scholarly journals Quality evaluation of smartphone applications for laboratory medicine

2018 ◽  
Vol 57 (3) ◽  
pp. 388-397 ◽  
Author(s):  
Snežana Jovičić ◽  
Joanna Siodmiak ◽  
Ian D. Watson

Abstract Background Many of the mobile applications (apps) used for delivering health interventions involve laboratory medicine data. This survey was conducted to search the online market for health apps that manage laboratory medicine data. The aim was to review them and perform a quality evaluation. Methods Apps search criteria were “Lab results blood work”, “Lab results”, and “Health apps”. After the stepwise exclusion process, 52 selected apps were downloaded and analyzed. For review and content analysis of the apps, a multidimensional tool for classifying and rating the quality of mobile health apps – Mobile App Rating Scale (MARS), was used. Results Selected apps were classified into five categories according to their intended use by patients or physicians, and the type of data engaged. Spearman’s correlation analysis found significant correlations between MARS individual scoring items, as with the subjective quality and number of technical aspects. Kruskal-Wallis analysis showed a significant difference in the number of technical aspects employed, MARS engagement and informational quality score items, total score, and subjective quality. The lowest values for all of these items were in the category of apps designed for patients, and the post hoc test showed that the difference was statistically significant between this and the values in all other categories. Conclusions Apps designed for patients, are of the poorest quality, considering the total quality of the content and information they provide, estimated using the MARS tool. This estimation needs to be validated for laboratory medicine apps, and eventually modified after consideration of specific quality benchmarks.

2019 ◽  
Author(s):  
Marco Bardus ◽  
Nathalie Awada ◽  
Lilian A Ghandour ◽  
Elie-Jacques Fares ◽  
Tarek Gherbal ◽  
...  

BACKGROUND With thousands of health apps in app stores globally, it is crucial to systemically and thoroughly evaluate the quality of these apps due to their potential influence on health decisions and outcomes. The Mobile App Rating Scale (MARS) is the only currently available tool that provides a comprehensive, multidimensional evaluation of app quality, which has been used to compare medical apps from American and European app stores in various areas, available in English, Italian, Spanish, and German. However, this tool is not available in Arabic. OBJECTIVE This study aimed to translate and adapt MARS to Arabic and validate the tool with a sample of health apps aimed at managing or preventing obesity and associated disorders. METHODS We followed a well-established and defined “universalist” process of cross-cultural adaptation using a mixed methods approach. Early translations of the tool, accompanied by confirmation of the contents by two rounds of separate discussions, were included and culminated in a final version, which was then back-translated into English. Two trained researchers piloted the MARS in Arabic (MARS-Ar) with a sample of 10 weight management apps obtained from Google Play and the App Store. Interrater reliability was established using intraclass correlation coefficients (ICCs). After reliability was ascertained, the two researchers independently evaluated a set of additional 56 apps. RESULTS MARS-Ar was highly aligned with the original English version. The ICCs for MARS-Ar (0.836, 95% CI 0.817-0.853) and MARS English (0.838, 95% CI 0.819-0.855) were good. The MARS-Ar subscales were highly correlated with the original counterparts (<i>P</i>&lt;.001). The lowest correlation was observed in the area of usability (<i>r</i>=0.685), followed by aesthetics (<i>r</i>=0.827), information quality (<i>r</i>=0.854), engagement (<i>r</i>=0.894), and total app quality (<i>r</i>=0.897). Subjective quality was also highly correlated (<i>r</i>=0.820). CONCLUSIONS MARS-Ar is a valid instrument to assess app quality among trained Arabic-speaking users of health and fitness apps. Researchers and public health professionals in the Arab world can use the overall MARS score and its subscales to reliably evaluate the quality of weight management apps. Further research is necessary to test the MARS-Ar on apps addressing various health issues, such as attention or anxiety prevention, or sexual and reproductive health.


