Systematic review and evaluation of web-accessible tools for management of diabetes and related cardiovascular risk factors by patients and healthcare providers

Abstract

ObjectiveTo identify and evaluate the effectiveness, clinical usefulness, sustainability, and usability of web-compatible diabetes-related tools.Data sourcesMedline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, world wide web.Study selectionStudies were included if they described an electronic audiovisual tool used as a means to educate patients, care givers, or clinicians about diabetes management and assessed a psychological, behavioral, or clinical outcome.Data extractionStudy abstraction and evaluation for clinical usefulness, sustainability, and usability were performed by two independent reviewers.ResultsOf 12616 citations and 1541 full-text articles reviewed, 57 studies met inclusion criteria. Forty studies used experimental designs (25 randomized controlled trials, one controlled clinical trial, 14 before–after studies), and 17 used observational designs. Methodological quality and ratings for clinical usefulness and sustainability were variable, and there was a high prevalence of usability errors. Tools showed moderate but inconsistent effects on a variety of psychological and clinical outcomes including HbA1c and weight. Meta-regression of adequately reported studies (12 studies, 2731 participants) demonstrated that, although the interventions studied resulted in positive outcomes, this was not moderated by clinical usefulness nor usability.LimitationThis review is limited by the number of accessible tools, exclusion of tools for mobile devices, study quality, and the use of non-validated scales.ConclusionFew tools were identified that met our criteria for effectiveness, usefulness, sustainability, and usability. Priority areas include identifying strategies to minimize website attrition and enabling patients and clinicians to make informed decisions about website choice by encouraging reporting of website quality indicators.

The Use of Videogames, Gamification, and Virtual Environments in the Self-Management of Diabetes: A Systematic Review of Evidence

“…A majority of the studies focused on the glucose monitoring process-such as allowing patients to upload their data so that healthcare providers may adjust their medication and dosage. 12,13 Technology interventions were observed to be effective and versatile in facilitating the management of the condition 14,15 and support the resultant changes in lifestyle. 16 With increasing interest in the use of games for health care, the objective of this study is to review the literature that focuses on the use of videogames, gamification methods, and VEs for day-to-day self-management of people with diabetes.…”

Evaluating the Effect of Web-Based Iranian Diabetic Personal Health Record App on Self-Care Status and Clinical Indicators: Randomized Controlled Trial

“…One of the most important cases in intervention implementation is usability testing [53] but this is often neglected, with up to 60% of diabetes-related websites having a minimum of 4 usability errors. So it can be said that the gold standard for intervention development should be represented to obtain high intervention effectiveness [54]. …”

Leveraging semantic web to retrieve customized medical information

“…A recent systematic review of web-accessible tools for management of diabetes [5] found that few web-based tools met all their health outcome criteria for clinical effectiveness, clinical usefulness, sustainability, and usability. They also found that greater interactivity resulted in better health outcomes.…”

“…However, current implementations suffer from limited effectiveness and usability errors, and consequently have high user attrition rate [5]. Our App uses open source tools for software development, semantic web and Health IT [6][7][8], so other researchers and entrepreneurs can build on our work and develop their own creative extensions.…”