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.
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