2021 ◽  
Author(s):  
Antonia Lambrecht ◽  
Nicolas Vuillerme ◽  
Christina Raab ◽  
David Simon ◽  
Eva-Maria Messner ◽  
...  

BACKGROUND Mobile applications promise to improve current health care. A growing number app quality studies exist to help patients and physicians choose appropriate, helpful and useful applications. However, current mobile app quality ratings are mostly physician-based. They exclude patients although as end-users, patients are able to provide the most relevant feedback. In a recent physician-based review of rheumatic apps, Rheuma Auszeit received the best overall rating (4.2/5), however this app has never been systematically evaluated by the intended end-users, rheumatic patients. OBJECTIVE The aim of this study was (1) to assess the quality of Rheuma Auszeit by rheumatic patients and (2) to evaluate the association between uMARS (User Version of the Mobile App Rating Scale) scores and patients’ characteristics. METHODS Consecutive patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis were seen at the rheumatology clinic at university hospital Erlangen, Germany. They were asked to evaluate the app Rheuma Auszeit using the uMARS and to complete a paper-based survey evaluating the individual preferences, attitudes and ehealth literacy. uMARS assesses the dimensions of engagement, functionality, aesthetics, information, and subjective quality on 5-point scales. The association between uMARS scores and patients’ characteristics was further explored. RESULTS Between December 2018 and January 2019, a total of 126 patients evaluated Rheuma Auszeit using uMARS and filled out the paper-based survey. The median uMARS score was 3.9, IQR 0.7. Functionality was the domain with the highest rating (median 4.8, IQR 0.8), followed by aesthetics (median 4.0, IQR 0.7), information (median 3.5, IQR 0.8), and engagement (median 3.2, IQR 1.0). Subjective quality was average (median 3.0, IQR 1.0). The lowest scoring individual item was customization with a median of 2.5/5. Lower functionality scores were reported among older female rheumatic patients (P<.004). Older male rheumatic patients reported a higher subjective quality score (P<.024). Perceived disease activity and disease duration did not significantly correlate with any uMARS subdomain scores. eHealth literacy significantly correlated with functionality uMARS subdomain ratings (Rho=0.18; P<.042). Preferred time of app usage significantly correlated with engagement (Rho=0.20; P<.024), functionality (Rho=0.19; P<.029), total uMARS score (Rho=0.21; P<.017) and subjective quality score (Rho=0.21; P<.017). The vast majority of rheumatic patients would consider recommending Rheuma Auszeit to other patients (117/126; 92.9%). CONCLUSIONS Rheuma Auszeit was well accepted by patients suffering from rheumatoid arthritis, psoriatic arthritis and ankylosing spondyloarthritis. Lacking customization could lead to low app compliance and should be improved. The study highlights the potential and feasibility of therapeutic complementary digital solutions in rheumatology.


10.2196/14479 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e14479 ◽  
Author(s):  
Eva-Maria Messner ◽  
Yannik Terhorst ◽  
Antonia Barke ◽  
Harald Baumeister ◽  
Stoyan Stoyanov ◽  
...  

Background The number of mobile health apps (MHAs), which are developed to promote healthy behaviors, prevent disease onset, manage and cure diseases, or assist with rehabilitation measures, has exploded. App store star ratings and descriptions usually provide insufficient or even false information about app quality, although they are popular among end users. A rigorous systematic approach to establish and evaluate the quality of MHAs is urgently needed. The Mobile App Rating Scale (MARS) is an assessment tool that facilitates the objective and systematic evaluation of the quality of MHAs. However, a German MARS is currently not available. Objective The aim of this study was to translate and validate a German version of the MARS (MARS-G). Methods The original 19-item MARS was forward and backward translated twice, and the MARS-G was created. App description items were extended, and 104 MHAs were rated twice by eight independent bilingual researchers, using the MARS-G and MARS. The internal consistency, validity, and reliability of both scales were assessed. Mokken scale analysis was used to investigate the scalability of the overall scores. Results The retranslated scale showed excellent alignment with the original MARS. Additionally, the properties of the MARS-G were comparable to those of the original MARS. The internal consistency was good for all subscales (ie, omega ranged from 0.72 to 0.91). The correlation coefficients (r) between the dimensions of the MARS-G and MARS ranged from 0.93 to 0.98. The scalability of the MARS (H=0.50) and MARS-G (H=0.48) were good. Conclusions The MARS-G is a reliable and valid tool for experts and stakeholders to assess the quality of health apps in German-speaking populations. The overall score is a reliable quality indicator. However, further studies are needed to assess the factorial structure of the MARS and MARS-G.


