Clinical Effectiveness, Feasibility, Acceptability and Usability in Mobile Health Applications for Epilepsy: A Systematic Review
Abstract number :
1.132
Submission category :
13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year :
2024
Submission ID :
1031
Source :
www.aesnet.org
Presentation date :
12/7/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Evelyn Gotlieb, BS – Icahn School of Medicine at Mount Sinai
Shahab Marzoughi, MD (in progress) – University of Calgary
Churl-Su Kwon, MD, MPH – Columbia University
MIchael Harmon, BA – Icahn School of Medicine at Mount Sinai
Maren Kimura, BHSc, MPH – University of Calgary
Ashley Truesdale, BMSc – University of Calgary
Chloe Sweetnam, MSc – The Kinetix Group
Celine Soundant, MLIS – Memorial Sloan Kettering Cancer Center
Margaret H. Downes, BA – Icahn School of Medicine at Mount Sinai
Neil A. Busis, MD – NYU Grossman School of Medicine
Benjamin Kummer, MD – Icahn School of Medicine at Mount Sinai
Nathalie Jette, MD, MSc – Cumming School of Medicine at the University of Calgary
Rationale: Mobile applications are widely used by people with epilepsy, their caregivers, and providers. The impact of these applications on the clinical effectiveness (CE) and feasibility, acceptability, or usability (FAU) in epilepsy remains unclear.
Methods: We conducted a systematic review of studies investigating the CE and FAU of mobile applications in epilepsy using MEDLINE ALL (Ovid) and EMBASE (Ovid) from database inception to July 2023. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting standards were followed. The protocol was registered on PROSPERO (CRD42019134848). We determined study quality for case-control or cohort studies using the Newcastle-Ottawa Quality Assessment Scale (NOQAS) and bias in randomized studies using the Cochrane Collaboration Handbook Risk of Bias tool. We assessed usability study quality using the validated 15-point Silva scale. All steps were completed in duplicate by two study authors and disagreement was resolved through discussion or involvement of a third author.
Results: We identified 7,967 studies, of which 15 were included. Of the 15 studies, 9 (60.0%) addressed CE, 7 (46.6%) acceptability, 5 (33.3%) usability, and 5 (33.3%) feasibility. Four studies (26.7%) evaluated both CE and FAU. Studies comprised prospective cohort (N=6, 40.0%), pilot (N=3, 20.0%), randomized trial (N=5, 33.3%) and pre/post (N=1, 6.7%) designs. Overall, cohort studies demonstrated fair quality (median NOQAS score 5, interquartile range [IQR] 5.0 - 5.8), whereas 3 (60.0%) randomized studies had some concern for bias. Usability studies demonstrated high methodological quality (median Silva score 10, IQR 10 - 11). Apps were most frequently studied in patient users (N=7 (77.8%) CE and 9 (100%) FAU studies). The most common app target in CE studies was physical health (N=5, 55.6%) contrasting with symptom management (N=8, 88.9%) in FAU studies.
Conclusions: Application use in epilepsy most commonly studied CE and evaluated patient-facing apps. Despite high methodological quality in usability studies and several randomized CE studies, cohort and randomized studies demonstrated fair quality and moderate bias, respectively. Additional high-quality evidence is necessary to evaluate the CE and FAU of app use in epilepsy.
Funding: None
Health Services (Delivery of Care, Access to Care, Health Care Models)