Geldsetzer Pascal, Flores Sergio, Wang Grace, Flores Blanca, Rogers Abu Bakarr, Bunker Aditi, Chang Andrew Y, Tisdale Rebecca
Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, CA, USA.
Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.
NPJ Digit Med. 2022 Jul 19;5(1):99. doi: 10.1038/s41746-022-00644-3.
Mobile health (mHealth) interventions hold promise for addressing the epidemic of noncommunicable diseases (NCDs) in low- and middle-income countries (LMICs) by assisting healthcare providers managing these disorders in low-resource settings. We aimed to systematically identify and assess provider-facing mHealth applications used to screen for, diagnose, or monitor NCDs in LMICs. In this systematic review, we searched the indexing databases of PubMed, Web of Science, and Cochrane Central for studies published between January 2007 and October 2019. We included studies of technologies that were: (i) mobile phone- or tablet-based, (ii) able to screen for, diagnose, or monitor an NCD of public health importance in LMICs, and (iii) targeting health professionals as users. We extracted disease type, intervention purpose, target population, study population, sample size, study methodology, technology stage, country of development, operating system, and cost. Our initial search retrieved 13,262 studies, 315 of which met inclusion criteria and were analyzed. Cardiology was the most common clinical domain of the technologies evaluated, with 89 publications. mHealth innovations were predominantly developed using Apple's iOS operating system. Cost data were provided in only 50 studies, but most technologies for which this information was available cost less than 20 USD. Only 24 innovations targeted the ten NCDs responsible for the greatest number of disability-adjusted life years lost globally. Most publications evaluated products created in high-income countries. Reported mHealth technologies are well-developed, but their implementation in LMICs faces operating system incompatibility and a relative neglect of NCDs causing the greatest disease burden.
移动健康（mHealth）干预措施有望通过协助医疗服务提供者在资源匮乏地区管理非传染性疾病（NCDs），来应对低收入和中等收入国家（LMICs）的非传染性疾病流行问题。我们旨在系统地识别和评估用于在低收入和中等收入国家筛查、诊断或监测非传染性疾病的面向医疗服务提供者的移动健康应用程序。在这项系统评价中，我们检索了PubMed、科学网和Cochrane中心的索引数据库，以查找2007年1月至2019年10月期间发表的研究。我们纳入了以下技术的研究：（i）基于手机或平板电脑的；（ii）能够在低收入和中等收入国家筛查、诊断或监测具有公共卫生重要性的非传染性疾病；（iii）以卫生专业人员为目标用户。我们提取了疾病类型、干预目的、目标人群、研究人群、样本量、研究方法、技术阶段、开发国家、操作系统和成本。我们的初步检索共获得13262项研究，其中315项符合纳入标准并进行了分析。心脏病学是所评估技术中最常见的临床领域，有89篇出版物。移动健康创新主要是使用苹果的iOS操作系统开发的。只有50项研究提供了成本数据，但大多数有此信息的技术成本低于20美元。只有24项创新针对导致全球残疾调整生命年损失最多的十种非传染性疾病。大多数出版物评估的是在高收入国家创建的产品。报道的移动健康技术已经很成熟，但它们在低收入和中等收入国家的实施面临操作系统不兼容以及对造成最大疾病负担的非传染性疾病相对忽视的问题。
