pmc.ncbi.nlm.nih.gov Open in urlscan Pro
2600:1901:0:c831::  Public Scan

Submitted URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9618024/
Effective URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC9618024/
Submission: On November 22 via api from US — Scanned from DE

Form analysis 4 forms found in the DOM

GET https://www.ncbi.nlm.nih.gov/search/all/

<form action="https://www.ncbi.nlm.nih.gov/search/all/" aria-describedby="search-field-desktop-navigation-help-text" autocomplete="off" class="usa-search usa-search--big ncbi-search-panel__form" data-testid="form" method="GET" role="search">
  <label class="usa-sr-only" data-testid="label" for="search-field-desktop-navigation"> Search… </label>
  <input class="usa-input" data-testid="textInput" id="search-field-desktop-navigation" name="term" placeholder="Search NCBI" type="search" value="">
  <button type="submit" class="usa-button
           

           
               
               
               
               
            

           
           
           
           " data-testid="button" data-ga-category="header" data-ga-action="NCBI" data-ga-label="header_search_button">
    <span class="usa-search__submit-text"> Search NCBI </span>
  </button>
</form>

<form class="usa-search usa-search--small ncbi--hide-at-desktop margin-top-6" role="search">
  <label class="usa-sr-only" for="search-field"> Search </label>
  <input class="usa-input" id="search-field-mobile-navigation" type="search" placeholder="Search NCBI" name="search">
  <button type="submit" class="usa-button
           

           
               
               
               
               
            

           
           
           
           " data-ga-category="header" data-ga-action="NCBI" data-ga-label="header_search_button">
    <!-- This SVG should be kept inline and not replaced with a link to the icon as otherwise it will render in the wrong color -->
    <img
      src="data:image/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIGhlaWdodD0iMjQiIHZpZXdCb3g9IjAgMCAyNCAyNCIgd2lkdGg9IjI0Ij48cGF0aCBkPSJNMCAwaDI0djI0SDB6IiBmaWxsPSJub25lIi8+PHBhdGggZmlsbD0iI2ZmZiIgZD0iTTE1LjUgMTRoLS43OWwtLjI4LS4yN0E2LjQ3MSA2LjQ3MSAwIDAgMCAxNiA5LjUgNi41IDYuNSAwIDEgMCA5LjUgMTZjMS42MSAwIDMuMDktLjU5IDQuMjMtMS41N2wuMjcuMjh2Ljc5bDUgNC45OUwyMC40OSAxOWwtNC45OS01em0tNiAwQzcuMDEgMTQgNSAxMS45OSA1IDkuNVM3LjAxIDUgOS41IDUgMTQgNy4wMSAxNCA5LjUgMTEuOTkgMTQgOS41IDE0eiIvPjwvc3ZnPg=="
      class="usa-search__submit-icon" alt="Search">
  </button>
</form>

<form class="usa-search usa-search--extra usa-search--article-right-column pmc-header__search__form" autocomplete="off" role="search">
  <label class="usa-sr-only" for="pmc-search">Search PMC Full-Text Archive</label>
  <span class="autoComplete_wrapper flex-1">
    <input class="usa-input width-full maxw-none" required="required" placeholder="Search PMC Full-Text Archive" id="pmc-search" type="search" name="term" data-autocomplete-url="/search/autocomplete/" aria-controls="autoComplete_list_1"
      aria-autocomplete="both" role="combobox" aria-owns="autoComplete_list_1" aria-haspopup="true" aria-expanded="false">
    <ul id="autoComplete_list_1" role="listbox" hidden="" aria-label="Suggestions"></ul>
  </span>
  <button class="usa-button" type="submit" formaction="https://www.ncbi.nlm.nih.gov/pmc/" data-ga-category="search" data-ga-action="PMC" data-ga-label="PMC_search_button">
    <span class="usa-search__submit-text">Search in PMC</span>
    <img src="/static/img/usa-icons-bg/search--white.svg" class="usa-search__submit-icon" alt="Search">
  </button>
</form>

<form id="collections-action-dialog-form" class="usa-form maxw-full collections-action-panel-form action-panel-content action-form action-panel-smaller-selectors" data-existing-collections-url="/list-existing-collections/"
  data-add-to-existing-collection-url="/add-to-existing-collection/" data-create-and-add-to-new-collection-url="/create-and-add-to-new-collection/" data-myncbi-max-collection-name-length="100"
  data-collections-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/">
  <input type="hidden" name="csrfmiddlewaretoken" value="513E3JdqFM7CNBIFJk2rck5R7CvIzmtdJjMmYDhqSabvCeEfjwLcWBS9JkR75djF">
  <fieldset class="usa-fieldset margin-bottom-2">
    <div class="usa-radio">
      <input type="radio" id="collections-action-dialog-new" class="usa-radio__input usa-radio__input--tile collections-new  margin-top-0" name="collections" value="new" data-ga-category="collections_button" data-ga-action="click"
        data-ga-label="collections_radio_new">
      <label class="usa-radio__label" for="collections-action-dialog-new">Create a new collection</label>
    </div>
    <div class="usa-radio">
      <input type="radio" id="collections-action-dialog-existing" class="usa-radio__input usa-radio__input--tile collections-existing" name="collections" value="existing" checked="true" data-ga-category="collections_button" data-ga-action="click"
        data-ga-label="collections_radio_existing">
      <label class="usa-radio__label" for="collections-action-dialog-existing">Add to an existing collection</label>
    </div>
  </fieldset>
  <fieldset class="usa-fieldset margin-bottom-2">
    <div class="action-panel-control-wrap new-collections-controls">
      <label for="collections-action-dialog-add-to-new" class="usa-label margin-top-0"> Name your collection <abbr title="required" class="usa-hint usa-hint--required text-no-underline">*</abbr>
      </label>
      <input type="text" name="add-to-new-collection" id="collections-action-dialog-add-to-new" class="usa-input collections-action-add-to-new" pattern="[^&quot;&amp;=<>/]*"
        title="The following characters are not allowed in the Name field: &quot;&amp;=<>/" maxlength="" data-ga-category="collections_button" data-ga-action="create_collection" data-ga-label="non_favorties_collection" required="">
    </div>
    <div class="action-panel-control-wrap existing-collections-controls">
      <label for="collections-action-dialog-add-to-existing" class="usa-label margin-top-0"> Choose a collection </label>
      <select id="collections-action-dialog-add-to-existing" class="usa-select collections-action-add-to-existing" data-ga-category="collections_button" data-ga-action="select_collection"
        data-ga-label="($('.collections-action-add-to-existing').val() === 'Favorites') ? 'Favorites' : 'non_favorites_collection'">
      </select>
      <div class="collections-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your collection due to an error<br>
        <a href="#">Please try again</a>
      </div>
    </div>
  </fieldset>
  <div class="display-inline-flex">
    <button class="usa-button margin-top-0 action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore="" data-ga-category="collections_button" data-ga-action="click" data-ga-label="add"> Add </button>
    <button class="usa-button usa-button--outline margin-top-0 action-panel-cancel" aria-label="Close 'Add to Collections' panel" ref="linksrc=close_collections_panel" data-ga-category="collections_button" data-ga-action="click"
      data-ga-label="cancel"> Cancel </button>
  </div>
</form>

Text Content

Skip to main content

An official website of the United States government

Here's how you know
Here's how you know

Official websites use .gov
A .gov website belongs to an official government organization in the United
States.

Secure .gov websites use HTTPS
A lock ( Lock Locked padlock icon ) or https:// means you've safely connected to
the .gov website. Share sensitive information only on official, secure websites.


