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2.
Stud Health Technol Inform ; 295: 91-94, 2022 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-35773814

RESUMO

For cardiological datasets acquired via different methodologies, ECG signals that are recorded in parallel allow for relatively accurate matching. Some research issues, e.g., the identification of timings of the cardiac cycle in seismocardiography, require higher temporal resolutions. Therefore, we introduce a method derived from a feasibility study to determine deviations and factors influencing the merging of signals simultaneously recorded with different modalities.


Assuntos
Eletrocardiografia , Coração , Viés , Eletrocardiografia/métodos , Frequência Cardíaca , Processamento de Sinais Assistido por Computador
3.
Stud Health Technol Inform ; 295: 95-99, 2022 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-35773815

RESUMO

This paper describes the protocol of the microgravity experiment BEAT (Ballistocardiography for Extraterrestrial Applications and Long-Term Missions). The current study makes use of signal acquisition of cardiac parameters with a high-precision Ballistocardiography (BCG)/Seismocardiography (SCG) measurement system, which is integrated in a smart shirt (SmartTex). The goal is to evaluate the feasibility of this concept for continuous wearable monitoring and wireless data transfer. BEAT is part of the "Wireless Compose-2" (WICO2) project deployed on the International Space Station (ISS) that will provide wireless network infrastructure for scientific, localization and medical experiments.


Assuntos
Balistocardiografia , Balistocardiografia/métodos , Coração , Frequência Cardíaca
4.
Stud Health Technol Inform ; 295: 271-275, 2022 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-35773861

RESUMO

For a decade, seismocardiography (SCG) on smartphones has been an interesting topic within the technical community, but mobile applications for this topic are rare on the market. The transition from laboratory to bedside application seems to have not yet been completed. To possibly increase the chances of a successful implementation, the added value of the method needs to be addressed clearly and backed up by research. The authors address the following aspects. 1. To improve comparability, standardization is required, 2. adequate validation processes in clinical settings will build trust, but foremost, 3. the field of application should be critically evaluated to identify the most meaningful and reasonable benefit of this method.


Assuntos
Aplicativos Móveis , Smartphone , Projetos de Pesquisa
5.
Ther Adv Endocrinol Metab ; 13: 20420188221098881, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35592657

RESUMO

Background: Obesity is common in many industrialized nations and often accompanied by related health issues. Furthermore, individuals living with overweight or obesity are often confronted with stigmatization in their daily lives. These problems may be aggravated if the objectivity of health care professionals is compromised due to (unconscious) prejudices. If pharmaceutical companies, regulatory agencies, and health insurers are also susceptible to these biases, decisions related to the development, approval, and reimbursement of obesity-related therapies may be negatively impacted. Materials and Methods: The 'Implicit Association Test' (IAT) is a psychometric test allowing to measure these attitudes and could therefore assist to reveal unconscious preferences. A self-developed mobile version, in the form of a ResearchKit-based IAT app was employed in the presented study. The objective was to determine (potential) weight bias and its characteristics for professionals attending a national obesity-related conference in Germany (G1), compared to a control group (without stated interest in the topic, G2) - both using the mobile app - and a historical control (G3) based on data provided by Project Implicit acquired by a web app. Results: Explicit evaluations of G1 were neutral at a higher percentage compared with G2 and G3, while implicit preference toward lean individuals did not differ significantly between G2 and G3, and G1. Conclusion: The greater discrepancy between the (more neutral) explicit attitude and the unconscious preference pointing in the anti-obesity direction could indicate an underestimated bias for the professional participants in G1. Implicit preference is often ingrained from childhood on, and difficult to overcome. Thus, even for professionals, it may unconsciously influence decisions made in the care they provide. Professionals in any given health care sector directed at obesity care should thus be made aware of this inconsistency to enable them to consciously counteract this potential effect.

