Objectives Mobile applications (apps) are multiplying in laryngology, with little standardization of content, functionality, or accessibility. The purpose of this study is to evaluate the quality, functionality, health literacy, readability, accessibility, and inclusivity of laryngology mobile applications. Methods Of the 3230 apps identified from the Apple and Google Play stores, 28 patient‐facing apps met inclusion criteria. Apps were evaluated using validated scales assessing quality and functionality: the Mobile App Rating Scale (MARS) and the Institute for Healthcare Informatics App Functionality Scale. The Clear Communication Index (CDC) Institute of Medicine Strategies for Creating Health Literate Mobile Applications, and Patient Education Materials Assessment Tool (PEMAT) were used to evaluate apps health literacy level. Readability was assessed using established readability formulas. Apps were evaluated for language, accessibility features, and representation of a diverse population. Results Twenty‐six apps (92%) had adequate quality (MARS score > 3). The mean PEMAT score was 89% for actionability and 86% for understandability. On average, apps utilized 25/33 health literate strategies. Twenty‐two apps (79%) did not pass the CDC index threshold of 90% for health literacy. Twenty‐four app descriptions (86%) were above an 8th grade reading level. Only 4 apps (14%) showed diverse representation, 3 (11%) had non‐English language functions, and 2 (7%) offered subtitles. Inter‐rater reliability for MARS was adequate (CA‐ICC = 0.715). Conclusion While most apps scored well in quality and functionality, many laryngology apps did not meet standards for health literacy. Most apps were written at a reading level above the national average, lacked accessibility features, and did not represent diverse populations. Laryngoscope, 133:1540–1549, 2023
Objective(s)This study examined the concurrent validity of two orofacial strength manometers: (1) the Iowa Oral Performance Instrument (IOPI) – the current, gold standard orofacial manometer; and (2) the Tongueometer – a newly‐available, lower cost, orofacial manometer.MethodsThis study compared IOPI and Tongueometer pressure readings across three experimental conditions. Experiment 1 compared full setup (manometer + tongue bulb) pressure readings between the IOPI and Tongueometer. Experiment 2 compared IOPI tongue bulb and Tongueometer tongue bulb pressure readings, while controlling for manometer. Experiment 3 compared IOPI manometer and Tongueometer manometer pressure readings, while controlling for tongue bulb. Pressures were applied manually within a laboratory setting. Lin's concordance correlation (ρc) was used to calculate level of agreement, with ρc interpreted as ‘poor’ if <0.90, ‘moderate’ if 0.90 to <0.95, ‘substantial’ if 0.95 to <0.99, and ‘excellent’ if ≥0.99.Results539 trials were analyzed. There was a median absolute difference of 2.4 kPa in pressure readings between the IOPI and Tongueometer full setups (manometer + tongue bulb). Correlations revealed substantial agreement between IOPI and Tongueometer full setups (experiment 1: n = 292; ρc = 0.986), tongue bulbs (experiment 2: n = 146; ρc = 0.987–0.992), and manometers (experiment 3: n = 101; ρc = 0.970).ConclusionsDifferences in pressures were consistently observed between the Tongueometer and IOPI. Despite these differences, substantial agreement was present. These data suggest the Tongueometer may be a valid, lower cost alternative to the IOPI for objectively assessing orofacial strength in clinical practice.Level of EvidenceLevel 2 Laryngoscope, 2023
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