Evaluation of Android and Apple Store Depression Applications Based on Mobile Application Rating Scale

There are a large number of mobile applications that allow the monitoring of health status. The quality of the applications is only evaluated by users and not by standard criteria. This study aimed to examine depression-related applications in major mobile application stores and to analyze them using the rating scale tool Mobile Application Rating Scale (MARS). A search of digital applications for the control of symptoms and behavioral changes in depression was carried out in the two reference mobile operating systems, Apple (App Store) and Android (Play Store), by means of two reviewers with a blind methodology between September and October 2019 in stores from Spain and the United Kingdom. Eighteen applications from the Android Play Store and twelve from the App Store were included in this study. The quality of the applications was evaluated using the MARS scale from 1 (inadequate) to 5 (excellent). The average score of the applications based on the MARS was 3.67 ± 0.53. The sections with the highest scores were “Functionality” (4.51) and “Esthetics” (3.98) and the lowest “Application Subjective quality” (2.86) and “Information” (3.08). Mobile Health applications for the treatment of depression have great potential to influence the health status of users; however, applications come to the digital market without health control.

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Ranked Apps for Depression by MARS on Android and Apple Store: A review (Preprint)

10.2196/preprints.19718 ◽

2020 ◽

Author(s):

Jaime Martin-Martin ◽

Antonio Muro-Culebras ◽

Adrian Escriche-Escuder ◽

Manuel González-Sánchez ◽

María Ruíz-Muñoz ◽

...

Keyword(s):

Health Status ◽

Operating Systems ◽

Rating Scale ◽

Mobile App ◽

Average Score ◽

App Store ◽

The United Kingdom ◽

Treatment Of Depression ◽

Final Score

BACKGROUND There are a large number of mobile applications that allow monitoring of health status. The quality of the applications is only evaluated by users and not by standard criteria. OBJECTIVE To examine depression-related applications in major mobile application stores and analyse them using the rating scale tool MARS. METHODS A search of digital applications for the control of symptoms and behavioral changes in depression was carried out in the two reference mobile operating systems Apple (App Store) and Android (Play Store) by means of two independent reviewers between September and October 2019. The search was performed on the two operating systems in the regions of Spain and the United Kingdom. Eighteen applications from the Android Play Store and twelve from the App Store were included in this study. The quality of the applications was evaluated using the MARS scale. Descriptive statistics (mean and standard deviation) were applied for the values of each section and the final score of the applications. RESULTS The average score of the applications ranged from 2.38 to 4.6 (3.67 ± 0.53) applying the MARS scale, ranging from 1 (inadequate) to 5 (excellent). The sections with the highest scores were Functionality (4.51) and Esthetics (3.98) and those with the lowest App Subjective quality (2.86) and Information (3.08). CONCLUSIONS MHealth apps (such as apps for the treatment of depression) have great potential to influence in the health status of users. Apps come to the digital market from mobile app stores without any kind of health control.

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German Mobile Apps for Inflammatory Bowel Disease Management: Review and Analysis using the Mobile Application Rating Scale (MARS) (Preprint)

10.2196/preprints.31102 ◽

2021 ◽

Author(s):

Maximilian Gerner ◽

Nicolas Vuillerme ◽

Timothée Aubourg ◽

Eva-Maria Messner ◽

Yannik Terhorst ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Mobile Application ◽