Search
Log in
 * Dashboard
 * Publications
 * Account settings
 * Log out

Search… Search NCBI

Primary site navigation

Search

Logged in as:

 * Dashboard
 * Publications
 * Account settings

Log in
Search PMC Full-Text Archive Search in PMC
 * Advanced Search
 * Journal List
 * User Guide

 * 
 * 
 * 
 * 
 * 


 * PERMALINK
   
   Copy

As a library, NLM provides access to scientific literature. Inclusion in an NLM
database does not imply endorsement of, or agreement with, the contents by NLM
or the National Institutes of Health.
Learn more: PMC Disclaimer | PMC Copyright Notice
BMC Med Inform Decis Mak
. 2022 Oct 30;22:281. doi: 10.1186/s12911-022-02029-8
 * Search in PMC
 * Search in PubMed
 * View in NLM Catalog
 * Add to search


EVALUATING AND RATING HIV/AIDS MOBILE APPS USING THE FEATURE-BASED APPLICATION
RATING METHOD AND MOBILE APP RATING SCALE

Ahmad Raeesi


AHMAD RAEESI

1Student Research Committee, Mashhad University of Medical Sciences, Mashhad,
Iran
2Department of Health Information Sciences, Kerman University of Medical
Sciences, Kerman, Iran
Find articles by Ahmad Raeesi
1,2, Reza Khajouei


REZA KHAJOUEI

3Department of Health Information Sciences, Faculty of Management and Medical
Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
Find articles by Reza Khajouei
3, Leila Ahmadian


LEILA AHMADIAN

4HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV
Surveillance, Institute for Futures Studies in Health, Kerman University of
Medical Sciences, Haft-Bagh Highway, Kerman, Iran
Find articles by Leila Ahmadian
4,✉
 * Author information
 * Article notes
 * Copyright and License information

1Student Research Committee, Mashhad University of Medical Sciences, Mashhad,
Iran
2Department of Health Information Sciences, Kerman University of Medical
Sciences, Kerman, Iran
3Department of Health Information Sciences, Faculty of Management and Medical
Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
4HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV
Surveillance, Institute for Futures Studies in Health, Kerman University of
Medical Sciences, Haft-Bagh Highway, Kerman, Iran
✉

Corresponding author.

Received 2021 Oct 11; Accepted 2022 Oct 21; Collection date 2022.

© The Author(s) 2022

Open AccessThis article is licensed under a Creative Commons Attribution 4.0
International License, which permits use, sharing, adaptation, distribution and
reproduction in any medium or format, as long as you give appropriate credit to
the original author(s) and the source, provide a link to the Creative Commons
licence, and indicate if changes were made. The images or other third party
material in this article are included in the article's Creative Commons licence,
unless indicated otherwise in a credit line to the material. If material is not
included in the article's Creative Commons licence and your intended use is not
permitted by statutory regulation or exceeds the permitted use, you will need to
obtain permission directly from the copyright holder. To view a copy of this
licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons
Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made
available in this article, unless otherwise stated in a credit line to the data.

PMC Copyright notice
PMCID: PMC9618024  PMID: 36310157


ABSTRACT


BACKGROUND

The purpose of this study was to evaluate HIV/AIDS mobile applications using the
Mobile App Rating Scale (MARS) and rate the features of these applications using
the new tool called the Feature-based Application Rating Method (FARM).


METHODS

In this study, all available HIV/AIDS apps in Iran from Cafe Bazaar and Google
Play Store due to inclusion criteria were studied. The evaluation of the quality
of applications was done using the MARS tool and the FARM tool. The FARM, which
was developed in this study, was applied to rank the features of the
applications.


RESULTS

In this study, 79 applications were included. The mean score of all apps using
both tools was 3.58 (SD = 0.95) out of 5. The overall mean quality score based
on the MARS was 3.14 (SD = 0.84), and the mean score of features based on FARM
was 3.81 (SD = 1.23). This study showed a higher than moderate correlation
between the scores assigned to apps based on the MARS and FARM tools (r > 0.4).


CONCLUSIONS

The HIV/AIDS mobile applications available in Iran had the "acceptable" ranking.
Also, our study results showed that to evaluate mobile apps, using a single tool
may not provide good insight to evaluators about the assessed apps. However,
using more than one tool may provide more details about the evaluated apps. To
improve the quality of mobile health apps and help users select the most
desirable app, we suggested using tools like FARM for ranking apps based on the
features of each app in the app stores.


SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at
10.1186/s12911-022-02029-8.

Keywords: HIV/AIDS, Mobile app rating scale, MARS, Feature-based application
rating method, FARM


BACKGROUND

The high penetration rate of mobile phones worldwide makes mobile applications
one of the fastest-growing technologies [1]. Approximately 70% of mobile phones
use the Android operating system [2]. During the second quarter of 2022, almost
3.5 million Android apps were available in the Google Play Store [3]. Of these,
54,603 are mobile health apps [4]. Mobile health apps have many uses in
preventing and treating chronic diseases like HIV/AIDS [5–8]. HIV/AIDS is one of
the most serious socio-economic threats to public health due to its chronic
nature, the possibility of its prevalence among individuals, and the absence of
a cure for this disease [9]. Approximately 38.4 million and 53 thousand people
were living with HIV/AIDS in the world and Iran, respectively [10, 11].

Mobile applications related to HIV/AIDS can help communicate with care providers
and reduce hospital care. These applications can be used to provide self-care
and help patients achieve compliance with antiretroviral therapy. Moreover,
these mobile applications can be used to send alerts and reminders, collect
data, provide real-time audio and video communication, deliver educational
information, and provide requested information to the community to prevent the
disease and control its transmission to others [7, 12, 13]. The number of these
apps and their features change over time [3, 14]. Despite the high number of
mobile health apps and their features, the quality and validity of many apps are
unknown [15, 16]. Therefore, there is a need for tools to continuously review
and evaluate these apps to determine their quality and validity.

Several tools have been used to evaluate mobile apps [17–22]. These tools
evaluate mobile apps based on quality and trustworthy health information [18,
19], some objective and subjective components [20], functionality scoring [21],
and usability [22]. One of these tools is the Mobile Application Rating Scale
(MARS), which evaluates and rates mobile apps in terms of qualitative,
objective, and subjective aspects that were developed in the previous study by
Stoyanov et al. [17]. The MARS tool consists of 23 questions in four objective
dimensions (A_D), including Engagement (5 questions), Functionality (4
questions), Aesthetics (3 questions), Information Quality (7 questions), and a
Subjective dimension (E) (4 questions) [17, 23]. The MARS tool is a
comprehensive and reliable tool that is widely used to rate the quality of
mobile health apps like Epilepsy, COVID-19, self-management mobile health apps,
Spine disorders, and Alzheimer's disease [24–28]. This tool has been widely
translated and validated into other languages, including French [29], Italian
[30], Korean [16], Spanish [31], Japanese [32], Arabic [33], and German [34].

Although the MARS tool can evaluate various aspects of a mobile application, it
has limitations in assessing the mobile application's features [35, 36]. In an
app, a feature is typically an essential function or a service provided by the
app for users [14]. Features may be desirable or undesirable to users. If the
existence of a feature is positive and useful for the users, that is a desirable
or positive feature. If the existence of a feature is negative for users, such
as advertisements, or its presence is irritating for users, such as the presence
of corrupted and misleading links, that is an undesirable or negative feature
[37–39]. Some previous studies [35, 40–44] that used the MARS tool to evaluate
the apps also reviewed the existence of features without reviewing the quality
of each feature separately. The only tool that was developed to rate the mobile
app features is the IQVIA functionality score (previously known as the IMS
functionality score) [26]. This tool is based on seven functionality criteria
and four functional subcategories detailed in the report of the IQVIA Institute
for Healthcare Informatics [21, 45]. In some previous studies [26, 43, 45], this
tool was used along with the MARS tool to rate mobile health app features. The
IQVIA functionality score focuses on the availability of the 11 previously
determined functionalities, and finally, each mobile app gives a score between 0
and 11. The MARS functionality score is an overall score on a five-point Likert
scale that is measured based on the quality of performance, navigation, ease of
use, and gestural design of that app [17, 21, 45]. The IQVIA evaluates the
availability of functionality of each feature without considering quality, and
the functionality section of the MARS tool evaluates the overall quality of
functionality of each app. The functionality score range of IQVIA differs from
the functionality score of MARS, so their scores are not comparable. The IQVIA
feature lists are predetermined and not flexible for each app. Also, in these
two tools, undesirable features are not considered.

