Mobile App Rating Scale Score Research Articles

Assessment of Eye Care Apps for Children and Adolescents Based on the Mobile App Rating Scale: Content Analysis and Quality Assessment.

In China, the current situation of myopia among children and adolescents is very serious. Prevention and control of myopia are inhibited by the lack of medical resources and the low awareness about eye care. Nevertheless, mobile apps provide an effective means to solve these problems. Since the health app market in China is still immature, it has become particularly important to conduct a study to assess the quality of eye-care apps to facilitate the development of better eye-care service strategies. This study aimed to evaluate the quality, functionality, medical evidence, and professional background of eye-care apps targeting children and adolescents in the Chinese app stores. A systematic search on iOS and Android app stores was performed to identify eye-care apps for children and adolescents. The general characteristics, development context, and functional features of the apps were described. Quality assessment of the apps was completed by 2 independent researchers using the Mobile App Rating Scale. This study included 29 apps, of which 17 (59%) were developed by commercial organizations and 12 (41%) had a design with relevant scientific basis. The main built-in functions of these apps include self-testing (18/29, 62%), eye exercises (16/29, 55%), and eye-care education (16/29, 55%). The mean overall quality of eye-care apps was 3.49 (SD 0.33), with a score ranging from 2.89 to 4.39. The overall Mobile App Rating Scale score exhibited a significant positive correlation with the subscale scores (r=0.81-0.91; P<.001). In addition, although most apps provided basic eye-care features, there are some deficiencies. For example, only a few apps were developed with the participation of medical organizations or professional ophthalmologists, and most of the apps were updated infrequently, failing to provide the latest eye-care information and technology in a timely manner. In general, the quality of eye-care apps for children and teenagers in Chinese app stores is good. These apps fulfill users' needs for eye-care services to a certain extent, but they still suffer from insufficient medical background, low user engagement, and untimely updates. In order to further improve the effectiveness of eye-care apps, cooperation with medical institutions and professional ophthalmologists should be strengthened to enhance the scientific and authoritative nature of the apps. At the same time, interactive features and regular updates should be added to enhance user participation and the continuity of the apps. This study provides a reference for future development or improvement of eye-care apps, which can help promote myopia prevention and control.

Insights into the Quality of Mobile Health Apps: Preliminary Results of an Analysis of MARS Scores.

Many mHelath applications have been developed, and the Mobile App Rating Scale (MARS) is a common tool for assessing them. This study aims to provide mean values for MARS scores found in recent literature. We systematically searched for literature in which MARS was used and analyzed them. MARS values for 5,920 applications from 215 studies were compiled. The mean MARS Quality Score is 3.51. The highest average score was achieved in the Functionality category (3.98), followed by Aesthetics (3.52), Information (3.33), Engagement (3.18) and Subjective (2.72). To the best of our knowledge, this is the first study to calculate average values for the five categories of the MARS and the MARS score based on such an extensive collection of data. The study shows that the overall quality of the applications is above the average value of 2.5.

Persian Mobile Apps for Diabetic Patients: App Review and Evaluation Study

Background: The development of mobile apps in healthcare facilities helps users perform self-care effectively. Objectives: This study aimed to evaluate the quality, functionality, and features of Persian language diabetes mobile apps. Methods: Persian language diabetes self-management mobile apps were searched in the Android and iOS App Stores using relevant keywords such as "diabetes" and "blood sugar." Twelve apps met the inclusion criteria. Nine evaluators assessed the apps' quality based on the Mobile App Rating Scale (MARS), their functionality according to the IMS institute for healthcare informatics app functionality scoring system, and their features and content using a checklist. Results: The mean MARS score of the apps was 3.02 out of 5. Among the four dimensions of engagement, aesthetics, functionality, and information quality, functionality had the highest mean ± SD score (3.64 ± 1.13). Most of the apps used 5 - 7 out of the 11 defined functionalities. All self-management apps included the functionality of monitoring blood glucose levels, and the majority had health status monitoring features. Conclusions: The mobile apps had several drawbacks, including a lack of engagement strategies, insufficient evidence-based information for patients, limited guideline-based self-management functionalities, failure to evaluate clinical effectiveness in trials, and an absence of mutual communication with healthcare providers.

Smartphone App Designed to Collect Health Information in Older Adults: Usability Study.