6.
Internist (Berl) ; 63(3): 274-280, 2022 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-35147711

RESUMO

Mobile health (mHealth) for the detection of atrial fibrillation is an innovative domestic monitoring of the heart rhythm. The use of mHealth in the context of atrial fibrillation increases the availability of diagnostic technologies and facilitates the integration into telemedical treatment concepts as well as the active participation of patients in the treatment process. The detection of atrial fibrillation with mHealth applications is usually based on electrocardiography (ECG) or by detection of the pulse wave using photoplethysmography (PPG). Some applications require additional sensors, others make use of sensors integrated into smartphones or smartwatches. A high diagnostic accuracy for the detection of atrial fibrillation has been shown for most mHealth applications regardless of the underlying technology (analytical validation); however, the evidence on positive care effects and improvement of medical endpoints (clinical validation) is so far scarce. Screening of symptomatic or asymptomatic patients and the follow-up care after antiarrhythmic measures are possibilities for the integration into the reality of care. The preventive detection of atrial fibrillation is an attractive field of application for mHealth with great potential for the future. Nevertheless, at present mHealth is only integrated to a limited extent into the reality of patient care. Adequate reimbursement and medical remuneration as well as opportunities to derive information and qualification are prerequisites in order to be able to guarantee a comprehensive implementation in the future. The Digital Health Care Act passed in 2019, regulates the reimbursement of digital healthcare applications but issues of primary preventive applications have not yet been included.


Assuntos
Fibrilação Atrial , Aplicativos Móveis , Telemedicina , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/terapia , Eletrocardiografia , Humanos , Fotopletismografia
7.
JMIR Mhealth Uhealth ; 10(1): e26563, 2022 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-35014965

RESUMO

BACKGROUND: Health apps are often used without adequately taking aspects related to their quality under consideration. This may partially be due to inadequate awareness about necessary criteria and how to prioritize them when evaluating an app. OBJECTIVE: The aim of this study was to introduce a method for prioritizing quality attributes in the mobile health context. To this end, physicians were asked about their assessment of nine app quality principles relevant in health contexts and their responses were used as a basis for designing a method for app prioritization. Ultimately, the goal was to aid in making better use of limited resources (eg, time) by assisting with the decision as to the specific quality principles that deserve priority in everyday medical practice and those that can be given lower priority, even in cases where the overall principles are rated similarly. METHODS: A total of 9503 members of two German professional societies in the field of orthopedics were invited by email to participate in an anonymous online survey over a 1-month period. Participants were asked to rate a set of nine app quality principles using a Kano survey with functional and dysfunctional (ie, positively and negatively worded) questions. The evaluation was based on the work of Kano (baseline), supplemented by a self-designed approach. RESULTS: Among the 9503 invited members, 382 completed relevant parts of the survey (return rate of 4.02%). These participants were equally and randomly assigned to two groups (test group and validation group, n=191 each). Demographic characteristics did not significantly differ between groups (all P>.05). Participants were predominantly male (328/382, 85.9%) and older than 40 years (290/382, 75.9%). Given similar ratings, common evaluation strategies for Kano surveys did not allow for conclusive prioritization of the principles, and the same was true when using the more elaborate approach of satisfaction and dissatisfaction indices following the work of Timko. Therefore, an extended, so-called "in-line-of-sight" method was developed and applied for this evaluation. Modified from the Timko method, this approach is based on a "point of view" (POV) metric, which generates a ranking coefficient. Although the principles were previously almost exclusively rated as must-be (with the exception of resource efficiency), which was not conducive to their prioritization, the new method applied from the must-be POV resulted in identical rankings for the test and validation groups: (1) legal conformity, (2) content validity, (3) risk adequacy, (4) practicality, (5) ethical soundness, (6) usability, (7) transparency, (8) technical adequacy, and (9) resource efficiency. CONCLUSIONS: Established survey methodologies based on the work of Kano predominantly seek to categorize the attributes to be evaluated. The methodology presented here is an interesting option for prioritization, and enables focusing on the most important criteria, thus saving valuable time when reviewing apps for use in the medical field, even with otherwise largely similar categorization results. The extent to which this approach is applicable beyond the scenario presented herein requires further investigation.


