Schar School of Policy and Government, George Mason University, Arlington, VA, United States.
University of Massachusetts Boston, Boston, MA, United States.
JMIR Mhealth Uhealth. 2019 Sep 4;7(9):e12604. doi: 10.2196/12604.
Numerous free and low-cost mobile apps for the care management of kidney disease have become available in recent years. Although these appear to be promising tools, they have not been evaluated comparatively based on standard mobile app metrics, and thus, limited evidence is available regarding their efficacy. This study systematically cataloged and assessed mobile apps designed to assist medication compliance and nutrition tracking that are useful to the chronic kidney disease (CKD) and the end-stage renal disease (ESRD) patients who are on dialysis.
The objective of this study was to comprehensively evaluate mobile apps used for medication compliance and nutrition tracking for possible use by CKD and ESRD patients.
A systematic review framework was applied to the search, screening, and assessment of apps identified and downloaded from the iOS and Android app stores. We selected apps using 13 relevant search terms, narrowed down based on a set of inclusion and exclusion criteria, and then used the Mobile App Rating Scale (MARS), a widely adopted app evaluation tool to assess the effectiveness of apps. The internal consistency and interrater reliability were tested using Cronbach alpha and interclass correlation coefficients (ICCs), respectively.
The MARS total score had excellent internal consistency (Cronbach alpha=.90) and a moderate level of interrater reliability (2-way mixed ICC 0.65). Overall, 11 out of the 12 reviewed apps met the minimum acceptable score of 3.0 in MARS rating. The 3 apps with the highest combined scores were My Kidneys, My Health Handbook (MARS=4.68); My Food Coach (MARS=4.48); and National Kidney Foundation Malaysia (MARS=4.20). The study identified 2 general weaknesses in the existing apps: the apps fell short of accommodating advanced interactive features such as providing motivational feedback and promoting family member and caregiver participations in the app utilization.
The MARS rating system performed well in the app evaluation. The 3 highest ranked apps scored consistently high across the 5 dimensions specified in MARS. These apps were developed in collaboration with reputable organizations and field experts, demonstrating the importance of expert guidance in developing medical apps.
近年来，出现了许多免费和低成本的用于肾病管理的移动应用程序。尽管这些应用程序似乎很有前景，但它们尚未根据标准移动应用程序指标进行比较评估，因此，关于它们的疗效的证据有限。本研究系统地对旨在帮助药物依从性和营养跟踪的移动应用程序进行了分类和评估，这些应用程序对接受透析治疗的慢性肾脏病（CKD）和终末期肾脏疾病（ESRD）患者有用。
本研究的目的是全面评估用于药物依从性和营养跟踪的移动应用程序，以便 CKD 和 ESRD 患者可能使用。
应用系统评价框架对从 iOS 和 Android 应用商店中搜索、筛选和评估的应用程序进行了搜索、筛选和评估。我们使用 13 个相关搜索词选择应用程序，根据一套包含和排除标准进行了筛选，然后使用广泛采用的应用程序评估工具移动应用程序评级量表（MARS）评估应用程序的有效性。使用 Cronbach alpha 和组内相关系数（ICC）分别测试内部一致性和评分者间信度。
MARS 总分具有良好的内部一致性（Cronbach alpha=.90）和中等水平的评分者间信度（2 路混合 ICC 0.65）。总体而言，12 个审查的应用程序中有 11 个在 MARS 评分中达到了 3.0 的最低可接受分数。综合得分最高的 3 个应用程序是“My Kidneys, My Health Handbook”（MARS=4.68）；“My Food Coach”（MARS=4.48）；以及“马来西亚国家肾脏基金会”（MARS=4.20）。研究发现现有应用程序存在 2 个普遍弱点：应用程序缺乏容纳高级交互功能的能力，例如提供激励反馈并促进家庭成员和护理人员参与应用程序的使用。
MARS 评分系统在应用程序评估中表现良好。前 3 名得分最高的应用程序在 MARS 规定的 5 个维度上均取得了较高的一致得分。这些应用程序是与知名组织和领域专家合作开发的，这表明在开发医疗应用程序时专家指导的重要性。
