Smartphone apps on burns first aid: A review of the advice

An artificial intelligence language model improves readability of burns first aid information

AIMS

This study aimed to assess the potential of using an artificial intelligence (AI) large language model to improve the readability of burns first aid information.

METHODS

An AI language model (ChatGPT-3) was used to rewrite content from the top 50 English-language webpages containing burns first aid information to be understandable by an individual with the literacy level of an 11-year-old, as recommended by the American Medical Association and Health Education England. The assessment of readability was conducted using five validated tools.

RESULTS

In their original form, only 4% of the patient education materials (PEMs) met the target readability level across all tools. The median grade was 6.9 (SD=1.1). One-sample one-tailed t-test revealed that this was not significantly below the target (p = .31). After AI-modification, 18% of PEMs reached the target level using all tools, with a median grade of 6 (SD=0.9), which was significantly below the target level (p < .001). Once rewritten using AI, paired t-test demonstrated that all readability scores improved significantly (p < .001).

CONCLUSION

Utilising an AI language model proved an effective and viable method for enhancing readability of burns first aid information.

Readability, accountability, and quality of burns first aid information available online

AIM

To assess the readability, accountability, and quality of burns first aid information available online.

METHODS

The top 50 English language webpages containing burns first aid information were compiled and categorised. Readability was measured using five validated tools. Accountability was assessed using the Journal of the American Medical Association (JAMA) benchmarks. Quality was evaluated using a scale based on previous literature.

RESULTS

Two (4%) webpages were judged to be at the target reading level using all tools. Median grade ranged from 4.6 to 9.6 (M = 6.9, SD = 1.1). One-sample one-tailed t-test determined that median grade was not significantly below the target grade of ≤ 6.9 (p = 0.314). Only seven (14%) webpages satisfied all the JAMA accountability benchmarks. No webpages fulfilled all 15 quality criteria. Mean quality score was 9.8 (SD = 2.4). Only 27 (54%) advised 20 min of cooling. One-way analysis of variance demonstrated that accountability was influenced by source (p = 0.01). Pearson's correlation coefficient revealed that accountability and quality had a positive correlation (r = 0.32, p = 0.02).

CONCLUSION

Much of the burns first aid information available online is written above the recommended reading level and fails to meet standards of accountability or quality.

Is the quality of mobile health applications for burns being adequately assessed?

High quality mobile health applications (mhealth apps) have the potential to enhance the prevention, diagnosis and treatment of burns. The primary aim of this study was to evaluate whether the quality of mhealth apps for burns care is being adequately assessed. The secondary aim was to determine whether these apps meet regulatory standards in the UK. We searched AMED, BNI, CINAHL, Cochrane library, Embase, Emcare, Medline and PsychInfo to identify studies assessing mhealth app quality for burns. The PRISMA reporting guideline was adhered to. Two independent reviewers screened abstracts to identify relevant studies. The quality of identified studies was assessed according to the framework proposed by Nouri et al, including design, information/content, usability, functionality, ethical issues, security/privacy and user-perceived value. Of the 28 included studies, none assessed all seven domains of quality. Design was assessed in 4/28 studies; information/content in 26/28 studies; usability in 12/28 studies; functionality in 10/28 studies; ethical issues were never assessed in any studies; security/privacy was not assessed; subjective assessment was made in 9/28 studies. 17/28 studies included apps that met the definition of 'medical device' according to MHRA guidance, yet only one app was appropriately certified with the UK Conformity Assessed (UKCA) mark. The quality of mHealth apps for burns are not being adequately assessed. The majority of apps should be considered medical devices according to UK standards, yet only one was appropriately certified. Regulatory bodies should support mhealth app developers, so as to improve quality control whilst simultaneously fostering innovation.

A Rapid Review of Burns First Aid Guidelines: Is There Consistency Across International Guidelines?

We conducted a rapid review of current international and Australian/New Zealand guidelines on first aid for burns to identify any critical variation and any recent major changes in the literature that would warrant a significant change to current recommendations. A search was conducted to identify Australian/New Zealand and international first aid guidelines for burn care using guideline databases, and we compared key recommendations from each guideline relating to burns first aid. A literature search of relevant databases (Medline, Embase, Cochrane Database of Systematic Reviews, PROSPERO international register of systematic reviews, and ClinicalTrials.gov databases) was conducted to identify existing and in-progress research published on the topic of first aid for burn injuries. Seven guidelines were identified from the Australia/New Zealand region, and 11 international guidelines were identified from the United States of America and Europe. All Australian and New Zealand guidelines recommended a cooling duration of 20 minutes and made some mention of when to refer a burn for medical evaluation, while international guidelines saw cooling duration variation, a number of guidelines failed to mention referral criteria. The review of published systematic reviews and clinical trials revealed a lack of new evidence in the last six years. Our rapid review identified key variation between first aid guidelines for burns that would benefit from the development of an international consensus on management. We identified no new significant evidence that would alter guideline recommendations and did not identify any upcoming reviews or clinical trials on this subject.