2019 ◽  
Author(s):  
Florian Dittrich ◽  
Sascha Beck ◽  
Anna Katharina Harren ◽  
Felix Reinecke ◽  
Sebastian Serong ◽  
...  

BACKGROUND It is undeniable that appropriate smartphone apps offer enormous opportunities for dealing with future challenges in orthopedic surgery and public health, in general. However, it is still unclear how the apps currently available in the two major app stores can be used in daily clinical routine by German orthopedic surgeons. OBJECTIVE This study aimed to gain evidence regarding the quantity and quality of apps available in the two major app stores and their suitability for use by orthopedic surgeons in Germany. METHODS We conducted a systematic, keyword-based app store screening to obtain evidence concerning the quantity and quality of commercially available apps. Apps that met the inclusion criteria were evaluated using the <i>app synopsis–checklist for users</i> and the German Mobile App Rating Scale for secure use, trustworthiness, and quality. RESULTS The investigation revealed serious shortcomings regarding legal and medical aspects. Furthermore, most apps turned out to be useless and unsuitable for the clinical field of application (4242/4249, 99.84%). Finally, 7 trustworthy and high-quality apps (7/4249, 0.16%) offering secure usage in the daily clinical routine of orthopedists were identified. These apps mainly focused on education (5/7). None of them were CE (Conformité Européenne) certified. Moreover, there are no studies providing evidence that these apps have any positive use whatsoever. CONCLUSIONS The data obtained in our study suggest that the number of trustworthy and high-quality apps on offer is extremely low. Nowadays, finding appropriate apps in the fast-moving, complex, dynamic, and rudimentarily controlled app stores is most challenging. Promising approaches, for example, systematic app store screenings, app-rating developments, reviews or app libraries, and the creation of consistent standards have been established. However, further efforts are necessary to ensure that these innovative mobile health apps not only provide the correct information but are also safe to use in daily clinical practice.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Daniel McAleese ◽  
Angeliki Papadaki

AbstractThe popularity of smartphone apps is rising globally. However, the quality of widely available health apps and their effectiveness to promote behaviour change, by incorporating behavioural change techniques (BCTs) that have been suggested to result in behaviour change, is questionable. The aim of this study was to conduct a content analysis of smartphone apps that utilise the Mediterranean diet (MD), a dietary pattern linked to numerous health benefits, to promote healthy dietary behaviours. The specific objectives were to evaluate the quality of these apps and their use of BCTs. The iTunes Store and Google Play were searched for all available apps (free and requiring payment to download) promoting the MD. Apps were excluded if they were not available in English, did not focus only on the MD or the download process was corrupt. The Mobile App Rating Scale (MARS) was used to assess app engagement, functionality, aesthetics and information quality (the average of which represents a quality mean score (QMS)) and subjective quality. The Abraham & Michie behaviour change taxonomy was adapted to create a 20-item checklist to assess the presence of BCTs in the eligible apps. Thirty nine apps (64.1% of which were free to download) were analysed. The overall QMS was 2.96 ± 0.46. The lowest and highest scored QMS constructs were engagement (2.42 ± 0.62) and functionality (3.95 ± 0.45), respectively, whilst the overall mean subjective quality score was 1.71 ± 0.51 (scores’ range 1–5). Apps were scored higher for aesthetics if they required payment (3.14 vs. 2.78, p = 0.047). Apps incorporated an average of 3.10 ± 1.87 BCTs, with no difference in the number of BCTs present according to platform or cost. From the five BCTs that have been suggested to promote behaviour change, ‘self-monitoring’ was present in six apps, ‘intention formation’ in 15 and ‘goal setting’ in one. None of the apps incorporated the ‘review of behavioural goals’ and ‘feedback on performance’ BCTs. The total QMS score was positively associated with the presence of BCTs (r = 0.409, p = 0.008). Based on the MARS assessment, apps promoting the MD that are available in the public domain were of moderate quality. In contrast, the low presence, particularly of efficacious, BCTs and low subjective quality scores suggest that apps are actually of poor quality and potentially not effective in promoting behaviour change towards an MD diet. These findings provide important insights for the future development of high-quality apps to promote the MD at population level.


