Mobile Health App for Tuberculosis Screening and Compliance to Undergo Chest X-ray Examination Among Presumptive Cases Detected by the App in Myanmar: Usability Study

Htet, Kyaw Ko Ko; Phyu, Aye Nyein; Thwin, Thandar; Chongsuvivatwong, Virasakdi

doi:10.2196/37779

Cited by 8 publications

(6 citation statements)

References 21 publications

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“…Regarding usability from the perspective of the women in this study, similar research in other eHealth ambits and general users has stated that simple designs and previous testing of the interventions with the patients can help ensure an overall good perception of usability [ 25 - 27 ]. The items that defined this domain in our resultant questionnaire regarded aspects that have been previously described separately by other authors, such as the easiness of understanding, convenience of using QR codes to access the information [ 28 ], and helpfulness in daily life [ 29 ] or in other medical specialties [ 1 ].…”

Section: Discussionmentioning

confidence: 96%

Using QR Codes as a Form of eHealth to Promote Health Among Women in a Pandemic: Cross-sectional Study

et al. 2022

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Background QR codes have played an integral role during the pandemic in many sectors, but their use has been limited in the health care sector, especially by patients. Although some authors have stated that developing specific content for women on how to cope with health problems could be an effective way to prevent problems, especially during pandemics, there is little research regarding the use of QR codes to promote health during a pandemic, and even fewer studies are focused on women. Moreover, although the importance of assessing these interventions from the users’ perspective has been stated, research carried out from this point of view is still scarce. Objective This study aimed to assess the usefulness of using QR codes with information to promote women’s health in the context of a pandemic. We also sought to design and validate a questionnaire to assess this. Methods A cross-sectional study was conducted among women in the gynecology waiting rooms of a reference hospital. Exploratory factorial analysis with the split-half method and Cronbach α values was performed for questionnaire validation. Univariant and bivariant analyses were performed to analyze the data obtained. Results In total, 186 women took part in the study. Exploratory factor analysis identified 2 domains: usability and applicability in medical practice. The Cronbach α value was .81. Overall, 83.7% of the answers to the first domain and 56.4% of those to the second were favorable. Women with university education or those who had used QR codes before scored better in the usability domain, while no differences were observed in the applicability scores. Conclusions Using QR codes in the gynecology clinics’ waiting rooms can help promote women’s health during a pandemic, regardless of their education level or whether they have used QR codes before. The questionnaire developed herein is a helpful tool to assess this. These findings are important for clinical practice. This research can be performed in other ambits, specialties, or countries.

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Section: Discussionmentioning

confidence: 96%

Using QR Codes as a Form of eHealth to Promote Health Among Women in a Pandemic: Cross-sectional Study

et al. 2022

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“…The app used a cutoff score ≥0.0053 to identify presumptive TB, that is, people with ≥0.5% probability of having TB. The sensitivity of mobile app screening was 80.6% and the specificity was 63.5% [7,8]. This mobile app for community TB screening was reported to have good usability, and the individuals with presumptive TB detected by the app showed good compliance to CXR examinations [8].…”

Section: Introductionmentioning

confidence: 92%

“…The compliance with CXR examination was 38.2% for routine passive TB screening based on TBSS and 88% for active screening based on CXRs according to the recent 2018 National TB Prevalence Survey in Myanmar [21]. Active TB screening via the mobile health app had 71.1% CXR compliance for presumptive cases of TB detected by the app [8].…”

Section: Compliance With Cxr Examinationsmentioning

confidence: 99%

“…The sensitivity and specificity parameters to detect active TB with TBSS, the mobile app using screening for social and pathological characteristics, CXR examinations, and the Gene Xpert MTB/RIF examinations were estimated based on analysis of the National TB Prevalence Survey [7,8]. A decision tree model was developed using those parameters based on the national TB prevalence of 468 per 100,000 population (Multimedia Appendix 4) [21].…”

Section: Decision Treementioning

confidence: 99%

“…The sensitivity of mobile app screening was 80.6% and the specificity was 63.5% [7,8]. This mobile app for community TB screening was reported to have good usability, and the individuals with presumptive TB detected by the app showed good compliance to CXR examinations [8]. However, any TB screening strategy also needs to evaluate its usability in terms of cost and effectiveness in the local context [9].…”

Section: Introductionmentioning

confidence: 99%

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Active Tuberculosis Screening via a Mobile Health App in Myanmar: Incremental Cost-Effectiveness Evaluation

Htet,

Phyu,

Zayar

et al. 2023

JMIR Form Res

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Background A mobile app that calculates a tuberculosis (TB) risk score based on individual social and pathological characteristics has been shown to be a better predictor of the risk of contracting TB than conventionally used TB signs and symptoms (TBSS) in Myanmar, where the TB burden is high. Its cost-effectiveness, however, has not yet been assessed. Objective This study aimed to determine the incremental costs of this mobile app and of chest x-rays (CXRs) in averting disability-adjusted life years (DALYs) among missed cases of active TB in the population being screened. Methods Elements of incremental costs and effectiveness of 3 initial TB screening strategies were examined, including TBSS followed by CXR, the mobile app followed by CXR, and universal CXR. The incremental cost-effectiveness ratio (ICER; ie, the additional cost for each additional DALY averted) was compared to TBSS screening. Based on the latest 2020 gross domestic product (GDP) per capita of Myanmar (US $1477.50), the ICER was compared to willingness-to-pay (WTP) thresholds of 1, 2, and 3 times the GDP per capita. Probabilistic sensitivity analysis was conducted with a Monte Carlo simulation to compute the levels of probability that the ICER for each strategy was below each WTP threshold. Results For each 100,000 population, the incremental cost compared to TBSS of active TB screening was US $345,942 for the mobile app and US $1,810,712 for universal CXR. The incremental effectiveness was 325 DALYs averted for the mobile app and 576 DALYs averted for universal CXR. For the mobile app, the estimated ICER was US $1064 (72% of GDP per capita) per 1 DALY averted. Furthermore, 100% of the simulated values were below an additional cost of 1 times the GDP per capita for 1 additional DALY averted. The universal CXR strategy has an estimated ICER of US $3143 (2.1 times the GDP per capita) per 1 DALY averted and an additional 77.2% DALYs averted compared to the app (ie, 576 – 325 / 325 DALYs); however, 0.5% of the simulated values were higher than an additional expenditure of 3 times the GDP per capita. Conclusions Based on the status of the economy in 2020, the mobile app strategy is affordable for Myanmar. The universal CXR strategy, although it could prevent an additional 77% of DALYs, is probably unaffordable. Compared to the TBSS strategy, the mobile app system based on social and pathological characteristics of TB has potential as a TB screening tool to identify missing TB cases and to reduce TB morbidity and mortality, thereby helping to achieve the global goal of “End TB” in resource-limited settings with a high TB burden.

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Innovations in Tuberculosis Disease Screening

Yousif,

Mesilhy,

Aly

et al. 2024

Surveillance, Prevention, and Control of Infectious Diseases

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Mobile Health App for Tuberculosis Screening and Compliance to Undergo Chest X-ray Examination Among Presumptive Cases Detected by the App in Myanmar: Usability Study

Cited by 8 publications

References 21 publications

Using QR Codes as a Form of eHealth to Promote Health Among Women in a Pandemic: Cross-sectional Study

Using QR Codes as a Form of eHealth to Promote Health Among Women in a Pandemic: Cross-sectional Study

Active Tuberculosis Screening via a Mobile Health App in Myanmar: Incremental Cost-Effectiveness Evaluation

Innovations in Tuberculosis Disease Screening

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