Critical appraisal of a mHealth-assisted community-based cardiovascular disease risk screening program in rural Kenya: an operational research study

Aw, Michael; Ochieng, Benard; Attambo, Daniel; Opot, Danet; Aw, James; Francis, Stacy; Hawkes, Michael

doi:10.1080/20477724.2020.1816286

Cited by 13 publications

(28 citation statements)

References 37 publications

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“…However, their adoption and implementation in full capacity face challenges in terms of infrastructure, training, access to better devices such as smartphones, and some hesitancies from patients and providers. Such challenges have been reported in studies from other African countries including Uganda, 93,94 Kenya, 95,96,97,98 , and Tanzania. 99,100…”

Section: Discussionmentioning

confidence: 59%

The potential of digital health technologies in African context, Ethiopia

Manyazewal

Woldeamanuel

Blumberg

et al. 2021

Preprint

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The World Health Organization (WHO) recently put forth a Global Strategy on Digital Health 2020 - 2025 with several countries having already achieved key milestones. We aimed to understand whether and how digital health technologies (DHTs) are absorbed in Africa, tracking Ethiopia as a key node. We conducted a systematic review, searching PubMed-MEDLINE, ScienceDirect, African Journals Online, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform databases from inception to 02 February 2021 for studies of any design that investigated the potential of DHTs in clinical or public health practices in Ethiopia. This review was designed to inform our ongoing DHT-enabled randomized controlled trial (RCT) (ClinicalTrials.gov ID: NCT04216420). We found 23,897 potentially-relevant citations, among which 47 studies met the inclusion criteria, comprising a total of 594,999 patients, healthy individuals, and healthcare professionals. The studies involved seven DHTs: mHealth (25 studies, 573,623 participants); electronic health records (13 studies, 4,534 participants); telemedicine (3 studies, 445 participants); cloud-based application (2 studies, 2,382 participants); genomics data (1 study, 47 participants); information communication technology (2 studies, 551 participants), and artificial intelligence (1 study, 13,417 participants). The studies targeted six health conditions: maternal and child health (15), infectious diseases (11), non-communicable diseases (3), dermatitis (1), surgery (3), and general health conditions (14). The outcomes of interest were feasibility, usability, willingness or readiness, effectiveness, quality improvement, and knowledge or attitude towards DHTs. Four studies involved RCTs. The analysis showed that although DHTs are a relatively recent phenomenon in Ethiopia, their potential harnessing clinical and public health practices are highly visible. Their adoption and implementation in full capacity requires more training, access to better devices such as smartphones, and infrastructure. DHTs hold much promise tackling major clinical and public health backlogs and strengthening the healthcare ecosystem in Africa. More RCTs are needed on emerging DHTs including artificial intelligence, big data, cloud, genomics data, cybersecurity, telemedicine, and wearable devices to provide robust evidence of their potential use in such settings and to materialize the WHO's Global Digital Health Strategy. Keywords: Digital Health, mHealth, Electronic medical records, Telemedicine, eHealth, Information communication technology, Africa, Ethiopia.

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Section: Discussionmentioning

confidence: 59%

The potential of digital health technologies in African context, Ethiopia

Manyazewal

Woldeamanuel

Blumberg

et al. 2021

Preprint

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“…However, their adoption and implementation in full capacity face challenges in terms of infrastructure, training, access to better devices such as smartphones, and some hesitancies from patients and providers. Such challenges have been reported in studies from other African countries including Uganda 100 , 101 , Kenya 102 – 105 , and Tanzania 106 , 107 . A meta-analysis was not conducted due to the heterogeneous nature of the compiled studies.…”

Section: Discussionmentioning

confidence: 60%

The potential use of digital health technologies in the African context: a systematic review of evidence from Ethiopia

