The Quality of Mobile Applications Used for the Identification of Pressure Ulcer in Adults: A Systematic Survey and Review of Applications in App Store (Preprint)

BACKGROUND The increasing global use of smartphones has contributed to the growing use of applications for various health conditions, showing promising results. Through mobile applications it is possible to perform the chronological and iconographic follow-up of wounds such as pressure ulcers using a simple and practical tool. However, numerous surveys have pointed out issues related to the functionability, design, safety and veracity of application information. OBJECTIVE The objective of this study was to perform a systematic review of published studies regarding mobile applications and a systematic survey in app stores looking for applications developed to identify and/or evaluate and/or treat and/or prevent pressure ulcers in adults, and to evaluate those applications based on quality characteristics of the software. METHODS This review followed PRISMA guidelines. The main bibliographic databases searched encompassed the period between January 1, 2007 and October 15, 2018, and an application survey was also made in application stores. The selected studies were evaluated according to software quality characteristics through the International Organization for Standardization/International Electrotechnical Commission, i.e. ISO/IEC 25010 2011 that evaluates functionability, efficiency, compatibility, usability, reliability, safety, maintenance and portability. RESULTS The search in databases and online application stores returned a total of 2075 studies. After the removal of the duplicates and the screening of the titles and abstracts, 48 complete texts were evaluated for eligibility, and from them 6 studies were included for the qualitative synthesis. CONCLUSIONS In the present review it was observed that all the studies are in the initial phase of development or improvement and therefore the Apps still need to be evaluated using different quality characteristics of software so that in the future it can approach a gold standard. Therefore, the prescription of an App for the identification and/or evaluation and/or treatment and/or prevention of PU in adults is currently limited. However, the evaluated studies provided important insights for future research. It is of the utmost importance that future surveys develop Apps jointly with users, using collaborative and co-creative processes and assess patients in real-world situations, across different service settings, as well as they should consider different ethnicities so that Apps are useful to end-users such as patients, family members, health professionals and students in the health area. In addition, it is necessary for the studies to describe the methodological course of development of the App in a clear and objective way, in order to allow the reproducibility of the study, and to offer inputs in order to allow future research to approach the development of ideal Apps, geared to positively impact the health of end-users. CLINICALTRIAL "Protocol record: PROSPERO CRD42018114137; https://www.crd.york.ac.uk/prospero/#recordDetails".