mHealth Assessment: Conceptualization of a Global Framework

Bradway, Meghan; Carrión, Carme; Vallespin, Barbara Eliza; Saadatfard, Omid; Puigdomènech, Elisa; Espallargues, Mireia; Kotzeva, Anna

doi:10.2196/mhealth.7291

Cited by 119 publications

(106 citation statements)

References 16 publications

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“…This framework 2 4 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 describes the development process in five steps: (1) the scoping of the DA; (2) the formation of the steering group (preferably multidisciplinary); (3) the design phase; (4) alpha testing (user testing), and (5) beta testing (field testing). This method also corresponds to previously proposed frameworks for the development of eHealth solutions of high reliability, usefulness, and quality [31]. Figure 1 depicts the development process for the DA (adapted from Coulter et al [29]).…”

Section: Planning the Developmentmentioning

confidence: 87%

Developing a Self-Administered Decision Aid for Fecal Immunochemical Test�Based Colorectal Cancer Screening Tailored to Citizens With Lower Educational Attainment: Qualitative Study (Preprint)

Gabel¹,

Kirkegaard²,

Larsen³

et al. 2017

Preprint

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BACKGROUND Citizens with lower educational attainments (EA) take up colorectal cancer screening to a lesser degree, and more seldom read and understand conventional screening information than citizens with average EAs. The information needs of citizens with lower EA are diverse, however, with preferences ranging from wanting clear recommendations to seeking detailed information about screening. Decision aids have been developed to support citizens with lower EA in making informed decisions about colorectal cancer screening participation, but none embrace diverse information needs. OBJECTIVE The aim of this study was to develop a self-administered decision aid for participation in fecal immunochemical test–based colorectal cancer screening. The decision aid should be tailored to citizens with lower EA and should embrace diverse information needs. METHODS The Web-based decision aid was developed according to an international development framework, with specific steps for designing, alpha testing, peer reviewing, and beta testing the decision aid. In the design phase, a prototype of the decision aid was developed based on previous studies about the information needs of lower EA citizens and the International Patient Decision Aid Standards guidelines. Alpha testing was conducted using focus group interviews and email correspondence. Peer review was conducted using email correspondence. Both tests included both lower EA citizens and health care professionals. The beta testing was conducted using telephone interviews with citizens with lower EA. Data were analyzed using thematic analysis. RESULTS The developed decision aid presented information in steps, allowing citizens to read as much or as little as wanted. Values clarification questions were included after each section of information, and answers were summarized in a “choice-indicator” on the last page, guiding the citizens toward a decision about screening participation. Statistics were presented in both natural frequencies, absolute risk formats and graphically. The citizens easily and intuitively navigated around the final version of the decision aid and stated that they felt encouraged to think about the benefits and harms of colorectal cancer screening without being overloaded with information. They found the decision aid easy to understand and the text of suitable length. The health care professionals agreed with the citizens on most parts; however, concerns were raised about the length and readability of the text. CONCLUSIONS We have developed a self-administered decision aid presenting information in steps. We involved both citizens and health care professionals to target the decision aid for citizens with lower EA. This decision aid represents a new way of communicating detailed information and may be able to enhance informed choices about colorectal cancer screening participation among citizens with lower EA.

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Section: Planning the Developmentmentioning

confidence: 87%

Developing a Self-Administered Decision Aid for Fecal Immunochemical Test�Based Colorectal Cancer Screening Tailored to Citizens With Lower Educational Attainment: Qualitative Study (Preprint)

Gabel¹,

Kirkegaard²,

Larsen³

et al. 2017

Preprint

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“…The evaluated studies highlighted that, in addition to traditional HTA domains (e.g. effectiveness and safety), usability and accessibility issues should be taken into account in all applications, from mHealth to robotics [42,43,55,56]. A well-designed user experience improves product acceptance and increases people's confidence in the product.…”

Section: Discussionmentioning

confidence: 99%

“…The HTA framework should provide information from the following domains: intended use, functionalities and content, level of development, data security and privacy, interoperability standards, and usability. [42] In addition, Zelmer et al's articles related to e-mental health apps also highlighted the aspects of clinical applicability, supported platforms, targeted users, developers' transparency, funding transparency, and price [43].…”

Section: Literature Review and Web Searchmentioning

confidence: 99%

“…For this reason, we left them out, as our aim is to create a tool to provide fast assessments in a rapidly developing technology sector. The Digi-HTA domains and criteria are presented in Table 1.The detailed criteria in our framework are based on aspects of the mini-HTA questionnaire, ideas from NHS DAQ as well as information from literature, interviews, and workshops [9,29,31,[39][40][41][42][43]46,[55][56][57][58][59][60][61][62][63][64][67][68][69][70][71].…”

