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Farrugia C, Lhostette A, Brasseur M, Biot T, Calmes H, Dendoncker C, Dupret AS, Estheve S, Filiol S, Guidi V, Hadrot L, Perez M, Ravinet A, Tardieu L, Magro L, Alfandari S, Simon N, Guenounou S, Cornillon J. [Diet guidelines in adult and pediatric patient after allogeneic stem cell transplantation (SFGM-TC)]. Bull Cancer 2024:S0007-4551(24)00193-0. [PMID: 38926054 DOI: 10.1016/j.bulcan.2024.04.014] [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: 03/04/2024] [Accepted: 04/20/2024] [Indexed: 06/28/2024]
Abstract
The nutritional status after bone marrow transplant plays an important role in the outcome of patients. Post-allograft dietary instructions are therefore essential to ensure quality nutrition while minimizing the risk of infection. For patients, this is one of their main concerns on discharge from hospital. With the aim of harmonizing post-allograft dietary instructions, a multidisciplinary working group has been set up within a number of French centers performing hematopoietic stem cell allogenic transplantation. The dietary guidelines have been updated by this working group, through videoconference meetings, an online questionnaire, a review of the literature and deliberations at harmonization days. These instructions will be incorporated into the next update of the adult and pediatric post-transplant follow-up booklet.
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Affiliation(s)
- Carole Farrugia
- CHU Saint-Éloi, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - Alexandra Lhostette
- Service d'hémato-onco pédiatrique, CHU ADV, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France
| | - Marion Brasseur
- Service de greffe de moelle, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Thomas Biot
- Service de diététique, CHU de Liège, 1, avenue de l'Hôpital, 4000 Liège, Belgique
| | - Hélène Calmes
- Service d'onco-hématologie pédiatrique, 330, avenue de Grande-Bretagne, 31000 Toulouse, France
| | - Caroline Dendoncker
- Service d'endocrinologie, diabétologie, métabolisme, nutrition, CHU de Lille, Lille, France
| | - Anne Sophie Dupret
- Unité diététique hématologie-oncologie pédiatrique, CHU de La Timone, 54, rue Saint-Pierre, 13005 Marseille, France
| | - Sophie Estheve
- Service d'hématologie, CHU de Sud-Réunion, avenue Président-Mitterrand, 97410 Terre-Sainte, Saint-Pierre, Réunion
| | - Sylivie Filiol
- Service d'hématologie et de thérapie cellulaire, hôpital Nord, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France
| | - Virginie Guidi
- Service d'hématologie adulte, 1, rue Lucie-et-Raymond-Aubrac, 63100 Clermont-Ferrand, France
| | - Lisa Hadrot
- Service d'hématologie, ICANS, 17, rue Albert-Calmette, BP 23025, 67033 Strasbourg, France
| | - Manon Perez
- Service d'hématologie, Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - Aurélie Ravinet
- Service d'hématologie adulte, 1, rue Lucie-et-Raymond-Aubrac, 63100 Clermont-Ferrand, France
| | - Laure Tardieu
- Service d'hématologie et thérapie cellulaire, 2, avenue Martin-Luter-King, 87042 Limoges, France
| | - Léonardo Magro
- Service d'hématologie adulte, CHRU de Lille, Lille, France
| | - Serge Alfandari
- Maladies infectieuses, CH Dron, 59200 Tourcoing, France; CHU de Lille, 59000 Lille, France
| | - Nicolas Simon
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), ULR 7365, CHU de Lille, université de Lille, Lille, France
| | - Sarah Guenounou
- Service d'hématologie, institut universitaire du cancer de Toulouse Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - Jérôme Cornillon
- Service d'hématologie et de thérapie cellulaire, hôpital Nord, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France.
