Mazzi Christian P, Kidd Michael
Faculty of Medicine, The University of Sydney, Chatswood, NSW 2067 Australia.
J Med Internet Res. 2002 Jan-Mar;4(1):e1. doi: 10.2196/jmir.4.1.e1.
While still in its infancy, Internet-based diabetes management shows great promise for growth. However, the following aspects must be considered: what are the key metrics for the evaluation of a diabetes-management site? how should these sites grow in the future and what services should they offer?
The purpose of this paper is to examine the needs of the patient and the health care professional in an Internet-based diabetes-management solution and how these needs are translated into services offered.
An evaluation framework was constructed based on a literature review that identified the requirements for an Internet-based-diabetes-management solution. The requirements were grouped into 5 categories: Monitoring, Information, Personalization, Communication, and Technology. Two of the market leaders (myDiabetes and LifeMasters) were selected and were evaluated with the framework. The Web sites were evaluated independently by 5 raters using the evaluation framework. All evaluations were performed from November 1, 2001 through December 15, 2001.
The agreement level between raters ranged from 60% to 100%. The multi-rater reliability (kappa) was 0.75 for myDiabetes and 0.65 for LifeMasters, indicating substantial agreement. The results of the evaluations indicate that LifeMasters is a more-complete solution than myDiabetes in all dimensions except Information, where both sites were equivalent. LifeMasters satisfied 32 evaluation criteria while myDiabetes satisfied 24 evaluation criteria, out of a possible 40 in the framework.
The framework is based on the recognition that the management of diabetes via the Internet is based on several integrated dimensions: Monitoring, Information, Personalization, Communication, and Technology. A successful diabetes-management system should efficiently integrate all dimensions. The evaluation found that LifeMasters is successful in integrating the health care professional in the management of diabetes and that MyDiabetes is quite effective in providing a communication channel for community creation (however, communication with the health care professional is lacking).
基于互联网的糖尿病管理虽仍处于起步阶段，但展现出了巨大的增长潜力。然而，必须考虑以下几个方面：评估糖尿病管理网站的关键指标有哪些？这些网站未来应如何发展，又应提供哪些服务？
本文旨在探讨基于互联网的糖尿病管理解决方案中患者和医疗保健专业人员的需求，以及这些需求如何转化为所提供的服务。
基于文献综述构建了一个评估框架，该综述确定了基于互联网的糖尿病管理解决方案的要求。这些要求被分为五类：监测、信息、个性化、沟通和技术。选择了两家市场领先者（myDiabetes和LifeMasters）并使用该框架进行评估。5名评估者使用评估框架对这些网站进行独立评估。所有评估均在2001年11月1日至2001年12月15日期间进行。
评估者之间的一致程度在60%至100%之间。myDiabetes的多评估者信度（kappa）为0.75，LifeMasters为0.65，表明有实质性的一致性。评估结果表明，在除信息维度外的所有维度上，LifeMasters都是比myDiabetes更完整的解决方案，在信息维度上两个网站相当。在框架中可能的40项标准中，LifeMasters满足32项评估标准，而myDiabetes满足24项评估标准。
该框架基于这样的认识，即通过互联网进行糖尿病管理基于几个综合维度：监测、信息、个性化、沟通和技术。一个成功的糖尿病管理系统应有效地整合所有维度。评估发现，LifeMasters在将医疗保健专业人员纳入糖尿病管理方面很成功，而MyDiabetes在提供创建社区的沟通渠道方面相当有效（然而，与医疗保健专业人员的沟通不足）。