Studies evaluating the usability of mobile-phone assessments in older adults are limited. This study aims to identify design-based barriers and facilitators to mobile app survey completion among 2 samples of older adults; those in the Framingham Heart Study and a more diverse sample from a hospital-based setting. We used mixed methods to identify challenging and beneficial features of the mobile app in participants from the electronic Framingham Heart Study (n=15; mean age of 72 years; 6/15, 40% women; 15/15, 100% non-Hispanic and White) and among participants recruited from a hospital-based setting (n=15; mean age of 71 years; 7/15, 47% women; 3/15, 20% Hispanic; and 8/15, 53% non-White). A variety of app-based measures with different response formats were tested, including self-reported surveys, pictorial assessments (to indicate body pain sites), and cognitive testing tasks (eg, Trail Making Test and Stroop). Participants completed each measure using a think-aloud protocol, while being audio- and video-recorded with a qualitative interview conducted at the end of the session. Recordings were coded for participant usability errors by 2 pairs of coders. Participants completed the Mobile App Rating Scale to assess the app (response range 1=inadequate to 5=excellent). In electronic Framingham Heart Study participants, the average total Mobile App Rating Scale score was 7.6 (SD 1.1), with no significant differences in the hospital-based sample. In general, participants were pleased with the app and found it easy to use. A large minority had at least 1 navigational issue, most committed only once. Most older adults did not have difficulty completing the self-reported multiple-choice measures unless it included lengthy instructions but participants had usability issues with the Stroop and Trail Making Test. Our methods and results help guide app development and app-based survey construction for older adults, while also giving consideration to sociodemographic differences.

Digital Apps to Improve Mobility in Adults with Neurological Conditions: A Health App-Focused Systematic Review.

The provision of mobility exercises through a smartphone application (app) for people undertaking neurological rehabilitation may improve mobility outcomes. However, it is difficult for clinicians and consumers to select high-quality, appropriate apps. This review aimed to identify (1) which mobile health (mHealth) apps are suitable for prescribing mobility exercises for adults with neurological health conditions, (2) how well these apps incorporate telehealth strategies, and (3) how well these apps rate in terms of quality and capacity for behaviour change. The Australian Apple iTunes Store was systematically searched, by using a search code and manually, for apps suitable for training mobility in neurological rehabilitation. Additional searches were conducted in known app repositories and for web-based apps. Trained reviewers extracted data from the included apps, including population-specific characteristics; quality, by using the Mobile App Rating Scale (MARS); and behaviour change potential, by using the App Behaviour Change Scale (ABACUS). The included apps (n = 18) provided <50 to >10,000 exercises, many incurred a subscription fee (n = 13), and half included telehealth features. App quality was moderate (mean MARS score of 3.2/5 and SD of 0.5), and potential for behaviour change was poor (mean ABACUS score of 5.7/21 and SD of 2.1). A limited number of high-quality apps are available for the prescription of mobility exercises in people with neurological conditions.

Patient-Centered Chronic Wound Care Mobile Apps: Systematic Identification, Analysis, and Assessment.

The prevalence of chronic wounds is predicted to increase within the aging populations in industrialized countries. Patients experience significant distress due to pain, wound secretions, and the resulting immobilization. As the number of wounds continues to rise, their adequate care becomes increasingly costly in terms of health care resources worldwide. eHealth support systems are being increasingly integrated into patient care. However, to date, no systematic analysis of such apps for chronic wounds has been published. The aims of this study were to systematically identify and subjectively assess publicly available German- or English-language mobile apps for patients with chronic wounds, with quality assessments performed by both patients and physicians. Two reviewers independently conducted a systematic search and assessment of German- or English-language mobile apps for patients with chronic wounds that were available in the Google Play Store and Apple App Store from April 2022 to May 2022. In total, 3 apps met the inclusion and exclusion criteria and were reviewed independently by 10 physicians using the German Mobile App Rating Scale (MARS) and the System Usability Scale (SUS). The app with the highest mean MARS score was subsequently reviewed by 11 patients with chronic wounds using the German user version of the MARS (uMARS) and the SUS. Additionally, Affinity for Technology Interaction (ATI) scale scores were collected from both patients and physicians. This study assessed mobile apps for patients with chronic wounds that were selected from a pool of 118 identified apps. Of the 73 apps available in both app stores, 10 were patient oriented. After excluding apps with advertisements or costs, 3 apps were evaluated by 10 physicians. Mean MARS scores ranged from 2.64 (SD 0.65) to 3.88 (SD 0.65) out of 5, and mean SUS scores ranged from 50.75 (SD 27) to 80.5 (SD 17.7) out of 100. WUND APP received the highest mean MARS score (mean 3.88, SD 0.65 out of 5) among physicians. Hence, it was subsequently assessed by 11 patients and achieved a similar rating (uMARS score: mean 3.89, SD 0.4 out of 5). Technical affinity, as measured with the ATI scale, was slightly lower in patients (score: mean 3.62, SD 1.35 out of 6) compared to physicians (score: mean 3.88, SD 1.03 out 6). The quality ratings from physicians and patients were comparable and indicated mediocre app quality. Technical affinity, as assessed by using the ATI scale, was slightly lower for patients. Adequate apps for patients with chronic wounds remain limited, emphasizing the need for improved app development to meet patient needs. The ATI scale proved valuable for assessing technical affinity among different user groups.

