PDF(Pubmed)
Abstract：
There are more than 350,000 digital health interventions (DHIs) in the app stores. To ensure that they are effective and safe to use, they should be assessed for compliance with best practice standards.
The objective of this paper was to examine and compare the compliance of DHIs with best practice standards and adherence to user experience (UX), professional and clinical assurance (PCA), and data privacy (DP).
We collected assessment data from 1574 DHIs using the Organisation for the Review of Care and Health Apps Baseline Review (OBR) assessment tool. As part of the assessment, each DHI received a score out of 100 for each of the abovementioned areas (ie, UX, PCA, and DP). These 3 OBR scores are combined to make up the overall ORCHA score (a proxy for quality). Inferential statistics, probability distributions, Kruskal-Wallis, Wilcoxon rank sum test, Cliff delta, and Dunn tests were used to conduct the data analysis.
We found that 57.3% (902/1574) of the DHIs had an Organisation for the Review of Care and Health Apps (ORCHA) score below the threshold of 65. The overall median OBR score (ORCHA score) for all DHIs was 61.5 (IQR 51.0-73.0) out of 100. A total of 46.2% (12/26) of DHI\'s health care domains had a median equal to or above the ORCHA threshold score of 65. For the 3 assessment areas (UX, DP, and PCA), DHIs scored the highest for the UX assessment 75.2 (IQR 70.0-79.6), followed by DP 65.1 (IQR 55.0-73.4) and PCA 49.6 (IQR 31.9-76.1). UX scores had the least variance (SD 13.9), while PCA scores had the most (SD 24.8). Respiratory and urology DHIs were consistently highly ranked in the National Institute for Health and Care Excellence Evidence Standards Framework tiers B and C based on their ORCHA score.
There is a high level of variability in the ORCHA scores of DHIs across different health care domains. This suggests that there is an urgent need to improve compliance with best practices in some health care areas. Possible explanations for the observed differences might include varied market maturity and commercial interests within the different health care domains. More investment to support the development of higher-quality DHIs in areas such as ophthalmology, allergy, women\'s health, sexual health, and dental care may be needed.
The objective of this paper was to examine and compare the compliance of DHIs with best practice standards and adherence to user experience (UX), professional and clinical assurance (PCA), and data privacy (DP).
We collected assessment data from 1574 DHIs using the Organisation for the Review of Care and Health Apps Baseline Review (OBR) assessment tool. As part of the assessment, each DHI received a score out of 100 for each of the abovementioned areas (ie, UX, PCA, and DP). These 3 OBR scores are combined to make up the overall ORCHA score (a proxy for quality). Inferential statistics, probability distributions, Kruskal-Wallis, Wilcoxon rank sum test, Cliff delta, and Dunn tests were used to conduct the data analysis.
We found that 57.3% (902/1574) of the DHIs had an Organisation for the Review of Care and Health Apps (ORCHA) score below the threshold of 65. The overall median OBR score (ORCHA score) for all DHIs was 61.5 (IQR 51.0-73.0) out of 100. A total of 46.2% (12/26) of DHI\'s health care domains had a median equal to or above the ORCHA threshold score of 65. For the 3 assessment areas (UX, DP, and PCA), DHIs scored the highest for the UX assessment 75.2 (IQR 70.0-79.6), followed by DP 65.1 (IQR 55.0-73.4) and PCA 49.6 (IQR 31.9-76.1). UX scores had the least variance (SD 13.9), while PCA scores had the most (SD 24.8). Respiratory and urology DHIs were consistently highly ranked in the National Institute for Health and Care Excellence Evidence Standards Framework tiers B and C based on their ORCHA score.
There is a high level of variability in the ORCHA scores of DHIs across different health care domains. This suggests that there is an urgent need to improve compliance with best practices in some health care areas. Possible explanations for the observed differences might include varied market maturity and commercial interests within the different health care domains. More investment to support the development of higher-quality DHIs in areas such as ophthalmology, allergy, women\'s health, sexual health, and dental care may be needed.
