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He Y, Zhu W, Wang T, Chen H, Xin J, Liu Y, Lei J, Liang J. Mining User Reviews From Hypertension Management Mobile Health Apps to Explore Factors Influencing User Satisfaction and Their Asymmetry: Comparative Study. JMIR Mhealth Uhealth 2024; 12:e55199. [PMID: 38547475 PMCID: PMC11009850 DOI: 10.2196/55199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 12/19/2023] [Accepted: 03/14/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Hypertension significantly impacts the well-being and health of individuals globally. Hypertension management apps (HMAs) have been shown to assist patients in controlling blood pressure (BP), with their efficacy validated in clinical trials. However, the utilization of HMAs continues to be suboptimal. Presently, there is a dearth of real-world research based on big data and exploratory mining that compares Chinese and American HMAs. OBJECTIVE This study aims to systematically gather HMAs and their user reviews from both China and the United States. Subsequently, using data mining techniques, the study aims to compare the user experience, satisfaction levels, influencing factors, and asymmetry between Chinese and American users of HMAs. In addition, the study seeks to assess the disparities in satisfaction and its determinants while delving into the asymmetry of these factors. METHODS The study sourced HMAs and user reviews from 10 prominent Chinese and American app stores globally. Using the latent Dirichlet allocation (LDA) topic model, the research identified various topics within user reviews. Subsequently, the Tobit model was used to investigate the impact and distinctions of each topic on user satisfaction. The Wald test was applied to analyze differences in effects across various factors. RESULTS We examined a total of 261 HMAs along with their associated user reviews, amounting to 116,686 reviews in total. In terms of quantity and overall satisfaction levels, Chinese HMAs (n=91) and corresponding reviews (n=16,561) were notably fewer compared with their American counterparts (n=220 HMAs and n=100,125 reviews). The overall satisfaction rate among HMA users was 75.22% (87,773/116,686), with Chinese HMAs demonstrating a higher satisfaction rate (13,866/16,561, 83.73%) compared with that for American HMAs (73,907/100,125, 73.81%). Chinese users primarily focus on reliability (2165/16,561, 13.07%) and measurement accuracy (2091/16,561, 12.63%) when considering HMAs, whereas American users prioritize BP tracking (17,285/100,125, 17.26%) and data synchronization (12,837/100,125, 12.82%). Seven factors (easy to use: P<.001; measurement accuracy: P<.001; compatibility: P<.001; cost: P<.001; heart rate detection function: P=.02; blood pressure tracking function: P<.001; and interface design: P=.01) significantly influenced the positive deviation (PD) of Chinese HMA user satisfaction, while 8 factors (easy to use: P<.001; reliability: P<.001; measurement accuracy: P<.001; compatibility: P<.001; cost: P<.001; interface design: P<.001; real-time: P<.001; and data privacy: P=.001) affected the negative deviation (ND). Notably, BP tracking had the greatest effect on PD (β=.354, P<.001), while cost had the most significant impact on ND (β=3.703, P<.001). All 12 factors (easy to use: P<.001; blood pressure tracking function: P<.001; data synchronization: P<.001; blood pressure management effect: P<.001; heart rate detection function: P<.001; data sharing: P<.001; reliability: P<.001; compatibility: P<.001; interface design: P<.001; advertisement distribution: P<.001; measurement accuracy: P<.001; and cost: P<.001) significantly influenced the PD and ND of American HMA user satisfaction. Notably, BP tracking had the greatest effect on PD (β=0.312, P<.001), while data synchronization had the most significant impact on ND (β=2.662, P<.001). In addition, the influencing factors of PD and ND in user satisfaction of HMA in China and the United States are different. CONCLUSIONS User satisfaction factors varied significantly between different countries, showing considerable asymmetry. For Chinese HMA users, ease of use and interface design emerged as motivational factors, while factors such as cost, measurement accuracy, and compatibility primarily contributed to user dissatisfaction. For American HMA users, motivational factors were ease of use, BP tracking, BP management effect, interface design, measurement accuracy, and cost. Moreover, users expect features such as data sharing, synchronization, software reliability, compatibility, heart rate detection, and nonintrusive advertisement distribution. Tailored experience plans should be devised for different user groups in various countries to address these diverse preferences and requirements.