Assuntos
Aplicativos Móveis , Médicos , Telemedicina , Humanos , Masculino , Nigéria , Inquéritos e Questionários
8.
Urologe A ; 61(2): 125-132, 2022 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-34862517

RESUMO

BACKGROUND: The range of medical apps is broad and diverse. The previous evaluations are inconsistent and limited to the respective areas of application. OBJECTIVES: The main objective of this work is to comprehensively present, organize, and evaluate the current range of urological apps with the help of a semi-automatic retrospective app store analysis (SARASA). METHODS: Application of an adaptable method based on filter processes according to predefined criteria by means of SARASA to characterize urological apps from various subject areas in the Apple App Store with subsequent manual filtering and evaluation. RESULTS: From the original list of 34,830 apps in the "Medicine" category of the Apple App Store on 27 September 2021, 3556 apps remained after apps without a German-language store description were removed. 43 subject-specific apps remained for further analysis and description. The number of reviews, rating, topicality, urological issues, technical support and richness of content were taken into account. The two most relevant apps for each topic are presented in detail. CONCLUSION: SARASA offers an easy-to-use method for applying filter processes to identify apps in app stores that meet predefined, formal criteria. The highest number of apps can be classified in categories of patient information and further education and training. An app officially listed by the German Federal Institute for Drugs and Medical Products (BfArM) in the sense of a digital health application (DiGA), the costs of which are reimbursed by the health insurance companies, is available for urology in only one single case. The authors see great potential for future developments in this regard.


Assuntos
Aplicativos Móveis , Atenção à Saúde , Humanos , Idioma , Estudos Retrospectivos
9.
Front Digit Health ; 4: 785591, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35373181

RESUMO

Objective: To determine whether a framework-based approach for mobile apps is appropriate for the implementation of psychological testing, and equivalent to established methods. Methods: Apple's ResearchKit was used for implementing native implicit association test methods (IAT), and an exemplary app was developed to examine users' implicit attitudes toward overweight or thin individuals. For comparison, a web-based IAT app, based on code provided by Project Implicit, was used. Adult volunteers were asked to test both versions on an iPad with touch as well as keyboard input (altogether four tests per participant, random order). Latency values were recorded and used to calculate parameters relevant to the implicit setting. Measurements were analyzed with respect to app type and input method, as well as test order (ANOVA and χ2 tests). Results: Fifty-one datasets were acquired (female, n = 21; male, n = 30, average age 35 ± 4.66 years). Test order and combination of app type and input method influenced the latency values significantly (both P<0.001). This was not mirrored for the D scores or average number of errors vs. app type combined with input method (D scores: P = 0.66; number of errors: P = 0.733) or test order (D scores: P = 0.096; number of errors: P = 0.85). Post-hoc power analysis of the linear ANOVA showed 0.8 by f 2=0.25, with α = 0.05 and 4 predictors. Conclusions: The results suggest that a native mobile implementation of the IAT may be comparable to established implementations. The validity of the acquired measurements seems to depend on the properties of the chosen test rather than the specifics of the chosen platform or input method.

10.
Z Orthop Unfall ; 159(3): 259-265, 2021 06.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-32365397

RESUMO

The recently ratified Digital Healthcare Act - DVG - has paved the way, among other issues, for the prescription of health apps. The German DVG creates an entitlement to health apps for the very first time. However, this entitlement is initially limited to low-risk medical devices that have been included in the publicly accessible Register for Digital Health Applications by the German Federal Institute for Drugs and Medical Devices. Listing in the register is granted, if the manufacturer has submitted a health app and verified that it meets basic requirements for medical devices and data security as well as positive health care effects. It is questionable, whether the DVG will lead to sustainable improvements in future patient care. In order to pursue this question and align the DGOUC's digitization strategy closely with its basis, an online survey was conducted among the respective members on the DVG's content and its associated opportunities and risks. A total of 461 German-speaking, predominantly male, experienced and elderly physicians in leading positions took part in the survey. In this study, it was shown that the majority of the participating German orthopaedic and trauma surgeons is not familiar with the DVG's contents. Despite a fundamentally positive attitude towards digitization, scepticism about the use of "apps on prescription" and potential risks still prevails at present. The closing of ranks between medicine, IT and the legislature via interdisciplinary expert groups and the involvement of medical societies might be obligatory.


