Abstract
Purpose :
Digital health applications (apps) offer users with diabetes the ability to monitor their condition from home, however, there are inconsistencies in how these apps are designed and developed. We investigated the extent to which diabetes apps abided by the best practice evidence standards frameworks for digital health technologies (DTAC, 2021; NICE, 2021) by performing a systematic review to identify relevant apps and exploring how their design process performed against prescribed frameworks.
Methods :
We analysed articles published in English from 2017 in Medline and EMBASE. We included studies about any digital health technologies used exclusively by patients with Diabetes that were available on a smartphone or tablet. Two reviewers independently screened studies for inclusion, with a senior reviewer acting as arbitrator. Relevant data from included studies were extracted and checked for accuracy. A framework was created based on the best practice guidelines and studies were scored on adherence and presented using descriptive statistics and proportions.
Results :
The initial search identified 461 studies, of which 77 full texts were reviewed for eligibility, of these, 32 met the inclusion criteria and 44 were excluded due to being conference abstracts n=13, wrong outcomes; n=10, wrong study design; n=8 and wrong setting; n=8 (Figure 1).
Studies focused on Type 1 DM; n=9, Type 2 DM; n=14, both; n=6, or gestational DM; n=3. The studies spanned a total of 23 countries, with most studies originating from the USA; n=8, Australia; n=5, UK; n=2, Brazil; n=2 and Canada; n=2.
Across the included studies, a high percentage of studies did not adhere to guidelines on equalities considerations (93.8%), provide sufficient evidence of accurate and reliable measurements (78.1%), assess app accuracy (87.5%) or provide appropriate quality and safeguarding criteria (59.4%).
Conclusions :
Our results demonstrate that most diabetes digital health apps do not abide by the best practice development standards. Increased focus should be directed towards gaining high quality user feedback, ensuring the accuracy of app measurements are known, and giving more consideration to issues of equality in the design, as this would prevent research wastage in the longer term.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.