Development features and study characteristics of mobile health apps in the management of chronic conditions: a systematic review of randomised trials

AbstractCOVID-19 pandemic challenges have accelerated the reliance on digital health fuelling the expanded incorporation of mobile apps into healthcare services, particularly for the management of long-term conditions such as chronic diseases (CDs). However, the impact of health apps on outcomes for CD remains unclear, potentially owing to both the poor adoption of formal development standards in the design process and the methodological quality of studies. A systematic search of randomised trials was performed on Medline, ScienceDirect, the Cochrane Library and Scopus to provide a comprehensive outlook and review the impact of health apps on CD. We identified 69 studies on diabetes (n = 29), cardiovascular diseases (n = 13), chronic respiratory diseases (n = 13), cancer (n = 10) or their combinations (n = 4). The apps rarely adopted developmental factors in the design stage, with only around one-third of studies reporting user or healthcare professional engagement. Apps differed significantly in content, with a median of eight behaviour change techniques adopted, most frequently pertaining to the ‘Feedback and monitoring’ (91%) and ‘Shaping knowledge’ (72%) categories. As for the study methodologies, all studies adopted a traditional randomised control trial (RCT) design, with relatively short follow-ups and limited sample sizes. Findings were not significant for the majority of studies across all CD, with most RCTs revealing a high risk of bias. To support the adoption of apps for CD management, this review reinforces the need for more robust development and appropriate study characteristics to sustain evidence generation and elucidate whether study results reflect the true benefits of apps or a biased estimate due to unsuitable designs.

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Mobile health interventions to promote physical activity and reduce sedentary behaviour in the workplace: A systematic review

Digital Health ◽

10.1177/2055207619839883 ◽

2019 ◽

Vol 5 ◽

pp. 205520761983988 ◽

Cited By ~ 24

Author(s):

Sarah Ann Buckingham ◽

Andrew James Williams ◽

Karyn Morrissey ◽

Lisa Price ◽

John Harrison

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Sedentary Behaviour ◽

Mobile Health ◽

Technology Use ◽

Methodological Quality ◽

Experimental Studies ◽

Cochrane Library ◽

Behaviour Change Techniques ◽

The Impact

Objective This systematic review aimed to assess the effectiveness, feasibility and acceptability of mobile health (mHealth) technology (including wearable activity monitors and smartphone applications) for promoting physical activity (PA) and reducing sedentary behaviour (SB) in workplace settings. Methods Systematic searches were conducted in seven electronic databases (MEDLINE, SPORTDiscus, Scopus, EMBASE, PsycINFO, Web of Science and the Cochrane library). Studies were included if mHealth was a major intervention component, PA/SB was a primary outcome, and participants were recruited and/or the intervention was delivered in the workplace. Study quality was assessed using the Effective Public Health Practice Project (EPHPP) tool. Interventions were coded for behaviour change techniques (BCTs) using the Coventry, Aberdeen and London – Refined (CALO-RE) taxonomy. Results Twenty-five experimental and quasi-experimental studies were included. Studies were highly heterogeneous and only one was rated as ‘strong’ methodological quality. Common BCTs included self-monitoring, feedback, goal-setting and social comparison. A total of 14/25 (56%) studies reported a significant increase in PA, and 4/10 (40%) reported a significant reduction in sedentary time; 11/16 (69%) studies reported a significant impact on secondary outcomes including reductions in weight, systolic blood pressure and total cholesterol. While overall acceptability was high, a large decline in technology use and engagement was observed over time. Conclusions While methodological quality was generally weak, there is reasonable evidence for mHealth in a workplace context as a feasible, acceptable and effective tool to promote PA. The impact in the longer term and on SB is less clear. Higher quality, mixed methods studies are needed to explore the reasons for decline in engagement with time and the longer-term potential of mHealth in workplace interventions. Protocol registration: The review protocol was registered with PROSPERO: CRD42017058856

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Internetization of modern youth subculture

Vestnik of Samara State Technical University. Psychological and Pedagogical Sciences ◽

10.17673/vsgtu-pps.2020.3.2 ◽

2020 ◽

pp. 24-37

Author(s):

Ekaterina A. Glebova ◽

◽

Irina V. Bgantseva ◽

Irina A. Tislenkova ◽

Victoria V. Tikhaeva

Keyword(s):