Assessing the Quality and Behavior Change Potential of Vaping Cessation Apps: Systematic Search and Assessment.

An increasing number of people are using vapes (e-cigarettes), and with growing evidence of associated harms, there is a need for acceptable cessation support and interventions. Smartphone apps for health and well-being have increased in popularity and use. Limited published literature assesses the potential of apps to support vaping cessation. A systematic search of vaping cessation apps currently available in Australia for iOS and Android platforms was conducted. Apps were assessed against established health app assessment tools for quality and behavior change potential. A systematic search through the Australian Apple iTunes and Google Play stores was conducted using the search terms "vape"; "vaping"; "e-cigarette"; and "cessation," "quit," or "quitting" in May 2023. Only apps that encouraged the cessation of vaping were included. App descriptions were reviewed to determine if they were relevant for inclusion in this study, and relevant apps were downloaded onto the appropriate mobile device for review. The Mobile App Rating Scale (MARS) was used to rate the quality (engagement, functionality, aesthetics, and information) of the apps using an overall score out of 5. The App Behavior Change Scale (ABACUS) was used to assess the behavior change potential of each app using a score out of 21. An initial search of the app stores yielded 220 Android apps and 124 iOS apps. Screening against the inclusion criteria left 20 iOS apps and 10 Android apps for review. Six apps were available on both operating systems, and these were downloaded, reviewed, and reported separately for each operating system. The average MARS score for all apps assessed in this review was 3.1 (SD 0.41) out of 5. The reviewed apps overall performed well for the MARS elements relating to functionality, such as ease of use and navigation, but had the lowest scores for information-related elements, such as credibility. The number of ABACUS behavior change features per app ranged from 0 to 19 out of 21, with a mean of 8.9 (SD 4.51). The apps commonly included information-related features, such as requesting baseline information. The least common behavior change features were those relating to goal-setting, such as asking about the user's willingness for behavior change and providing feedback on current actions in comparison to future goals. The identified vaping cessation apps had moderate levels of quality and some behavior change components. Future vaping cessation apps could benefit from including more features that are known to support behavior change, such as goal-setting, to improve the potential benefit of these apps to support people to stop vaping. As guidelines for vaping cessation continue to be established, future apps need to reference these in their development.

Mobile Apps for Common Noncommunicable Disease Management: Systematic Search in App Stores and Evaluation Using the Mobile App Rating Scale.

The success of mobile apps in improving the lifestyle of patients with noncommunicable diseases through self-management interventions is contingent upon the emerging growth in this field. While users of mobile health (mHealth) apps continue to grow in number, little is known about the quality of available apps that provide self-management for common noncommunicable diseases such as diabetes, hypertension, and obesity. We aimed to investigate the availability, characteristics, and quality of mHealth apps for common noncommunicable disease health management that included dietary aspects (based on the developer's description), as well as their features for promoting health outcomes and self-monitoring. A systematic search of English-language apps on the Google Play Store (Google LLC) and Apple App Store (Apple Inc) was conducted between August 7, 2022, and September 13, 2022. The search terms used included weight management, obesity, diabetes, hypertension, cardiovascular diseases, stroke, and diet. The selected mHealth apps' titles and content were screened based on the description that was provided. Apps that were not designed with self-management features were excluded. We analyzed the mHealth apps by category and whether they involved health care professionals, were based on scientific testing, and had self-monitoring features. A validated and multidimensional tool, the Mobile App Rating Scale (MARS), was used to evaluate each mHealth app's quality based on a 5-point Likert scale from 1 (inadequate) to 5 (excellent). Overall, 42 apps were identified. Diabetes-specific mHealth apps accounted for 7% (n=3) of the market, hypertension apps for 12% (n=5), and general noncommunicable disease management apps for 21% (n=9). About 38% (n=16) of the apps were for managing chronic diseases, while 74% (n=31) were for weight management. Self-management features such as weight tracking, BMI calculators, diet tracking, and fluid intake tracking were seen in 86% (n=36) of the apps. Most mHealth apps (n=37, 88%) did not indicate whether there was involvement of health professionals in app development. Additionally, none of the apps reported scientific evidence demonstrating their efficacy in managing health. The overall mean MARS score was 3.2 of 5, with a range of 2.0 to 4.1. Functionality was the best-rated category (mean score 3.9, SD 0.5), followed by aesthetics (mean score 3.2, SD 0.9), information (mean score 3.1, SD 0.7), and engagement (mean score 2.9, SD 0.6). The quality of mHealth apps for managing chronic diseases was heterogeneous, with roughly half of them falling short of acceptable standards for both quality and content. The majority of apps contained scant information about scientific evidence and the developer's history. To increase user confidence and accomplish desired health outcomes, mHealth apps should be optimized with the help of health care professionals. Future studies on mHealth content analysis should focus on other diseases as well.