Author(s):  
Matthias Domhardt ◽  
Eva-Maria Messner ◽  
Anna-Sophia Eder ◽  
Sophie Engler ◽  
Lasse B. Sander ◽  
...  

Abstract Background The access to empirically-supported treatments for common mental disorders in children and adolescents is often limited. Mental health apps might extend service supplies, as they are deemed to be cost-efficient, scalable and appealing for youth. However, little is known about the quality of available apps. Therefore, we aimed to systematically evaluate current mobile-based interventions for pediatric anxiety, depression and posttraumatic stress disorder (PTSD). Methods Systematic searches were conducted in Google Play Store and Apple App Store to identify relevant apps. To be eligible for inclusion, apps needed to be: (1) designed to target either anxiety, depression or PTSD in youth (0–18 years); (2) developed for children, adolescents or caregivers; (3) provided in English or German; (4) operative after download. The quality of eligible apps was assessed with two standardized rating systems (i.e., Mobile App Rating Scale (MARS) and ENLIGHT) independently by two reviewers. Results Overall, the searches revealed 3806 apps, with 15 mental health apps (0.39%) fulfilling our inclusion criteria. The mean overall scores suggested a moderate app quality (MARS: M = 3.59, SD = 0.50; ENLIGHT: M = 3.22, SD = 0.73). Moreover, only one app was evaluated in an RCT. The correlation of both rating scales was high (r = .936; p < .001), whereas no significant correlations were found between rating scales and user ratings (p > .05). Conclusions Our results point to a rather poor overall app quality, and indicate an absence of scientific-driven development and lack of methodologically sound evaluation of apps. Thus, future high-quality research is required, both in terms of theoretically informed intervention development and assessment of mental health apps in RCTs. Furthermore, institutionalized best-practices that provide central information on different aspects of apps (e.g., effectiveness, safety, and data security) for patients, caregivers, stakeholders and mental health professionals are urgently needed.


2021 ◽  
Vol 8 ◽  
Author(s):  
Antonia Lambrecht ◽  
Nicolas Vuillerme ◽  
Christina Raab ◽  
David Simon ◽  
Eva-Maria Messner ◽  
...  