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Affiliation(s)
- Yunfan He
- Center for Health Policy Studies, School of Public Health, Zhejiang University, Hangzhou, China
| | - Wei Zhu
- Department of Cardiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, China
| | - Tong Wang
- School of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qingdao, China
- School of Basic Medical Sciences, Shandong University, Jinan, China
- Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China
| | - Han Chen
- Department of Cardiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Junyi Xin
- School of Information Engineering, Hangzhou Medical College, Hangzhou, China
| | | | - Jianbo Lei
- Clinical Research Center, Affiliated Hospital of Southwest Medical University, Luzhou, China
- The First Affiliated Hospital, Hainan Medical University, Haikou, China
- Center for Medical Informatics, Health Science Center, Peking University, Beijing, China
| | - Jun Liang
- Center for Health Policy Studies, School of Public Health, Zhejiang University, Hangzhou, China
- Department of AI and IT, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cancer Prevention and Intervention,, China National Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, China
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
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Liang J, He Y, Xie J, Fan X, Liu Y, Wen Q, Shen D, Xu J, Gu S, Lei J. Mining electronic health records using artificial intelligence: Bibliometric and content analyses for current research status and product conversion. J Biomed Inform 2023; 146:104480. [PMID: 37657713 DOI: 10.1016/j.jbi.2023.104480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/16/2023] [Accepted: 08/27/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND The use of Electronic Health Records is the most important milestone in the digitization and intelligence of the entire medical industry. AI can effectively mine the immense medical information contained in EHRs, potentially assist doctors in reducing many medical errors. OBJECTIVE This article aims to summarize the research status and trends in using AI to mine medical information from EHRs for the past thirteen years and investigate its information application. METHODS A systematic search was carried out in 5 databases, including Web of Science Core Collection and PubMed, to identify research using AI to mine medical information from EHRs for the past thirteen years. Furthermore, bibliometric and content analysis were used to explore the research hotspots and trends, and systematically analyze the conversion rate of research resources in this field. RESULTS A total of 631 articles were included and analyzed. The number of published articles has increased rapidly after 2017, with an average annual growth rate of 55.73%. The US (41.68%) and China (19.65%) publish the most articles, but there is a lack of international cooperation. The extraction of disease lesions is a hot topic at present, and the research topic is gradually shifting from disease risk grading to disease risk prediction. Classification (66%), and regress (15%) are the main implemented AI tasks. For AI algorithms, deep learning (31.70%), decision tree algorithms family (26.47%), and regression algorithms family (17.43%) are used most frequently. The funding rate for publications is 69.26%, and the input-output conversion rate is 21.05%. CONCLUSIONS Over the past decade, the use of AI to mine medical information from EHRs has been developing rapidly. However, it is necessary to strengthen international cooperation, improve EHRs data availability, focus on interpretable AI algorithms, and improve the resource conversion rate in future research.
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Affiliation(s)
- Jun Liang
- IT Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; Center for Health Policy Studies, School of Public Health, Zhejiang University, Hangzhou, Zhejiang Province, China; Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Yunfan He
- Center for Health Policy Studies, School of Public Health, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Jun Xie
- Information Technology Center, West China Hospital of Sichuan University/Engineering Research Center of Medical Information Technology, Ministry of Education, Chengdu, Sichuan Province, China
| | - Xianming Fan
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Yiqi Liu
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, China
| | - Qinglian Wen
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Dongxia Shen
- Editorial Department of Journal of Practical Oncology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Jie Xu
- IT Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Shuo Gu
- Hainan Provincial Center for Neurological Diseases, Department of Pediatric Neurosurgery of The First Affiliated Hospital, Hainan Medical University, Haikou, Hainan Province, China.
| | - Jianbo Lei
- Clinical Research Center, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China; School of Medical Information and Engineering, SouthWest Medical University, Luzhou, Sichuan Province, China; Institute of Medical Technology, Health Science Center, Peking University, Beijing, China.
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Hamideh Kerdar S, Gwiasda M, Berger B, Rathjens L, Schwarz S, Jenetzky E, Martin DD. Predictors of sustained use of mobile health applications: Content analysis of user perspectives from a fever management app. Digit Health 2023; 9:20552076231180418. [PMID: 37312942 PMCID: PMC10259139 DOI: 10.1177/20552076231180418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 05/19/2023] [Indexed: 06/15/2023] Open
Abstract
Objectives Mobile health applications could be means of educating and changing behaviours of their users. Their features and qualities determine the sustainability of use. The FeverApp with two main features of information and documentation is a research-based app. In this observational cohort study, to evaluate the influential predictors of use, users' feedback on the FeverApp, were analyzed. Methods Feedback is given using a structured questionnaire, four Likert items and two open questions regarding positive and negative impressions, available via app menu. Conventional content analysis (inductive approach) on the two open questions was performed. Comments were grouped into 12 codes. These codes were grouped hierarchically in an iterative process into nine subcategories and lastly into two main categories 'format' and 'content'. Descriptive and quantitative analysis were performed. Results Out of 8243 users, 1804 of them answered the feedback questionnaire. The features of the app (N = 344), followed by the information aspect (N = 330) were most frequently mentioned. Documentation process (N = 226), request for new features or improvement of the current ones (N = 193), and functioning (N = 132) were also highlighted in users' feedback. App's ease of use, design and being informative were important for the users. The first impression of the app seems important as the majority of feedback were given during the first month of using the app. Conclusion In-app feedback function could highlight shortcomings and strengths of mobile health apps. Taking users' feedback into consideration could increase the chance of sustained use. Besides ease of use and clear, likeable designs, users want apps that serve their needs while saving time.
