistical difference in the respondents’ attitudes, in terms of their gender, where the deviation was in favour of female respondents. Additionally, findings revealed another statistical difference on the basis of their age and level of education. Furthermore, a huge majority claimed that they generally used these types of applications for monitoring their blood pressure or pulse. Conclusion: The outcome of the study was that a significant number of respondents were already using or tended to use smartphones and various applications, including health ones. We expect that the results of this study will provide evidence of the essentiality of mobile health applications to be developed in Bulgaria. This is crucial for patients as this technology has the potential to open up several new possibilities for treatments and observations of diverse socially significant diseases.

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Digital Health Apps in the Clinical Care of Inflammatory Bowel Disease: Scoping Review

Journal of Medical Internet Research ◽

10.2196/14630 ◽

2019 ◽

Vol 21 (8) ◽

pp. e14630 ◽

Cited By ~ 9

Author(s):

Andrew Lukas Yin ◽

David Hachuel ◽

John P Pollak ◽

Ellen J Scherl ◽

Deborah Estrin

Keyword(s):

Inflammatory Bowel Disease ◽

Mobile Health ◽

Bowel Disease ◽

Digital Health ◽

Clinical Care ◽

Mobile App ◽

Health Apps ◽

Patient Reported ◽

Inflammatory Bowel

Background Digital health is poised to transform health care and redefine personalized health. As Internet and mobile phone usage increases, as technology develops new ways to collect data, and as clinical guidelines change, all areas of medicine face new challenges and opportunities. Inflammatory bowel disease (IBD) is one of many chronic diseases that may benefit from these advances in digital health. This review intends to lay a foundation for clinicians and technologists to understand future directions and opportunities together. Objective This review covers mobile health apps that have been used in IBD, how they have fit into a clinical care framework, and the challenges that clinicians and technologists face in approaching future opportunities. Methods We searched PubMed, Scopus, and ClinicalTrials.gov to identify mobile apps that have been studied and were published in the literature from January 1, 2010, to April 19, 2019. The search terms were (“mobile health” OR “eHealth” OR “digital health” OR “smart phone” OR “mobile app” OR “mobile applications” OR “mHealth” OR “smartphones”) AND (“IBD” OR “Inflammatory bowel disease” OR “Crohn's Disease” (CD) OR “Ulcerative Colitis” (UC) OR “UC” OR “CD”), followed by further analysis of citations from the results. We searched the Apple iTunes app store to identify a limited selection of commercial apps to include for discussion. Results A total of 68 articles met the inclusion criteria. A total of 11 digital health apps were identified in the literature and 4 commercial apps were selected to be described in this review. While most apps have some educational component, the majority of apps focus on eliciting patient-reported outcomes related to disease activity, and a few are for treatment management. Significant benefits have been seen in trials relating to education, quality of life, quality of care, treatment adherence, and medication management. No studies have reported a negative impact on any of the above. There are mixed results in terms of effects on office visits and follow-up. Conclusions While studies have shown that digital health can fit into, complement, and improve the standard clinical care of patients with IBD, there is a need for further validation and improvement, from both a clinical and patient perspective. Exploring new research methods, like microrandomized trials, may allow for more implementation of technology and rapid advancement of knowledge. New technologies that can objectively and seamlessly capture remote data, as well as complement the clinical shift from symptom-based to inflammation-based care, will help the clinical and health technology communities to understand the full potential of digital health in the care of IBD and other chronic illnesses.

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Promoting Health via Mobile Health Applications: Adaptation and Validation of a French Version of the Mobile App Rating Scale (Preprint)

JMIR mhealth and uhealth ◽

10.2196/30480 ◽

2021 ◽

Author(s):

Ina Saliasi ◽

Prescilla Martinon ◽

Emily Darlington ◽

Colette Smentek ◽

Delphine Tardivo ◽

...

