Abstract
BACKGROUND: There are approximately 14,000 health/medical iPhone apps with a relative lack of both stroke-specific content and studies on effectiveness, usability, and usefulness. OBJECTIVE: Systematic, evidence-based literature search to determine the current availability, usefulness, and efficacy of mobile apps targeting stroke survivors or management of vascular risk factors. METHODOLOGY: Repetitive search study in PubMed and EMBASE using pre-specified medical subject headings (MeSH) terms, Boolean logic, and Preferred Reporting items for Systematic Reviews and Meta-analysis (PRISMA) guidelines (last updated 8/12/12). Publications were screened for inclusion using the following criteria: (1) potential usefulness of smartphones in daily patient care, (2) meta-analyses of stroke/vascular risk factor smartphone applications, (3) trials of smartphone-based patient care tools. RESULTS: We retrieved 73 articles from 2005-12 from 77 identified; 40/73 were duplicates. The remaining 33 abstracts were reviewed independently by 3 reviewers for relevance. Upon final evaluation/adjudication: 13 articles addressed potential usefulness of smartphones, 3 were on traditional specific stroke risk factors (none for stroke itself), and 8 on the results of trials of smartphone-based patient care tools. Sample sizes ranged from 3 to 3,001. Four articles addressed diabetes, two hypercholesterolemia, three weight loss, three diet/activity, one heart disease, and none addressed hypertension specifically. Of these, 8 were clinical trials on effectiveness or usefulness (3 for patient evaluation/monitoring, 2 for rehabilitation, 1 each for diet/activity, imaging, and drug infusion). Only one study evaluated risk analysis of information security with no studies evaluating strict regulation and critical appraisal. CONCLUSION: Despite rapid growth of mobile health applications, there is a paucity of linguistically relevant and culturally sensitive and sustainable stroke-specific apps. There is also a significant lack of studies in general that rigorously test mobile apps for their efficacy, usefulness, and sustainability with specific attention to patient privacy and regulatory compliance.
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