Practical Implication ◽

Rapid Development ◽

Personality Development ◽

Teaching Staff ◽

Educational Work ◽

Study Results ◽

Youth Subculture ◽

Study Characteristics ◽

Questionnaire Method ◽

The Impact

The article under analysis studies the modern youth subculture in the time of rapid development of Internet technologies and granted opportunities for communication and pastime among young people. The objective of the article is to study characteristics of the modern youth subculture undergone the transformation influenced by internetization processes. To achieve the purpose, the following points were determined: 1) characterize the modern youth subculture existing on the basis of the Internet application “Instagram”; 2) analyze the results of the survey aimed at bringing to light a great popularity of the Instagram community among students and aimed at specifying the impact of the given application on participants; 3) find out the peculiarities of the modern subculture at the modern-day stage of the society development. The main methods of the study are the interpretation analysis of Russian and foreign scientific works and internet materials on the problems of modern youth subculture and its influence on the youth; the questionnaire method and the method of quantitative analysis. The scientific novelty lies in the fact that the characteristics of the modern youth subculture in the time of the society internetization are specified and its possible impact on a personality development and youth behaviour is demonstrated. The practical implication of the study results is in their possibilities to be used as topical information about the modern youth subculture in the time of the digital society by psychologists, any teaching staff and social care teachers in their scientific research and teaching-educational work with representatives of the young.

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Burden of tinea capitis among children in Africa: protocol for a systematic review and meta-analysis of observational studies, 1990–2020

BMJ Open ◽

10.1136/bmjopen-2020-041230 ◽

2020 ◽

Vol 10 (9) ◽

pp. e041230

Author(s):

Felix Bongomin ◽

Ronald Olum ◽

Lauryn Nsenga ◽

Joseph Baruch Baluku

Keyword(s):

Systematic Review ◽

Tinea Capitis ◽

Meta Analysis ◽

Cochrane Library ◽

Trend Test ◽

Qualitative Synthesis ◽

Institutional Review ◽

Ethical Approval ◽

Study Characteristics ◽

The Impact

IntroductionTinea capitis is the most common form of dermatophytosis among children, contributing significantly to the global burden of skin and hair infections. However, an accurate account of its burden in Africa, where most cases are thought to occur, is lacking. We aim to systematically evaluate the burden, aetiology and epidemiological trend of tinea capitis among children over a 30-year period in Africa.Methods and analysisA systematic review will be conducted using Embase, PubMed, African Journals Online, Web of Science and the Cochrane Library of Systematic Review. These resources will be used to identify studies published between 1990 and December 2020, which report the prevalence, aetiology and trend of tinea capitis among children younger than 18 years in Africa. Articles in English and French will be considered. Two independent reviewers will screen the articles for eligibility, and any discrepancies will be resolved by discussion and consensus between the authors. Methodological quality of all studies will be assessed and critically appraised. We will perform a metaregression to assess the impact of study characteristics on heterogeneity and also to correct the meta-analytical estimates for biases. A qualitative synthesis will be performed, and STATA V.16.0 software will be used to estimate the pooled prevalence and aetiology of tinea capitis. The Mann-Kendall trend test will be use to evaluate the trend in the prevalence of tinea capitis over the study period.Ethics and disseminationEthical approval from an institutional review board or research ethics committee is not required for this systematic review and meta-analysis. The results will be published in a peer-reviewed journal and presented in conferences.

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Medical therapy for polycystic liver disease

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2016.0023 ◽

2016 ◽

Vol 98 (1) ◽

pp. 18-23 ◽

Cited By ~ 12

Author(s):

S Khan ◽

A Dennison ◽

G Garcea

Keyword(s):

Quality Of Life ◽

Liver Disease ◽

Liver Volume ◽

Somatostatin Analogues ◽

Cochrane Library ◽

Polycystic Liver Disease ◽

Randomised Trials ◽

Polycystic Liver ◽

The Impact

Introduction Somatostatin analogues and rapamycin inhibitors are two classes of drugs available for the management of polycystic liver disease but their overall impact is not clearly established. This article systematically reviews the literature on the medical management of polycystic liver disease. The outcomes assessed include reduction in liver volume and the impact on quality of life. Methods The English language literature published between 1966 and August 2014 was reviewed from a MEDLINE®, PubMed, Embase™ and Cochrane Library search. Search terms included ‘polycystic’, ‘liver’, ‘sirolimus’, ‘everolimus’, ‘PCLD’, ‘somatostatin’, ‘octreotide’, ‘lanreotide’ and ‘rapamycin’. Both randomised trials and controlled studies were included. References of the articles retrieved were also searched to identify any further eligible publications. The studies included were appraised using the Jadad score. Results Seven studies were included in the final review. Five studies, of which three were randomised trials, investigated the role of somatostatin analogues and the results showed a mean reduction in liver volume ranging from 2.9% at six months to 4.95 ±6.77% at one year. Only one randomised study examined the influence of rapamycin inhibitors. This trial compared dual therapy with everolimus and octreotide versus octreotide monotherapy. Liver volume reduced by 3.5% and 3.8% in the control and intervention groups respectively but no statistical difference was found between the two groups (p=0.73). Two randomised trials investigating somatostatin analogues assessed quality of life using SF-36®. Only one subdomain score improved in one of the trials while two subdomain scores improved in the other with somatostatin analogue therapy. Conclusions Somatostatin analogues significantly reduce liver volumes after six months of therapy but have only a modest improvement on quality of life. Rapamycin inhibitors do not confer any additional advantage.

