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Close relative (consanguineous) marriage is widely practised globally, and it increases the risk of genetic disorders. Mobile apps may increase awareness and education regarding the associated risks in a sensitive, engaging, and accessible manner. This systematic review of patient-facing genetic/genomic mobile apps explores content, function, and quality. We searched the NHS Apps Library and the UK Google Play and Apple App stores for patient-facing genomic/genetic smartphone apps. Descriptive information and information on content was extracted and summarized. Readability was examined using the Flesch–Kincaid metrics. Two raters assessed each app, using the Mobile App Rating Scale (MARS) and the IMS Institute for Healthcare Informatics functionality score. A total of 754 apps were identified, of which 22 met the eligibility criteria. All apps intended to inform/educate users, while 32% analyzed genetic data, and 18% helped to diagnose genetic conditions. Most (68%) were clearly about genetics, but only 14% were affiliated with a medical/health body or charity, and only 36% had a privacy strategy. Mean reading scores were 35 (of 100), with the average reading age being equivalent to US grade 12 (UK year 13). On average, apps had 3.3 of the 11 IMS functionality criteria. The mean MARS quality score was 3.2 ± 0.7. Half met the minimum acceptability score (3 of 5). None had been formally evaluated. It was evident that there are few high-quality genomic/genetic patient-facing apps available in the UK. This demonstrates a need for an accessible, culturally sensitive, evidence-based app to improve genetic literacy within patient populations and specific communities.

BACKGROUND Electronic Patient Reported Outcomes (ePROs) are commonly used in oncology clinical practice and have shown benefits for patients and health resource use. This review and meta-analysis examined effectiveness of ePROs compared to usual care for health-related outcomes in people with cancer. OBJECTIVE To compare the single effect of administering ePROs to patients with cancer versus a control condition. METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Randomised controlled trials evaluating ePRO interventions, improving health-related outcomes, among cancer patients were included. Primary outcome: health-related quality of life (HRQOL). Secondary outcomes: symptoms, hospital admissions, unplanned visits, chemotherapy completion, survival, and satisfaction with care. Effect size of ePROs on health-related outcomes were analysed as standardised mean differences with 95% confidence intervals using the random effects model. RESULTS The search identified 10965 papers. Nineteen papers from 15 studies were included. Meta-analysis showed an improvement in HRQOL at three months, measured by the Functional Assessment of Cancer Therapy- General (FACT-G) (SMD: 0.28 95% CI: -1.22 to 1.78), and at six months with various HRQOL measures (SMD: 0.07 95% CI: -1.24 to 1.39). Results should be interpreted with caution given the wide confidence intervals. Nine studies reported a positive signal on HRQOL with six including tailored patient advice and six using clinician alert systems. CONCLUSIONS Meta-analysis showed a potential improvement in HRQOL at six months and in FACT-G scores at three months for studies that included tailored advice and clinician alerts suggesting these elements may improve ePRO effectiveness. Findings will provide guidance for future use and help healthcare professionals choose the most suitable ePRO features for their patients.

Objectives: To provide an overview of the methodological considerations for conducting commercial smartphone health app reviews (mHealth reviews), with the aim of systematising the process and supporting high-quality evaluations of mHealth apps. Design: Synthesis of our research team’s experiences of conducting and publishing various reviews of mHealth apps and hand-searching the top medical informatics journals (e.g., The Lancet Digital Health, npj Digital Medicine, Journal of Biomedical Informatics, and the Journal of the American Medical Informatics Association) over the last five years (2018-2022) to identify other app reviews to contribute to the discussion of this method and supporting framework for developing a research (review) question and determining the eligibility criteria. Results: We present seven steps to support rigour in conducting app reviews in health: 1) writing a research question, 2) conducting scoping searches and developing the protocol, 3) determining the eligibility criteria using the TECH framework, 4) conducting the final search and screening of health apps, 5) data extraction, 6) quality, functionality, and other assessments and 7) analysis and synthesis of findings. We introduce the novel TECH approach to developing review questions and the eligibility criteria, which considers the Target user, Evaluation focus, Connectedness, and the Health domain. Patient and public involvement and engagement opportunities are acknowledged, including co-developing the protocol and undertaking quality or usability assessments. Conclusion: Commercial mHealth app reviews can provide important insights into the health app market, including the availability of apps and their quality and functionality. We have outlined seven key steps for conducting rigorous health app reviews in addition to the TECH acronym, which can support researchers in writing research questions and determining the eligibility criteria. Future work will include a collaborative effort to develop reporting guidelines and a quality appraisal tool to ensure transparency and quality in systematic app reviews.