Due to the high number of mobile apps in app stores, it is difficult for users
to find their desired applications [46]. Currently, users choose a mobile
application based on the application's popularity, star rating, comments on app
stores, and the number of downloads, regardless of the quality of the
application [47]. Identifying and rating the quality of mobile apps and their
features can help users find and select an app based on the features they need
[14, 37]. Mobile apps may have different features compared to each other. The
previously developed evaluation tools [17–19, 21, 48, 49] have not adequately
addressed the evaluation of each mobile app feature. When users are faced with
an abundance of similar apps with many functionalities or features, they tend to
choose apps with their desired features [14]. Therefore, it is necessary to
develop a tool that has flexibility based on the availability of each feature on
a certain app to evaluate and rate mobile apps.

Some mobile apps related to HIV/AIDS exist in app stores [50]. The literature
review showed that few studies [50–53] evaluated the quality of HIV/AIDS-related
mobile applications, and none of these studies had rated these applications'
features. Despite the important role of mobile apps in HIV/AIDS prevention and
treatment, no study has been conducted to review HIV/AIDS mobile apps in Iran.
Therefore, the purpose of this study was to (1) evaluate the quality of
HIV/AIDS-related mobile applications in the Google Play and Café Bazaar stores
available in Iran using the Mobile Application Rating Scale (MARS); and (2) to
evaluate and rate that applications' features (desirable and undesirable) using
the new tool called the Feature-Based Application Rating Method (FARM).


METHODS

This article is the second part of a two-part series regarding evaluating
HIV/AIDS-related applications in various terms, including their features and
content [15]. This study was a cross-sectional descriptive-analytical study
carried out on HIV/AIDS mobile applications in the Persian or English language
available in Iran from May 6, 2021, to September 23, 2021. All HIV/AIDS-related
mobile apps in the following two app stores were evaluated: The Google Play
Store, the world's largest app store of mobile apps [3], and Café Bazaar, the
most prominent Iranian app store for Persian mobile applications [54]. More than
3500 Android mobile applications in the Café Bazaar are related to the health
and medical fields [55]. Given the small population size, all HIV/AIDS-related
applications were included in the study.

Mobile apps are searched using the keywords "HIV", "AIDS", "Human
Immunodeficiency Virus", "Acquired Immunodeficiency Syndrome", and the Persian
keywords with similar meanings in the Google Play Store and Café Bazaar store.
Then, the downloaded apps were installed on the Android smartphone (SAMSUNG
Galaxy A51). The inclusion criteria to enter into this study are: (1) the mobile
application can be installed on the Android operating system (Android 11.0); (2)
it is written in Persian or English; (3) it is available in Iran, and (4) the
focus of the mobile app is on HIV/AIDS.

Two evaluators with a background in health information technology independently
evaluated all mobile apps using the MARS and FARM tools. Before evaluation,
evaluators watched the MARS training video [56] and were trained about using the
FARM tool. They are not the HIV/AIDS mobile app's real users. These two
evaluators passed the related courses on the evaluation of mobile health apps.
The first evaluator performed the evaluation after downloading and installing
the included apps on the smartphone. When the evaluation was completed by the
first evaluator, the stored data during the evaluation of the first evaluator
inside of the apps was deleted, and then the second evaluator started the
evaluation of the apps. Both evaluators first evaluated the HIV/AIDS apps using
the MARS tool and then used the FARM. The evaluation sessions were limited to a
maximum of 45 min per each session. We also asked the evaluators to spend
sufficient time to gather the required information before assigning the scores.
The evaluation was done when the evaluators were mentally prepared to perform
the evaluation, and if the evaluators were tired, the evaluation stopped and
continued to another time when the evaluators had sufficient mental preparation.
The differences between the scores of the two evaluators were resolved by
discussion between them. If the differences were not resolved through discussion
between them, we used the third evaluator (supervisor) to resolve the
discrepancy. The collected data was recorded on a paper form and then entered
into a Microsoft Excel spreadsheet and SPSS for analysis.

In this study, all apps were downloaded directly from the Google Play Store and
Cafe Bazaar. Our searches in the Google Play Store showed that all HIV/AIDS
available mobile apps in Iran are free of charge. Also, the previous study [50]
stated that all HIV/AIDS-related apps are available free of charge. In this
study, the paid apps of Cafe Bazaar were included and evaluated.


DATA COLLECTION TOOLS

The MARS and FARM tools were used to rate the mobile apps. This study was
conducted to apply the FARM tool to evaluate the apps based on their features.
In this study, we used the MARS tool to compare the results of the FARM with a
previously developed tool and also to get a better view of the existing HIV/AIDS
apps. Since the MARS and other previously developed mobile app evaluation tools
[17–19, 21, 48, 49] have not adequately addressed the evaluation of mobile app
features, to address this issue in this study, a tool called the Feature-Based
App Rating Method (FARM) was developed to rate mobile apps based on their
features. The FARM evaluates and rates mobile apps based on both the
availability and quality of each feature. The items of this tool are not
predetermined; they are flexible based on each app's features.

To develop the FARM tool, all HIV/AIDS-related mobile apps in the Google Play
Store and the Café Bazaar that were included in this study were reviewed, and
all of their features were extracted, and a list of these features was prepared.
This list was considered as the desirable features for the FARM. The list of
undesirable features was also prepared based on a previous study [38] and the
opinions of four experts who had checked the validity of the FARM. The FARM is
available in Additional file 1. In total, 33 desirable features and nine
undesirable features were identified and added to the FARM. To determine a
ranking method for the features of the mobile apps and create a ranking method
in line with previously developed tools. The ranking methods of the previously
developed tools [17–20, 45, 48, 57] were reviewed. In the FARM, we used the
standard 5-point Likert ranking method to compare apps with other tools that
used the 5-point ranking method to rank the apps (such as star rating and the
MARS tool).

Two medical informatics specialists confirmed the ranking method used in the
FARM tool. A score of zero was assigned to the app to rank the applications
based on the FARM tool for the absence of each desirable feature. If the app
contained a desirable feature, the evaluators checked its functionalities and
assigned a score of one to five (1-inappropriate, 2-poor, 3-acceptable, 4-good,
and 5-excellent) to that feature based on the extent to which the feature met
its expected function. Moreover, to rank an undesirable feature, a score between
one (the undesirable feature is very annoying) and five (the absence of the
undesirable feature) was assigned to that feature.

The validity of MARS and FARM was confirmed by two Medical Informatics
specialists and two Health Information Management specialists. To investigate
the reliability of the MARS and FARM tools, the first 20 mobile apps retrieved
from the Google Play Store were evaluated using these tools, and Cronbach's
alpha was calculated for each tool. The internal reliability of the MARS tool
was 0.94 for all questions. The internal reliability of the MARS dimensions was
between 0.63 and 0.93. The internal reliability of the FARM tool was 0.85 for
the desirable features and 0.76 for undesirable features.


DATA ANALYSIS

This study used descriptive statistics, including mean and standard deviation,
to calculate the app ratings. To calculate the mean scores, the zero scores of
the FARM tool and the N/A score of the MARS tool were not considered. The mean
scores for the MARS and FARM tools were classified as the scores between 1 to 2
being considered as "inappropriate", 2 to 3 as "poor", 3 to 4 as "acceptable", 4
to 5 as "good", and 5 as "excellent". The Kolmogorov–Smirnov normalization test
did not confirm the normality of variables related to the MARS and FARM tools.
Therefore, the Spearman correlation test was used to examine the relationship
between the dimensions of the MARS and FARM tools. The internal validity and
consistency of the evaluators were calculated using the two-way mixed internal
correlation coefficient (ICC) [58]. Microsoft Excel version 2019 was used to
analyze the descriptive data, and SPSS version 24 was used to analyze the
analytical statistics.


RESULTS

A total of 971 apps were retrieved from the two app stores, of which 79 apps
based on the inclusion criteria were included in the study. Of these, 29 apps
were in the Café Bazaar and 50 were in the Google Play Store. All HIV/AIDS apps
available in the Google Play Store are free. Five of 29 (17%) Café Bazaar
applications are paid apps, and 14 (48%) are in-app purchases. The process
utilized to identify the apps is shown in Fig. 1.