Rating Scale ◽

Mobile Apps ◽

App Store ◽

Study Results ◽

Inflammatory Bowel ◽

Google Play

BACKGROUND Patients suffering from inflammatory bowel diseases (IBD) frequently need long-term medical treatment. Mobile apps promise to complement and improve IBD management, however, so far there is no scientific analysis of their quality. OBJECTIVE To evaluate the quality of German IBD mobile apps targeting inflammatory bowel disease patients and physicians treating IBD patients using the Mobile Application Rating Scale (MARS). METHODS The German Apple App Store and Google Play store were systematically searched to identify German IBD mobile apps for patients and physician use. MARS was used to independently assess app quality by 6 physicians, 3 using Android and 3 using iOS smartphones. Apps were randomly assigned so that the 4 apps with the most downloads were rated by all raters and the remaining apps were rated by 1 Android and 1 iOS user. RESULTS In total, we identified 1764 apps in the Apple App Store and Google Play Store. After removing apps that were not related to IBD (1386) and not available in German (317), 61 apps remained. After removing duplicates (3), congress (7), journal (4), and clinical study apps (6), as well as excluding apps that were available in only one of the two app stores (20) and apps which can only be used with an additional device (7) , 14 apps fulfilled the inclusion criteria. The app “CED Dokumentation und Tipps” had the highest overall MARS score with 4.11/5. Median MARS scores of the 14 apps were ranging from 2.38 and 4.11. All of the analyzed apps addressed patients. Three apps are classified as medical products. There was no significant difference between iOS and Android raters. CONCLUSIONS The quality of German IBD apps is largely heterogeneous. Furthermore, despite promising international study results, little evidence exists proving a clinical benefit for German IBD apps. MARS seems to be a suitable method to identify relevant apps. Accordingly, clinical studies and also patient inclusion in the app development process are needed to effectively implement mobile apps in routine care.

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Breast Cancer-Related Apps in Google Play and App Store: Evaluate of Their Functionality and Quality

10.21203/rs.3.rs-448075/v1 ◽

2021 ◽

Author(s):

Aydanur AYDIN ◽

Ayla GÜRSOY

Keyword(s):

Breast Cancer ◽

Mobile Applications ◽

Rating Scale ◽

Mobile App ◽

Innovative Technology ◽

Average Score ◽

Evidence Based ◽

Health Technologies ◽

App Store

Abstract Aim: This study aimed to evaluate the functionality and quality of breast cancer-related apps which can be accessed from Turkey. Methods: The research covers 707 mobile applications, which were searched using the keywords "cancer", "oncology" and "breast cancer" in Google and App store stores between January and June 2019. The quality of apps was assessed with the user version of the Mobile App Rating Scale (MARS). Results: Mobile applications focus on communication, education and treatment order / plan categories. The average MARS quality score for applications in all of the two stores was determined as 3.42. According to the average score of the scale sub-dimensions; It was seen that they were ranked as functionality, aesthetics, information quality and participation. MARS scale sub-groups were listed as functionality, aesthetics, knowledge quality, and participation. Conclusion: e-Health is a subject that has just started to be used actively in health. Although basic information about breast cancer was used, information on prevention, early diagnosis and precautions was relatively limited and was not personalized. Support from healthcare professionals and further efforts should be made to develop evidence-based breast cancer knowledge and innovative technology and applications regarding cancer. Implications for practice: e-Health technologies are a good tool in breast cancer, but appear to lack evidence-based content and individual specific areas such as age and education level.

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Psychometric evaluation of the Mobile Application Rating Scale (MARS) (Preprint)

10.2196/preprints.17689 ◽

2020 ◽

Cited By ~ 2

Author(s):

Yannik Terhorst ◽

Paula Philippi ◽

Lasse Sander ◽

Dana Schultchen ◽

Sarah Paganini ◽

...

Keyword(s):