Introduction: Mobile applications promise to improve current health care. However, current mobile app quality ratings are mostly physician-based. The aim of this study was (1) to assess the quality of the self-management app Rheuma Auszeit using the validated uMARS (User Version of the Mobile App Rating Scale) app quality assessment tool and (2) to evaluate the association between uMARS scores and patients' characteristics.Materials and Methods: Consecutive patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis were seen at the rheumatology clinic at university hospital Erlangen, Germany. They were asked to test Rheuma Auszeit, evaluate its quality using uMARS and complete a paper-based survey evaluating the individual preferences, attitudes and ehealth literacy. The association between uMARS scores and patients' characteristics was further explored.Results: Between December 2018 and January 2019, a total of 126 patients evaluated Rheuma Auszeit using uMARS and filled out the paper-based survey. The median uMARS score was 3.9, IQR 0.7. Functionality was the domain with the highest rating (median 4.8, IQR 0.8), followed by aesthetics (median 4.0, IQR 0.7), information (median 3.5, IQR 0.8), and engagement (median 3.2, IQR 1.0). Subjective quality was average (median 3.0, IQR 1.0). The lowest scoring individual item was customization with a median of 2.5/5. Lower functionality scores were reported among older female rheumatic patients (P &lt; 0.004). Older male rheumatic patients reported a higher subjective quality score (P &lt; 0.024). Perceived disease activity and disease duration did not significantly correlate with any uMARS subdomain scores. eHealth literacy significantly correlated with functionality uMARS subdomain ratings (Rho = 0.18; P &lt; 0.042). Preferred time of app usage significantly correlated with engagement (Rho = 0.20; P &lt; 0.024), functionality (Rho = 0.19; P &lt; 0.029), total uMARS score (Rho = 0.21; P &lt; 0.017) and subjective quality score (Rho = 0.21; P &lt; 0.017). The vast majority of rheumatic patients would consider recommending Rheuma Auszeit to other patients (117/126; 92.9%).Conclusion: Rheuma Auszeit was well-accepted by German patients suffering from rheumatoid arthritis, psoriatic arthritis and ankylosing spondyloarthritis. Lacking customization could lead to low app compliance and should be improved. Lower functionality scores among older female rheumatic patients highlight the need for patient education. The study underlines the potential and feasibility of therapeutic complementary digital solutions in rheumatology.


10.2196/16956 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e16956
Author(s):  
Marco Bardus ◽  
Nathalie Awada ◽  
Lilian A Ghandour ◽  
Elie-Jacques Fares ◽  
Tarek Gherbal ◽  
...  

Background With thousands of health apps in app stores globally, it is crucial to systemically and thoroughly evaluate the quality of these apps due to their potential influence on health decisions and outcomes. The Mobile App Rating Scale (MARS) is the only currently available tool that provides a comprehensive, multidimensional evaluation of app quality, which has been used to compare medical apps from American and European app stores in various areas, available in English, Italian, Spanish, and German. However, this tool is not available in Arabic. Objective This study aimed to translate and adapt MARS to Arabic and validate the tool with a sample of health apps aimed at managing or preventing obesity and associated disorders. Methods We followed a well-established and defined “universalist” process of cross-cultural adaptation using a mixed methods approach. Early translations of the tool, accompanied by confirmation of the contents by two rounds of separate discussions, were included and culminated in a final version, which was then back-translated into English. Two trained researchers piloted the MARS in Arabic (MARS-Ar) with a sample of 10 weight management apps obtained from Google Play and the App Store. Interrater reliability was established using intraclass correlation coefficients (ICCs). After reliability was ascertained, the two researchers independently evaluated a set of additional 56 apps. Results MARS-Ar was highly aligned with the original English version. The ICCs for MARS-Ar (0.836, 95% CI 0.817-0.853) and MARS English (0.838, 95% CI 0.819-0.855) were good. The MARS-Ar subscales were highly correlated with the original counterparts (P<.001). The lowest correlation was observed in the area of usability (r=0.685), followed by aesthetics (r=0.827), information quality (r=0.854), engagement (r=0.894), and total app quality (r=0.897). Subjective quality was also highly correlated (r=0.820). Conclusions MARS-Ar is a valid instrument to assess app quality among trained Arabic-speaking users of health and fitness apps. Researchers and public health professionals in the Arab world can use the overall MARS score and its subscales to reliably evaluate the quality of weight management apps. Further research is necessary to test the MARS-Ar on apps addressing various health issues, such as attention or anxiety prevention, or sexual and reproductive health.


