Evidence assessing the development, evaluation and implementation of digital health technologies in wound care: A rapid scoping review

Shi, Chunhu; Dumville, Jo C; Juwale, Harun; Moran, Connor; Atkinson, Ross

doi:10.1016/j.jtv.2022.09.006

Cited by 16 publications

(12 citation statements)

References 30 publications

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“…While these advancements hold the potential to enhance nursing practices, they also introduce certain risks. The development and evaluation of wound care mobile applications are often inadequately supervised, potentially exposing users to unvalidated content or content influenced by commercial biases [ 25 , 32 , 33 ].…”

Section: Introductionmentioning

confidence: 99%

Content of a wound care mobile application for newly graduated nurses: an e-Delphi study

Gagnon,

Chartrand,

Probst

et al. 2024

BMC Nurs

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Background Wound care represents a considerable challenge, especially for newly graduated nurses. The development of a mobile application is envisioned to improve knowledge transfer and facilitate evidence-based practice. The aim of this study was to establish expert consensus on the initial content of the algorithm for a wound care mobile application for newly graduated nurses. Methods Experts participated in online surveys conducted in three rounds. Twenty-nine expert wound care nurses participated in the first round, and 25 participated in the two subsequent rounds. The first round, which was qualitative, included a mandatory open-ended question solicitating suggestions for items to be included in the mobile application. The responses underwent content analysis. The subsequent two rounds were quantitative, with experts being asked to rate their level of agreement on a 5-point Likert scale. These rounds were carried out iteratively, allowing experts to review their responses and see anonymized results from the previous round. We calculated the weighted kappa to determine the individual stability of responses within-subjects between the quantitative rounds. A consensus threshold of 80% was predetermined. Results In total, 80 items were divided into 6 categories based on the results of the first round. Of these, 75 (93.75%) achieved consensus during the two subsequent rounds. Notably, 5 items (6.25%) did not reach consensus. The items with the highest consensus related to the signs and symptoms of infection, pressure ulcers, and the essential elements for healing. Conversely, items such as toe pressure measurement, wounds around drains, and frostbite failed to achieve consensus. Conclusions The results of this study will inform the development of the initial content of the algorithm for a wound care mobile application. Expert participation and their insights on infection-related matters have the potential to support evidence-based wound care practice. Ongoing debates surround items without consensus. Finally, this study establishes expert wound care nurses’ perspectives on the competencies anticipated from newly graduated nurses.

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Section: Introductionmentioning

confidence: 99%

Content of a wound care mobile application for newly graduated nurses: an e-Delphi study

Gagnon,

Chartrand,

Probst

et al. 2024

BMC Nurs

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Content of a wound care mobile application for newly graduated nurses: An e-Delphi study

Gagnon,

Chartrand,

Probst

et al. 2023

Preprint

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Background Wound care represents a considerable challenge, especially for newly graduated nurses. The development of a mobile application is envisioned to improve knowledge transfer and facilitate evidence-based practice. The aim of this study was to establish expert consensus on the initial content of the algorithm for a wound care mobile application for newly graduated nurses. Methods Experts participated in online surveys conducted in three rounds. Twenty-nine expert wound care nurses participated in the first round, and 25 participated in the two subsequent rounds. The first round, which was qualitative, included a mandatory open-ended question solicitating suggestions for items to be included in the mobile application. The responses underwent content analysis. The subsequent two rounds were quantitative, with experts being asked to rate their level of agreement on a 5-point Likert scale. These rounds were carried out iteratively, allowing experts to review their responses and see anonymized results from the previous round. We calculated the weighted kappa to determine the individual stability of responses within-subjects between the quantitative rounds. A consensus threshold of 80% was predetermined. Results In total, 80 items were divided into 6 themes based on the results of the first round. Of these, 75 (93.75%) achieved consensus during the two subsequent rounds. Notably, 5 items (6.25%) did not reach consensus. The items with the highest consensus related to the signs and symptoms of infection, pressure ulcers, and the essential elements for healing. Conversely, items such as toe pressure measurement, wounds around drains, and frostbite failed to achieve consensus. Conclusions The results of this study will inform the development of the initial content of the algorithm for a wound care mobile application. Expert participation and their insights on infection-related matters have the potential to support evidence-based wound care practice. Ongoing debates surround items without consensus. Finally, this study establishes expert wound care nurses’ perspectives on the competencies anticipated from newly graduated nurses.

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“…However, budgetary constraints as well as logistic and mobility concerns among individuals in this population have made home- and community-based care the mainstay of treatment. 8 Digital health solutions have been used to augment the reach of wound care professionals, with telemedicine comprising the first wave of digitally-enabled home-based treatment programs. 9 …”

Section: Introductionmentioning

confidence: 99%

A feasibility study on the efficacy of a patient-owned wound surveillance system for diabetic foot ulcer care (ePOWS study)

Lo,

Harish,

Tan

et al. 2023

DIGITAL HEALTH

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Objective Wound image analysis tools hold promise in helping patients to monitor their wounds. We aim to perform a novel feasibility study on the efficacy of a patient-owned wound surveillance system for diabetic foot ulcer (DFU) care. Methods This two-institutional, prospective, single-arm pilot study examined patients with DFU. An artificial intelligence-enabled image analysis app calculating the wound surface area was installed and patients or caregivers were instructed to take pictures of wounds during dressing changes. Patients were followed until wound deterioration, wound healing, or wound stability at 6 months occurred and the outcomes of interest included study adherence, algorithm performance, and user experience. Results Between January 2021 and December 2021, 39 patients were enrolled in the study, with a mean age of 61.6 ± 8.6 years, and 69% ( n = 27) of subjects were male. All patients had documented diabetes and 85% ( n = 33) of them had peripheral arterial disease. A mean follow-up for those completing the study was 12.0 ± 8.5 weeks. At the conclusion of the study, 80% of patients ( n = 20) had primary wound healing whilst 20% ( n = 5) had wound deterioration. The study completion rate was 64% ( n = 25). Usage of the app for surveillance of DFU healing, as compared to physician evaluation, yielded a sensitivity of 100%, specificity of 20%, positive predictive value of 83%, and negative predictive value of 100%. Of those who provided user experience feedback, 59% ( n = 10) felt the app was easy to use, 47% ( n = 8) would recommend the wound analysis app to others but only 6% would pay for the app out of pocket ( n = 1). Conclusion Implementation of a patient-owned wound surveillance system is feasible. Most patients were able to effectively monitor wounds using a smartphone app-based solution. The image analysis algorithm demonstrates strong performance in identifying wound healing and is capable of detecting deterioration prior to interval evaluation by a physician. Patients generally found the app easy to use but were reluctant to pay for the use of the solution out of pocket.

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Evidence assessing the development, evaluation and implementation of digital health technologies in wound care: A rapid scoping review

Cited by 16 publications

References 30 publications

Content of a wound care mobile application for newly graduated nurses: an e-Delphi study

Content of a wound care mobile application for newly graduated nurses: an e-Delphi study

Content of a wound care mobile application for newly graduated nurses: An e-Delphi study

A feasibility study on the efficacy of a patient-owned wound surveillance system for diabetic foot ulcer care (ePOWS study)

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