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Digital health interventions, especially mobile apps, have become instrumental in helping women at risk of polycystic ovary syndrome (PCOS), increasing their understanding of the condition, improving self-care, and fostering empowerment. However, their rapid proliferation has brought about significant challenges regarding quality assessment and evidence-based determination. Therefore, establishing reliable quality assessment methods is essential to assist patients with PCOS in identifying effective and trustworthy mobile health tools. This study was designed to assess the content and quality of mobile apps developed for patients with PCOS using the Mobile App Rating Scale (MARS) to provide insights into their strengths, limitations, and areas needing improvement. In this descriptive-analytical study conducted in June 2024, a comprehensive search was performed to identify English and Persian mobile apps related to PCOS through the Café Bazaar and Google Play Store platforms, using both direct search methods and auxiliary tools such as AppAgg and AppBrain. Two trained reviewers (AR and NN) independently reviewed the apps using the MARS tool. The interrater reliability was measured using the intraclass correlation coefficient test. The quality of each app was scored across 4 dimensions: engagement, functionality, aesthetics, and information quality. Of the initial 199 apps identified, 15 met the inclusion criteria after screening and updates. The interrater agreement rate was 85%, which is considered acceptable. The apps' overall quality was sufficient, as assessed using the MARS, with a mean score of 3.6 (SD 0.52) of 5. Functionality and aesthetics emerged as the highest-scoring dimensions, highlighting user-friendliness and visual appeal (n=10). In contrast, engagement following information quality received the lowest average score, indicating limited interactivity and gaps in providing evidence-based information. The Ask PCOS app achieved the highest overall score, performing exceptionally well in subjective quality (4.75) and app-specific quality (4.33), reflecting its strong capacity to positively impact users' knowledge, attitudes, and behaviors related to PCOS. Uvi Health and Ask PCOS scored highest in engagement (4.2), while PCOS & PCOD Diet & Remedies led in functionality (5), and Uvi Health topped aesthetics (5). The findings revealed that even though many available PCOS-related apps demonstrate strengths in technical performance and design, critical limitations persist regarding user engagement and the credibility of the information provided. The predominance of commercially affiliated apps without academic or clinical oversight was identified as a key contributing factor to these shortcomings. These results underscore the need for future app development to incorporate more user-engaging features, reliable evidence-based content, and personalization strategies to enhance user engagement and support effective PCOS self-management. Addressing these limitations and leveraging the capabilities of existing mobile devices are essential steps toward improving the overall quality and impact of mobile health interventions for individuals with PCOS.

The success of mobile apps in improving the lifestyle of patients with noncommunicable diseases through self-management interventions is contingent upon the emerging growth in this field. While users of mobile health (mHealth) apps continue to grow in number, little is known about the quality of available apps that provide self-management for common noncommunicable diseases such as diabetes, hypertension, and obesity. We aimed to investigate the availability, characteristics, and quality of mHealth apps for common noncommunicable disease health management that included dietary aspects (based on the developer's description), as well as their features for promoting health outcomes and self-monitoring. A systematic search of English-language apps on the Google Play Store (Google LLC) and Apple App Store (Apple Inc) was conducted between August 7, 2022, and September 13, 2022. The search terms used included weight management, obesity, diabetes, hypertension, cardiovascular diseases, stroke, and diet. The selected mHealth apps' titles and content were screened based on the description that was provided. Apps that were not designed with self-management features were excluded. We analyzed the mHealth apps by category and whether they involved health care professionals, were based on scientific testing, and had self-monitoring features. A validated and multidimensional tool, the Mobile App Rating Scale (MARS), was used to evaluate each mHealth app's quality based on a 5-point Likert scale from 1 (inadequate) to 5 (excellent). Overall, 42 apps were identified. Diabetes-specific mHealth apps accounted for 7% (n=3) of the market, hypertension apps for 12% (n=5), and general noncommunicable disease management apps for 21% (n=9). About 38% (n=16) of the apps were for managing chronic diseases, while 74% (n=31) were for weight management. Self-management features such as weight tracking, BMI calculators, diet tracking, and fluid intake tracking were seen in 86% (n=36) of the apps. Most mHealth apps (n=37, 88%) did not indicate whether there was involvement of health professionals in app development. Additionally, none of the apps reported scientific evidence demonstrating their efficacy in managing health. The overall mean MARS score was 3.2 of 5, with a range of 2.0 to 4.1. Functionality was the best-rated category (mean score 3.9, SD 0.5), followed by aesthetics (mean score 3.2, SD 0.9), information (mean score 3.1, SD 0.7), and engagement (mean score 2.9, SD 0.6). The quality of mHealth apps for managing chronic diseases was heterogeneous, with roughly half of them falling short of acceptable standards for both quality and content. The majority of apps contained scant information about scientific evidence and the developer's history. To increase user confidence and accomplish desired health outcomes, mHealth apps should be optimized with the help of health care professionals. Future studies on mHealth content analysis should focus on other diseases as well.