摘要：
背景：应用程序商店中有超过350,000种数字健康干预措施（DHI）。为了确保它们有效和安全地使用，应评估他们是否符合最佳实践标准。
目的：本文的目的是研究和比较DHI与最佳实践标准的合规性以及对用户体验（UX）的依从性，专业和临床保证(PCA)，数据隐私（DP）。
方法：我们使用护理和健康应用审查组织基线审查（OBR）评估工具从1574个DHI收集了评估数据。作为评估的一部分,每个DHI在上述每个领域都获得了100分的分数(即，UX,PCA,和DP）。将这3个OBR得分组合以构成总体ORCHA得分(质量的代理)。推论统计，概率分布，Kruskal-Wallis,Wilcoxon秩和检验,悬崖三角洲,采用Dunn检验进行数据分析。
结果：我们发现57.3%(902/1574)的DHI的护理和健康应用审查组织(ORCHA)评分低于65的阈值。所有DHI的总体中位OBR评分（ORCHA评分）为100分中的61.5分（IQR51.0-73.0分）。DHI的医疗保健领域中有46.2％（12/26）的中位数等于或高于ORCHA阈值65分。对于3个评估领域(UX，DP,和PCA)，DHI在UX评估中得分最高75.2（IQR70.0-79.6），其次是DP65.1（IQR55.0-73.4）和PCA49.6（IQR31.9-76.1）。UX分数方差最小(SD13.9)，而PCA评分最多（SD24.8）。根据其ORCHA评分，呼吸和泌尿科DHI在美国国家健康与护理研究所卓越证据标准框架B和C级中始终排名很高。
结论：在不同的医疗保健领域中，DHI的ORCHA评分存在高度差异。这表明，迫切需要改善某些医疗保健领域对最佳做法的遵守情况。对观察到的差异的可能解释可能包括不同医疗保健领域内的不同市场成熟度和商业利益。加大投入,支持在眼科等领域开发更高质量的DHIs,过敏,妇女的健康，性健康,可能需要牙科护理。
目的：本文的目的是研究和比较DHI与最佳实践标准的合规性以及对用户体验（UX）的依从性，专业和临床保证(PCA)，数据隐私（DP）。
方法：我们使用护理和健康应用审查组织基线审查（OBR）评估工具从1574个DHI收集了评估数据。作为评估的一部分,每个DHI在上述每个领域都获得了100分的分数(即，UX,PCA,和DP）。将这3个OBR得分组合以构成总体ORCHA得分(质量的代理)。推论统计，概率分布，Kruskal-Wallis,Wilcoxon秩和检验,悬崖三角洲,采用Dunn检验进行数据分析。
结果：我们发现57.3%(902/1574)的DHI的护理和健康应用审查组织(ORCHA)评分低于65的阈值。所有DHI的总体中位OBR评分（ORCHA评分）为100分中的61.5分（IQR51.0-73.0分）。DHI的医疗保健领域中有46.2％（12/26）的中位数等于或高于ORCHA阈值65分。对于3个评估领域(UX，DP,和PCA)，DHI在UX评估中得分最高75.2（IQR70.0-79.6），其次是DP65.1（IQR55.0-73.4）和PCA49.6（IQR31.9-76.1）。UX分数方差最小(SD13.9)，而PCA评分最多（SD24.8）。根据其ORCHA评分，呼吸和泌尿科DHI在美国国家健康与护理研究所卓越证据标准框架B和C级中始终排名很高。
结论：在不同的医疗保健领域中，DHI的ORCHA评分存在高度差异。这表明，迫切需要改善某些医疗保健领域对最佳做法的遵守情况。对观察到的差异的可能解释可能包括不同医疗保健领域内的不同市场成熟度和商业利益。加大投入,支持在眼科等领域开发更高质量的DHIs,过敏,妇女的健康，性健康,可能需要牙科护理。