FIG. 1.



Open in a new tab

Flow chart of the selection process for inclusion of the Apps

The mean rating score of apps in stores was 4.37 (SD = 0.60). The organizational
affiliations of 19 apps (38%) in the Google Play Store were unknown; one app
(2%) was commercial, 14 apps (28%) were governmental, non-governmental
organizations developed ten apps (20%), and the affiliations of 6 apps (12%)
were universities. The organizational affiliations of 13 apps (45%) in the Café
Bazaar were unknown; thirteen apps (45%) were commercial; three apps (7%) were
non-governmental organizations, and the university developed one app (3%).


THE RESULTS OF THE EVALUATION OF THE MOBILE APP

The results of evaluating HIV/AIDS-related apps using the MARS and FARM tools
are shown in Table 1. The average score of all apps using both tools was 3.53
(SD = 0.68) out of 5. As Table 1 shows, the overall mean score for Google Play
Store apps was 3.74 (SD = 0.68), and for Café Bazaar apps it was 3.15
(SD = 0.52). Among all the dimensions of both tools, "undesirable features" was
the highest-scoring domain (4.67 ± 0.42). The lowest score was related to
"Engagement" (2.85 ± 0.93).

TABLE 1.

The results of the evaluation of HIV/AIDS apps based on MARS and FARM tools

FARM dimensions FARM total score MARS dimensions MARS total score Total score
Desirable Features Absence of undesirable feature Engagement Functionality
Aesthetics Information Quality Subjective dimension Mean (SD) Mean (SD) Mean
(SD) Mean (SD) Mean (SD) Mean (SD) Mean (SD) Mean (SD) Mean (SD) Mean (SD) Cafe
Bazaar apps 2.53 (0.74) 4.60 (0.32) 3.59 (0.47) 2.64 (0.67) 3.99 (0.47) 3.10
(0.98) 2.32 (0.74) 1.80 (0.73) 2.71 (0.62) 3.15 (0.52) Google Play Store apps
3.22 (1.10) 4.71 (0.47) 4.12 (0.73) 2.98 (1.04) 4.01 (0.66) 3.38 (0.81) 3.55
(0.97) 2.92 (1.32) 3.37 (0.85) 3.74 (0.68) Mean of all apps 2.93 (1.02) 4.67
(0.42) 3.92 (0.69) 2.85 (0.93) 4.00 (0.59) 3.28 (0.88) 3.10 (1.07) 2.50 (1.26)
3.13 (0.83) 3.53 (0.68)

Open in a new tab

Fourteen apps (28%) out of 50 apps in the Google Play Store give a score above
4: "Every Dose, Every Day" (4.76 ± 0.29), "HIV Oral PrEP Implementation Tool"
(4.75 ± 0.40), "inPractice HIV" (4.71 ± 0.30), "HIV Client Treatment
Preparedness" (4.70 ± 0.24), "HIV Care Tools" (4.65 ± 0.30), "WHO HIV Tx"
(4.59 ± 0.38), "Liverpool HIV iChart" (4.55 ± 0.27), "YourPrEP" (4.53 ± 0.34),
"WHO HTS Info"‏ (4.51 ± 0.39), "HIV-HCV Drug Therapy Guide" (4.51 ± 0.39),
"ClinicalInfo HIV/AIDS Guidelines" (4.45 ± 0.40), "life4me + " (4.24 ± 0.53),
"EACS" (4.08 ± 0.79), and "HIV-Rx DDI Check" (4.02 ± 0.66). Also, two apps (7%)
out of 29 Cafe Bazaar apps give scores above 4: "Pishgiriye Pas az Tamas (PEP)"
(4.49 ± 0.44), and "Agahi Bakshi AIDS" (4.18 ± 0.60). The lowest score among all
apps was taken by the Cafe Bazaar app named "AIDS va Darman" (2.02 ± 1.31).
Among all of the Google Play Store HIV/AIDS rated apps, 14 apps (28%) scored
above 4, 23 apps (46%) scored between 3 and 4, and 13 apps (26%) scored between
2 and 3. Among all of the Cafe Bazaar HIV/AIDS rated apps, two apps (7%) scored
above 4, nine apps (31%) scored 3 to 4, and 18 apps (62%) scored between 2 and
3.


THE MARS TOOL RESULTS

The MARS total mean score for all apps was 3.13 ± 0.83. The highest rank was
related to the Functionality dimension (4.00 ± 0.59), and the lowest was related
to the Subjective dimension (2.50 ± 1.26) (Table 1). Fifteen apps (19%) scored
above 4 out of 5. The highest three scored apps were "HIV Oral PrEP
Implementation Tool" (4.82 ± 0.66), "inPractice HIV" (4.74 ± 0.45), and "Every
Dose, Every Day" (4.71 ± 0.56). Also, 23 apps (29%) scored 3, 38 apps (48%)
scored 2, and only three apps (4%) scored 1. The lowest three scored apps were
"HIV AIDS Awareness" (1.77 ± 0.92), "AIDS va Darman" (1.80 ± 1.06), and "AIDS va
Moghabele ba an" (1.86 ± 0.96).


THE RESULTS OF RANKING MOBILE APP FEATURES USING THE FARM TOOL

The results of the ranking of HIV/AIDS mobile app features using the FARM tool
are shown in Table 1. The FARM mean score of all apps was (3.92 ± 0.69) out of
5. The apps retrieved from Cafe Bazaar did not have 21 (63%) of the 33 evaluated
features in this study. All the Cafe Bazaar apps had a textual content. The
features "app description inside of the app" (3.50 ± 1.29), the "search
functionality" (3.16 ± 0.71), and the "Bookmark feature" (3.12 ± 0.83),
respectively, scored the highest rank.

The ranking of the Cafe Bazaar HIV/AIDS apps based on undesirable features
showed that features such as "being a free app but requiring payment for basic
features" (3.86 ± 1.16), "advertising" (4.00 ± 0.80), and "the existence of
unrelated information" (4.28 ± 0.84) had the lowest score for Café Bazaar apps.
The features "Difficulties to login into the app" (5.0 ± 0), "Inactive and
misleading buttons" (4.97 ± 0.19), and "stopping the app after execution"
(4.97 ± 0.19) had the highest ranking.

In Google Play Store apps, evaluators assigned the highest scores to the
features "Collect medication data" (4.37 ± 0.51), "medication management and
medication reminder" (4.28 ± 1.49), and "documentation and presentation of the
disease progression" (4.00 ± 1.73). The lowest scores were assigned to desirable
features such as "direct interaction and visual contact" (1.14 ± 0.35), "direct
audio contact" (1.38 ± 0.49), and "communication with people with similar
conditions" (1.40 ± 0.49).

According to the ranking results of the Google Play Store apps based on the
absence of undesirable features, the lowest scores were assigned to "corrupted
and misleading links" (4.50 ± 0.91), "inactive and misleading buttons"
(4.60 ± 0.78), and "taking a long time to load the content of the app after
executing the program" (4.66 ± 0.89). The highest ratings in this regard were
related to "being a free app but requiring payment for basic features"
(4.88 ± 0.44), "difficulties in logging into the app" (4.84 ± 0.51), and
"advertising" (4.82 ± 0.48).

The agreement rate between the two evaluators regarding the app's rating based
on FARM and MARS tools is shown in Table 2. The agreement rate between the two
evaluators for the overall MARS score, calculated using the ICC, was 0.947 (CI
95% = 0.919–0.965). The agreement between the two evaluators for the overall
FARM score was 0.882 (CI 95% = 0.819–0.922).

TABLE 2.

The agreement rate between the two evaluators regarding the rating based on FARM
and MARS

Tools Dimensions ICC Confidence interval of 95% for ICC MARS Engagement 0.916
0.871–0.945 Functionality 0.930 0.893–0.954 Aesthetics 0.840 0.756–0.895
Information quality 0.944 0.913–0.964 Subjective dimension 0.919 0.866–0.950
FARM Desirable features 0.931 0.892–0.955 Absence of undesirable feature 0.537
0.296–0.696

Open in a new tab

The relationship between the dimensions of the MARS tool and the FARM tool was
calculated using the Spearman correlation test, and the results are shown in
Table 3. The lowest correlation was found between the score of the Subjective
dimension and the functionality score of the MARS tool (r = 0.450). The highest
correlation was found between the score of the Subjective dimension and the
Information quality score of the MARS tool (r = 0.832).