The use of mobile health (mHealth) apps can assist with the management of gestational diabetes (GDM). Although a number of studies have demonstrated their efficacy in improving maternal-fetal outcomes, opinions differ regarding their usability and overall quality. Poorly designed apps, with ill-conceived features or inappropriate content, may pose a threat to patient safety. Nevertheless, very few studies provide in-depth evaluations of app design quality, and the diversity of features and techniques used remains insufficiently explored. We aimed to evaluate the quality and multifunctionality of commercially available mHealth apps for GDM. This is a systematic app review guided by the TECH (target user, evaluation focus, connectedness, and health domain) framework and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist. Searches were conducted on the Apple App Store and Google Play. Apps were screened by name, description, and full navigation to identify inclusions. The quality of the apps was evaluated using the Mobile App Rating Scale and IMS Institute for Healthcare Informatics Functionality Score. Multifunctionality of the apps was evaluated using the GDM-adapted features and techniques list developed from the App Behavior Change Scale, NICE (National Institute for Health and Care Excellence) 2015 guidelines, and previous studies. The general features list, which contains instruction, data security, customization, and technical issues, was derived from previous studies. The search (June 2024) identified 23 commercially available apps from UK app stores. The overall app quality was evaluated to be satisfactory (Mobile App Rating Scale: mean 4.0, SD 0.36; IMS Institute for Healthcare Informatics Functionality Score: mean 5.83, SD 3.03). The multifunctionality evaluation found that the apps had a mean of 17.95 and SD of 7.31 across all 45 items. Overall, our findings suggested that mHealth apps for GDM achieved a certain level of multifunctionality. However, their feature types and supporting digital techniques are relatively basic. The apps focused on education and managing blood glucose control rather than integrating other self-monitoring data and pregnancy-relevant management into their design. The digital techniques used to achieve these features included text and manual operation, rather than other automated features. This is the first app review to consider the relationship between app features and usability for women with GDM. Future app development should integrate a wide range of pregnancy-relevant information and more automated features and use advanced digital techniques to enable a holistic digital solution for women with GDM.

An increasing number of people are using vapes (e-cigarettes), and with growing evidence of associated harms, there is a need for acceptable cessation support and interventions. Smartphone apps for health and well-being have increased in popularity and use. Limited published literature assesses the potential of apps to support vaping cessation. A systematic search of vaping cessation apps currently available in Australia for iOS and Android platforms was conducted. Apps were assessed against established health app assessment tools for quality and behavior change potential. A systematic search through the Australian Apple iTunes and Google Play stores was conducted using the search terms \"vape\"; \"vaping\"; \"e-cigarette\"; and \"cessation,\" \"quit,\" or \"quitting\" in May 2023. Only apps that encouraged the cessation of vaping were included. App descriptions were reviewed to determine if they were relevant for inclusion in this study, and relevant apps were downloaded onto the appropriate mobile device for review. The Mobile App Rating Scale (MARS) was used to rate the quality (engagement, functionality, aesthetics, and information) of the apps using an overall score out of 5. The App Behavior Change Scale (ABACUS) was used to assess the behavior change potential of each app using a score out of 21. An initial search of the app stores yielded 220 Android apps and 124 iOS apps. Screening against the inclusion criteria left 20 iOS apps and 10 Android apps for review. Six apps were available on both operating systems, and these were downloaded, reviewed, and reported separately for each operating system. The average MARS score for all apps assessed in this review was 3.1 (SD 0.41) out of 5. The reviewed apps overall performed well for the MARS elements relating to functionality, such as ease of use and navigation, but had the lowest scores for information-related elements, such as credibility. The number of ABACUS behavior change features per app ranged from 0 to 19 out of 21, with a mean of 8.9 (SD 4.51). The apps commonly included information-related features, such as requesting baseline information. The least common behavior change features were those relating to goal-setting, such as asking about the user's willingness for behavior change and providing feedback on current actions in comparison to future goals. The identified vaping cessation apps had moderate levels of quality and some behavior change components. Future vaping cessation apps could benefit from including more features that are known to support behavior change, such as goal-setting, to improve the potential benefit of these apps to support people to stop vaping. As guidelines for vaping cessation continue to be established, future apps need to reference these in their development.