Mobile health applications for epilepsy in Indian app stores: A systematic review and content analysis using the mobile app rating scale

ObjectiveThe growing prevalence of smartphones may prompt individuals with epilepsy to pursue unfulfilled healthcare requirements through mobile health (mHealth) apps, but the content and quality of these mHealth apps are rarely analysed. Hence, this study aimed to identify and assess the quality of epilepsy apps for patients with epilepsy (PWE), their caregivers, and healthcare practitioners (HCPs) available in the Play Store and App Store of India. MethodsWe performed a systematic search on the Google Play Store and Apple App Store of India to identify the mHealth apps for epilepsy which were released and updated till May 2023. The identified applications were downloaded and the quality was assessed using a Mobile app rating scale (MARS) for the overall quality, Aesthetics, Engagement, Functionality, and Information by three independent reviewers. The intraclass correlation coefficient (ICC) was calculated to assess the interrater reliability between the reviewers. An unpaired t-test was calculated to analyse the difference in mean scores for Android and iOS applications. ResultsThe systematic search yielded a total of 2518 apps, out of which 26 were selected for inclusion in the study. Among these, 9 apps were compatible with Android, 11 with iOS, and 6 on both platforms. The mean (SD) MARS score of the apps was 3.5 (0.6) and the ICC for the overall app quality was 0.90 (95% CI: 0.82–0.96). Overall, apps scored highest in functionality (3.9), followed by aesthetics (3.6), information (3.3), and engagement (3.2). Among the included apps, the overall quality score was found to be higher for iOS apps than Android (MD = 0.54; 95% CI: 0.02 – 1.07; p-value: 0.042). ConclusionOur study identified twenty-six mHealth applications for epilepsy that integrated various aspects of epilepsy self-management. The results of this study emphasize the importance of ensuring that current and future applications offer evidence-based information, integrate features that align with patient preferences, and generate evidence regarding the effectiveness of application usage.

Functionality and Quality of Asthma mHealth Apps and Their Consistency With International Guidelines: Structured Search and Evaluation.

Asthma is a chronic respiratory disorder requiring long-term pharmacotherapy and judicious patient self-management. Few studies have systematically evaluated asthma mobile health (mHealth) apps for quality and functionality; however, none have systematically assessed these apps for their content alignment with international best practice guidelines. This review aims to conduct a systematic search and evaluation of current mHealth apps in the Australian marketplace for their functionality, quality, and consistency with best practice guidelines. The most recent Global Initiative for Asthma (GINA) guidelines were reviewed to identify key recommendations that could be feasibly incorporated into an mHealth app. We developed a checklist based on these recommendations and a modified version of a previously developed framework. App stores were reviewed to identify potential mHealth apps based on predefined criteria. Evaluation of suitable apps included the assessment of technical information, an app quality assessment using the validated Mobile App Rating Scale (MARS) framework, and an app functionality assessment using the Intercontinental Medical Statistics Institute for Health Informatics (IMS) Functionality Scoring System. Finally, the mHealth apps were assessed for their content alignment with the GINA guidelines using the checklist we developed. Of the 422 apps initially identified, 53 were suitable for further analysis based on inclusion and exclusion criteria. The mean number of behavioral change techniques for a single app was 3.26 (SD 2.27). The mean MARS score for all the reviewed apps was 3.05 (SD 0.54). Of 53 apps, 27 (51%) achieved a total MARS score of ≥3. On average, the reviewed apps achieved 5.1 (SD 2.79) functionalities on the 11-point IMS functionality scale. The median number of functionalities identified was 5 (IQR 2-7). Overall, 10 (22%) of the 45 apps with reviewer consensus in this domain provided general knowledge regarding asthma. Of 53 apps, skill training in peak flow meters, inhaler devices, recognizing or responding to exacerbations, and nonpharmacological asthma management were identified in 8 (17%), 12 (25%), 11 (28%), and 14 (31%) apps, respectively; 19 (37%) apps could track or record "asthma symptoms," which was the most commonly recorded metric. The most frequently identified prompt was for taking preventive medications, available in 9 (20%) apps. Five (10%) apps provided an area for patients to store or enter their asthma action plan. This study used a unique checklist developed based on the GINA guidelines to evaluate the content alignment of asthma apps. Good-quality asthma apps aligned with international best practice asthma guidelines are lacking. Future app development should target the currently lacking key features identified in this study, including the use of asthma action plans and the deployment of behavioral change techniques to engage and re-engage with users. This study has implications for clinicians navigating the ever-expanding mHealth app market for chronic diseases. PROSPERO CRD42021269894; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269894. RR2-10.2196/33103.

Refinement and Usability Analysis of an eHealth App for Ankylosing Spondylitis as a Complementary Treatment to Physical Therapy: Development and Usability Study.