ObjectivesTo provide an overview of the methodological considerations for conducting commercial smartphone health app reviews (mHealth reviews), with the aim of systematising the process and supporting high-quality evaluations of mHealth apps.DesignSynthesis of our research team’s experiences of conducting and publishing various reviews of mHealth apps available on app stores and hand-searching the top medical informatics journals (eg, The Lancet Digital Health, npj Digital Medicine, Journal of Biomedical Informatics and the Journal of the American Medical Informatics Association) over the last five years (2018–2022) to identify other app reviews to contribute to the discussion of this method and supporting framework for developing a research (review) question and determining the eligibility criteria.ResultsWe present seven steps to support rigour in conducting reviews of health apps available on the app market: (1) writing a research question or aims, (2) conducting scoping searches and developing the protocol, (3) determining the eligibility criteria using the TECH framework, (4) conducting the final search and screening of health apps, (5) data extraction, (6) quality, functionality and other assessments and (7) analysis and synthesis of findings. We introduce the novel TECH approach to developing review questions and the eligibility criteria, which considers the Target user, Evaluation focus, Connectedness and the Health domain. Patient and public involvement and engagement opportunities are acknowledged, including co-developing the protocol and undertaking quality or usability assessments.ConclusionCommercial mHealth app reviews can provide important insights into the health app market, including the availability of apps and their quality and functionality. We have outlined seven key steps for conducting rigorous health app reviews in addition to the TECH acronym, which can support researchers in writing research questions and determining the eligibility criteria. Future work will include a collaborative effort to develop reporting guidelines and a quality appraisal tool to ensure transparency and quality in systematic app reviews.

Background Patient-facing digital technologies may reduce barriers to and alleviate the burden on genetics services. However, no work has synthesised the evidence for patient-facing digital interventions for genomics/genetics education and empowerment, or to facilitate service engagement more broadly. It is also unclear which groups have been engaged by digital interventions. Aim This systematic review explores which existing patient-facing digital technologies have been used for genomics/genetics education and empowerment, or to facilitate service engagement, and for whom and for which purposes the interventions have been developed. Methods The review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Eight databases were searched for literature. Information was extracted into an Excel sheet and analysed in a narrative manner. Quality assessments were conducted using the Mixed Methods Appraisal Tool. Results Twenty-four studies were included, of which 21 were moderate or high quality. The majority (88%) were conducted in the United States of America or within a clinical setting (79%). More than half (63%) of the interventions were web-based tools, and almost all focussed on educating users (92%). There were promising results regarding educating patients and their families and facilitating engagement with genetics services. Few of the studies focussed on empowering patients or were community-based. Conclusion Digital interventions may be used to deliver information about genetics concepts and conditions, and positively impact service engagement. However, there is insufficient evidence related to empowering patients and engaging underserved communities or consanguineous couples. Future work should focus on co-developing content with end users and incorporating interactive features.