As the Chinese society ages and the concern for health and quality of life grows, the demand for care services in China is increasing. The widespread use of internet technology has greatly improved the convenience and efficiency of web-based services. As a result, the Chinese government has been implementing \"Internet+Nursing Services\" since 2019, with mobile apps being the primary tools for users to access these services. The quality of these apps is closely related to user experience and the smooth use of services. This study aims to evaluate the functionality, services, and quality of \"Internet+Nursing Service\" apps; identify weaknesses; and provide suggestions for improving service programs and the research, development, improvement, and maintenance of similar apps. In December 2022, two researchers searched for \"Internet+Nursing Service\" apps by applying the search criteria on the Kuchuan mobile app monitoring platform. After identifying the apps to be included based on ranking criteria, they collected information such as the app developer, app size, version number, number of downloads, user ratings, and number and names of services. Afterward, 5 trained researchers independently evaluated the quality of the apps by using the Chinese version of the user version of the Mobile App Rating Scale (uMARS-C). The total uMARS-C score was based on the average of the five evaluators' ratings. A total of 17 \"Internet+Nursing Service\" apps were included. Among these, 12 (71%) had been downloaded more than 10,000 times, 11 (65%) had user ratings of 4 or higher, the median app size was 62.67 (range 22.71-103; IQR 37.51-73.47) MB, 16 (94%) apps provided surgical wound dressing change services, 4 (24%) covered first-tier cities, and only 1 (6%) covered fourth-tier cities. The median total uMARS-C score was 3.88 (range 1.92-4.92; IQR 3.71-4.05), which did not correlate with app store user ratings (r=0.003; P=.99). The quality of most apps (11/17, 65%) was average. Most apps (12/17, 71%) were rated as \"good\" or above (≥4 points) in terms of information quality, layout, graphics, performance, and ease of use; however, the vast majority of apps were rated as \"fair\" or even \"poor\" (<4 points) in terms of credibility (14/17, 82%) and demand (16/17, 94%). \"Internet+Nursing Service\" apps need to broaden their service coverage, increase service variety, and further optimize their service structure. The overall quality of these apps is generally poor. App developers should collaborate with medical professionals and communicate with target users before launching their products to ensure accurate content, complete functionality, and good operation that meets user needs.

Exercise prescription is a structured and individualized intervention that requires appropriate progression, tailoring, and behavioral support to ensure safety and long-term effectiveness. With the expansion of mobile health technologies, exercise prescription apps are increasingly used to support the remote delivery of prescribed exercise programs. However, the extent to which widely adopted apps align with established clinical standards remains unclear. This study aimed to evaluate the clinical usability of popular, no-cost exercise prescription apps from a professional perspective, focusing on clinical integrity, intervention fidelity, behavioral mechanisms, and clinician-assessed digital usability. A systematic search of Google Play and the Apple App Store identified widely adopted apps that enable clinician-directed exercise prescription. Eligible apps were evaluated using established frameworks, including the frequency, intensity, time, and type (FITT) and FITT, volume, and progression (FITT-VP) principles; the Consensus on Exercise Reporting Template (CERT); the Behavior Change Technique Taxonomy version 1 (BCTTv1); and the Mobile App Rating Scale (MARS). Descriptive analyses and interrater reliability assessments were performed. Six apps met the inclusion criteria. All satisfied the basic FITT requirements; however, none incorporated explicit guidance on exercise progression or individualized adjustment consistent with the FITT-VP principles. CERT evaluation demonstrated comprehensive reporting of structural components but a consistent absence of progression logic, tailoring strategies, and adverse event documentation. Although multiple behavior change techniques were identified, several techniques considered important for graded progression and sustained adherence in unsupervised settings were infrequently implemented or absent. Overall app quality was moderate, characterized by strong functionality but limited engagement. Only 2 apps reported evidence of scientific evaluation. Widely adopted exercise prescription apps meet fundamental structural requirements but do not fully support the progressive and individualized processes central to clinical exercise prescription. These findings highlight a gap between structural prescription delivery and independent clinical exercise management. Exercise prescription apps may therefore be most appropriately positioned as adjunctive tools within clinician-guided or hybrid care models. Future development should prioritize transparent progression mechanisms, individualized adjustment, and the implementation of clinically relevant behavior change strategies to enhance safety and long-term effectiveness.