Mobile eHealth apps have been used as a complementary treatment to increase the quality of life of patients and provide new opportunities for the management of rheumatic diseases. Telemedicine, particularly in the areas of prevention, diagnostics, and therapy, has become an essential cornerstone in the care of patients with rheumatic diseases. This study aims to improve the design and technology of YogiTherapy and evaluate its usability and quality. We newly implemented the mobile eHealth app YogiTherapy with a modern design, the option to change language, and easy navigation to improve the app's usability and quality for patients. After refinement, we evaluated the app by conducting a study with 16 patients with AS (4 female and 12 male; mean age 48.1,SD16.8 y). We assessed the usability of YogiTherapy with a task performance test (TPT) with a think-aloud protocol and the quality with the German version of the Mobile App Rating Scale (MARS). In the TPT, the participants had to solve 6 tasks that should be performed on the app. The overall task completion rate in the TPT was high (84/96, 88% completed tasks). Filtering for videos and navigating to perform an assessment test caused the largest issues during the TPT, while registering in the app and watching a yoga video were highly intuitive. Additionally, 12 (75%) of the 16 participants completed the German version of MARS. The quality of YogiTherapy was rated with an average MARS score of 3.79(SD0.51) from a maximum score of 5. Furthermore, results from the MARS questionnaire demonstrated a positive evaluation regarding functionality and aesthetics. The refined and tested YogiTherapy app showed promising results among most participants. In the future, the app could serve its function as a complementary treatment for patients with AS. For this purpose, surveys with a larger number of patients should still be conducted. As a substantial advancement, we made the app free and openly available on the iOS App and Google Play stores.

Assessing the Usefulness of Mobile Apps for Noise Management in Occupational Health and Safety: Quantitative Measurement and Expert Elicitation Study.

Overexposure to occupational noise can lead to hearing loss. Occupational noise mapping is conventionally performed with a calibrated sound level meter (SLM). With the rise of mobile apps, there is a growing number of SLM apps available on mobile phones. However, few studies have evaluated such apps for accuracy and usefulness to guide those with occupational noise detection needs in selecting a quality app. The purpose of this study was to evaluate the accuracy and usefulness of SLM mobile apps to guide workplace health and safety professionals in determining these apps' suitability for assessing occupational noise exposure. The following three iOS apps were assessed: the NIOSH (National Institute for Occupational Safety and Health) Sound Level Meter, Decibel X, and SoundMeter X apps. The selected apps were evaluated for their accuracy in measuring sound levels in low-, moderate-, and high-noise settings within both simulated environments and real-world environments by comparing them to a conventional SLM. The usefulness of the apps was then assessed by occupational health specialists using the Mobile App Rating Scale (MARS). The NIOSH Sound Level Meter app accurately measured noise across a range of sound levels in both simulated settings and real-world settings. However, considerable variation was observed between readings. In comparison, the Decibel X and SoundMeter X apps showed more consistent readings but consistently underestimated noise levels, suggesting that they may pose a risk for workers. Nevertheless, none of the differences in sound measurements between the three apps and the conventional SLM were statistically significant (NIOSH Sound Level Meter: P=.78; Decibel X: P=.38; SoundMeter X: P=.40). The MARS scores for the three apps were all above 3.0, indicating the usefulness of these apps. Under the conditions of this study, the NIOSH Sound Level Meter app had equivalent accuracy to the calibrated SLM and a degree of usefulness according to the MARS. This suggests that the NIOSH Sound Level Meter app may be suitable for mapping noise levels as part of a monitoring strategy in workplaces. However, it is important to understand its limitations. Mobile apps should complement but not replace conventional SLMs when trying to assess occupational noise exposure risk. Our outcomes also suggest that the MARS tool may have limited applicability to measurement-based apps and may be more suited to information-based apps that collect, record, and store information.

Helping general dental practitioners use the Index of Orthodontic Treatment Need: an assessment of available educational apps.

Introduction The Index of Orthodontic Treatment Need (IOTN) defines who receives treatment on the NHS. The British Orthodontic Society developed the 'Easy IOTN' app to help the dental team use IOTN more effectively.Aim This study aims to investigate the quality of the 'Easy IOTN' app and any alternative mobile apps developed to aid a dentist's ability to use IOTN.Materials and methods The App Store and Google Play were searched to identify available apps which provide an educational resource for IOTN. Any app identified was assessed using the Mobile App Rating Scale (MARS) and the Royal College of Physicians' health informatics unit checklist. The 'Easy IOTN' app continuous professional development (CPD) section was assessed for accuracy using a focus group.Results Only the 'Easy IOTN' app was identified. It has a mean MARS score of 3.6. Significant inaccuracies were found within the CPD component of the 'Easy IOTN' app.Discussion A mean MARS score of 3.6 is deemed average and is comparable to the quality of other orthodontic apps which exist. Errors contained within the CPD component could confuse users and have a negative impact on IOTN skill development.Conclusions The educational component of the 'Easy IOTN' app is of an acceptable standard, but the CPD section is flawed.

