Aim There is both favorable and controversial evidence on the application of telemedicine in the emergency department (ED), which has created uncertainty regarding the effectiveness of these systems. We performed a systematic review of the literature on systematic reviews to provide an overview of the benefits and challenges to the application of telemedicine systems for the ED. Subject and methods PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar databases were explored for systematic reviews of telemedicine applications for the ED. Each review was critically appraised by two authors for data items to be extracted and evaluated. The most highly recommended technology, feasibility, benefits, and challenges to the application of telemedicine systems were studied and reported. Results We identified 18 studies of varying methodological quality and summarized their key findings. Form these 18 studies, 12 papers yielded a high risk of bias in their investigation. Nine papers concluded that real-time video conferencing was the best method of delivery, eight papers found cost reduction as an outcome of implementing these systems, and six studies found technical and infrastructure issues as a challenge when implementing telemedicine for EDs. Conclusion There is strong evidence suggesting that the use of telemedicine positively impacts patient care. However, there are many challenges in implementing telemedicine that may impede the process or even impact patient safety. In conclusion, despite the high potential of telemedicine systems, there is still a need for better quality of evidence in order to confirm their feasibility in the ED.
Background Approximately 110 million Farsi speakers worldwide have access to a growing mobile app market. Despite restrictions and international sanctions, Iran’s internal mobile health app market is growing, especially for Android-based apps. However, there is a need for guidelines for developing health apps that meet international quality standards. There are also no tools in Farsi that assess health app quality. Developers and researchers who operate in Farsi could benefit from such quality assessment tools to improve their outputs. Objective This study aims to translate and culturally adapt the Mobile Application Rating Scale in Farsi (MARS-Fa). This study also evaluates the validity and reliability of the newly developed MARS-Fa tool. Methods We used a well-established method to translate and back translate the MARS-Fa tool with a group of Iranian and international experts in Health Information Technology and Psychology. The final translated version of the tool was tested on a sample of 92 apps addressing smartphone addiction. Two trained reviewers completed an independent assessment of each app in Farsi and English. We reported reliability and construct validity estimates for the objective scales (engagement, functionality, aesthetics, and information quality). Reliability was based on the evaluation of intraclass correlation coefficients, Cronbach α and Spearman-Brown split-half reliability indicators (for internal consistency), as well as Pearson correlations for test-retest reliability. Construct validity included convergent and discriminant validity (through item-total correlations within the objective scales) and concurrent validity using Pearson correlations between the objective and subjective scores. Results After completing the translation and cultural adaptation, the MARS-Fa tool was used to assess the selected apps for smartphone addiction. The MARS-Fa total scale showed good interrater reliability (intraclass correlation coefficient=0.83, 95% CI 0.74-0.89) and good internal consistency (Cronbach α=.84); Spearman-Brown split-half reliability for both raters was 0.79 to 0.93. The instrument showed excellent test-retest reliability (r=0.94). The correlations among the MARS-Fa subdomains and the total score were all significant and above r=0.40, suggesting good convergent and discriminant validity. The MARS-Fa was positively and significantly correlated with subjective quality (r=0.90, P<.001), and so were the objective subdomains of engagement (r=0.85, P<.001), information quality (r=0.80, P<.001), aesthetics (r=0.79, P<.001), and functionality (r=0.57, P<.001), indicating concurrent validity. Conclusions The MARS-Fa is a reliable and valid instrument to assess mobile health apps. This instrument could be adopted by Farsi-speaking researchers and developers who want to evaluate the quality of mobile apps. While we tested the tool with a sample of apps addressing smartphone addiction, the MARS-Fa could assess other domains or issues since the Mobile App Rating Scale has been used to rate apps in different contexts and languages.
Introduction: Health information systems play an important role in improving the quality of patient care and patient safety. to ensure their effectiveness and efficiency, they need to be evaluated. Although HIS evaluation has been investigated in many studies, there is no consensus on which aspects of HIS to evaluate. The aim of this study is to identify the indicators for the evaluation of health information systems and to provide an overview of the criteria devised and studies conducted.Methods: An umbrella review was performed exploring databases PubMed, Science direct, Web of Science, Science, and IEEE while following the PRISMA protocol. Articles were reviewed by two authors independently using the covidence tool to check the inclusion criteria and to extract the data items. Risk of bias was assessed using ROBIS and AMSTAR.Result: All included studies showed a high risk of bias according to ROBIS criteria. The extracted evaluation criteria were classified into 13 categories. Most of the studies believe that a more reliable and standardized tool is needed for the evaluation of health information systems. Two studies mentioned that surveys and questionnaires were the most commonly used method for evaluation of the systems. Summative evaluation was the most used method in two studies and the least used method in another one study.Conclusion: All the included studies had high risk of bias. Accordingly, further research and evidence is needed in this field. Most of the studies highlighted the need for more reliable and standardized tools for evaluation of health information systems.
BACKGROUND There are 110 million Farsi speakers worldwide who have access to a growing mobile app market. Despite restrictions and international sanctions, the internal mHealth app market in Iran is growing, especially for Android-based apps. However, there are no guidelines for developing health apps that meet international quality standards. There are also no tools in Farsi that assess health app quality. Developers and researchers who operate in Farsi could benefit from such quality assessment tools to improve their outputs. OBJECTIVE This study aimed to translate and culturally adapt the Mobile App Rating Scale in Farsi (MARS-Fa). This study also evaluated the validity and reliability of the newly developed MARS-Fa tool. METHODS We used a well-established method to translate and back-translate the MARS-Fa tool with a group of Iranian and international experts in Health Information Technology and Psychology. We validated the MARS-Fa with a sample of 92 apps addressing smartphone addiction using two trained reviewers. We reported inter-rater reliability, internal consistency, and convergent and discriminant validity of the validation exercise. RESULTS Cronbach’s alpha coefficient was .84 for the total MARS-Fa and subjective quality, indicating excellent internal consistency. Spearman-Brown split-half reliability indicators were very good and excellent (.79 to .93). The MARS-Fa showed excellent inter-rater reliability (ICC=.91) and test-retest reliability (r=.94). The inter-item correlation coefficients among 18 items were greater than 0.20, suggesting good construct and discriminant validity. CONCLUSIONS The MARS-Fa tool can be reliably used to evaluate health apps by trained reviewers who speak Farsi. Further research should be done to validate the tool with health apps targeting other health problems.
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