Eczema apps conformance with clinical guidelines: a systematic assessment of functions, tools and content

Abstract

Summary Background Eczema is a prevalent complex skin condition requiring active disease monitoring and personalized education. No studies have assessed the quality of apps that aim to support eczema self‐management. Objectives To evaluate the quality and comprehensiveness of English, Chinese and Spanish self‐management eczema smartphone apps for patients and/or their caregivers. Methods A systematic assessment of eczema apps from July 2018 to November 2018. The assessment criteria were based on conformance with international eczema guidelines. The following domains were assessed: consistency and comprehensiveness of eczema‐specific educational information; quality and comprehensiveness of eczema‐specific tracking functions; compliance with health information best practice principles. Results In total, 98 apps were assessed: 82 (84%) provided educational information; 38 (39%) tracking functions; and 13 (13%) both. We found that 34% (28/82) of apps provided misleading information, particularly regarding aspects of treatment and disease progression of eczema. Only 15% (12/82) provided international guideline supported information on pharmacological therapies and 16% (13/82) on nonpharmacological therapies. Among 38 apps with a tracking function, 82% (31/38) measured specific symptoms, disease severity or current skin condition and 89% (34/38) helped users to record medication usage including application of topicals. Environmental or dietary allergens were recorded by 34% (13/38). None of the included apps complied with all criteria for educational information, tracking functions or health information principles. Conclusions Eczema apps have not yet reached their potential. The large variance in quality of eczema apps highlights the need for quality assurance mechanisms for health apps and guidance for clinicians that would enable them to make personalized recommendations for patients and caregivers. What's already known about this topic? There is limited information about the quality of eczema self‐management smartphone apps on the global market. What does this study add? This systematic assessment evaluated all English, Chinese and Spanish language apps that support eczema self‐management. The majority did not conform with information in guidelines and insufficiently support evidence‐based self‐management. The large variance in the quality of eczema apps highlights the need for mechanisms to ensure app quality and to guide personalized app selection for patients, caregivers and doctors.

Dermatomyositis: A diagnostic dilemma

“…1,2 RWE includes patients with health issues that would lead to exclusion from RCT, but these patients are also in need of efficient treatment for their disease. 1,2 RWE includes patients with health issues that would lead to exclusion from RCT, but these patients are also in need of efficient treatment for their disease.…”

“…4 This study demonstrates that dupilumab is an effective treatment that results in a decrease of disease activity and burden, as demonstrated through an average decrease of the Eczema Activity Score Index of more than 50% as well as a reduction in the Investigators Global Assessment to 0 or 1 in 38% of the patients included in the study. 1 Electronic devices not only revolutionize our private life, but might add a new dimension to the doctor-patient relationship. 4 This study is exemplary in registering data on patients undergoing new treatments.…”

“…For patients, clinicians and researchers, eczema apps might be useful for following the patients' symptoms and assessing whether a patient's condition has worsened and the patient needs follow-up visits. 1 This assessment was urgently needed to assess the quality of existing devices. However, evidence is needed to discriminate fair from foul.…”

Most eczema smartphone apps do not conform to clinical guidelines

“…In this issue of the BJD , van Galen et al . report the results of a systematic assessment of eczema smartphone apps which support eczema self‐management . Electronic devices not only revolutionize our private life, but might add a new dimension to the doctor–patient relationship.…”

“…In this issue of the BJD , we can learn how to choose the right eczema smartphone apps, how eczema apps perform and whether they are congruent with international clinical guidelines . The article by van Galen et al .…”