Assuntos
Aplicativos Móveis , Cirurgiões , Idoso , Atenção à Saúde , Instalações de Saúde , Humanos , Masculino , Inquéritos e Questionários
11.
Curr Sports Med Rep ; 19(4): 157-163, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282462

RESUMO

Digital transformation is becoming increasingly common in modern life and sports medicine, like many other medical disciplines, it is strongly influenced and impacted by this rapidly changing field. This review aims to give a brief overview of the potential that digital technologies can have for health care providers and patients in the clinical practice of sports medicine. We will focus on mobile applications, wearables, smart devices, intelligent machines, telemedicine, artificial intelligence, big data, system interoperability, virtual reality, augmented reality, exergaming, or social networks. While some technologies are already used in current medical practice, others still have undiscovered potential. Due to the diversity and ever changing nature of this field, we will briefly review multiple areas in an attempt to give readers some general exposure to the landscape instead of a thorough, deep review of one topic. Further research will be necessary to show how digitalization applications could best be used for patient treatments.


Assuntos
Medicina Esportiva , Inteligência Artificial , Big Data , Humanos , Aplicativos Móveis , Telemedicina , Dispositivos Eletrônicos Vestíveis
12.
Am J Infect Control ; 48(6): 708-712, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32234262

RESUMO

Alcohol-based hand disinfection is the key measure to prevent healthcare-associated infections and nosocomial transmission of pathogens. We conducted a survey among dental students, trainee nurses and medical technical assistants in training from the Generation Z to determine their knowledge regarding hand hygiene and to optimize education. Overall knowledge was worthy of improvement. Females performed better than males. Specifically tailored efforts seem necessary to increase hand hygiene competence in the Generation Z.


Assuntos
Infecção Hospitalar , Higiene das Mãos , Enfermeiras e Enfermeiros , Estudantes de Medicina , Infecção Hospitalar/prevenção & controle , Feminino , Fidelidade a Diretrizes , Desinfecção das Mãos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Estudantes de Odontologia , Inquéritos e Questionários
13.
JMIR Mhealth Uhealth ; 7(11): e16442, 2019 11 18.
Artigo em Inglês | MEDLINE | ID: mdl-31738179

RESUMO

BACKGROUND: Meta-information provided about health apps on app stores is often the only readily available source of quality-related information before installation. OBJECTIVE: The purpose of this study was to assess whether physicians deem a predefined set of quality principles as relevant for health apps; whether they are able to identify corresponding information in a given sample of app descriptions; and whether, and how, this facilitates their informed usage decisions. METHODS: All members of the German Society for Internal Medicine were invited by email to participate in an anonymous online survey over a 6-week period. Participants were randomly assigned one app description focusing on cardiology or pulmonology. In the survey, participants were asked three times about whether the assigned description sufficed for a usage decision: they were asked (1) after giving an appraisal of the relevance of nine predefined app quality principles, (2) after determining whether the descriptions covered the quality principles, and (3) after they assessed the availability of detailed quality information by means of 25 additional key questions. Tests for significance of changes in their decisions between assessments 1 and 2, and between assessments 2 and 3, were conducted with the McNemar-Bowker test of symmetry. The effect size represents the discordant proportion ratio sum as a quotient of the test statistics of the Bowker test and the number of observation units. The significance level was set to alpha=.05 with a power of 1-beta=.95. RESULTS: A total of 441 of 724 participants (60.9%) who started the survey fully completed the questionnaires and were included in the evaluation. The participants predominantly rated the specified nine quality principles as important for their decision (approximately 80%-99% of ratings). However, apart from the practicality criterion, information provided in the app descriptions was lacking for both groups (approximately 51%-92%). Reassessment of the apps led to more critical assessments among both groups. After having familiarized themselves with the nine quality principles, approximately one-third of the participants (group A: 63/220, 28.6%; group B: 62/221, 28.1%) came to more critical usage decisions in a statistically significant manner (McNemar-Bowker test, groups A and B: P<.001). After a subsequent reassessment with 25 key questions, critical appraisals further increased, although not in a statistically significant manner (McNemar-Bowker, group A: P=.13; group B: P=.05). CONCLUSIONS: Sensitizing physicians to the topic of quality principles via questions about attitudes toward established quality principles, and letting them apply these principles to app descriptions, lead to more critical appraisals of the sufficiency of the information they provided. Even working with only nine generic criteria was sufficient to bring about the majority of decision changes. This may lay the foundation for aiding physicians in their app-related decision processes, without unduly taking up their valuable time.