Features, functions, and quality of mobile applications for type 2 diabetes care in China: Systematic search of app stores

BackgroundType 2 diabetes (T2DM) is highly prevalent in China, affecting over 114 million people. While mHealth interventions have shown promise, there is limited research on T2DM management apps in real-world app stores. ObjectiveThis study aimed to systematically search and analyze T2DM care mobile apps in the Chinese market, describing their features, and functions, and evaluating the quality of the most popular apps using validated tools. MethodsWe conducted a comprehensive search in Chinese Android and iOS app stores for T2DM management apps. We downloaded 138 eligible ones for a general review of their key features and function. We also assessed the quality of the top 20 apps from both platforms using the Mobile App Rating Scale (MARS) by both researcher and patient. ResultsA total of 3524 apps were searched. 138 eligible apps were downloaded for general review and 29 popular apps were included for quality assessment. Most apps were designed for patient users (87.0 %) and developed by commercial companies (85.5 %). Common functions included blood glucose monitoring, diabetes education, integration with measuring devices, medication adherence reminders, teleconsultation services, and diabetes risk factor tracking. The researcher's evaluation yielded an average MARS score of 4.0 out of 5 for popular apps, with subscale scores of functionalities (4.5), aesthetics (4.1), engagement (3.7), and information (3.6). However, patient ratings were lower in functionality (3.5), aesthetics (3.4), and engagement (2.6), and the patient faced difficulties with information-related items. Similar trends were observed in subject quality items. ConclusionApp developers should engage caregivers, and family members as target users, and involve government agencies as partners to improve T2DM management apps. Future apps should incorporate scientifically proven advanced functions to enhance their effectiveness. The quality assessment highlighted weaknesses in engagement and information and the importance of user-centric approaches in app development.

715-P: How Frequently Do People with Diabetes Use a Digital Diabetes Logbook and How Satisfied Are They with It?

A randomized controlled trial (RCT) was conducted to evaluate the efficacy of a digital diabetes logbook (mySugr) to help with diabetes self-management. Frequency of use as well as satisfaction with the app were assessed. A total of 424 people were included in the RCT with 282 being randomized to the intervention group using the app for 3 months (2:1 randomization) (age: 51.2±14.6 years; 13.1% type 1, 66.7% type 2, 20.2% gestational diabetes). Frequency of use was assessed with user data from the pseudonymized study server. Satisfaction with mySugr was assessed with an adapted version of the Mobile App Rating Scale (MARS). Mean MARS scores were calculated (range: 1-5) with higher scores indicating higher satisfaction. User data from 249 participants of the intervention group (88.3%) were analyzable. The app was used on a median of 92.6% (IQR: 57.7 - 100%) of the study days (median study duration: 91 [IQR: 84-96] days). Over the study duration, participants logged 3.1±2.5 blood glucose values. Satisfaction was very high with a mean MARS score of 4.3±0.7. 64.7% of participants agreed that the app is appealing for people with diabetes and 82.5% agreed that the app is easy to use. Satisfaction was highest in women with gestational diabetes, followed by people with type 1 and people with type 2 diabetes (4.5±0.5 vs. 4.3±0.6 vs. 4.2±0.7; p=0.037). Higher satisfaction was associated with higher percentage of days with app use (r=0.23, p&amp;lt;0.001), higher logging frequency (r=0.20, p=0.002) and less problems with the app (r=-0.20, p=0.001). Those who contacted mySugr support when they had problems were significantly more satisfied than those who did not contact support when they had problems (4.6±0.4 vs. 3.8±0.7, p=0.023). Participants randomized to using mySugr for 3 months (no prior app use) were highly satisfied with the app. Frequency of use of the app across the study period was very high. Satisfaction was high in all diabetes types with women with gestational diabetes having the highest satisfaction. Disclosure N.Hermanns: Advisory Panel; Insulet Corporation, Research Support; Sanofi-Aventis Deutschland GmbH, Roche Diagnostics, Becton, Dickinson and Company, Speaker's Bureau; Dexcom, Inc., Berlin-Chemie AG. D.Ehrmann: Advisory Panel; Roche Diabetes Care, mySugr, Dexcom, Inc., Speaker's Bureau; Berlin-Chemie AG, Dexcom, Inc. S.Silbermann: Employee; Roche Diabetes Care. J.Kober: Employee; mySugr. I.Vesper: None. K.Finke-gröne: None. T.Roos: None. E.Bingol: Employee; Roche Diabetes Care. B.Kulzer: Advisory Panel; Berlin-Chemie AG, Abbott Diabetes, Bayer Inc., Dexcom, Inc., Novo Nordisk, Insulet Corporation, embecta, Research Support; Sanofi, Roche Diabetes Care. Funding Roche Diabetes Care GmbH (DC000097)