Keyword(s):

Mobile Health ◽

Rating Scale ◽

Mobile App ◽

French Version ◽

Mobile Health Applications ◽

Health Applications

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The Functionality, Quality and Consistency with International Guidelines of Asthma Mobile Health Applications: Protocol for a Systematic Review. (Preprint)

10.2196/preprints.33103 ◽

2021 ◽

Author(s):

Billy Robinson ◽

Enying Gong ◽

Brian Oldenburg ◽

Katharine See

Keyword(s):

Systematic Review ◽

Mobile Health ◽

Best Practice ◽

Self Management ◽

Best Practice Guidelines ◽

Mobile Health Applications ◽

Gina Guidelines ◽

Mhealth Apps ◽

Health Applications

BACKGROUND Asthma is a chronic respiratory disorder which requires long-term pharmacotherapy and patient empowerment to manage their condition and recognise and respond to asthma exacerbations. Mobile health applications (mHealth apps) represent a potential medium through which patients could improve the ability to self-manage their asthma. Few studies have conducted a systematic evaluation of asthma mobile applications for the quality and functionality of the apps using a validated tool. None of these reviews have systematically assessed these applications for their content compared to available international best practice guidelines. OBJECTIVE The objective of this study is to conduct a systematic review of adult-targeted asthma mobile health applications. As part of this review the potential for an mHealth app to improve asthma self-management and the overall quality of the application will be evaluated, using the Mobile App Rating Scale (MARS) framework, and the quality of the information within an app, using the current Global Initiative for Asthma (GINA) guidelines as a reference, will be assessed. METHODS A methodological stepwise approach was taken in creating this review. First the most recent GINA guidelines were independently reviewed by two authors to identify key recommendations that could feasibly be incorporated into a mHealth app. A previously developed asthma assessment framework was identified and modified to suit our research and ensure all of these identified recommendations were included. Two popular App stores were then reviewed to identify potential mHealth Apps. These Apps were screened based on pre-defined inclusion and exclusion criteria. Suitable applications were then evaluated. Technical information was obtained from publicly available information. The next step was to perform an application quality assessment using the validated MARS framework to objectively determine the quality of the application. Application functionality was then assessed using the IMS Institute for Health Informatics Functionality Scoring system. Finally, the mHealth applications will be assessed using a checklist that we have developed. RESULTS To date, funding has been received for the project from the Respiratory Department at Northern Health, Victoria. Three reviewers have been recruited to systematically evaluate the applications. Results for this study are expected by the end of this year. CONCLUSIONS This review represents the first that we know of that will examine all mobile health applications available in Australia targeted to adult asthmatics for their functionality, quality and consistency with international best practice guidelines. Though the review will only be conducted on mHealth Apps available in Australia, many applications are available internationally and thus should be largely generalisable to other English-speaking regions and users. The results of this review will help to fill gaps in the literature and assist clinicians in providing evidence-based advice to adult patients wishing to use mHealth apps as part of their asthma self-management. CLINICALTRIAL PROSPERO 269894

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Effectiveness of using SOKARY Mobile Application on the compliance of patients with Type II diabetes: A quasi-experimental study

10.53350/pjmhs211572001 ◽

2021 ◽

Vol 15 (7) ◽

pp. 2001-2005

Author(s):

Ehsan A. Yahia ◽

Magda M. Bayoumi

Keyword(s):

Mobile Health ◽

Type Ii Diabetes ◽

Mobile Application ◽

Healthy Lifestyle ◽

Mobile App ◽

Type Ii ◽

Level Of Activity ◽

Quasi Experimental ◽

Mobile Health Applications ◽

Health Applications

Mobile health applications are an easy, friendly access method for enhancing patient’s compliance and overall health status. This study aimed to evaluate the effectiveness of using mobile health applications on patients’ compliance. A Quasi-experimental design was used with a purposeful sample of 150 subjects who have been diagnosed with type II diabetes were recruited. SOKARY android mobile application diabetes App was selected mobile health application in Arabic interface included many features as recording blood glucose level, nutrition and physical activity with medication reminders and healthy lifestyle advice notifications. The findings showed that the effectiveness of post-using the Mobile App on patient’s compliance is statistically significant 52.64+5.1, (p=0.000). Obviously, the improvement is statistically significant as recognized in lowering the level of HbA1c (p> 0.029) and BMI (p>0.006) and increasing level of activity (p>0.002) and overall patient’s compliance (p>0.004). In conclusion, the results reported significant improvement in patients’ compliance and highly recommended to utilize such mobile health applications among patients to prevent the complications of Type II diabetes. Keywords:SOKARY Mobile Application, type II diabetes, patient’s compliance, HbA1c, level of activity, BMI.