TABLE 3.

The correlation between the FARM dimensions and The MARS dimensions

Tools and dimensions FARM dimensions MARS dimensions Desirable Features Absence
of Engagement Functionality Aesthetics Information quality Subjective dimension
FARM dimensions Desirable feature 1.0 0.574 0.734 0.461 0.615 0.753 0.745
Absence of undesirable features 0.574 1.0 0.555 0.499 0.514 0.538 0.524 MARS
dimensions Engagement 0.734 0.555 1.0 0.620 0.713 0.684 0.802 Functionality
0.461 0.499 0.620 1.0 0.603 0.464 0.450 Aesthetics 0.615 0.514 0.713 0.603 1.0
0.660 0.643 Information quality 0.753 0.538 0.684 0.464 0.660 1.0 0.832
Subjective dimension 0.745 0.524 0.802 0.450 0.643 0.832 1.0

Open in a new tab


DISCUSSION

The results of this study showed that there is a higher than the moderate
correlation between the scores assigned to apps based on the MARS and FARM
tools. Therefore, the high MARS score somewhat indicates the existence of
desirable and the absence of undesirable features in the app. So, evaluating
mobile apps by using a single tool may not provide good insight about the
evaluated apps. However, using more than one tool provides more details about
the evaluated apps.

According to the results of this study, the HIV/AIDS mobile applications
available in Iran had an "acceptable" ranking. However, the overall ranking
score of the MARS tool and desired features for Cafe Bazaar apps scored "poor".
In previous studies [27, 44, 59–62] conducted on health applications using the
MARS tool, evaluated apps were ranked as "acceptable". Moreover, the results of
the study done by Young et al. [63] showed that the overall quality of the apps
for men who have sex with men (MSM) in China is "acceptable". In this study, we
evaluated all HIV/AIDS mobile applications available in Iran, including mobile
applications related to HIV pre-exposure prophylaxis. Sharpe et al. [64], in
2018, only evaluated 11 mobile apps for HIV pre-exposure prophylaxis using the
MARS tool. Just one mobile app (PreP4U) reviewed in the study by Sharpe et al.
[64] was available in Iran in 2021 and was also reviewed in our study. The
results of the average ratings of this mobile app were almost the same as in our
study.

The FARM does not check the quality of information. In this study, the quality
of information is checked with the "information quality" section of the MARS
tool. The Google Play Store apps were ranked "acceptable" in terms of
"information quality", but the Cafe Bazaar apps were rated "poor". The first
published part of our study rated the HIV/AIDS mobile apps based on the evidence
showed that the Cafe Bazaar apps were rated as "inappropriate" and the Google
Play Store applications were rated as "good" [15]. Due to the importance of the
information content of an app [65], it is necessary to evaluate and, if
possible, eliminate apps with inappropriate information from app stores. The
results of our study confirm the results of the Robustillo Cortés et al. [53]
study conducted in 2013. Their study indicates that the quality of the evaluated
apps on HIV is limited, and only one app (inPractice HIV) is categorized in
Class A. This app, in our study, was ranked as "good". According to the results
of our study, of all the Café-Bazaar apps, only one has been written by health
organizations. Also, the affiliation of more than half of the apps was not
determined, and they may not be reliable. This is in line with the results of a
study by Rosa et al. [52], which showed that more than half of the apps were not
written by health professionals.

In this study, the mean FARM score for all desirable features was low. Most apps
were ranked with a low score in terms of their desirable features. However, the
high number of features considered in the FARM tool may affect the total
desirable score results. Also, the Functionality dimension of the MARS tool had
the highest score among all other dimensions of the MARS tool. According to the
Functionality dimension, all apps ranked higher than the "acceptable" score, but
most ranked as "inadequate" in terms of desirable features. In most previous
studies using the MARS tool [26, 28, 30, 60, 66], the functionality score was
the highest compared to the scores of the other dimensions of the MARS tool.
Therefore, ranking apps with the Functionality dimension of the MARS tool and
its general questions cannot conclude that the apps contain desirable features.
In the study of Schnall et al. [50], only nine features of HIV/AIDS-related
mobile apps were evaluated, and the results had not been compared with other
valid tools, nor had the evaluated features been ranked. Our study confirmed the
results of the Schnall et al. study [50], which showed that a small number of
HIV/AIDS-related apps have the desired functionalities.

In this study, the best features of the HIV/AIDS mobile apps were collecting
medication data, medication management and medication reminders, and
documentation and presentation of the disease progression. A previous study [67]
showed that the most interesting features for HIV/AIDS patients' needs are the
reminders/alerts feature, collecting lab data and lab results tracking, and
notes about health status. These features were better designed than other
features, but they need to be given more attention and designed better.

Based on our results, the lowest undesirable feature score of the Cafe Bazaar
apps was assigned to the "being a free app, but requiring payment for basic
features" and "advertising" features. The Cafe Bazaar apps did not have a good
status in terms of the existence of undesirable features. Although an app may
have rich content, it's very annoying for users to face a lot of advertising and
unwanted features.

The FARM evaluates and rates mobile apps based on the availability and quality
of each feature. The items of the FARM are flexible based on each app's
features. In this study, we included all the features available at the time of
the study. The features of the apps may change with each update, and apps may
contain different features compared to each other. Feature lists also differ
from one disease to another. The list of FARM features may change over time with
app updates and with a decrease or increase in the number of included apps. The
FARM has flexibility and can be used to rank mobile apps to help users choose
the app they want.

Currently, most of the features of mobile apps in the App Store are unknown to
users, a few apps have mentioned the features in the app description section,
but the quality of these features is unknown. So, the results of evaluated
HIV/AIDS mobile apps in this study can be helpful for these app users to choose
their desired apps. The desirable and undesirable features extracted in the FARM
can help mobile app developers to develop new applications for HIV/AIDS
patients. Furthermore, the tools used in this study to rate the desirable and
undesirable features of mobile apps can be used by researchers to evaluate
mobile apps in future works. Further research is required to investigate the
implications of the FARM tool.

For future work, we recommend mobile app evaluators use and test the FARM tool
to evaluate other mobile health apps. For studies that use the FARM, it is
suggested to first prepare a list of the features of the mobile apps that they
want to evaluate, then rank the quality of each feature of a mobile app using
the FARM, and finally, the mean of these scores is the mobile app's overall
score. The FARM can be used for just one app. Mobile app developers can use the
FARM to rate their mobile apps. It is also suggested to divide the features into
sub-features, first assign a score to the sub-features, and then calculate the
feature score based on the average score of the features. Moreover, we recommend
using quantitative methods like quantitative usability methods for each feature
instead of qualitative methods. Also, for qualitative evaluations, use more than
two evaluators or real users.


STRENGTHS AND LIMITATIONS OF THE STUDY

Using the five-choice ranking in the developed tool in this study for rating app
features is one of the strengths of this study because this made the results
comparable with the results of the evaluations done with the other tools with
the same ranking [17, 19]. Moreover, in this study, we ranked the desirable and
undesirable features available in the apps and compared the rankings with the
MARS tool.

This study has several limitations. First, this study was conducted on mobile
applications available in Iran. Since not all applications are available in Iran
due to the sanctions against the country and regional restrictions, this study
was conducted in a country with limited access to mobile apps, and therefore the
results may not be generalizable to other HIV/AIDS-related mobile apps available
in other countries. However, in terms of the number of evaluated HIV/AIDS apps,
this study has the highest number of apps being assessed compared to the
previous studies [50–53].

Second, in this study, mobile apps running on the IOS operating system were not
evaluated due to sanctions against the country and the removal of Iranian apps
from this store. To deal with this issue, the researcher wrote to Apple Company
to access the mobile apps for conducting this research but failed to obtain the
necessary permission. According to the findings of a previous study [50], more
than 60% of HIV/AIDS mobile apps are available on the IOS and Android platforms.