A217 A REVIEW OF MOBILE HEALTH APPLICATIONS FOR INDIVIDUALS LIVING WITH INFLAMMATORY BOWEL DISEASE USING MOBILE APPLICATION RATING SCALE (MARS)

Abstract Background Inflammatory bowel disease (IBD) is a chronic disorder that can be managed but not cured. The relapsing and remitting symptoms of IBD impact patients' quality of life and is associated with considerable healthcare costs. Different mobile health apps have been developed around the world for IBD and other chronic medical conditions. These apps can potentially decrease healthcare utilization and the burden of the disease. Purpose We aimed to review IBD mobile health apps available in English and evaluate their quality and content. Method We searched the Apple Store and Play Store in July 2022 using IBD-related keywords (e.g., “IBD,” “Crohn,” “Crohns,” “colitis,” “ulcerative colitis,” and “inflammatory bowel disease.”) to identify apps for iOS and Android devices, respectively. We included apps available in English, designed specifically for IBD, and free to download and use. Two researchers reviewed, rated, and evaluated the retrieved apps independently. The Mobile App Rating Scale (MARS) was used to rate the included apps. The MARS rates apps on a scale of 1 to 5 and includes an overall score as well as scores for engagement, functionality, information, aesthetics, and subject quality. A score ≥3 is deemed acceptable. Result(s) Search queries yielded 88 relevant apps, of which 38 met the inclusion criteria and were included in this review. The included apps for IBD were most tracking and monitoring symptoms of the disease (n=22). Two of the apps were affiliated with universities, and three of the apps were specifically developed for children. In addition, 11 apps were designed for IBD, regardless of disease subtype (Crohn’s disease [CD] or ulcerative colitis [UC]), and 27 apps were designed specifically for either UC or CD. The mean MARS score for IBD apps was 3.3 (SD=0.6), with more than half deemed acceptable. Apps scored highest on the functionality (mean=3.7, SD=0.6) and information (mean=3.6, SD=0.5) dimension of MARS and lowest on the engagement dimension (mean=3, SD=0.8). Image Conclusion(s) Most IBD-related apps provide acceptable information and functionality but should improve their engagement to be welcomed by users. This review provides a roadmap for improving available apps and future app development for individuals with IBD. App developers in the field of IBD must ensure they create high-quality, engaging, esthetic and evidence-based apps. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared

Mobile applications in the Philippines during the COVID-19 pandemic: systematic search, use case mapping, and quality assessment using the Mobile App Rating Scale (MARS)

BackgroundIn the Philippines, various mobile health apps were implemented during the COVID-19 pandemic with very little knowledge in terms of their quality. The aims of this paper were 1) to systemically search for mobile apps with COVID-19 pandemic use case that are implemented in the Philippines; 2) to assess the apps using Mobile App Rating Scale (MARS); and 3) to identify the critical points for future improvements of these apps.MethodsTo identify existing mobile applications with COVID-19 pandemic use case employed in the Philippines, Google Play and Apple App Stores were systematically searched. Further search was conducted using the Google Search. Data were extracted from the app web store profile and apps were categorized according to use cases. Mobile apps that met the inclusion criteria were independently assessed and scored by two researchers using the MARS—a 23-item, expert-based rating scale for assessing the quality of mHealth applications.ResultsA total of 27 apps were identified and assessed using MARS. The majority of the apps are designed for managing exposure to COVID-19 and for promoting health monitoring. The overall MARS score of all the apps is 3.62 points (SD 0.7), with a maximum score of 4.7 for an app used for telehealth and a minimum of 2.3 for a COVID-19 health declaration app. The majority (n = 19, 70%) of the apps are equal to or exceeded the minimum “acceptable” MARS score of 3.0. Looking at the categories, the apps for raising awareness received the highest MARS score of 4.58 (SD 0.03) while those designed for managing exposure to COVID-19 received the lowest mean score of 3.06 (SD 0.6).ConclusionsThere is a heterogenous quality of mHealth apps implemented during the COVID-19 pandemic in the Philippines. The study also identified areas to better improve the tools. Considering that mHealth is expected to be an integral part of the healthcare system post-pandemic, the results warrant better policies and guidance in the development and implementation to ensure quality across the board and as a result, positively impact health outcomes.