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Dal Bello S, Mancin S, Morales Palomares S, Lopane D, Di Gianfrancesco L, Soligo C, Tarantino T, Perdonò P, Hurle R, Bernardini B, Piccioni F, Pastore M, Pellegrinelli A, Porreca A, Mazzoleni B. Nutritional Prehabilitation in Patients Undergoing Cystectomy: A Systematic Review. Nutrients 2024; 16:1682. [PMID: 38892615 PMCID: PMC11174884 DOI: 10.3390/nu16111682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/15/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND/AIM Nutrition is a key element of the prehabilitation process prior to surgery. The aim of this study was to identify the clinical pathways of nutritional prehabilitation before cystectomy. METHODS A systematic literature review was conducted in PubMed, the Cochrane Library, CINAHL, Scopus and the Web of Science databases. Quality and risk of bias assessment was conducted adhering to the JBI framework and evidence was evaluated according to the Oxford Centre for Evidence Based Medicine levels of evidence. RESULTS Out of 586 records identified, six studies were included. Among them, only two were randomized controlled trials. Immunonutrition has been shown to improve postoperative bowel function (3.12 vs. 3.74 days; RR 0.82; CI, 0.73-0.93; p = 0.0029) and decrease postoperative complications (-36.7%; p = 0.008) and readmission rates (-15.38%; p = 0.03). Furthermore, oral nutritional supplements combined with nutritional counseling demonstrated an accelerated recovery of bowel function (-1 day; p < 0.01), a reduction in the length of hospital stay (-1.75 days; p = 0.01), an improvement in handgrip strength (+6.8%, p < 0.001), an increase in bone mass (+0.3 kg, p = 0.04), and a better BMI value (+2.3%, p = 0.001). CONCLUSIONS Nutritional prehabilitation demonstrates potential in enhancing postoperative outcomes following radical cystectomy. Oral supplements, immunonutrition, and counseling exhibit efficacy in improving postoperative results.
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Affiliation(s)
- Susy Dal Bello
- Veneto Institute of Oncology IOV—IRCCS, 35128 Padua, Italy; (S.D.B.); (C.S.); (T.T.); (P.P.)
| | | | - Sara Morales Palomares
- Department of Pharmacy, Health and Nutritional Sciences (DFSSN), University of Calabria, 87036 Rende, Italy
| | - Diego Lopane
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Luca Di Gianfrancesco
- Veneto Institute of Oncology IOV—IRCCS, 35128 Padua, Italy; (S.D.B.); (C.S.); (T.T.); (P.P.)
| | - Chiara Soligo
- Veneto Institute of Oncology IOV—IRCCS, 35128 Padua, Italy; (S.D.B.); (C.S.); (T.T.); (P.P.)
| | - Tommaso Tarantino
- Veneto Institute of Oncology IOV—IRCCS, 35128 Padua, Italy; (S.D.B.); (C.S.); (T.T.); (P.P.)
| | - Paolo Perdonò
- Veneto Institute of Oncology IOV—IRCCS, 35128 Padua, Italy; (S.D.B.); (C.S.); (T.T.); (P.P.)
| | - Rodolfo Hurle
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | | | | | | | | | - Angelo Porreca
- Veneto Institute of Oncology IOV—IRCCS, 35128 Padua, Italy; (S.D.B.); (C.S.); (T.T.); (P.P.)
| | - Beatrice Mazzoleni
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy;
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3
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Sguanci M, Ferrara G, Palomares SM, Parozzi M, Godino L, Gazineo D, Anastasi G, Mancin S. Dysgeusia and Chronic Kidney Disease: A Scoping Review. J Ren Nutr 2024:S1051-2276(24)00067-0. [PMID: 38729584 DOI: 10.1053/j.jrn.2024.04.005] [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: 01/16/2024] [Revised: 04/15/2024] [Accepted: 04/26/2024] [Indexed: 05/12/2024] Open
Abstract
Dysgeusia is a common altered taste perception in chronic kidney disease patients. The study aims to identify available treatments for educating, screening, and clinically managing dysgeusia in this population. A scoping review was conducted following the protocol of Arksey and O'Malley, incorporating the Joanna Briggs Institute methodology, and adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Among the 424 identified records, 13 studies were included. Screening methodologies, educational strategies, particularly a hospital-based program focusing on salt reduction, showed a significant improvement in dysgeusia (P < .001). The identified clinical treatments exclusively included oral zinc supplementation, with dosages ranging from 50 to 220 mg, reporting heterogeneous results not consistent across different studies. The personalized management of dysgeusia associated with chronic kidney disease is crucial, requiring targeted education and treatment protocols to prevent and address nutritional complications such as malnutrition.