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Firearms and violence in Europe–A systematic review

PLoS ONE ◽

10.1371/journal.pone.0248955 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0248955

Author(s):

Katharina Krüsselmann ◽

Pauline Aarten ◽

Marieke Liem

Keyword(s):

Systematic Review ◽

Interpersonal Violence ◽

The United States ◽

Future Research ◽

Firearm Violence ◽

European Data ◽

Study Results ◽

Firearm Availability ◽

Study Characteristics ◽

The Impact

Background Higher availability of firearms has been connected to higher rates of interpersonal violence in previous studies. Yet, those studies have focused mainly on the United States, or used aggregated international data to study firearm violence. Whether those aggregated findings are applicable to understanding the phenomenon in continental Europe specifically remains unclear. The aim of this systematic review is to bring together all studies that exclusively use European data. Methods Nine databases were searched, resulting in more than 1900 individual studies. These studies were assessed on relevance and eligibility for this study, based on their title, abstract and full text. Information on study characteristics, operationalizations of main concepts and study results were extracted from the six eligible studies. Results Four studies assessed the impact of firearm restrictive regulations on the rate of firearm homicides. Two other studies correlated rates of firearm availability and -violence. Results vary: some studies show a clear decline once availability of firearms is restricted, while others indicate a limited effect on only a very specific subgroup, such as female victims, or national guards with weapons at home. Moreover, studies used various operationalizations for firearm availability, thereby decreasing the comparability of findings. Conclusion Empirical research exclusively using European data is still lacking. To increase comparability of future studies, methodological inconsistencies and regional gaps need to be overcome. Assessing how firearm availability can be measured with reliable and valid proxies across countries will be a crucial first step to improve future research on the link between firearms and firearm violence.

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Effect of aspirin in takotsubo syndrome: protocol of a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-046727 ◽

2021 ◽

Vol 11 (8) ◽

pp. e046727

Author(s):

Jinhai Lin ◽

Bingxin Wu ◽

Luoqi Lin ◽

Yining Ding ◽

Biying Zhong ◽

...

Keyword(s):

Meta Analysis ◽

Random Effect ◽

Systemic Review ◽

Cochrane Library ◽

Takotsubo Syndrome ◽

Coronary Syndrome ◽

Study Results ◽

Long Term Treatment ◽

The Impact

IntroductionTakotsubo syndrome (TTS) is a sudden reversible weakening of the left ventricle function induced by severe stress and resembles many features as acute coronary syndrome. Even though many guidelines had been published about TTS, there is no consensus regarding the long-term treatment. Aspirin is one of the most common prescribed medicines at discharge for patients with the intention to reduce thrombus events and improve the overall prognosis. However, existing studies yielded conflicting results concerning its effects. This study aims to evaluate the impact of long-term maintenance treatment of aspirin in TTS and provides insights in clinical management.Methods and analysisAfter searching through electronic databases (PubMed, Embase, Cochrane Library, Web of Science, National Library of Medicine Gateway, CNKI, Wanfang and VIP), grey literatures, conference abstract and trial registries for clinical studies investigating the impact of aspirin on patients with TTS, a systemic review and meta-analysis will be conducted. The search will be limited from inception of each database to 1 August 2020. The outcomes including all-cause death, TTS recurrence, stroke, transient ischaemic attack or myocardial infarction at 30-day and 5-year follow-up will be examined. Risk of bias will be assessed by Newcastle-Ottawa quality assessment scale for observational studies and Cochrane Effective Practice and Organization of Care evaluation tool for interventional studies. Grading of Recommendations Assessment, Development and Evaluations method will be applied to assess the quality of evidence. If available, the effects of aspirin on the above outcomes for patients with TTS will be evaluated using random-effect modelling with relative risk at 95% CIs. Subgroup analysis and sensitivity analysis will also be performed when possible.Ethics and disseminationEthics approval was not required due to the retrospective nature of the study. Results of the review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42020212729.