et al. 2021

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The World Health Organization (WHO) recently put forth a Global Strategy on Digital Health 2020–2025 with several countries having already achieved key milestones. We aimed to understand whether and how digital health technologies (DHTs) are absorbed in Africa, tracking Ethiopia as a key node. We conducted a systematic review, searching PubMed-MEDLINE, Embase, ScienceDirect, African Journals Online, Cochrane Central Registry of Controlled Trials, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform databases from inception to 02 February 2021 for studies of any design that investigated the potential of DHTs in clinical or public health practices in Ethiopia. This review was registered with PROSPERO (CRD42021240645) and it was designed to inform our ongoing DHT-enabled randomized controlled trial (RCT) (ClinicalTrials.gov ID: NCT04216420). We found 27,493 potentially relevant citations, among which 52 studies met the inclusion criteria, comprising a total of 596,128 patients, healthy individuals, and healthcare professionals. The studies involved six DHTs: mHealth (29 studies, 574,649 participants); electronic health records (13 studies, 4534 participants); telemedicine (4 studies, 465 participants); cloud-based application (2 studies, 2382 participants); information communication technology (3 studies, 681 participants), and artificial intelligence (1 study, 13,417 participants). The studies targeted six health conditions: maternal and child health (15), infectious diseases (14), non-communicable diseases (3), dermatitis (1), surgery (4), and general health conditions (15). The outcomes of interest were feasibility, usability, willingness or readiness, effectiveness, quality improvement, and knowledge or attitude toward DHTs. Five studies involved RCTs. The analysis showed that although DHTs are a relatively recent phenomenon in Ethiopia, their potential harnessing clinical and public health practices are highly visible. Their adoption and implementation in full capacity require more training, access to better devices such as smartphones, and infrastructure. DHTs hold much promise tackling major clinical and public health backlogs and strengthening the healthcare ecosystem in Ethiopia. More RCTs are needed on emerging DHTs including artificial intelligence, big data, cloud, cybersecurity, telemedicine, and wearable devices to provide robust evidence of their potential use in such settings and to materialize the WHO’s Global Strategy on Digital Health.

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“…Several apps were used in the studies to screen for disease by recording user perceptions [ 18 , 22 , 23 ], capturing physiological recordings [ 16 , 17 ], and obtaining clinical readings/recordings [ 15 , 19 , 20 , 21 ]. The number of study participants varied between fifteen [ 18 ] and over two thousand [ 15 , 22 ].…”

Section: Resultsmentioning

confidence: 99%

“…The number of study participants varied between fifteen [ 18 ] and over two thousand [ 15 , 22 ]. The studies were experimental [ 15 , 19 ] and observational [ 16 , 17 , 18 , 20 , 21 , 22 , 23 ]. Table 3 represents the countries in which the studies took place and the economic status and mobile cellular subscriptions per 100 people; the latter show an upward trend in cellular subscriptions over the years [ 24 , 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…Table 3 represents the countries in which the studies took place and the economic status and mobile cellular subscriptions per 100 people; the latter show an upward trend in cellular subscriptions over the years [ 24 , 25 ]. Figure 2 illustrates the app functionalities to screen chronic illness, such as CVD [ 16 ], central sleep apnoea [ 17 ], cognitive impairment [ 18 ], depression [ 22 , 23 ], eye disease [ 15 , 20 , 21 ], and hearing loss [ 19 ]. In a single session, screening for CVD, eye disease and hearing loss were performed [ 15 , 16 , 19 , 20 , 21 ].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Smartphone as a Disease Screening Tool: A Systematic Review

Moses

Adibi

Wickramasinghe

et al. 2022

Sensors

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Disease screening identifies a disease in an individual/community early to effectively prevent or treat the condition. COVID-19 has restricted hospital visits for screening and other healthcare services resulting in the disruption of screening for cancer, diabetes, and cardiovascular diseases. Smartphone technologies, coupled with built-in sensors and wireless technologies, enable the smartphone to function as a disease-screening and monitoring device with negligible additional costs and potentially higher quality results. Thus, we sought to evaluate the use of smartphone applications for disease screening and the acceptability of this technology in the medical and healthcare sectors. We followed a systematic review process using four databases, including Medline Complete, Web of Science, Embase, and Proquest. We included articles published in English examining smartphone application utilisation in disease screening. Further, we presented and discussed the primary outcomes of the research articles and their statistically significant value. The initial search yielded 1046 studies for the initial title and abstract screening. Of the 105 articles eligible for full-text screening, we selected nine studies and discussed them in detail under four main categories: an overview of the literature reviewed, participant characteristics, disease screening, and technology acceptance. According to our objective, we further evaluated the disease-screening approaches and classified them as clinically administered screening (33%, n = 3), health-worker-administered screening (33%, n = 3), and home-based screening (33%, n = 3). Finally, we analysed the technology acceptance among the users and healthcare practitioners. We observed a significant statistical relationship between smartphone applications and standard clinical screening. We also reviewed user acceptance of these smartphone applications. Hence, we set out critical considerations to provide equitable healthcare solutions without barriers when designing, developing, and deploying smartphone solutions. The findings may increase research opportunities for the evaluation of smartphone solutions as valid and reliable screening solutions.

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Critical appraisal of a mHealth-assisted community-based cardiovascular disease risk screening program in rural Kenya: an operational research study

Cited by 13 publications

References 37 publications

The potential of digital health technologies in African context, Ethiopia

The potential of digital health technologies in African context, Ethiopia

The potential use of digital health technologies in the African context: a systematic review of evidence from Ethiopia

Smartphone as a Disease Screening Tool: A Systematic Review

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