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Affiliation(s)
- Marco Sguanci
- Italian Nephrological Nursing Society (SIAN), Olbia, Italy; Department of Medicine and Surgery, Research Unit of Nursing Science, University of Rome, Rome, Italy
| | - Gaetano Ferrara
- Italian Nephrological Nursing Society (SIAN), Olbia, Italy; Nephrology and Dialysis Unit, Ramazzini Hospital, Carpi, Italy
| | - Sara Morales Palomares
- Italian Nephrological Nursing Society (SIAN), Olbia, Italy; Department of Pharmacy, Health and Nutritional Sciences (DFSSN), University of Calabria, Rende, Italy
| | - Mauro Parozzi
- Italian Nephrological Nursing Society (SIAN), Olbia, Italy; Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
| | - Lea Godino
- Italian Nephrological Nursing Society (SIAN), Olbia, Italy; Medical Genetics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Domenica Gazineo
- Italian Nephrological Nursing Society (SIAN), Olbia, Italy; Governo Clinico e Qualità, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giuliano Anastasi
- Italian Nephrological Nursing Society (SIAN), Olbia, Italy; Department of Trauma, AOU G. Martino University Hospital, Messina, Italy
| | - Stefano Mancin
- Italian Nephrological Nursing Society (SIAN), Olbia, Italy; IRCCS Humanitas Research Hospital, Milan, Italy
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Mancin S, Sguanci M, Anastasi G, Godino L, Lo Cascio A, Morenghi E, Piredda M, Grazia De Marinis M. A methodological framework for rigorous systematic reviews: Tailoring comprehensive analyses to clinicians and healthcare professionals. Methods 2024; 225:38-43. [PMID: 38499262 DOI: 10.1016/j.ymeth.2024.03.006] [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: 02/24/2024] [Revised: 03/12/2024] [Accepted: 03/12/2024] [Indexed: 03/20/2024] Open
Abstract
Systematic reviews represent a fundamental study design, providing the highest level of evidence across diverse research inquiries, encompassing both public health and clinical research and practice. However, for healthcare professionals, the process of selecting, synthesizing, and interpreting evidence can be challenging, and requires specialized skills. Therefore, it is imperative to explore innovative solutions aimed at simplifying and making the traditional systematic review process more accessible while ensuring the validity and reliability of results. In this perspective, our research objective is to develop a systematic review framework that, while maintaining a rigorous methodological approach, streamlines the process for healthcare professionals. This study describes such approach in every phase, from the collection of evidence to the writing of the text, creating a guide for the healthcare professional who approaches this type of research. The qualitative and organizational analysis tools are also described, providing useful information for the use of non-paid programs. This systematic review aims to develop a framework with a rigorous methodological approach that allows simplify the process for clinicians and healthcare professionals. The implementation of this methodology in clinical practice offers new perspectives to ensure a thoughtful consideration and application of scientific evidence and opens the way to innovative and easily accessible solutions to facilitate the conduct of systematic reviews in the clinical care setting.