2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e69-e69
Author(s):  
James Benoit ◽  
Lisa Hartling ◽  
Shannon Scott

Abstract Primary Subject area Technology Background Providing resources that aid in detection and identification of serious childhood illness helps parents feel better equipped to assess their child’s health and significantly changes parental health-seeking behaviours. Some of these resources are limited by accessibility and scalability. Remote locations and staffing limitations create challenges for parents aiming to access health information about their child. Mobile health (mHealth) apps offer a scalable, accessible solution for improving health literacy by enabling access to health information through mobile devices. Objectives To systematically identify all Canadian and US child health apps for parents. Design/Methods We used an environmental scan approach – a review designed to summarize information for decision makers. The Android and Apple app marketplaces were used as search platforms. We built a list of search terms and used these platforms to search for apps targeted at parents, related to pediatric illnesses in US and Canada. Then once we determined that the app met the inclusion criteria, each included app was assessed using the Mobile App Rating Scale (MARS), a validated tool for assessing health apps. The MARS examines apps on five domains: engagement, functionality, aesthetics, information quality, and subjective quality. Results 650 unique apps were screened and 53 apps were included. On a scale of 1-5, the 53 apps assessed had an average Engagement score of 2.82/5 (θ = 0.86), Functionality of 3.98/5 (θ = 0.72), Aesthetics of 3.09/5 (θ = 0.87), Information quality of 2.73/5 (θ = 1.32), and Subjective quality of 2.2 (θ = 0.79). App scores ranged from 2.2/5 to 4.5/5 (µ= 3.2, θ =0.6).The top three apps were Baby and Child First Aid (4.5/5), Ada (4.5/5), and HANDi Paediatric (4.2/5). Taken together, the top three apps covered topics of emergency pediatric first aid, identification of (and appropriate response to) common childhood illnesses, a means of checking symptoms, and a means of responding to emergency situations. There was a lack of Canadian-based app content available to parents in both marketplaces. In addition, published evidence of the included apps’ impact was poor: only 5/53 apps had an evidence base showing the app had been trialed. Conclusion There is a need for evidence-based apps of Canadian origin related to childhood illnesses. The results of this scan created a picture of the health app landscape by examining trends in apps related to pediatric health that are readily available to parents, and by identifying gaps in app design that can be addressed.


2018 ◽  
Author(s):  
Alejandro Salazar ◽  
Helena de Sola ◽  
Inmaculada Failde ◽  
Jose Antonio Moral-Munoz

BACKGROUND Chronic pain is a major health issue requiring an approach that not only considers medication, but also many other factors included in the biopsychosocial model of pain. New technologies, such as mobile apps, are tools to address these factors, although in many cases they lack proven quality or are not based on scientific evidence, so it is necessary to review and measure their quality. OBJECTIVE The aim is to evaluate and measure the quality of mobile apps for the management of pain using the Mobile App Rating Scale (MARS). METHODS This study included 18 pain-related mobile apps from the App Store and Play Store. The MARS was administered to measure their quality. We list the scores (of each section and the final score) of every app and we report the mean score (and standard deviation) for an overall vision of the quality of the pain-related apps. We compare the section scores between the groups defined according to the tertiles via analysis of variance (ANOVA) or Kruskal-Wallis test, depending on the normality of the distribution (Shapiro-Wilk test). RESULTS The global quality ranged from 1.74 (worst app) to 4.35 (best app). Overall, the 18 apps obtained a mean score of 3.17 (SD 0.75). The best-rated sections were functionality (mean 3.92, SD 0.72), esthetics (mean 3.29, SD 1.05), and engagement (mean 2.87, SD 1.14), whereas the worst rated were app specific (mean 2.48, SD 1.00), information (mean 2.52, SD 0.82), and app subjective quality (mean 2.68, SD 1.22). The main differences between tertiles were found on app subjective quality, engagement, esthetics, and app specific. CONCLUSIONS Current pain-related apps are of a certain quality mainly regarding their technical aspects, although they fail to offer information and have an impact on the user. Most apps are not based on scientific evidence, have not been rigorously tested, and the confidentiality of the information collected is not guaranteed. Future apps would need to improve these aspects and exploit the capabilities of current devices.


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