Section: Health Technology Assessment Framework For Digital Healthcarmentioning

confidence: 99%

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Digi-HTA: Health technology assessment framework for digital healthcare services

et al. 2019

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Health technology assessment (HTA) refers to the systematic evaluation of the properties, effects, and/or impacts of health technology. The main purpose of the assessment is to inform decisionmakers in order to better support the introduction of new health technologies. New digital healthcare solutions like mHealth, artificial intelligence (AI), and robotics have brought with them a great potential to further develop healthcare services, but their introduction should follow the same criteria as that of other healthcare methods. They must provide evidence-based benefits and be safe to use, and their impacts on patients and organizations need to be clarified. The first objective of this study was to describe the state-of-the-art HTA methods for mHealth, AI, and robotics. The second objective of this study was to evaluate the domains needed in the assessment. The final aim was to develop an HTA framework for digital healthcare services to support the introduction of novel technologies into Finnish healthcare. In this study, the state-of-the-art HTA methods were evaluated using a literature review and interviews. It was noted that some good practices already existed, but the overall picture showed that further development is still needed, especially in the AI and robotics fields. With the cooperation of professionals, key aspects and domains that should be taken into account to make fast but comprehensive assessments were identified. Based on this information, we created a new framework which supports the HTA process for digital healthcare services. The framework was named Digi-HTA.

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“…This potentially innovative aspect of mHealth solutions, however, is currently largely confined to the non-healthcare context (e.g. lifestyle and public health applications) and lacking in acceptable frameworks for its wider adoption into the healthcare systems [2,3] . Diffusion of new technologies necessitates clarifying the actual purpose of the innovations both from the point of view of healthcare system and the immediate needs of the users of the system, including patients and clinicians.…”

Section: Introductionmentioning

confidence: 99%

Designing a mHealth clinical decision support system for Parkinson’s disease: a theoretically grounded user needs approach

Timotijević

Hodgkins

Banks

et al. 2020

BMC Med Inform Decis Mak

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Background: Despite the established evidence and theoretical advances explaining human judgments under uncertainty, developments of mobile health (mHealth) Clinical Decision Support Systems (CDSS) have not explicitly applied the psychology of decision making to the study of user needs. We report on a user needs approach to develop a prototype of a mHealth CDSS for Parkinson's disease (PD), which is theoretically grounded in the psychological literature about expert decision making and judgement under uncertainty.Methods: A suite of user needs studies was conducted in 4 European countries (Greece, Italy, Slovenia, the UK) prior to the development of PD_Manager, a mHealth-based CDSS designed for Parkinson's disease, using wireless technology. Study 1 undertook Hierarchical Task Analysis (HTA) including elicitation of user needs, cognitive demands and perceived risks/benefits (ethical considerations) associated with the proposed CDSS, through structured interviews of prescribing clinicians (N = 47). Study 2 carried out computational modelling of prescribing clinicians' (N = 12) decision strategies based on social judgment theory. Study 3 was a vignette study of prescribing clinicians' (N = 18) willingness to change treatment based on either self-reported symptoms data, devices-generated symptoms data or combinations of both. Results: Study 1 indicated that system development should move away from the traditional silos of 'motor' and 'non-motor' symptom evaluations and suggest that presenting data on symptoms according to goal-based domains would be the most beneficial approach, the most important being patients' overall Quality of Life (QoL). The computational modelling in Study 2 extrapolated different factor combinations when making judgements about different questions. Study 3 indicated that the clinicians were equally likely to change the care plan based on information about the change in the patient's condition from the patient's self-report and the wearable devices. Conclusions: Based on our approach, we could formulate the following principles of mHealth design: 1) enabling shared decision making between the clinician, patient and the carer; 2) flexibility that accounts for diagnostic and treatment variation among clinicians; 3) monitoring of information integration from multiple sources. Our approach highlighted the central importance of the patient-clinician relationship in clinical decision making and the relevance of theoretical as opposed to algorithm (technology)-based modelling of human judgment.

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mHealth Assessment: Conceptualization of a Global Framework

Cited by 119 publications

References 16 publications

Developing a Self-Administered Decision Aid for Fecal Immunochemical Test�Based Colorectal Cancer Screening Tailored to Citizens With Lower Educational Attainment: Qualitative Study (Preprint)

Developing a Self-Administered Decision Aid for Fecal Immunochemical Test�Based Colorectal Cancer Screening Tailored to Citizens With Lower Educational Attainment: Qualitative Study (Preprint)

Digi-HTA: Health technology assessment framework for digital healthcare services

Designing a mHealth clinical decision support system for Parkinson’s disease: a theoretically grounded user needs approach

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