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Affiliation(s)
- Stefano Mancin
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
| | - Marco Sguanci
- Department of Medicine and Surgery, Research Unit of Nursing Science, University Campus Bio-Medico, Roma, Italy
| | - Giuliano Anastasi
- Department of Trauma, AOU G. Martino University Hospital, Messina, Italy
| | - Lea Godino
- Medical Genetics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Alessio Lo Cascio
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | | | - Michela Piredda
- Department of Medicine and Surgery, Research Unit of Nursing Science, University Campus Bio-Medico, Roma, Italy
| | - Maria Grazia De Marinis
- Department of Medicine and Surgery, Research Unit of Nursing Science, University Campus Bio-Medico, Roma, Italy; Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
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Schab M, Skoczen S. Nutritional status, body composition and diet quality in children with cancer. Front Oncol 2024; 14:1389657. [PMID: 38706604 PMCID: PMC11066172 DOI: 10.3389/fonc.2024.1389657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/02/2024] [Indexed: 05/07/2024] Open
Abstract
During cancer treatment, nutritional status disorders such as malnutrition or obesity affect the tolerance of cancer treatment, quality of life, but also the pharmacokinetics of drugs. It is hypothesized that changes in fat and lean body mass can modify chemotherapy volume distribution, metabolism and clearance. In children with cancer, lean body mass decreases or remains low during treatment and fat mass increases. Body composition is influenced by the cancer itself, aggressive multimodal-therapies, changes in metabolism, unbalanced diet and reduced physical activity. Due to the side effects of treatment, including changes in the sense of taste and smell, nausea, vomiting, diarrhea, and stress, eating according to recommendation for macronutrients and micronutrients is difficult. Research indicates that throughout cancer treatment, the consumption of fruits, vegetables, and dairy products tends to be insufficient, whereas there is an elevated intake of sugar and unhealthy snacks. Children exhibit a preference for high-carbohydrate, salty, and strongly flavored products. This review revealed the importance of body composition and its changes during cancer treatment in children, as well as eating habits and diet quality.
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Affiliation(s)
- Magdalena Schab
- Doctoral School of Medical and Health Science, Jagiellonian University Medical College, Krakow, Poland
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Szymon Skoczen
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
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Mazzoleni B, Ferrari G, Savioni F, Gravante F, Lopane D, Dacomi A, Coldani C, Tomaiuolo G, Cattani D, Anastasi G, Mancin S. Non-pharmacological strategies to alleviate dysgeusia in patients undergoing chemotherapy: A systematic review. Eur J Oncol Nurs 2024; 70:102569. [PMID: 38593535 DOI: 10.1016/j.ejon.2024.102569] [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: 02/10/2024] [Revised: 03/10/2024] [Accepted: 03/16/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE Dysgeusia is a common side effect in oncology patients, significantly impacting their quality of life. This systematic review aims to evaluate the effectiveness of non-pharmacological strategies in treating dysgeusia in patients undergoing chemotherapy or radiotherapy. METHODS Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive literature search across five databases: PubMed, Embase, Cochrane Library, CINAHL, and the British Nursing Database. We used the Joanna Briggs Institute Critical Appraisal Tools to assess the quality of the included studies. A harvest plot was used to synthesise evidence about the differential effects of population-level interventions. RESULTS Nine studies of non-pharmacological strategies to manage dysgeusia were included. These studies encompassed a variety of interventions, including oral applications and supplements, instrumental techniques, and educational programs. The review identified promising interventions such as cryotherapy and Miraculine supplementation, which showed potential in mitigating taste alterations. Instrumental techniques like photobiomodulation therapy and complementary and integrative medicine approaches, including acupuncture and herbs, were also found to be beneficial. Educational and self-management strategies emerged as effective interventions for empowering patients to manage dysgeusia. Despite the diversity of interventions and the limitations of the included studies, such as small sample sizes and geographical differences, these findings underscore the potential of non-pharmacological strategies in managing dysgeusia. CONCLUSION The results support the integration of these strategies into clinical practice, highlighting the importance of multidisciplinary approaches to improve patient care. Further research should prioritize rigorous studies to enhance evidence and explore long-term effects.