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Association between statin use and plasma D-dimer levels

Thrombosis and Haemostasis ◽

10.1160/th14-11-0937 ◽

2015 ◽

Vol 114 (09) ◽

pp. 546-557 ◽

Cited By ~ 64

Author(s):

Dimitri Mikhailidis ◽

Anetta Undas ◽

Gregory Lip ◽

Paul Muntner ◽

Vera Bittner ◽

...

Keyword(s):

Statin Therapy ◽

Effect Size ◽

Meta Analysis ◽

Cochrane Library ◽

Study Characteristics ◽

Circulating Markers ◽

Haemostatic Factors ◽

Randomised Controlled ◽

The Impact ◽

D Dimer

SummaryD-dimers, specific breakdown fragments of cross-linked fibrin, are generally used as circulating markers of activated coagulation. Statins influence haemostatic factors, but their effect on plasma D-dimer levels is controversial. Therefore, the aim of this meta-analysis was to evaluate the association between statin therapy and plasma D-dimer levels. We searched PubMed, Web of Science, Cochrane Library, Scopus and EMBASE (up to September 25, 2014) to identify randomised controlled trials (RCTs) investigating the impact of statin therapy on plasma D-dimer levels. Two independent reviewers extracted data on study characteristics, methods and outcomes. Meta-analysis of data from nine RCTs with 1,165 participants showed a significant effect of statin therapy in reducing plasma D-dimer levels (standardised mean difference [SMD]: –0.988 µg/ml, 95 % confidence interval [CI]: –1.590 – –0.385, p=0.001). The effect size was robust in sensitivity analysis and omission of no single study significantly changed the overall estimated effect size. In the subgroup analysis, the effect of statins on plasma D-dimer levels was significant only in the subsets of studies with treatment duration ≥ 12 weeks (SMD: –0.761 µg/ml, 95 %CI: –1.163– –0.360; p< 0.001), and for lipophilic statins (atorvastatin and simvastatin) (SMD: –1.364 µg/ml, 95 % CI: –2.202– –0.526; p=0.001). Hydrophilic statins (pravastatin and rosuvastatin) did not significantly reduce plasma D-dimer levels (SMD: –0.237 µg/ml, 95 %CI: –1.140–0.665, p=0.606). This meta-analysis of RCTs suggests a decrease of plasma D-dimer levels after three months of statin therapy, and especially after treatment with lipophilic statins. Well-designed trials are required to validate these results.Note: The review process for this paper was fully handled by Christian Weber, Editor in Chief.

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Abstract 18967: Analysis of Vitamin D Levels in Patients With and Without Statin-induced Myalgia - A Systematic Review and Meta-analysis of 7 Studies with 2416 Patients

Circulation ◽

10.1161/circ.130.suppl_2.18967 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Marta Michalska-Kasiczak ◽

Amirhossein Sahebkar ◽

Dimitri P Mikhailidis ◽

Jacek Rysz ◽

Paul Muntner ◽

...

Keyword(s):

Vitamin D ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Final Analysis ◽

Vitamin D Supplementation ◽

Cochrane Library ◽

Increased Risk ◽

Vitamin D Levels ◽

Study Characteristics ◽

The Impact

Introduction: Vitamin D (vit D) deficiency may be associated with an increased risk of statin-related muscle complaints, and symptomatic myalgia in statin-treated patients. Hypothesis: The aim of this meta-analysis was to investigate whether subjects with statin-induced myalgia have lower serum vit D levels compared with those who are asymptomatic. Methods: We searched PubMed, Web of Science, Cochrane Library, Scopus and EMBASE (up to March 2014) to identify studies that investigated the impact of vit D levels in statin-treated subjects with and without myalgia. Two independent reviewers extracted data on study characteristics, methods and outcomes. Results: The electronic search yielded 437 articles, of those 20 were scrutinized in the full text, of which 13 studies were considered unsuitable. The final analysis included 7 studies with 2416 statin-treated patients divided to subgroups of patients with (n = 666 [27.6%]) or without (n = 1750) myalgia. The combination of data from individual observational studies revealed a significantly lower vit D plasma concentration in the statin-induced myalgia compared with the asymptomatic subgroup with weighted mean difference -9.41 ng/mL(95% confidence interval (Cl): -10.17 to -8.64; p < 0.00001) (figure) . Conclusions: This meta-analysis provides evidence that low vit D levels are associated with myalgia in patients on statin therapy. Well-designed, randomized controlled trials are necessary to establish whether vitamin D supplementation reduces risk for statin myalgia in patients with vitamin D deficiency.