Background Regular blood testing is an integral part of systemic anticancer therapy delivery. Blood tests are required before every administration of treatment to ensure that a patient is sufficiently well to receive it. Blood testing is burdensome for patients as they require either an extra visit within 48 hours of planned administration of treatment or a significantly long visit if performed on the day of treatment. The additional time for appointments can have a significant impact on the quality of life of someone who is living with cancer. In the United Kingdom, the COVID-19 pandemic created unprecedented disruption to the delivery of cancer care. Face-to-face hospital visits were reduced, resulting in the need to develop more innovative ways of working to minimize treatment interruptions. This led to significant uptake of digital technologies, with new models of care rapidly deployed across the UK health service to meet these challenges. Objective This study aimed to explore the acceptability of a point-of-care home blood monitoring device for people with cancer who are receiving systemic anticancer therapy, which is being developed in response to the increased need for remote care for patients with cancer. Methods Qualitative focus groups and semistructured interviews were conducted with patients (23/47, 49%), caregivers (6/47, 13%), and health care professionals (18/47, 38%) over a 19-month time frame from May 2019 to December 2020. Data were analyzed using framework analysis guided by the Unified Theory of Acceptance and Use of Technology model. Results Analysis identified 4 overarching themes: performance expectancy, effort expectancy, social influence, and facilitating conditions. Conclusions This study found that patients with cancer, their caregivers, and health care professionals had positive perceptions about home blood monitoring. Although they are often considered synonymously, self-testing and self-management are not mutually exclusive, and this study illustrated some disparity in opinions regarding patient self-management. Home blood monitoring has the potential to provide patients with cancer with a convenient option for blood monitoring. It would minimize hospital attendances, decrease late treatment deferrals, and provide prompt recognition of cancer treatment toxicities, thus enhancing the existing nurse-led protocols and clinical pathways. Home blood monitoring would create a long-term sustainable transformation for the delivery of cancer care, using digital health to act as a facilitator to address a pertinent issue regarding improving the efficiency of hospital resources and increasing the delivery of personalized patient care. Further studies are needed to determine how and where home blood monitoring would fit within clinical pathways, in a way that is robust and equitable.

BACKGROUND Regular blood testing is an integral part of systemic anti-cancer therapy delivery. Blood tests are required before every administration of treatment to ensure a patient is well enough to receive it. Blood testing is burdensome for patients as they require either an extra visit within 48 hours of planned administration, or a significantly longer visit if done on the day of treatment. The additional time for appointments can have a significant impact upon the quality of life of someone who is living with cancer. In the UK the COVID-19 pandemic created an unprecedented disruption to the delivery of cancer care. Face to face hospital visits were reduced, resulting in a need to develop more innovative ways of working to minimise treatment interruptions. This led to a significant uptake of digital technologies, with new models of care rapidly deployed across the UK health service to meet these challenges. OBJECTIVE In this study we explore the acceptability of a point of care home blood monitoring device for people with cancer who are receiving systemic anti-cancer therapy, which is being developed in response to the increased need for remote care for patients with cancer. METHODS Qualitative focus groups and semi-structured interviews were conducted with patients (n=23), caregivers (n=6), and healthcare professionals (n=18) over a 19-month timeframe, from May 2019 to December 2020. Data were analysed using framework analysis guided by the Unified Theory of Acceptance and Use of Technology model. RESULTS Analysis identified four overarching themes: 1) performance expectancy; 2) effort expectancy; 3) social influence; 4) facilitating conditions. CONCLUSIONS This study found that patients with cancer, caregivers, and healthcare professionals had positive perceptions of home blood monitoring. Whilst they are often considered synonymously, self-testing and self-management are not mutually exclusive, and this study illustrated some disparity in opinion regarding patient self-management. Home blood monitoring has the potential to provide patients with cancer with a convenient option for blood monitoring. It would minimise hospital attendances, decrease late treatment deferrals, and provide prompt recognition of cancer treatment toxicities, enhancing existing nurse-led protocols and clinical pathways. Home blood monitoring would create a long-term sustainable transformation for the delivery of cancer care, utilising digital health to act as a facilitator to address a pertinent issue regarding improving the efficiency of hospital resources and increasing the delivery of personalised patient care. CLINICALTRIAL REC Reference 18/EE/0343, IRAS project ID 234137