Abstract
BackgroundChronic rheumatic diseases need long-term treatment and professional supervision. Mobile apps promise to improve the lives of patients and physicians. In routine practice, however, rheumatology apps are largely unknown and little is known about their quality and safety.ObjectiveThe aim of this study was to provide an overview of mobile rheumatology apps currently available in German app stores, evaluate app quality using the Mobile Application Rating Scale (MARS), and compile brief, ready-to-use descriptions for patients and rheumatologists.MethodsThe German App Store and Google Play store were systematically searched to identify German rheumatology mobile apps for patient and physician use. MARS was used to independently assess app quality by 8 physicians, 4 using Android and 4 using iOS smartphones. Apps were randomly assigned so that 4 apps were rated by all raters and the remaining apps were rated by two Android and two iOS users. Furthermore, brief app descriptions including app developers, app categories, and features were compiled to inform potential users and developers.ResultsIn total, 128 and 63 apps were identified in the German Google Play and App Store, respectively. After removing duplicates and only including apps that were available in both stores, 28 apps remained. Sixteen apps met the inclusion criteria, which were (1) German language, (2) availability in both app stores, (3) targeting patients or physicians as users, and (4) clearly including rheumatology or rheumatic diseases as subject matter. Exclusion criteria were (1) congress apps and (2) company apps with advertisements. Nine apps addressed patients and 7 apps addressed physicians. No clinical studies to support the effectiveness and safety of apps could be found. Pharmaceutical companies were the main developers of two apps. Rheuma Auszeit was the only app mainly developed by a patient organization. This app had the highest overall MARS score (4.19/5). Three out of 9 patient apps featured validated questionnaires. The median overall MARS score was 3.85/5, ranging from 2.81/5 to 4.19/5. One patient-targeted and one physician-targeted app had MARS scores >4/5. No significant rater gender or platform (iOS/Android) differences could be observed. The overall correlation between app store ratings and MARS scores was low and inconsistent between platforms.ConclusionsTo our knowledge, this is the first study that systematically identified and evaluated mobile apps in rheumatology for patients and physicians available in German app stores. We found a lack of supporting clinical studies, use of validated questionnaires, and involvement of academic developers. Overall app quality was heterogeneous. To create high-quality apps, closer cooperation led by patients and physicians is vital.
Highlights
There is great potential in using eHealth tools, especially in chronic rheumatic diseases [1]
After removing duplicates and only including apps that were available in both stores, 28 apps remained
In the anticipated reality of Rheumatology 4.0 computer-aided diagnostic systems allowing precise and quick diagnosis [2], mobile apps and other eHealth tools could improve the positions of all stakeholders, including patients, physicians, health insurance companies, and the pharmaceutical industry
Summary
There is great potential in using eHealth tools, especially in chronic rheumatic diseases [1]. In the anticipated reality of Rheumatology 4.0 computer-aided diagnostic systems allowing precise and quick diagnosis [2], mobile apps and other eHealth tools could improve the positions of all stakeholders, including patients, physicians, health insurance companies, and the pharmaceutical industry. A recent study showed that remote monitoring of disease activity using physical activity trackers precisely detects flareups in patients with rheumatoid arthritis [4]. This is a good example in which an accurate clinical assessment is accomplished using an eHealth tool without necessitating a direct patient-physician encounter. Rheumatology apps are largely unknown and little is known about their quality and safety
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