Third, another limitation of this study was using two evaluators to rate 79
mobile apps with many features using FARM and MARS. We used two evaluators
because most of the previous studies that used the MARS tool for evaluating
mobile health apps used two evaluators [16, 17, 29–33, 36, 42, 44, 45, 64]. The
evaluation process may be affected by evaluator bias, fatigue bias, experience
bias, and familiarity bias with using two evaluators. To reduce the above
mentioned biases in this study, the evaluators were trained about biases before
conducting the evaluation. The evaluation was performed when the evaluators were
mentally prepared to complete the evaluation, and if the evaluators were tired,
the evaluation was stopped and continued until another time when the evaluators
had sufficient mental preparation.

Fourth, according to similar studies [15–20, 26, 35], we applied a subjective
approach to evaluate HIV/AIDS mobile apps. Given to limitations of subjective
evaluation methods, using quantitative methods is recommended for future
studies.


CONCLUSIONS

In this study, we used the MARS tool and a new tool called the FARM to evaluate
desirable and undesirable features of HIV/AIDS mobile apps. This study showed
that the rank of HIV/AIDS-related available apps in Iran is "acceptable".
According to the results of the MARS tool and desirable features, Cafe Bazaar
apps were ranked as "poor" and lacked a third of the desirable features. The
developers of the Cafe Bazaar apps should add some features based on users’
needs to their apps.

The FARM can determine the desirable and undesirable features of mobile apps and
the quality of those features and then rank mobile apps based on their features.
Our study results also showed that using a single tool to evaluate mobile apps
may not provide good insight to evaluators about the assessed apps. However,
using more than one tool provides more details about the evaluated apps. The
FARM is a new tool. Therefore, further studies are needed to test the FARM on
mobile health apps in different health domains.


SUPPLEMENTARY INFORMATION

12911_2022_2029_MOESM1_ESM.docx (25.2KB, docx)

Additional file 1: The Feature-Based Application Rating Method (the FARM) Tool.


ACKNOWLEDGEMENTS

We would like to thank Fatemeh Tabatabaei for her contribution to the app's
evaluation. Also, we would like to thank Dr. Mohammad Reza Safaei for his
consultation about HIV/AIDS disease. The authors would like to thank Felix Holl,
a researcher working at the Neu-Ulm University of Applied Sciences, Germany, for
his valuable comments and insights on the manuscript.


ABBREVIATIONS

FARM

Feature-based Application Rating Method

MARS

Mobile Apps Rating Scale

HIV

Human Immunodeficiency Virus

AIDS

Acquired Immune Deficiency Syndrome

ICC

Internal Correlation Coefficient

SD

Standard Deviation

WHO

World Health Organization

CI

Confidence Interval

IOS

IPhone Operating System


AUTHOR CONTRIBUTIONS

LA, RK, and AR designed the study. LA and RK supervised the project. AR
contributed to the app's evaluation. AR and LA analyzed and interpreted the
data. LA and AR wrote the final manuscript. All authors read and approved the
final manuscript.


FUNDING

This research did not receive any specific grant from funding agencies in the
public, commercial, or not-for-profit sectors.


AVAILABILITY OF DATA AND MATERIALS

Data sharing is not applicable to this article as no datasets were generated or
analysed during the current study.


DECLARATIONS


ETHICS APPROVAL AND CONSENT TO PARTICIPATE

In this study, all apps were downloaded directly from the Google Play Store and
Cafe Bazaar, and no apps were downloaded illegally. This study was approved by
the Research Ethics Committee of the Kerman University of Medical Sciences (I.D.
approved: IR.KMU.REC.1397.246). We confirm that all methods were performed in
accordance with the relevant guidelines and regulations. We did not include
individuals as study participants, so there was no requirement for informed
consent.


CONSENT FOR PUBLICATION

Not applicable.


COMPETING INTERESTS

The authors declare no competing interests.


FOOTNOTES

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in
published maps and institutional affiliations.


CONTRIBUTOR INFORMATION

Ahmad Raeesi, Email: ah.raesse@gmail.com.

Reza Khajouei, Email: r.khajouei@yahoo.com.

Leila Ahmadian, Email: l.ahmadian@kmu.ac.ir, Email: ahmadianle@yahoo.com.


