Evidence mapPaperPMID 40705705Full record

SynthesisJournal of medical Internet research2025

Adherence to Usability and Accessibility Principles in Digital Health Applications for Patients With Diabetes: Systematic Review.

Sarah Louise Watson, Hanan Khalid Mofty, Michael Donnelly, Tunde Peto, Ruth Esther Hogg

Abstract readSystematic Review
In one paragraph

Synthesis in Journal of medical Internet research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Sarah Louise WatsonCentre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.ORCID https://orcid.org/0000-0003-4758-7112
Hanan Khalid MoftyCentre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.ORCID https://orcid.org/0000-0002-3614-7990
Michael DonnellyCentre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.ORCID https://orcid.org/0000-0001-8380-7413
Tunde PetoCentre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.ORCID https://orcid.org/0000-0001-6265-0381
Ruth Esther HoggCentre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.ORCID https://orcid.org/0000-0001-9413-2669

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHealth apps have the potential to enable people with diabetes to access care more easily, monitor their condition, and reduce the number of times they need to attend health care appointments. However, the development pipeline for apps may differ widely before the apps are released for use, due to limited funding, difficulty in obtaining iterative feedback from patients/users, and varying levels of developer expertise. In response to concerns about the quality and consistency of apps being released, two guidelines were created: the Digital Technology Assessment Criteria (DTAC) and the National Institute for Health and Care Excellence (NICE) Evidence Standards Framework. These two frameworks aim to standardize the development and evaluation of digital health technologies (DHTs). They outline core requirements, such as accessibility, clinical safety, data protection, interoperability, usability, and safeguarding, which help ensure that digital health apps are accessible, safe, effective, and suitable for real-world use.

objectiveThis systematic review evaluated the performance of diabetes digital health apps, as presented in published studies, in terms of adherence to DTAC 2021 and NICE 2022 guidelines during development.

methodsWe systematically searched Embase and MEDLINE and identified 43 studies that met the inclusion criteria. Each study was assessed against 13 binary scoring criteria derived from the two frameworks.

resultsOur findings highlighted that 93% (n=40) of the studies met fewer than 40% of the recommended criteria. Specifically, 88.4% (n=38) studies did not report accurate and reliable measurements, 86% (n=37) omitted app accuracy validation, and 83.7% (n=36) failed to address inequalities considerations. Only 3 (7%) studies achieved scores between 7 and 9 out of a possible 13, and none fully adhered to the guideline criteria.

conclusionsThese results suggest a significant gap between digital health guidelines and real-world app development practices. We recommend the adoption of DTAC and NICE guidelines more widely and consistently during design and development. Additionally, we suggest that journals request that authors submit an adherence checklist alongside their manuscript to improve standardization and transparency across digital health publications.

trial registrationPROSPERO CRD42022322040; https://www.crd.york.ac.uk/PROSPERO/view/CRD42022322040.

Indexed as

Diabetes MellitusMobile ApplicationsDigital HealthHumansTelemedicineaccessibilityadherencediabetes appsdigital health guidelinesreliability, usability

Identifiers

PMID40705705
PMCPMC12514418

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.