Assuntos
Aplicativos Móveis/normas , Médicos/psicologia , Controle de Qualidade , Adulto , Idoso , Feminino , Alemanha , Humanos , Medicina Interna/organização & administração , Medicina Interna/estatística & dados numéricos , Internet , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis/estatística & dados numéricos , Médicos/normas , Médicos/estatística & dados numéricos , Inquéritos e Questionários , Estudos de Validação como Assunto
14.
JMIR Mhealth Uhealth ; 7(11): e12442, 2019 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-31750841

RESUMO

BACKGROUND: Cystic fibrosis (CF) continues to be the most common life-limiting chronic pulmonary disease in adolescents and young adults. Treatment of CF demands a high treatment time investment to slow the progression of lung function decline, the most important contributor to morbidity and mortality. Adherence is challenging in CF due to the high treatment burden and the lack of immediate health consequences in case of nonadherence. Lung function decline is particularly pronounced in the transition phase between 12 and 24 years of age. The improvement of self-management and self-responsibility and independence from parents and desire for normalcy are conflicting aspects for many adolescents with CF, which influence adherence to the time-consuming pulmonary therapy. Mobile health (mHealth) care apps could help to support self-management and independence and thereby reconcile seemingly conflicting goals to improve adherence, quality of life, and ultimately CF life expectancy. OBJECTIVE: This study aimed to (1) assess user behavior and satisfaction among adolescents and young adults with CF over an observation period of three months using an mHealth app; (2) identify areas of improvement for this mHealth app; and (3) compare overall and disease-specific satisfaction, lung function, and anthropometry before and after using the mHealth app. METHODS: A total of 27 adolescents and young adults with CF (age range 12-24 years, mean age 16 years, SD 3 years; 14 females, 11 males) used a free mHealth app for three months of whom 25 provided questionnaire data for analysis at the end of the study. Data collection was carried out using questionnaires on usage characteristics and life satisfaction, and standardized assessment of lung function and anthropometry. RESULTS: The use of the reminder function for medication declined from 70% (15/21) of the participants at week 4 to 65% (13/20) at week 8 of the observation period. At the end of the study, only 17% (4/23) of the participants wanted to continue using the app. Nevertheless, 56% (14/25) of participants saw the mobile app as a support for everyday life. Potential improvements targeting hedonistic qualities were identified to improve mHealth app adherence. Comparisons of satisfaction with different life aspects hinted at improvements or stabilization for the subitem respiration and the subitem lack of handicap by CF, suggesting that app use might stabilize certain CF-specific aspects of the weighted satisfaction with life. Lung function and anthropometry were not affected consistently. CONCLUSIONS: Most of the patients did not want to continue using the app after the study period. Only a few CF-specific aspects of weighted life satisfaction were possibly stabilized by the mHealth app; clinical parameters were not affected. Adaptation of the functions to adolescent-specific needs could improve the long-term use and thus positively affect the disease course.