REFERENCES

 * 1.Ericsson Mobility Report- June 2022 report edition. Ericsson. 2022.
   https://www.ericsson.com/en/reports-and-papers/mobility-report/reports/june-2022.
   Accessed 7 Sep 2022.
 * 2.Mobile operating systems’ market share worldwide from January 2012 to
   August 2022 | Statista. Statista. 2022.
   https://www.statista.com/statistics/272698/global-market-share-held-by-mobile-operating-systems-since-2009/.
   Accessed 7 Sep 2022.
 * 3.Number of apps available in leading app stores as of 2nd quarter 2022 |
   Statista. Statista. 2022.
   https://www.statista.com/statistics/276623/number-of-apps-available-in-leading-app-stores/.
   Accessed 7 Sep 2022.
 * 4.Number of mHealth apps available in the Google Play Store from 1st quarter
   2015 to 2nd quarter 2022. Statista. 2022.
   https://www.statista.com/statistics/779919/health-apps-available-google-play-worldwide/.
   Accessed 6 Sep 2022.
 * 5.Peng Y, Wang H, Fang Q, Xie L, Shu L, Sun W, et al. Effectiveness of mobile
   applications on medication adherence in adults with chronic diseases: a
   systematic review and meta-analysis. J Manag Care Spec Pharm.
   2020;26:550–561. doi: 10.18553/jmcp.2020.26.4.550. [DOI] [PMC free article]
   [PubMed] [Google Scholar]
 * 6.Moses JC, Adibi S, Shariful Islam SM, Wickramasinghe N, Nguyen L.
   Application of smartphone technologies in disease monitoring: a systematic
   review. Healthc (Basel, Switzerland) 2021;9:889. doi:
   10.3390/healthcare9070889. [DOI] [PMC free article] [PubMed] [Google Scholar]
 * 7.Catalani C. mHealth for HIV treatment and prevention: a systematic review
   of the literature. Open AIDS J. 2013;7:17–41. doi:
   10.2174/1874613620130812003. [DOI] [PMC free article] [PubMed] [Google
   Scholar]
 * 8.Abbasi R, Nabovati E, Raeesi A, Ostadmohammadi F. Investigating the quality
   of persian mobile applications related to patients with chronic diseases. J
   Heal Biomed Inform. 2020;7:273–281. [Google Scholar]
 * 9.Zadsar M, Pourfathollah AA, Rasouli M, Karimi G. Trends in
   sero-epidemiology of human immunodeficiency virus in voluntary blood
   donations in Iran, 2008–2013. Arch Iran Med. 2017;20:135–140. [PubMed]
   [Google Scholar]
 * 10.Islamic Republic of Iran | UNAIDS. UNAIDS. 2022.
   https://www.unaids.org/en/regionscountries/countries/islamicrepublicofiran.
   Accessed 7 Sep 2022.
 * 11.Global Statistics | HIV.gov. HIV.gov. 2022.
   https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics.
   Accessed 7 Sep 2022.
 * 12.Schnall R, Rojas M, Travers J, Brown W, Bakken S, Bakken S, et al. Use of
   Design science for informing the development of a mobile app for persons
   living with HIV. AMIA .Annual Symp proceedingsAMIA Symp. 2014;2014:1037–45.
   [PMC free article] [PubMed]
 * 13.Devi BR, Syed-Abdul S, Kumar A, Iqbal U, Nguyen P-AA, Li Y-CC, et al.
   mHealth: an updated systematic review with a focus on HIV/AIDS and
   tuberculosis long term management using mobile phones. Comput Methods Prog
   Biomed. 2015;122:257–265. doi: 10.1016/j.cmpb.2015.08.003. [DOI] [PubMed]
   [Google Scholar]
 * 14.Jiang H, Zhang J, Li X, Ren Z, Lo D, Wu X, et al. Recommending new
   features from mobile app descriptions. ACM Trans Softw Eng Methodol.
   2019;28:1–29. doi: 10.1145/3344158. [DOI] [Google Scholar]
 * 15.Raeesi A, Khajouei R, Ahmadian L. Evaluation of HIV/AIDS-related mobile
   health applications content using an evidence-based content rating tool. BMC
   Med Inform Decis Mak. 2021;21:135. doi: 10.1186/s12911-021-01498-7. [DOI]
   [PMC free article] [PubMed] [Google Scholar]
 * 16.Hee Ko KK, Kim SK, Lee Y, Lee JY, Stoyanov SR. Validation of a Korean
   version of mobile app rating scale (MARS) for apps targeting disease
   management. Health Inform J. 2022;28:1–15. doi: 10.1177/14604582221091975.
   [DOI] [PubMed] [Google Scholar]
 * 17.Stoyanov SR, Hides L, Kavanagh DJ, Zelenko O, Tjondronegoro D, Mani M.
   Mobile app rating scale: a new tool for assessing the quality of health
   mobile apps. JMIR Mhealth Uhealth. 2015;3:e27. doi: 10.2196/mhealth.3422.
   [DOI] [PMC free article] [PubMed] [Google Scholar]
 * 18.HONcode: Principles for Quality and Trustworthy Health Information.
   http://www.hon.ch/HONcode/Patients/Conduct.html. Accessed 30 Dec 2020.
 * 19.DISCERN - The DISCERN Instrument.
   http://www.discern.org.uk/discern_instrument.php. Accessed 7 Sep 2022.
 * 20.Chyjek K, Farag S, Chen KT. Rating pregnancy wheel applications using the
   applications scoring system. Obstet Gynecol. 2015;125:1478–1483. doi:
   10.1097/AOG.0000000000000842. [DOI] [PubMed] [Google Scholar]
 * 21.Aitken M, Gauntlett C. Patient apps for improved healthcare: from novelty
   to mainstream. IMS Institute for Healthcare Informatics. 2013; October:60.
   http://ignacioriesgo.es/wp-content/uploads/2014/03/iihi_patient_apps_report_editora_39_2_1.pdf.
 * 22.Zhou L, Bao J, Setiawan IMA, Saptono A, Parmanto B. The mhealth app
   usability questionnaire (MAUQ): development and validation study. JMIR
   mHealth uHealth. 2019;7:1–15. doi: 10.2196/11500. [DOI] [PMC free article]
   [PubMed] [Google Scholar]
 * 23.Stoyanov SR, Hides L, Kavanagh DJ, Zelenko O, Tjondronegoro D, Mani M.
   Mobile Application Rating Scale (MARS). 2015.
   https://jmir.org/api/download?alt_name=mhealth_v3i1e27_app2.pdf&filename=86161240dc0e5f7e86306b19d1bcd1a8.pdf.
   [DOI] [PMC free article] [PubMed]
 * 24.Carvalho C, Prando BC, Dantas LO, da Serrão PRMS. Mobile health
   technologies for the management of spine disorders: a systematic review of
   mHealth applications in Brazil. Musculoskelet Sci Pract. 2022;60:102562. doi:
   10.1016/j.msksp.2022.102562. [DOI] [PubMed] [Google Scholar]
 * 25.Alwakeel L, Lano K. Functional and technical aspects of self-management
   mHealth apps: systematic app search and literature review. JMIR Hum Fact.
   2022;9(2):e29767. doi: 10.2196/29767. [DOI] [PMC free article] [PubMed]
   [Google Scholar]
 * 26.Schmeelk S, Davis A, Li Q, Shippey C, Utah M, Myers A, et al. Monitoring
   symptoms of COVID-19: review of mobile apps. JMIR Mhealth Uhealth.
   2022;10:e36065. doi: 10.2196/36065. [DOI] [PMC free article] [PubMed] [Google
   Scholar]
 * 27.Escoffery C, McGee R, Bidwell J, Sims C, Thropp EK, Frazier C, et al. A
   review of mobile apps for epilepsy self-management. Epilepsy Behav.
   2018;81:62–69. doi: 10.1016/j.yebeh.2017.12.010. [DOI] [PubMed] [Google
   Scholar]
 * 28.Choi SK, Yelton B, Ezeanya VK, Kannaley K, Friedman DB. Review of the
   content and quality of mobile applications about Alzheimer’s disease and
   related dementias. J Appl Gerontol. 2018;39:601–608. doi:
   10.1177/0733464818790187. [DOI] [PMC free article] [PubMed] [Google Scholar]
 * 29.Saliasi I, Martinon P, Darlington E, Smentek C, Tardivo D, Bourgeois D, et
   al. Promoting health via mHealth applications using a french version of the
   mobile app rating scale: adaptation and validation study. JMIR mHealth
   uHealth. 2021;9:e30480. doi: 10.2196/30480. [DOI] [PMC free article] [PubMed]
   [Google Scholar]
 * 30.Domnich A, Arata L, Amicizia D, Signori A, Patrick B, Stoyanov S, et al.
   Development and validation of the Italian version of the Mobile Application
   Rating Scale and its generalisability to apps targeting primary prevention.
   BMC Med Inform Decis Mak. 2016;16:83. doi: 10.1186/s12911-016-0323-2. [DOI]
   [PMC free article] [PubMed] [Google Scholar]
 * 31.Martin Payo R, Fernandez Álvarez MM, Blanco Díaz M, Cuesta Izquierdo M,
   Stoyanov SR, Llaneza SE. Spanish adaptation and validation of the mobile
   application rating scale questionnaire. Int J Med Inform. 2019;129:95–99.
   doi: 10.1016/j.ijmedinf.2019.06.005. [DOI] [PubMed] [Google Scholar]
 * 32.Yamamoto K, Ito M, Sakata M, Koizumi S, Hashisako M, Sato M, et al.
   Japanese version of the mobile app rating scale (MARS): development and
   validation. JMIR mHealth uHealth. 2022;10:e33725. doi: 10.2196/33725. [DOI]
   [PMC free article] [PubMed] [Google Scholar]
 * 33.Bardus M, Awada N, Ghandour LA, Fares EJ, Gherbal T, Al-Zanati T, et al.
   The Arabic version of the mobile app rating scale: development and validation