Mobile Health Apps for Breast Cancer: Content Analysis and Quality Assessment

The number of mobile health apps is rapidly increasing. This means that consumers are faced with a bewildering array of choices, and finding the benefit of such apps may be challenging. The significant international burden of breast cancer (BC) and the potential of mobile health apps to improve medical and public health practices mean that such apps will likely be important because of their functionalities in daily life. As the app market has grown exponentially, several review studies have scrutinized cancer- or BC-related apps. However, those reviews concentrated on the availability of the apps and relied on user ratings to decide on app quality. To minimize subjectivity in quality assessment, quantitative methods to assess BC-related apps are required. The purpose of this study is to analyze the content and quality of BC-related apps to provide useful information for end users and clinicians. Based on a stepwise systematic approach, we analyzed apps related to BC, including those related to prevention, detection, treatment, and survivor support. We used the keywords "breast cancer" in English and Korean to identify commercially available apps in the Google Play and App Store. The apps were then independently evaluated by 2 investigators to determine their eligibility for inclusion. The content and quality of the apps were analyzed using objective frameworks and the Mobile App Rating Scale (MARS), respectively. The initial search identified 1148 apps, 69 (6%) of which were included. Most BC-related apps provided information, and some recorded patient-generated health data, provided psychological support, and assisted with medication management. The Kendall coefficient of concordance between the raters was 0.91 (P<.001). The mean MARS score (range: 1-5) of the apps was 3.31 (SD 0.67; range: 1.94-4.53). Among the 5 individual dimensions, functionality had the highest mean score (4.37, SD 0.42) followed by aesthetics (3.74, SD 1.14). Apps that only provided information on BC prevention or management of its risk factors had lower MARS scores than those that recorded medical data or patient-generated health data. Apps that were developed >2 years ago, or by individuals, had significantly lower MARS scores compared to other apps (P<.001). The quality of BC-related apps was generally acceptable according to the MARS, but the gaps between the highest- and lowest-rated apps were large. In addition, apps using personalized data were of higher quality than those merely giving related information, especially after treatment in the cancer care continuum. We also found that apps that had been updated within 1 year and developed by private companies had higher MARS scores. This may imply that there are criteria for end users and clinicians to help choose the right apps for better clinical outcomes.

Are Mobile Applications in Laryngology Designed for All Patients?

Mobile applications (apps) are multiplying in laryngology, with little standardization of content, functionality, or accessibility. The purpose of this study is to evaluate the quality, functionality, health literacy, readability, accessibility, and inclusivity of laryngology mobile applications. Of the 3230 apps identified from the Apple and Google Play stores, 28 patient-facing apps met inclusion criteria. Apps were evaluated using validated scales assessing quality and functionality: the Mobile App Rating Scale (MARS) and the Institute for Healthcare Informatics App Functionality Scale. The Clear Communication Index (CDC) Institute of Medicine Strategies for Creating Health Literate Mobile Applications, and Patient Education Materials Assessment Tool (PEMAT) were used to evaluate apps health literacy level. Readability was assessed using established readability formulas. Apps were evaluated for language, accessibility features, and representation of a diverse population. Twenty-six apps (92%) had adequate quality (MARS score > 3). The mean PEMAT score was 89% for actionability and 86% for understandability. On average, apps utilized 25/33 health literate strategies. Twenty-two apps (79%) did not pass the CDC index threshold of 90% for health literacy. Twenty-four app descriptions (86%) were above an 8th grade reading level. Only 4 apps (14%) showed diverse representation, 3 (11%) had non-English language functions, and 2 (7%) offered subtitles. Inter-rater reliability for MARS was adequate (CA-ICC=0.715). While most apps scored well in quality and functionality, many laryngology apps did not meet standards for health literacy. Most apps were written at a reading level above the national average, lacked accessibility features, and did not represent diverse populations. Laryngoscope, 133:1540-1549, 2023.

Measuring Mobile Phone Application Usability for Anticoagulation from the Perspective of Patients, Caregivers, and Healthcare Professionals.

Oral anticoagulants (OAC) are recommended for preventing stroke and systemic embolism in atrial fibrillation. Proper use is imperative for maximizing anticoagulation therapy’s effectiveness and safety. In preparation for the implementation of a smartphone-based SmartMed app (application) aiming to promote patient self-management, medication adherence, and data collection for patients on anticoagulation therapy, its usability assessment can ensure the value of OAC app development and adoption. We evaluated the SmartMed app’s usability using the System Usability Scale (SUS) and the app-specific domain of the Mobile App Rating Scale (MARS) for its perceived impact on taking OAC regularly. We recruited 25 OAC users and their home caregivers and 59 healthcare professionals, including pharmacists, nurses, and cardiac surgeons from one medical center and one regional hospital in Taiwan. All participants (n = 84) thought the SmartMed app was useful, with mean SUS and MARS scores of 81.49 (±14.42) and 4.65 (±0.49), respectively. Usability evaluation revealed that fewer experiences with smartphone apps and different healthcare professionals (pharmacists versus nurses or cardiac surgeons) were associated with lower SUS scores and perceived impact. Throughout the evaluation process, the SmartMed app’s design was considered helpful from multiple stakeholders’ perspectives. Further ongoing mobile technology supports are necessary to establish the SmartMed app’s effectiveness.