Nagino Ken, Sung Jaemyoung, Midorikawa-Inomata Akie, Eguchi Atsuko, Fujimoto Keiichi, Okumura Yuichi, Miura Maria, Yee Alan, Hurramhon Shokirova, Fujio Kenta, Akasaki Yasutsugu, Hirosawa Kunihiko, Huang Tianxiang, Ohno Mizu, Morooka Yuki, Zou Xinrong, Kobayashi Hiroyuki, Inomata Takenori
Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Ophthalmol Sci. 2023 May 31;4(1):100342. doi: 10.1016/j.xops.2023.100342. eCollection 2024 Jan-Feb.
Numerous smartphone applications have been devised for diagnosis, treatment, and symptom management in ophthalmology. Despite the importance of systematic evaluation of the purpose, target disease, effectiveness, and utility of smartphone applications to their effective utilization, few studies have formally evaluated their validity, reliability, and clinical utility.
This report identifies smartphone applications with potential for clinical implementation in ophthalmology and summarizes the evidence on their practical utility.
We searched PubMed and EMBASE on July 28, 2022, for articles reporting original data on the effectiveness of treatment, disease detection, diagnostic accuracy, disease monitoring, and usability of smartphone applications in ophthalmology published between January 1, 1987, and July 25, 2022. Their quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist.
The initial search yielded 510 articles. After removing 115 duplicates and 285 articles based on inclusion and exclusion criteria, the full texts of the remaining 110 articles were reviewed. Furthermore, 71 articles were included in the final qualitative synthesis. All studies were determined to be of high (87.3%) or moderate (12.7%) quality. In terms of respective application of interest, 24 (33.8%) studies assessed diagnostic accuracy, 17 (23.9%) assessed disease detection, and 3 (4.2%) assessed intervention efficacy. A total of 48 smartphone applications were identified, of which 27 (56.3%) were publicly available. Seventeen (35.4%) applications included functions for ophthalmic examinations, 13 (27.1%) included functions aimed at disease detection, 10 (20.8%) included functions to support medical personnel, five (10.4%) included functions related to disease education, and three (6.3%) included functions to promote treatment adherence for patients. The largest number of applications targeted amblyopia (18.8%), followed by retinal disease (10.4%). Two (4.2%) smartphone applications reported significant efficacy in treating diseases.
In this systematic review, a comprehensive appraisal is presented on studies related to diagnostic accuracy, disease detectability, and efficacy of smartphone applications in ophthalmology. Forty-eight applications with potential clinical utility are identified. Appropriate smartphone applications are expected to enable early detection of undiagnosed diseases via telemedicine and prevent visual dysfunction via remote monitoring of chronic diseases.
Proprietary or commercial disclosure may be found after the references.
已经设计出许多智能手机应用程序用于眼科的诊断、治疗和症状管理。尽管对智能手机应用程序的目的、目标疾病、有效性和实用性进行系统评估对其有效利用很重要，但很少有研究正式评估它们的有效性、可靠性和临床实用性。
本报告识别出具有眼科临床应用潜力的智能手机应用程序，并总结了其实际效用的证据。
我们于2022年7月28日在PubMed和EMBASE上检索了1987年1月1日至2022年7月25日期间发表的关于智能手机应用程序在眼科治疗效果、疾病检测、诊断准确性、疾病监测和可用性的原始数据的文章。使用乔安娜·布里格斯研究所的批判性评价清单对其质量进行评估。
初步检索得到510篇文章。根据纳入和排除标准去除115篇重复文章和285篇文章后，对其余110篇文章的全文进行了审查。此外，71篇文章被纳入最终的定性综合分析。所有研究的质量均被判定为高（87.3%）或中等（12.7%）。就各自感兴趣的应用而言，24项（33.8%）研究评估了诊断准确性，17项（23.9%）评估了疾病检测，3项（4.2%）评估了干预效果。总共识别出48款智能手机应用程序，其中27款（56.3%）是公开可用的。17款（35.4%）应用程序包括眼科检查功能，13款（27.1%）包括疾病检测功能，10款（20.8%）包括支持医务人员的功能，5款（10.4%）包括与疾病教育相关的功能，3款（6.3%）包括促进患者治疗依从性的功能。应用程序针对弱视的数量最多（18.8%），其次是视网膜疾病（10.4%）。两款（4.2%）智能手机应用程序报告了在治疗疾病方面的显著疗效。
在本系统评价中，对智能手机应用程序在眼科的诊断准确性、疾病可检测性和疗效相关研究进行了全面评估。识别出48款具有潜在临床效用的应用程序。适当的智能手机应用程序有望通过远程医疗实现未诊断疾病的早期检测，并通过慢性病的远程监测预防视觉功能障碍。
专有或商业披露信息可在参考文献之后找到。