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Affiliation(s)
- Beatrice Mazzoleni
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Giulia Ferrari
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | | | - Francesco Gravante
- Department of Anaesthesiology, Intensive Care Unit, Local Health Autority of Caserta, Caserta, Italy
| | - Diego Lopane
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Alessandra Dacomi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Chiara Coldani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giuseppina Tomaiuolo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Daniela Cattani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giuliano Anastasi
- Department of Trauma, AOU G. Martino University Hospital, Messina, Italy
| | - Stefano Mancin
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
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7
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De Pasquale G, Mancin S, Matteucci S, Cattani D, Pastore M, Franzese C, Scorsetti M, Mazzoleni B. Nutritional prehabilitation in head and neck cancer: A systematic review of literature. Clin Nutr ESPEN 2023; 58:326-334. [PMID: 38057023 DOI: 10.1016/j.clnesp.2023.10.033] [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: 07/17/2023] [Revised: 10/20/2023] [Accepted: 10/26/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND/SCOPE Malnutrition is a common problem among patients with head and neck cancer and can have adverse effects on overall health and treatment outcomes. Nutritional and physical prehabilitation are potential strategies to optimize the nutritional status of these patients. This systematic review aimed to identify and describe prehabilitative interventions that can promote an improvement in nutritional status. METHODS A systematic review of the literature was conducted in the databases PubMed/Medline, Embase, CINAHL, Scopus and on the platform Web of Science and in Cochrane Library. The selected studies concern adults with head and neck tumours, not malnourished at the time of diagnosis, who undergo nutritional or physical prehabilitation. RESULTS Out of 1369 results, 7 studies were included. Multimodal prehabilitation interventions that combine nutritional counseling, oral nutritional supplements, and swallowing exercises to prevent dysphagia have shown positive outcomes in maintaining caloric intake, body weight, swallowing ability, and a reduced incidence of fibrosis in the upper gastrointestinal tract, as well as improving quality of life. CONCLUSION Despite the limited number of clinical studies available in the literature, the results suggest that nutritional and physical prehabilitation interventions have a positive effect on the nutritional status and clinical outcomes of patients with head and neck cancer, helping mitigate the risk of malnutrition and improve general well-being.
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Affiliation(s)
| | - Stefano Mancin
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
| | | | - Daniela Cattani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | | | - Ciro Franzese
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Marta Scorsetti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Beatrice Mazzoleni
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
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Andreoli D, Mancin S, Sguanci M, Ricco M, Gazineo D, Godino L. Assessment of healthcare application quality: Development of a standardized methods for healthcare professionals. MethodsX 2023; 11:102391. [PMID: 37791010 PMCID: PMC10542414 DOI: 10.1016/j.mex.2023.102391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/21/2023] [Indexed: 10/05/2023] Open
Abstract
The advancement of the mobile app market is reshaping healthcare, emphasizing the imperative for quality and efficacy in health applications. This methodology has been devised to assess mobile health applications, aiming to assist healthcare professionals in selecting apps for e-healthcare consumers. Key facets of this approach are: •A stringent selection process within mobile app stores•A standardized assessment using the Mobile App Rating Scale to achieve consistent and replicable evaluations, systematically organizing app evaluations•A comprehensive framework guiding healthcare practitioners in determining which apps to integrate into clinical practice and which to exclude Central to this method is the emphasis on distinguishing apps that enhance clinical practice from those that fall short in important areas such as the effectiveness of proposed health features, data accuracy, adherence to clinical guidelines, data security, and user privacy. With heightened attention to usability and accessibility, the methodology also addresses the common risks inherent in mHealth implementation, ensuring that selected apps not only meet technical criteria but also align with the broader healthcare ecosystem's needs and challenges.
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Affiliation(s)
- Desirèe Andreoli
- Azienda Ospedaliera Santa Maria della Misericordia, Perugia, Italy
- SIAN, Società Infermieri Area Nefrologica, Olbia, Italy
| | - Stefano Mancin
- SIAN, Società Infermieri Area Nefrologica, Olbia, Italy
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Marco Sguanci
- Department of Medicine and Surgery, Research Unit of Nursing Science, Università Campus Bio-Medico di Roma, Italy
| | - Mattia Ricco
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Domenica Gazineo
- SIAN, Società Infermieri Area Nefrologica, Olbia, Italy
- Governo Clinico e Qualità, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Lea Godino
- SIAN, Società Infermieri Area Nefrologica, Olbia, Italy
- Medical Genetics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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