Assuntos
Fibrose Cística/psicologia , Fibrose Cística/terapia , Aplicativos Móveis/normas , Adolescente , Criança , Feminino , Humanos , Masculino , Aplicativos Móveis/estatística & dados numéricos , Projetos Piloto , Autogestão/psicologia , Inquéritos e Questionários , Adulto Jovem
15.
Laryngorhinootologie ; 98(S 01): S253-S289, 2019 Mar.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-31096301

RESUMO

The implementation of mobile information and communication technology in the field of health services, e. g. in the form of apps, is becoming increasingly important. Unfortunately, the necessary quality criteria are often mising. Thus, it seems important, that in addition to an app controlling authority highly qualified health care professionals participate in the development of these applications. For reasons of liability, however, the physician must exercise great caution in the selection and recommendation of medical apps, especially considering, that only a few apps are certified as medical devices. There are a large number of medical apps on the market, with only a small proportion being assigned to the field of otorhinolaryngology. The areas of audiology, sleep medicine and allergology are most frequently represented. Althouhgh there is increasing scientific work on this topic in the field of otorhinolaryngology, there is a lack of scientific evidence of contents and results, as is generally the case of medical apps. However, there are other possibilities for users to rate medical apps regarding defined qualitiy criteria such as functionality, scientific integrity, but also data privacy. None of the apps assessed by such a evaluation tool met all the required quality criteria, but the applied instrument helped to better assess the application. However, it was possible to consider the quality criteria in the developmental process of an medical app for the field of otorhinolaryngoglogy. In summary, the present work provide a comprehensive insight into the topic "Apps in Otorhinolaryngology" with the aim to use these modern aids in a beneficial way.


Assuntos
Aplicativos Móveis , Otolaringologia
16.
JMIR Mhealth Uhealth ; 7(2): e13375, 2019 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-30810534

RESUMO

BACKGROUND: Currently, there are no binding requirements for manufacturers prescribing which information must be included in the app descriptions of health apps. OBJECTIVE: The aim of this study was to investigate how medical students perceive a selection of quality principles, intended for usage decisions in the app context, and establish whether the information presented in a sample of app descriptions is perceived as sufficient for facilitating an informed usage decision. METHODS: A total of 123 students (mean age 24.2 years, SD 3.4) participating in a 6-week teaching module covering cardiology and pulmonology at the University of Göttingen (original enrollment 152 students, response rate 80.9%) were included. Students were asked to read 3 store description texts of cardiological or pneumological apps and initially assess whether the descriptions sufficed for a usage decision. Subsequently, they were queried on their perception of the relevance of 9 predefined quality principles, formulated for usage decisions. An appraisal of whether the app description texts contained sufficient information to satisfy these quality principles followed. By means of 20 guiding questions, participants were then asked to identify relevant information (or a lack thereof) within the descriptions. A reassessment of whether the description texts sufficed for making a usage decision ensued. A total of 343 complete datasets were obtained. RESULTS: A majority of the quality principles were described as "very important" and "important" for making a usage decision. When accessed via the predefined principles, students felt unable to identify sufficient information within the app descriptions in 68.81% (2124/3087) of cases. Notably, information regarding undesired effects (91.8%, 315/343), ethical soundness (90.1%, 309/343), measures taken to avert risks (89.2%, 306/343), conflicts of interest (88.3%, 303/343), and the location of data storage (87.8%, 301/343) was lacking. Following participants' engagement with the quality principles, statistically significant changes in their assessment of whether the app descriptions sufficed for a usage decision can be seen-McNemar-Bowker test (3)=45.803919, P<.001, Cohen g=.295. In 34.1% (117/343) cases, the assessment was revised. About 3 quarters of changed assessments were seen more critically (76.9%, 90/117). Although, initially, 70% (240/343) had been considered "sufficient," this rate was reduced to 54.2% (186/343) in the second assessment. CONCLUSIONS: In a considerable number of app descriptions, participants were unable to locate the information necessary for making an informed usage decision. Participants' sensitization to the quality principles led to changes in their assessment of app descriptions as a tool for usage decisions. Better transparency in app descriptions released by manufacturers and the exposure of users to quality principles could collectively form the basis for well-founded usage decisions.