Health Care ◽

Construct Validity ◽

Mobile Application ◽

Concurrent Validity ◽

Rating Scale ◽

Psychometric Evaluation ◽

Confirmatory Factor ◽

Health Domains ◽

Psychometric Quality

BACKGROUND Mobile health apps (MHA) have the potential to improve health care. The commercial MHA market is rapidly growing, but the content and quality of available MHA are unknown. Consequently, instruments of high psychometric quality for the assessment of the quality and content of MHA are highly needed. The Mobile Application Rating Scale (MARS) is one of the most widely used tools to evaluate the quality of MHA in various health domains. Only few validation studies investigating its psychometric quality exist with selected samples of MHAs. No study has evaluated the construct validity of the MARS and concurrent validity to other instruments. OBJECTIVE This study evaluates the construct validity, concurrent validity, reliability, and objectivity, of the MARS. METHODS MARS scoring data was pooled from 15 international app quality reviews to evaluate the psychometric properties of the MARS. The MARS measures app quality across four dimensions: engagement, functionality, aesthetics and information quality. App quality is determined for each dimension and overall. Construct validity was evaluated by assessing related competing confirmatory models that were explored by confirmatory factor analysis (CFA). A combination of non-centrality (RMSEA), incremental (CFI, TLI) and residual (SRMR) fit indices was used to evaluate the goodness of fit. As a measure of concurrent validity, the correlations between the MARS and 1) another quality assessment tool called ENLIGHT, and 2) user star-rating extracted from app stores were investigated. Reliability was determined using Omega. Objectivity was assessed in terms of intra-class correlation. RESULTS In total, MARS ratings from 1,299 MHA covering 15 different health domains were pooled for the analysis. Confirmatory factor analysis confirmed a bifactor model with a general quality factor and an additional factor for each subdimension (RMSEA=0.074, TLI=0.922, CFI=0.940, SRMR=0.059). Reliability was good to excellent (Omega 0.79 to 0.93). Objectivity was high (ICC=0.82). The overall MARS rating was positively associated with ENLIGHT (r=0.91, P<0.01) and user-ratings (r=0.14, P<0.01). CONCLUSIONS he psychometric evaluation of the MARS demonstrated its suitability for the quality assessment of MHAs. As such, the MARS could be used to make the quality of MHA transparent to health care stakeholders and patients. Future studies could extend the present findings by investigating the re-test reliability and predictive validity of the MARS.

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An Analysis of Apps with a Medication List Functionality for Older People with Heart Failure: Evaluation using the Mobile Application Rating Scale (MARS) and the IMS Institute for Healthcare Informatics Functionality Score (Preprint)

10.2196/preprints.30674 ◽

2021 ◽

Author(s):

Yohanca Maria Diaz-Skeete ◽

David McQuaid ◽

Adewale Samuel Akinosun ◽

Idongesit Ekerete ◽

Natacha Carragher ◽

...

Keyword(s):

Heart Failure ◽

Mobile Application ◽

Rating Scale ◽

Scientific Evidence ◽

Medication List ◽

Healthcare Informatics ◽

Medication History ◽

Clinic Efficiency ◽

Google Play

BACKGROUND Managing the care of older patients with heart failure (HF) largely centres on medication management. Due to their frequent medication or dosing changes, an app supporting them to keep an up-to-date list of medication could be advantageous. During COVID-19 times, HF outpatients’ consultations are taking place virtually or by phone. An app with the capability to share the medication list with healthcare professionals before consultation could support the clinic efficiency, for example, reducing consultation time. However, the influence of apps on maintaining an up to date medication history for older adults with HF in Ireland remains largely unexplored. OBJECTIVE The objectives of this review are twofold: to review apps with a medication list functionality and to evaluate the quality of the apps included in the review using the Mobile Application Rating Scale (MARS) and the IMS Institute for Healthcare Informatics functionality scale. METHODS A systematic search of apps was conducted in June 2019 using the Google Play StoreTM and iTunes App StoreTM. The MARS was used independently by four researchers to assess the quality of the apps using an Android phone and an iPad. Apps were also evaluated using the IMS Institute for Healthcare Informatics functionality score. RESULTS Google play and iOS app stores searches identified 483 potential apps (292 from Android stores and 191 from Apple stores). Six apps met the inclusion criteria. Medisafe app had the highest overall MARS score (4/5) and the medication list & medical records app had the lowest overall score (2.5/5). Five out of the six apps achieved an acceptable quality MARS score (>3.0). Two apps scored the maximum number of features (n=11) according to the IMS Institute for Healthcare Informatics functionality score and two scored the lowest (n=5). The apps had on average 8 functions based on the IMS functionality criteria (range 5 to 11). CONCLUSIONS The quality of current apps with a medication list functionality varies regarding their technical aspects. Most of the apps reviewed have an acceptable MARS objective quality. However, the subjective quality or satisfaction with the apps was poor. Only three apps are based on scientific evidence and have been previously tested. Two apps featured all the IMS Institute for Healthcare Informatics functionalities and half do not provide clear instructions on how to enter medication data, do not display vital parameters data in an easy to understand format and do not guide users on how or when to take their medication. CLINICALTRIAL N/A