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Affiliation(s)
- Sara Hamideh Kerdar
- Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Moritz Gwiasda
- Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Bettina Berger
- Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Larisa Rathjens
- Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Silke Schwarz
- Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Ekkehart Jenetzky
- Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes-Gutenberg-University, Mainz, Germany
| | - David D Martin
- Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
- Department of Pediatrics, Eberhard-Karls University Tübingen, Tübingen, Germany
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Nuo M, Fang H, Wang T, Liang J, He Y, Han H, Lei J. Understanding the research on tracking, diagnosing, and intervening in sleep disorders using mHealth apps: Bibliometric analysis and systematic reviews. Digit Health 2023; 9:20552076231165967. [PMID: 37051563 PMCID: PMC10084565 DOI: 10.1177/20552076231165967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 04/14/2023] Open
Abstract
Objectives In solving the global challenge of sleep disorders, Mobile Health app is one of the important means to monitor, diagnose, and intervene in sleep disorders. This study aims to (1) summarize the status and trends of research in this field; (2) assess the production and usage of sleep mHealth apps; (3) calculate the conversion rate of grants that the proportion of newly developed apps from being funded and developed to published on application stores. Methods Using bibliometric and content analysis methods, based on "Research Paper-Product Output-Product Application" chain and considering the "Research Grants" of articles, we conducted a systematic review of eight databases, to identify relevant studies over the last decade. Results Over the past decade, 1399 authors published 313 papers in 182 journals and conferences. The number of publications increased with an average annual growth of 41.6%. The current focus area is research using cognitive behavioral therapy to intervene in sleep. Sleep-staging tracking is a shortcoming of this field. A total 368 sleep mHealth apps (233 newly developed and 135 existing) were examined in 313 papers; 323 grants supported 178 articles (56.9%). Only 12 of the newly developed apps are used in the real world, resulting in a 9% grant conversion rate. Conclusions In the last decade, the field of tracking, diagnosing, and intervening in sleep disorders using mHealth apps has shown a trend of rapid development. However, the conversion rate of products from being funded and developed for use by end-users is low.
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Affiliation(s)
- Mingfu Nuo
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China
| | - Hongjuan Fang
- Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tong Wang
- Department of Medical Informatics, School of Public Health, Jilin University, Changchun, China
| | - Jun Liang
- IT Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- School of Public Health, Zhejiang University, Hangzhou, China
- Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yunfan He
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Hongbin Han
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China
- Department of Radiology, Peking University Third Hospital, Health Science Center, Peking University, Beijing, China
| | - Jianbo Lei
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China
- Center for Medical Informatics, Health Science Center, Peking University, Beijing, China
- School of Medical Informatics and Engineering, Southwest Medical University, Luzhou, China
- Jianbo Lei, Institute of Medical Technology, Health Science Center, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, China.
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Wang T, Wang W, Liang J, Nuo M, Wen Q, Wei W, Han H, Lei J. Identifying major impact factors affecting the continuance intention of mHealth: a systematic review and multi-subgroup meta-analysis. NPJ Digit Med 2022; 5:145. [PMID: 36109594 PMCID: PMC9476418 DOI: 10.1038/s41746-022-00692-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 09/01/2022] [Indexed: 11/24/2022] Open
Abstract
The mobile health (mHealth) industry is an enormous global market; however, the dropout or continuance of mHealth is a major challenge that is affecting its positive outcomes. To date, the results of studies on the impact factors have been inconsistent. Consequently, research on the pooled effects of impact factors on the continuance intention of mHealth is limited. Therefore, this study aims to systematically analyze quantitative studies on the continuance intention of mHealth and explore the pooled effect of each direct and indirect impact factor. Until October 2021, eight literature databases were searched. Fifty-eight peer-reviewed studies on the impact factors and effects on continuance intention of mHealth were included. Out of the 19 direct impact factors of continuance intention, 15 are significant, with attitude (β = 0.450; 95% CI: 0.135, 0.683), satisfaction (β = 0.406; 95% CI: 0.292, 0.509), health empowerment (β = 0.359; 95% CI: 0.204, 0.497), perceived usefulness (β = 0.343; 95% CI: 0.280, 0.403), and perceived quality of health life (β = 0.315, 95% CI: 0.211, 0.412) having the largest pooled effect coefficients on continuance intention. There is high heterogeneity between the studies; thus, we conducted a subgroup analysis to explore the moderating effect of different characteristics on the impact effects. The geographic region, user type, mHealth type, user age, and publication year significantly moderate influential relationships, such as trust and continuance intention. Thus, mHealth developers should develop personalized continuous use promotion strategies based on user characteristics.
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Affiliation(s)
- Tong Wang
- Department of Medical Informatics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Wei Wang
- Department of Medical Informatics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Jun Liang
- IT Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
- School of Public Health, Zhejiang University, Hangzhou, Zhejiang Province, China
- Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Mingfu Nuo
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China
| | - Qinglian Wen
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Wei Wei
- Department of Gastroenterology, Wangjing hospital, Beijing, China
- Key Laboratory of Traditional Chinese Medicine Treatment of Functional Gastrointestinal Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Hongbin Han
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China.
| | - Jianbo Lei
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China.
- Center for Medical Informatics, Health Science Center, Peking University, Beijing, China.
- School of Medical Informatics and Engineering, Southwest Medical University, Luzhou, Sichuan Province, China.
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