Drug-drug interactions (DDIs) pose a significant risk to patient safety and increase health care costs. Mobile apps offer potential solutions for managing DDIs, yet their quality and effectiveness from the user's perspective remain unclear. The aim is to evaluate the quality of publicly available mobile apps for DDI management in the US using the Mobile App Rating Scale (MARS) and to identify patterns that reflect user satisfaction and preferences. A structured review was conducted to identify mobile apps for DDI management, resulting in 19 eligible apps. Two health care-affiliated evaluators independently assessed each app using the mobile app rating scale (MARS). Dimensionality scores were calculated, and correlation analysis was conducted to examine relationships among dimensions. K-means clustering was applied to group apps based on their MARS scores. Scatter plots visualized app distributions across clusters. To validate the clustering model and assess alignment with user satisfaction, mean weighted user ratings were compared with mean MARS scores per cluster. Correlation analysis was also performed between individual MARS dimensions and user ratings within each cluster. The mean MARS score was 3.54 out of 5, with the Information dimension scoring the highest (mean 3.68, SD 0.51) and Engagement the lowest (mean 3.42, SD 0.80). The Kruskal-Wallis test revealed no significant differences in median scores across the four dimensions (χ²3=2.109, P=.55). All MARS dimensions were positively correlated (r=0.65 to 0.92), indicating interrelated quality characteristics. K-means clustering identified three app groups with varying quality profiles: Cluster 1 (n=7, mean MARS=2.86), Cluster 2 (n=7, mean=3.57), and Cluster 3 (n=5, mean=4.44). Cluster 1 apps showed strongest correlations between user satisfaction and functionality (r=0.74) and engagement (r=0.53). Cluster 2 users prioritized information (r=0.41) and aesthetics (r=0.58), and Cluster 3 exhibited balanced influence from information (r=0.62), aesthetics (r=0.58), and functionality (r=0.39). Scatter plots indicated that engagement, functionality, and aesthetics were key drivers of user perception, while information, though consistently strong, played a lesser role in differentiating the apps. The weighted user ratings aligned with MARS scores, supporting the validity of the clustering model. This study assesses the quality of mobile apps for DDI management by integrating MARS with K-means Clustering. This approach enabled a structured classification of apps based on the MARS scores, identifying distinct clusters that reflect overall app quality profiles across key usability dimensions. The study revealed that the influence of MARS dimensions on app ratings varies by cluster, highlighting that the significance of these dimensions shifts according to the specific needs and preferences of different user groups.

Pulmonary hypertension (PH) is a chronic and complex condition, requiring consistent management and education. The widespread use of smartphones has opened possibilities for mobile health apps to support both patients and health care professionals in monitoring and managing PH more effectively. This study aimed to identify and assess the quality of free smartphone apps for PH targeted at either patients or health care professionals. A systematic search was conducted on freely available apps for patients with PH and health care professionals, accessed from a Spanish IP address, on Android (Google Play) and iOS (App Store) platforms. Searches were performed in October 2022 and 2023. Apps were independently analyzed by two reviewers, focusing on general characteristics. Quality assessment was based on the Mobile Application Rating Scale (MARS) framework, and Mann-Whitney U tests compared mean MARS scores against specific variables. In the overall study, 21 apps were identified. In the 2022 search, 19 apps were listed (9 iOS, 7 Android, 3 available on both platforms). In the subsequent 2023 search, 16 apps were identified (6 Android, 7 iOS, 3 available on both platforms). Of those identified in 2022, 14 remained available in 2023, with only 7 updated since 2022. In addition, 12 apps targeted patients or the general population, while 9 targeted health care professionals; none involved patients in the development or design. Conversely, 13 apps involving health care professionals were identified. There were 10 apps that received pharmaceutical industry funding. The primary goal for 81% (17/21) of the apps was to disseminate general information about PH. The overall mean MARS quality was acceptable in 2022 and 2023, with mean ratings of 3.1 (SD 0.6) and 3.3 (SD 0.5), respectively. The functionality category achieved the highest scores in both years, indicating ease of use and intuitive navigation. In contrast, the subjective quality domain consistently received the lowest ratings in the MARS assessment across both years. None of the apps underwent clinical testing themselves; however, 2 incorporated tools or algorithms derived from trials. The overall quality of iOS apps statistically outperformed that of Android apps in both years (P<.05). Furthermore, the involvement of health care professionals in app development was associated with enhanced quality, a trend observed in both years (P=.003 for both years). This review of mobile health apps for PH reveals their emergent development stage, with generally acceptable quality but lacking refinement. It highlights the critical role of health care professionals in app development, as they contribute significantly to quality and reliability. Despite this, a notable stagnation in app quality and functionality improvement over 2 years points to a need for continuous innovation and clinical validation for effective clinical integration. This research advocates for future app developers to actively engage with health care professionals, integrate patient insights, and mandate rigorous clinical validation for PH management.