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Assessing Apps for Patients with Genitourinary Tumors Using the Mobile Application Rating Scale (MARS): Systematic Search in App Stores and Content Analysis (Preprint)

10.2196/preprints.17609 ◽

2019 ◽

Author(s):

Miguel Ángel Amor-García ◽

Roberto Collado-Borrell ◽

Vicente Escudero-Vilaplana ◽

Alejandra Melgarejo-Ortuño ◽

Ana Herranz-Alonso ◽

...

Keyword(s):

Prostate Cancer ◽

Health Care ◽

Health Professionals ◽

Health Care Professionals ◽

Mobile Application ◽

Rating Scale ◽

Cross Sectional ◽

Cancer Symptoms ◽

Genitourinary Cancers

BACKGROUND The large number of available cancer apps and their impact on the population necessitates a transparent, objective, and comprehensive evaluation by app experts, health care professionals, and users. To date, there have been no analyses or classifications of apps for patients with genitourinary cancers, which are among the most prevalent types of cancer. OBJECTIVE The objective of our study was to analyze the quality of apps for patients diagnosed with genitourinary cancers using the Mobile Application Rating Scale (MARS) and identify high-quality apps. METHODS We performed an observational cross-sectional descriptive study of all smartphone apps for patients diagnosed with genitourinary cancers available on iOS and Android platforms. In July 2019, we searched for all available apps for patients with genitourinary cancers (bladder, prostate, cervical, uterine, endometrial, kidney, testicular, and vulvar) or their caregivers. Apps were downloaded and evaluated, and the general characteristics were entered into a database. The evaluation was performed by 2 independent researchers using the MARS questionnaire, which rates 23 evaluation criteria clustered in 5 domains (Engagement, Functionality, Esthetics, Information, and Subjective Quality) on a scale from 1 to 5. RESULTS In total, 46 apps were analyzed. Of these, 31 (67%) were available on Android, 6 (13%) on iOS, and 9 (20%) on both platforms. The apps were free in 89% of cases (41/46), and 61% (28/46) had been updated in the previous year. The apps were intended for prostate cancer in 30% of cases (14/46) and cervical cancer in 17% (8/46). The apps were mainly informative (63%, 29/46), preventive (24%, 11/46), and diagnostic (13%, 6/46). Only 7/46 apps (15%) were developed by health care organizations. The mean MARS score for the overall quality of the 46 apps was 2.98 (SD 0.77), with a maximum of 4.63 and a minimum of 1.95. Functionality scores were quite similar for most of the apps, with the greatest differences in Engagement and Esthetics, which showed acceptable scores in one-third of the apps. The 5 apps with the highest MARS score were the following: “Bladder cancer manager,” “Kidney cancer manager,” “My prostate cancer manager,” “Target Ovarian Cancer Symptoms Diary,” and “My Cancer Coach.” We observed statistically significant differences in the MARS score between the operating systems and the developer types (P<.001 and P=.01, respectively), but not for cost (P=.62). CONCLUSIONS MARS is a helpful methodology to decide which apps can be prescribed to patients and to identify which features should be addressed to improve these tools. Most of the apps designed for patients with genitourinary cancers only try to provide data about the disease, without coherent interactivity. The participation of health professionals in the development of these apps is low; nevertheless, we observed that both the participation of health professionals and regular updates were correlated with quality.

