Quality of Digital Health Interventions Across Different Health Care Domains: Secondary Data Analysis Study.

BACKGROUND: 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. OBJECTIVE: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

System Usability Scale Benchmarking for Digital Health Apps: Meta-analysis.

BACKGROUND: The System Usability Scale (SUS) is a widely used scale that has been used to quantify the usability of many software and hardware products. However, the SUS was not specifically designed to evaluate mobile apps, or in particular digital health apps (DHAs). OBJECTIVE: The aim of this study was to examine whether the widely used SUS distribution for benchmarking (mean 68, SD 12.5) can be used to reliably assess the usability of DHAs. METHODS: A search of the literature was performed using the ACM Digital Library, IEEE Xplore, CORE, PubMed, and Google Scholar databases to identify SUS scores related to the usability of DHAs for meta-analysis. This study included papers that published the SUS scores of the evaluated DHAs from 2011 to 2021 to get a 10-year representation. In total, 117 SUS scores for 114 DHAs were identified. R Studio and the R programming language were used to model the DHA SUS distribution, with a 1-sample, 2-tailed t test used to compare this distribution with the standard SUS distribution. RESULTS: The mean SUS score when all the collected apps were included was 76.64 (SD 15.12); however, this distribution exhibited asymmetrical skewness (-0.52) and was not normally distributed according to Shapiro-Wilk test (P=.002). The mean SUS score for "physical activity" apps was 83.28 (SD 12.39) and drove the skewness. Hence, the mean SUS score for all collected apps excluding "physical activity" apps was 68.05 (SD 14.05). A 1-sample, 2-tailed t test indicated that this health app SUS distribution was not statistically significantly different from the standard SUS distribution (P=.98). CONCLUSIONS: This study concludes that the SUS and the widely accepted benchmark of a mean SUS score of 68 (SD 12.5) are suitable for evaluating the usability of DHAs. We speculate as to why physical activity apps received higher SUS scores than expected. A template for reporting mean SUS scores to facilitate meta-analysis is proposed, together with future work that could be done to further examine the SUS benchmark scores for DHAs.

Space, time and memory: tales from a long road.

Points, lines and surfaces are the basic elements of Euclidean geometry. In this paper, accompanying a keynote at ICSC 2018, we will explore how, in physics, cognition and our lived experience, it is often better to think in terms of interconnected threads than an evolving state of the world now. In physics 'now' is an illusion, merely a convenient construction, each particle and person is more like an independent strand in space-time, and similarly, in our minds, strands of memories from different roles and contexts flow almost independently. Paths create lines on the map and may be inscribed as signs in the landscape, but our journeys along paths create temporal threads that interweave as we meet along the way. This paper draws on my research over many years on time and user interaction and also my personal experiences during a thousand-mile walk around the periphery of Wales in 2013.

A taxonomy of clutter reduction for information visualisation.

Information visualisation is about gaining insight into data through a visual representation. This data is often multivariate and increasingly, the datasets are very large. To help us explore all this data, numerous visualisation applications, both commercial and research prototypes, have been designed using a variety of techniques and algorithms. Whether they are dedicated to geo-spatial data or skewed hierarchical data, most of the visualisations need to adopt strategies for dealing with overcrowded displays, brought about by too much data to fit in too small a display space. This paper analyses a large number of these clutter reduction methods, classifying them both in terms of how they deal with clutter reduction and more importantly, in terms of the benefits and losses. The aim of the resulting taxonomy is to act as a guide to match techniques to problems where different criteria may have different importance, and more importantly as a means to critique and hence develop existing and new techniques.

Enabling automatic clutter reduction in parallel coordinate plots.

We have previously shown that random sampling is an effective clutter reduction technique and that a sampling lens can facilitate focus+context viewing of particular regions. This demands an efficient method of estimating the overlap or occlusion of large numbers of intersecting lines in order to automatically adjust the sampling rate within the lens. This paper proposes several ways for measuring occlusion in parallel coordinate plots. An empirical study into the accuracy and efficiency of the occlusion measures show that a probabilistic approach combined with a 'binning' technique is very fast and yet approaches the accuracy of the more expensive 'true' complete measurement.