Assuntos
Aplicativos Móveis/normas , Desenvolvimento de Programas/normas , Estudantes de Medicina/psicologia , Adulto , Comportamento de Escolha , Comportamento do Consumidor/estatística & dados numéricos , Feminino , Humanos , Masculino , Aplicativos Móveis/estatística & dados numéricos , Desenvolvimento de Programas/métodos , Desenvolvimento de Programas/estatística & dados numéricos , Melhoria de Qualidade , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários
17.
JMIR Mhealth Uhealth ; 6(11): e11753, 2018 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-30459140

RESUMO

BACKGROUND: In the app stores of mobile platforms, consumers are confronted with an enormous number of mobile apps. Over the past few years, considerable research has been undertaken into to identifying, characterizing, and evaluating apps, be it in health-related or other contexts. However, many of these projects are restricted to specific areas of application and offer little flexibility in adapting the applied criteria. OBJECTIVE: This paper presents an adaptable method for selecting and characterizing mobile apps listed in a mobile App Store (the Apple App Store). The method is based on filtering processes using predefined criteria, through a semiautomated retrospective App Store analysis (SARASA). METHODS: To illustrate the SARASA process, keyword-based filtering and metadata-based description, review, and ranking steps were applied to a dataset, more specifically, an April 2018 readout of the Medical category of the German App Store, with the aim of obtaining a list of cardiology-related apps. RESULTS: From the original list of 39,427 apps within the "Medical" category of the App Store on April 14, 2018, 34,382 apps with store descriptions in languages other than German were removed. For the remaining 5045 apps, keywords related to cardiology were applied to filter the output, obtaining a final total of 335 subject-specific apps for further analysis and description. CONCLUSIONS: SARASA provides an easy to use method for applying filtering processes to identify apps matching predefined, formal criteria from app stores. The criteria can be well adapted to the needs of users. Automatic and manual analyses are easily combined when using SARASA. In the future, additional features, such as algorithmic topic analyses, may supplement the process. Although the area of application is currently limited to Apple's App Store, expansion to other stores is planned. The method stands or falls with the transparency of the app store providers and the manufacturers to make relevant meta-information available. It is up to them to liberalize information and restrict censorship to provide clients, customers, and users truly fair circumstances finding their way around the app market.

18.
JMIR Mhealth Uhealth ; 6(4): e10394, 2018 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-29695374

RESUMO

BACKGROUND: In addition to mandatory CE marking ("CE" representing Conformité Européenne, with the CE marking being a symbol of free marketability in the European Economic Area) for medical devices, there are various seals, initiatives, action groups, etc, in the health app context. However, whether manufacturers use them to distinguish their apps and attach relevance to them is unclear. OBJECTIVE: The objective was to take a snapshot of quality seals, regulatory marks, and other orientation aids available on the German app market and to determine whether manufacturers deem such labels relevant enough to apply them to their apps, namely as reflected by mentions in app description texts in a typical app store (ie, Apple's App Store). METHODS: A full survey of the metadata of 103,046 apps from Apple's German App Store in the Medicine and Health & Fitness categories was carried out. For apps with German-language store descriptions (N=8767), these were automatically searched for the occurrence of relevant keywords and validated manually (N=41). In addition, the websites of various app seal providers were checked for assigned seals. RESULTS: Few manufacturers referenced seals in the descriptions (5/41), although this would have been expected more often based on the seals we were able to identify from the seal providers' Web pages, and there were 34 of 41 that mentioned CE status in the descriptions. Two apps referenced an app directory curated by experts; however, this is not an alternative to CE marks and seals of approval. CONCLUSIONS: Currently, quality seals seem to be irrelevant for manufacturers. In line with regulatory requirements, mentions of medical device status are more frequent; however, neither characteristic is effective for identifying high-quality apps. To improve this situation, a possibly legally obligatory, standardized reporting system should be implemented.