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Mobile Applications in Otolaryngology: A Systematic Review of the Literature, Apple App Store and the Google Play Store

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420940350 ◽

2020 ◽

Vol 130 (1) ◽

pp. 78-91

Author(s):

Eleonora M. C. Trecca ◽

Antonio Lonigro ◽

Matteo Gelardi ◽

Brandon Kim ◽

Michele Cassano

Keyword(s):

Rating Scale ◽

Case Reports ◽

Mobile App ◽

App Store ◽

Literature Reviews ◽

Scientific Associations ◽

Conference Papers ◽

Further Development ◽

Google Play

Objectives: Although the last few years have seen an increased number of smartphone applications (apps) disseminated in the field of Otolaryngology (ORL), these apps vary widely in quality. The aim of this paper, therefore, is to systematically review ORL apps directed towards patients in mobile app stores and the current literature. Methods: The Google Play Store, Apple App Store and PubMed were searched for ORL apps for patients using various keywords pertaining to different ORL subspecialties. Apps not relevant to the scope of this research and/or duplicates, educational apps, apps promoting a business, apps requiring specific separate hardware, and apps in non-English were excluded. In PubMed, keywords pertaining to the subspecialties were combined with “mobile app” in a search query; literature reviews, editorials, case reports, conference papers, duplicate articles, and articles irrelevant to ORL apps were excluded. The quality of apps with the highest number of reviews was assessed using the “Mobile App Rating Scale” (MARS), while the quality of the articles was rated using “The Strengthening the Reporting of Observational Studies in Epidemiology” (STROBE) Statement. Results: After searching the app stores, 1074 apps were included and grouped according to their ORL subspecialties. The overall MARS score of the ten most popular apps in each category was 3.65 out of 5. A total of 636 articles were identified in the literature, and 193 were included. The mean adherence percentage of the articles to the STROBE checklist was of 84.37%. Conclusions: Although the apps currently available need further development, their application in ORL appears promising. Further dialogue between physicians and patients, as well as formal support from professional and scientific associations, should be encouraged.

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Toward Gamified Pain Management Apps: Mobile Application Rating Scale–Based Quality Assessment of Pain-Mentor’s First Prototype Through an Expert Study

JMIR Formative Research ◽

10.2196/13170 ◽

2020 ◽

Vol 4 (5) ◽

pp. e13170

Author(s):

Alexandra Hoffmann ◽

Corinna A Faust-Christmann ◽

Gregor Zolynski ◽

Gabriele Bleser

Keyword(s):

Chronic Pain ◽

Pain Management ◽

Mobile Application ◽

Rating Scale ◽

Pain Treatment ◽

Semistructured Interview ◽

Content Quality ◽

Management Techniques ◽

Health Experts

Background The use of health apps to support the treatment of chronic pain is gaining importance. Most available pain management apps are still lacking in content quality and quantity as their developers neither involve health experts to ensure target group suitability nor use gamification to engage and motivate the user. To close this gap, we aimed to develop a gamified pain management app, Pain-Mentor. Objective To determine whether medical professionals would approve of Pain-Mentor’s concept and content, this study aimed to evaluate the quality of the app’s first prototype with experts from the field of chronic pain management and to discover necessary improvements. Methods A total of 11 health professionals with a background in chronic pain treatment and 2 mobile health experts participated in this study. Each expert first received a detailed presentation of the app. Afterward, they tested Pain-Mentor and then rated its quality using the mobile application rating scale (MARS) in a semistructured interview. Results The experts found the app to be of excellent general (mean 4.54, SD 0.55) and subjective quality (mean 4.57, SD 0.43). The app-specific section was rated as good (mean 4.38, SD 0.75). Overall, the experts approved of the app’s content, namely, pain and stress management techniques, behavior change techniques, and gamification. They believed that the use of gamification in Pain-Mentor positively influences the patients’ motivation and engagement and thus has the potential to promote the learning of pain management techniques. Moreover, applying the MARS in a semistructured interview provided in-depth insight into the ratings and concrete suggestions for improvement. Conclusions The experts rated Pain-Mentor to be of excellent quality. It can be concluded that experts perceived the use of gamification in this pain management app in a positive manner. This showed that combining pain management with gamification did not negatively affect the app’s integrity. This study was therefore a promising first step in the development of Pain-Mentor.