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A Research on the Classification and Applicability of the Mobile Health Applications

Journal of Personalized Medicine ◽

10.3390/jpm10010011 ◽

2020 ◽

Vol 10 (1) ◽

pp. 11 ◽

Cited By ~ 6

Author(s):

Ivan Miguel Pires ◽

Gonçalo Marques ◽

Nuno M. Garcia ◽

Francisco Flórez-Revuelta ◽

Vasco Ponciano ◽

...

Keyword(s):

Mobile Health ◽

Mobile Applications ◽

Healthcare Professionals ◽

Comprehensive Analysis ◽

Online Application ◽

Mobile Health Applications ◽

Secondary Objective ◽

Scientific Validation ◽

Health Applications

Mobile health applications are applied for different purposes. Healthcare professionals and other users can use this type of mobile applications for specific tasks, such as diagnosis, information, prevention, treatment, and communication. This paper presents an analysis of mobile health applications used by healthcare professionals and their patients. A secondary objective of this article is to evaluate the scientific validation of these mobile health applications and to verify if the results provided by these applications have an underlying sound scientific foundation. This study also analyzed literature references and the use of mobile health applications available in online application stores. In general, a large part of these mobile health applications provides information about scientific validation. However, some mobile health applications are not validated. Therefore, the main contribution of this paper is to provide a comprehensive analysis of the usability and user-perceived quality of mobile health applications and the challenges related to scientific validation of these mobile applications.

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Is the quality of mobile health applications for burns being adequately assessed?

Journal of Burn Care & Research ◽

10.1093/jbcr/irab197 ◽

2021 ◽

Author(s):

Benjamin Patel ◽

Thomas Edwards ◽

Timothy Schrire ◽

Katie Barnard ◽

Sankhya Sen

Keyword(s):

Information Content ◽

Mobile Health ◽

Ethical Issues ◽

Subjective Assessment ◽

Cochrane Library ◽

Mobile Health Applications ◽

The Uk ◽

Mhealth Apps ◽

Health Applications

Abstract High quality mobile health applications (mhealth apps) have the potential to enhance the prevention, diagnosis and treatment of burns. The primary aim of this study was to evaluate whether the quality of mhealth apps for burns care is being adequately assessed. The secondary aim was to determine whether these apps meet regulatory standards in the UK. We searched AMED, BNI, CINAHL, Cochrane library, Embase, Emcare, Medline and PsychInfo to identify studies assessing mhealth app quality for burns. The PRISMA reporting guideline was adhered to. Two independent reviewers screened abstracts to identify relevant studies. The quality of identified studies was assessed according to the framework proposed by Nouri et al, including design, information/content, usability, functionality, ethical issues, security/privacy and user-perceived value. Of the 28 included studies, none assessed all seven domains of quality. Design was assessed in 4/28 studies; information/content in 26/28 studies; usability in 12/28 studies; functionality in 10/28 studies; ethical issues were never assessed in any studies; security/privacy was not assessed; subjective assessment was made in 9/28 studies. 17/28 studies included apps that met the definition of ‘medical device’ according to MHRA guidance, yet only one app was appropriately certified with the UK Conformity Assessed (UKCA) mark. The quality of mHealth apps for burns are not being adequately assessed. The majority of apps should be considered medical devices according to UK standards, yet only one was appropriately certified. Regulatory bodies should support mhealth app developers, so as to improve quality control whilst simultaneously fostering innovation.

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