Lupus erythematosus (LE) is a chronic autoimmune disease that significantly impacts patients' quality of life. Photosensitivity is a key impairment that severely limits the quality of life, especially in cutaneous lupus erythematosus (CLE), where exposure to sunlight can lead to rashes, exacerbations, and pain. In systemic lupus erythematosus (SLE), other manifestations such as joint pain, fatigue, and organ damage may contribute to decreased physical function and emotional distress. Mobile health apps (MHA) offer potential support for comprehensive disease management for the symptoms mentioned above. However, there is a lack of systematic analysis of available lupus management apps. This study aims to systematically identify publicly available German or English MHA for lupus management as well as to assess their quality by surveying both patients and physicians. A systematic search and assessment of German or English mobile apps for patients with lupus, available in the Google Play Store and Apple App Store, was conducted independently by two reviewers. The two apps that met all relevant criteria were then reviewed independently by seven physicians using the German Mobile Application Rating Scale (MARS) and the System Usability Scale (SUS). Subsequently, they were reviewed by five patients (three with SLE and two with CLE), using the user version of MARS (uMARS) and SUS. Additionally, the Affinity for Technology Interaction (ATI) scale was collected from both patients and physicians to evaluate the technical affinity in both groups. In total, 29 apps were available on the Apple Store and 26 on the Google Store, with 18 apps being present and downloadable on both platforms. Of the 18 apps, 16 were excluded because they did not meet the inclusion and exclusion criteria. Only two apps, Lupus Log and Lupus Minder met all the required criteria and were included in the study. The mean MARS scores varied from 2.61/5 to 4.17/5 and mean SUS from 17.5/100 to 100/100 between physicians. The app with the highest mean overall MARS score was Lupus Log, which was rated with 3.91/5 on average by the physicians. Patients evaluated the app with a comparably mean uMARS score (3.95/5). Technical affinity, objectified by ATI, was higher in patients than physicians (3.9 vs 3.68). Systematic identification and evaluation showed high-quality apps for patient-centered lupus MHA as indicated by MARS and uMARS scores greater than 3 for both Lupus Log and Lupus Minder.

The prevalence of chronic wounds is predicted to increase within the aging populations in industrialized countries. Patients experience significant distress due to pain, wound secretions, and the resulting immobilization. As the number of wounds continues to rise, their adequate care becomes increasingly costly in terms of health care resources worldwide. eHealth support systems are being increasingly integrated into patient care. However, to date, no systematic analysis of such apps for chronic wounds has been published. The aims of this study were to systematically identify and subjectively assess publicly available German- or English-language mobile apps for patients with chronic wounds, with quality assessments performed by both patients and physicians. Two reviewers independently conducted a systematic search and assessment of German- or English-language mobile apps for patients with chronic wounds that were available in the Google Play Store and Apple App Store from April 2022 to May 2022. In total, 3 apps met the inclusion and exclusion criteria and were reviewed independently by 10 physicians using the German Mobile App Rating Scale (MARS) and the System Usability Scale (SUS). The app with the highest mean MARS score was subsequently reviewed by 11 patients with chronic wounds using the German user version of the MARS (uMARS) and the SUS. Additionally, Affinity for Technology Interaction (ATI) scale scores were collected from both patients and physicians. This study assessed mobile apps for patients with chronic wounds that were selected from a pool of 118 identified apps. Of the 73 apps available in both app stores, 10 were patient oriented. After excluding apps with advertisements or costs, 3 apps were evaluated by 10 physicians. Mean MARS scores ranged from 2.64 (SD 0.65) to 3.88 (SD 0.65) out of 5, and mean SUS scores ranged from 50.75 (SD 27) to 80.5 (SD 17.7) out of 100. WUND APP received the highest mean MARS score (mean 3.88, SD 0.65 out of 5) among physicians. Hence, it was subsequently assessed by 11 patients and achieved a similar rating (uMARS score: mean 3.89, SD 0.4 out of 5). Technical affinity, as measured with the ATI scale, was slightly lower in patients (score: mean 3.62, SD 1.35 out of 6) compared to physicians (score: mean 3.88, SD 1.03 out 6). The quality ratings from physicians and patients were comparable and indicated mediocre app quality. Technical affinity, as assessed by using the ATI scale, was slightly lower for patients. Adequate apps for patients with chronic wounds remain limited, emphasizing the need for improved app development to meet patient needs. The ATI scale proved valuable for assessing technical affinity among different user groups.