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A systematic review of the impact of outpatient clinical pharmacy services on medication-related outcomes in patients receiving anticancer therapies

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155218783814 ◽

2018 ◽

Vol 25 (1) ◽

pp. 130-139 ◽

Cited By ~ 5

Author(s):

Sam Maleki ◽

Marliese Alexander ◽

Tsien Fua ◽

Chen Liu ◽

Danny Rischin ◽

...

Keyword(s):

Systematic Review ◽

Clinical Pharmacy ◽

Adverse Drug Reaction Reporting ◽

Randomised Control Trial ◽

Cochrane Library ◽

Symptom Improvement ◽

Significant Heterogeneity ◽

Pharmacy Services ◽

Clinical Pharmacy Services ◽

The Impact

Background Patients receiving anticancer therapies are frequently prescribed complex and high-risk medication regimens, which at times can result in medication misadventures. The objective of this review was to assess the effect of outpatient clinical pharmacy services on medication-related outcomes in patients receiving anticancer therapies, including patients undergoing radiotherapy. Methods A systematic review of original publications indexed in EMBASE, MEDLINE and Cochrane Library from June 2007 to June 2017. Eligible studies evaluated outpatient pharmacy clinic services for cancer patients and reported at least one medication-related quantitative outcome measure. Two authors independently reviewed full-text articles for inclusion, then extracted data and performed quality and risk of bias assessments. Results Of 908 identified publications, 13 met predefined eligibility criteria; 1 randomised control trial, 2 controlled cohort studies and 10 uncontrolled before–after studies. Many excluded studies described outpatient pharmacy services but lacked medication-related outcomes. All included studies had informative practice model designs, with interventions for drug-related problems including drug dose optimisation ( n = 8), reduced drug interaction ( n = 6) and adverse drug reaction reporting ( n = 3). Most studies ( n = 11) reported on symptom improvement, commonly nausea ( n = 7) and pain ( n = 5). Of four studies in radiotherapy cohorts, pharmacist involvement was associated with improved symptoms, satisfaction and wellbeing scores. Conclusion Few studies have objectively assessed outpatient pharmacy cancer services, even fewer in the radiotherapy settings. Although the results support these services, significant heterogeneity and bias in the study designs prohibit robust conclusions and further controlled trials are required.

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Tuina for Chronic Non-specific Low Back Pain: a systematic review and meta-analysis (Preprint)

10.2196/preprints.20615 ◽

2020 ◽

Author(s):

Juan Yang ◽

Jeffrey S. Brault ◽

Mark A. Jensen ◽

Alexander Do ◽

Qingyu Ma ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Meta Analysis ◽

Biomedical Literature ◽

World Health ◽

Cochrane Library ◽

Secondary Outcome ◽

Low Back ◽

Study Results ◽

The Impact

BACKGROUND Chronic non-specific low back pain (CNLBP) is one of the most common complex conditions strongly associated with high rates of disability. Even though many studies on Tuina for CNLBP patients reported, until now, there is no study synthesize the currently available publications. OBJECTIVE This protocol aims to provide authors the guideline used to systematically review the effect and safety of Tuina therapy for treating patients with CNLBP. METHODS An electronic literature search will be conducted in the following databases: MEDLINE, Embase, Cochrane Library, Springer, Web of Science, Scopus, World Health Organization International Clinical Trials Registry Platform (ICTRP), the Chinese Biomedical Literature Database (CBM), the China National Knowledge Infrastructure (CNKI), Wan-fang database (WAN FANG), Chinese Biomedical Literature Databases (CBM), and Chinese Scientific Journal Database VIP Information (VIP). From database inception to Dec 30, 2019, English, and Chinese language only. Randomized controlled trials (RCTs) involving Tuina for patients with CNLBP will be reviewed. The primary outcomes of the study are an improvement of pain, analgesic medication reduction, improvement of functional disability, and degree of satisfaction with the intervention. A secondary outcome is any adverse event (AE) of Tuina intervention. If samples are enough, a meta-analysis with the software RevMan5.3.5 will be performed. If data permit, a subgroup analysis will be conducted to explain the study findings. RESULTS The study was started on April 30th, 2020. Study results will be submitted for publication in July 2020. CONCLUSIONS This protocol will establish a framework of a high-quality literature synthesis on the impact of Tuina treatment in patients with CNLBP. The proposed review will determine whether Tuina is effective and safe for CNLBP patients. CLINICALTRIAL PROSPERO CRD42020166731

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