BACKGROUND
Mobile health (mHealth) apps are becoming increasingly used in surgical practices for training, education, and communication. Factors leading to increased delays, morbidity and mortality in surgery include inadequate pre-operative patient preparation due to failure to identify patients and the procedure details, and missed instruments and equipment required for the procedure. Many apps are available for supporting pre-, intra- and post-operative care. However, there is a lack of studies that assess the quality of apps that act as surgical preparatory guides.
OBJECTIVE
To evaluate the quality of the surgical apps that act as surgical preparatory guides for operating room personnel through an in-house quality assessment tool.
METHODS
The quality assessment tool comprised of 35 questions categorised into 5 sections on engagement (customisation, interactivity, target audience; 19 points), functionality (performance, ease of use, navigation; 12 points), aesthetics (layout, visual appeal; 6 points), information (quality and quantity of information, visual information, credibility; 29 points), and privacy and security (4 points). An app search was conducted in the Australian Apple and Google Play stores based on the keywords: “surgical apps”, “surgical preferences”, “surgeon preferences”, “operating room” and “perioperative procedures”. The overall total scores and scores for each section were reported as medians and inter-quartile ranges (IQR), expressed as raw scores and percentages.
RESULTS
Five unique apps were evaluated on both iOS and Android platforms. The median overall score across all apps was 35/70 (50.0%; IQR 38.6%-64.3%). ScrubUp (48/70, 68.6%) and MySurgeon (42/70, 60.0%) had the highest overall scores, followed by PrefCard (35/70, 50.0%) and Scrubnote (28/70, 40.0%). The lowest scoring app was BrainPadd (26/70, 37.1%). The sections with the highest median scores, in decreasing order, were privacy and security (100.0%, IQR 75.0%-100.0%), aesthetics (83.3%, IQR 75.0%-91.7%), engagement (78.9%, IQR 57.9%-86.8%), functionality (58.3%, IQR 29.2%-75.0%) and information (17.2%; IQR 15.5%-34.5%). Most apps scored well (4/4, 100.0%) on privacy and security, except for Scrubnote (2/4, 50.0%). ScrubUp scored a perfect score for aesthetics (6/6, 100.0%). MySurgeon (17/19, 89.5%) had the highest engagement score; while ScrubUp and MySurgeon had the highest functionality scores (9/12, 75.0% each). All apps scored below 50% for the information section, with ScrubUp having the highest score of 13/29 (44.8%).
CONCLUSIONS
ScrubUp and MySurgeon had the highest quality scores and can be used by operating room personnel for their surgical preparation. Developers are encouraged to use the quality evaluation criteria in our tool to develop appropriate apps for surgical preparation. Operating room personnel can also use this tool as a guide to select and assess their preferred apps in their practices.
Development of a Methodological Quality Criteria List for Observational Studies: The Observational Study Quality Evaluation