19.
Artigo em Alemão | MEDLINE | ID: mdl-29368121

RESUMO

For a number of reasons, achieving reimbursability for digital health products has so far proven difficult. Demonstrating the benefits of the technology is the main hurdle in this context. The generally accepted evaluation processes, especially parallel group comparisons in randomized controlled trials (RCTs) for (clinical) benefit assessment, are primarily intended to deal with questions of (added) medical benefit. In contrast to drugs or classical medical devices, users of digital health solutions often profit from gaining autonomy, increased awareness and mindfulness, better transparency in the provision of care, and improved comfort, although there are also digital solutions with an interventional character targeting clinical outcomes (e. g. for indications such as anorexia, depression). Commonly accepted methods for evaluating (clinical) benefits primarily rely on medical outcomes, such as morbidity and mortality, but do not adequately consider additional benefits unique to digital health. The challenge is therefore to develop evaluation designs that respect the particularities of digital health without reducing the validity of the evaluations (especially with respect to safety). There is an increasing need for concepts that include both continuous feedback loops for adapting and improving an application while at the same time generate sufficient evidence for complex benefit assessments. This approach may help improve risk benefit ratio assessments of digital health when it comes to implementing digital innovations in healthcare.


Assuntos
Programas Nacionais de Saúde/tendências , Mecanismo de Reembolso/tendências , Telemedicina/tendências , Análise Custo-Benefício/tendências , Previsões , Alemanha , Humanos , Avaliação de Processos e Resultados em Cuidados de Saúde/tendências
20.
JMIR Mhealth Uhealth ; 5(9): e139, 2017 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-28912113

RESUMO

BACKGROUND: Advantages of mobile Augmented Reality (mAR) application-based learning versus textbook-based learning were already shown in a previous study. However, it was unclear whether the augmented reality (AR) component was responsible for the success of the self-developed app or whether this was attributable to the novelty of using mobile technology for learning. OBJECTIVE: The study's aim was to test the hypothesis whether there is no difference in learning success between learners who employed the mobile AR component and those who learned without it to determine possible effects of mAR. Also, we were interested in potential emotional effects of using this technology. METHODS: Forty-four medical students (male: 25, female: 19, mean age: 22.25 years, standard deviation [SD]: 3.33 years) participated in this study. Baseline emotional status was evaluated using the Profile of Mood States (POMS) questionnaire. Dermatological knowledge was ascertained using a single choice (SC) test (10 questions). The students were randomly assigned to learn 45 min with either a mobile learning method with mAR (group A) or without AR (group B). Afterwards, both groups were again asked to complete the previous questionnaires. AttrakDiff 2 questionnaires were used to evaluate the perceived usability as well as pragmatic and hedonic qualities. For capturing longer term effects, after 14 days, all participants were again asked to complete the SC questionnaire. All evaluations were anonymous, and descriptive statistics were calculated. For hypothesis testing, an unpaired signed-rank test was applied. RESULTS: For the SC tests, there were only minor differences, with both groups gaining knowledge (average improvement group A: 3.59 [SD 1.48]; group B: 3.86 [SD 1.51]). Differences between both groups were statistically insignificant (exact Mann Whitney U, U=173.5; P=.10; r=.247). However, in the follow-up SC test after 14 days, group A had retained more knowledge (average decrease of the number of correct answers group A: 0.33 [SD 1.62]; group B: 1.14 [SD 1.30]). For both groups, descriptively, there were only small variations regarding emotional involvement, and learning experiences also differed little, with both groups rating the app similar for its stimulating effect. CONCLUSIONS: We were unable to show significant effects for mAR on the immediate learning success of the mobile learning setting. However, the similar level of stimulation being noted for both groups is inconsistent with the previous assumption of the success of mAR-based approach being solely attributable to the excitement of using mobile technology, independent of mAR; the mAR group showed some indications for a better long-term retention of knowledge. Further studies are needed to examine this aspect. TRIAL REGISTRATION: German Clinical Trials Register (DRKS): 00012980; http://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00012980 (Archived by WebCite at http://www.webcitation.org/ 6tCWoM2Jb).

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