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Health Status of Children and Young Persons With Congenital Adrenal Hyperplasia in the United Kingdom: Results of a Multi-Center Cohort Study

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1459 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A717-A717

Author(s):

Irina-Alexandra Bacila ◽

Neil Lawrence ◽

Sundus Mahdi ◽

Sabah Alvi ◽

Timothy Cheetham ◽

...

Keyword(s):

Quality Of Life ◽

United Kingdom ◽

Health Status ◽

Congenital Adrenal Hyperplasia ◽

Adrenal Hyperplasia ◽

Hydroxylase Deficiency ◽

The United Kingdom ◽

Number Of Patients ◽

21 Hydroxylase Deficiency

Abstract Introduction: The association between congenital adrenal hyperplasia (CAH) and increased morbidity and mortality in adult life has been well established, however, limited knowledge exists regarding the onset of co-morbidities during childhood. Objective: To establish the health status of children and young persons (CYP) with CAH in the United Kingdom. Methods: This cross-sectional multi-center study involved 14 tertiary endocrine units across the United Kingdom. We recruited 107 patients aged 8-18 years with 21-hydroxylase deficiency and 83 matched controls. We collected and analyzed demographic, clinical, and metabolic data, as well as psychological questionnaires (Strengths and Difficulties [SDQ], Paediatric Quality of Life [PedsQL]and Self-Image Profile [SIP]). Results: The majority of patients (62.2%) were diagnosed within the first month of life, most commonly presenting with ambiguous genitalia (32.7%) or salt losing crisis (25.2%). After diagnosis, 37.3% of patients required admission for adrenal crisis, 11.2% presenting three or more episodes. Of the female patients, 57.6% had undergone urogenital examination under anesthesia and 35.5% had genital surgery. Most CAH patients received glucocorticoid (GC) replacement therapy with hydrocortisone (HC) (94.3%) and the rest with prednisolone, with a mean for relative GC doses of 13.3 (±3.7) mg/m2 per day HC-equivalent. 76.6% of patients received treatment with fludrocortisone, with a mean dose of 105.0 (±50.2) µg/m2 per day. Comparing height-Standard Deviation Score (SDS), patients under 12 years were taller (p=0.011) and patients aged 12-18 years shorter (p=0.031) than controls. Bone age was advanced in patients, with a mean difference from the chronological age of 1.9 (±2.2) years. CAH patients were more frequently overweight (26.4%) or obese (22.6%) compared to controls (10.8% and 10.8% respectively, p<0.001). Five patients had high blood pressure. A small number of patients had abnormal lipid profiles: raised total cholesterol (7%), low HDL (13%), raised LDL (4%) and triglycerides (15%). Insulin resistance as defined by HOMA-IR was found in 53.8% of patients with CAH, which was comparable to healthy controls (56.3%). 15.8% of patients had SDQ scores within the “high” and “very high” categories of concern. In the PedsQL questionnaires, ‘school functioning’ was the lowest scoring dimension with a median (IQR) of 70 (55 - 80), followed by ‘emotional functioning’ with a median score of 75 (65 - 85). The SIP scores were comparable to normative values, for all age and gender groups. Conclusion: Children with CAH have increased prevalence of growth and weight gain problems, metabolic co-morbidities, as well as reduced quality of life and mental wellbeing. There is a pressing need to optimize management and monitoring strategies in CYP with CAH order to improve long-term health outcomes.

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