   study. JMIR mHealth uHealth. 2020;8:e16956. doi: 10.2196/16956. [DOI] [PMC
   free article] [PubMed] [Google Scholar]
 * 34.Messner EM, Terhorst Y, Barke A, Baumeister H, Stoyanov S, Hides L, et al.
   The German version of the mobile app rating scale (MARS-G): development and
   validation study. JMIR mHealth uHealth. 2020;8:e14479. doi: 10.2196/14479.
   [DOI] [PMC free article] [PubMed] [Google Scholar]
 * 35.Armas R, Montenegro C, Larco A, Yanez C. Identifying key quality features
   of mhealth applications: unsupervised feature selection approach: MARS case
   study. Intell Sustain Syst Lect Notes Networks Syst. 2022;333:13–21.
 * 36.Santo K, Richtering SS, Chalmers J, Thiagalingam A, Chow CK, Redfern J.
   Mobile phone apps to improve medication adherence: a systematic stepwise
   process to identify high-quality apps. JMIR mHealth uHealth. 2016;4:e132.
   doi: 10.2196/mhealth.6742. [DOI] [PMC free article] [PubMed] [Google Scholar]
 * 37.Wu H, Deng W, Niu X, Nie C. Identifying key features from app user
   reviews. In: 2021 IEEE/ACM 43rd International Conference on Software
   Engineering (ICSE). 2021. p. 922–32.
 * 38.Mangone ER, Lebrun V, Muessig KE. Mobile phone apps for the prevention of
   unintended pregnancy: a systematic review and content analysis. JMIR mHealth
   uHealth. 2016;4:e6. doi: 10.2196/mhealth.4846. [DOI] [PMC free article]
   [PubMed] [Google Scholar]
 * 39.Luiz W, Viegas F, Alencar R, Mourão F, Salles T, Carvalho D, et al. A
   feature-oriented sentiment rating for mobile app reviews. In: Proceedings of
   the 2018 World Wide Web Conference. Republic and Canton of Geneva, CHE:
   International World Wide Web Conferences Steering Committee; 2018. p.
   1909–1918.
 * 40.Knitza J, Tascilar K, Messner E-M, Meyer M, Vossen D, Pulla A, et al.
   German mobile apps in rheumatology: review and analysis using the mobile
   application rating scale (MARS) JMIR mHealth uHealth. 2019;7:e14991. doi:
   10.2196/14991. [DOI] [PMC free article] [PubMed] [Google Scholar]
 * 41.Sereda M, Smith S, Newton K, Stockdale D. Mobile apps for management of
   tinnitus: users’ survey, quality assessment, and content analysis. JMIR
   mHealth uHealth. 2019;7:e10353. doi: 10.2196/10353. [DOI] [PMC free article]
   [PubMed] [Google Scholar]
 * 42.Talwar D, Yeh Y-L, Chen W-J, Chen L-S. Characteristics and quality of
   genetics and genomics mobile apps: a systematic review. Eur J Hum Genet.
   2019;27:833–840. doi: 10.1038/s41431-019-0360-2. [DOI] [PMC free article]
   [PubMed] [Google Scholar]
 * 43.Diaz-Skeete YM, McQuaid D, Akinosun AS, Ekerete I, Carragher N, Carragher
   L. Analysis of apps with a medication list functionality for older adults
   with heart failure using the mobile app rating scale and the IMS Institute
   for healthcare informatics functionality score: evaluation study. JMIR
   mHealth uHealth. 2021;9:e30674. doi: 10.2196/30674. [DOI] [PMC free article]
   [PubMed] [Google Scholar]
 * 44.Kim BY, Sharafoddini A, Tran N, Wen EY, Lee J. Consumer mobile apps for
   potential drug-drug interaction check: systematic review and content analysis
   using the mobile app rating scale (MARS) JMIR mHealth uHealth. 2018;6:e74.
   doi: 10.2196/mhealth.8613. [DOI] [PMC free article] [PubMed] [Google Scholar]
 * 45.Choi YK, Demiris G, Lin SY, Iribarren SJ, Landis CA, Thompson HJ, et al.
   Smartphone applications to support sleep self-management: review and
   evaluation. J Clin Sleep Med. 2018;14:1783–1790. doi: 10.5664/jcsm.7396.
   [DOI] [PMC free article] [PubMed] [Google Scholar]
 * 46.Cummings E, Borycki EM, Roehrer E. Issues and considerations for
   healthcare consumers using mobile applications. Stud Heal Technol Inf.
   2013;183:227–231. [PubMed] [Google Scholar]
 * 47.Kuehnhausen M, Frost VS. Trusting smartphone apps? To install or not to
   install, that is the question. In: 2013 IEEE International multi-disciplinary
   conference on cognitive methods in situation awareness and decision support
   (CogSIMA). 2013. p. 30–7.
 * 48.Jin M, Kim J. Development and evaluation of an evaluation tool for
   healthcare smartphone applications. Telemed e-Health. 2015;21:831–837. doi:
   10.1089/tmj.2014.0151. [DOI] [PubMed] [Google Scholar]
 * 49.Nouri R, Kalhori SRN, Ghazisaeedi M, Marchand G, Yasini M. Criteria for
   assessing the quality of mHealth apps: a systematic review. J Am Med Inform
   Assoc. 2018;25:1089–1098. doi: 10.1093/jamia/ocy050. [DOI] [PMC free article]
   [PubMed] [Google Scholar]
 * 50.Schnall R, Mosley JP, Iribarren SJ, Bakken S, Carballo-Dieguez A, Brown
   Iii W, et al. Comparison of a user-centered design, self-management app to
   existing mhealth apps for persons living with HIV. JMIR Mhealth Uhealth.
   2015;3:e91. doi: 10.2196/mhealth.4882. [DOI] [PMC free article] [PubMed]
   [Google Scholar]
 * 51.Muessig KE, Pike EC, Legrand S, Hightow-weidman LB. Mobile phone
   applications for the care and prevention of HIV and other sexually
   transmitted diseases: a review. J Med Internet Res. 2013;15:e1. doi:
   10.2196/jmir.2301. [DOI] [PMC free article] [PubMed] [Google Scholar]
 * 52.Cantudo Cuenca MR, Cantudo Cuenca MD, Morillo VR. Availability and medical
   professional involvement in mobile healthcare applications related to
   pathophysiology and pharmacotherapy of HIV/AIDS. Eur J Hosp Pharm.
   2013;20:356–361. doi: 10.1136/ejhpharm-2013-000340. [DOI] [Google Scholar]
 * 53.Robustillo Cortés M de las A, Cantudo Cuenca MR, Morillo Verdugo R, Calvo
   Cidoncha E. High quantity but limited quality in healthcare applications
   intended for HIV-infected patients. Telemed e-Health. 2014;20:729–35. [DOI]
   [PubMed]
 * 54.Cafe Bazaar Online Persian App Store. https://cafebazaar.ir/app. Accessed
   7 Sep 2022.
 * 55.SaeedI MG, Kalhori SRN, Nouria R, Yasini M, Nouri R, Yasini M. Persian
   mHealth apps: a cross sectional study based on use case classification. Stud
   Health Technol Inform. 2016;228:230–234. [PubMed] [Google Scholar]
 * 56.Stoyanov S. MARS Training Video. YouTube. 2016.
   https://www.youtube.com/watch?v=25vBwJQIOcE. Accessed 7 Sep 2022.
 * 57.Wyatt JC, Thimbleby H, Rastall P, Hoogewerf J, Wooldridge D, Williams J.
   What makes a good clinical app? Introducing the RCP health informatics unit
   checklist. Clin Med J R Coll Phys London. 2015;15:519–521. doi:
   10.7861/clinmedicine.15-6-519. [DOI] [PMC free article] [PubMed] [Google
   Scholar]
 * 58.Hallgren KA. Computing inter-rater reliability for observational data: an
   overview and tutorial. Tutor Quant Methods Psychol. 2012;8:23–34. doi:
   10.20982/tqmp.08.1.p023. [DOI] [PMC free article] [PubMed] [Google Scholar]
 * 59.Chapman C, Elizabeth Champion K, Psych B, Birrell L, Deen H, Brierley M-E,
   et al. Smartphone apps about crystal methamphetamine (“Ice”): systematic
   search in app stores and assessment of composition and quality. JMIR mHealth
   uHealth. 2018;6:e10442. doi: 10.2196/10442. [DOI] [PMC free article] [PubMed]
   [Google Scholar]
 * 60.Salazar A, de Sola H, Failde I, Moral-Munoz JA. Measuring the quality of
   mobile apps for the management of pain: systematic search and evaluation
   using the mobile app rating scale. JMIR mHealth uHealth. 2018;6:e10718. doi:
   10.2196/10718. [DOI] [PMC free article] [PubMed] [Google Scholar]
 * 61.Moral-Munoz JA, Esteban-Moreno B, Herrera-Viedma E, Cobo MJ, Pérez IJ.
   Smartphone applications to perform body balance assessment: a standardized
   review. J Med Syst. 2018;42:119. doi: 10.1007/s10916-018-0970-1. [DOI]
   [PubMed] [Google Scholar]
 * 62.Mani M, Kavanagh DJ, Hides L, Stoyanov SR. Review and Evaluation of
   Mindfulness-based iPhone Apps. JMIR mHealth uHealth. 2015;3:e82. doi:
   10.2196/mhealth.4328. [DOI] [PMC free article] [PubMed] [Google Scholar]
 * 63.Yang G, Long J, Luo D, Xiao S, Kaminga AC. The characteristics and quality
   of mobile phone apps targeted at men who have sex with men in China: A window
   of opportunity for health information dissemination? JMIR mHealth uHealth.
   2019;7:e12573. doi: 10.2196/12573. [DOI] [PMC free article] [PubMed] [Google
   Scholar]
 * 64.Sharpe JD, Kamara MT. A systematic evaluation of mobile apps to improve
   the uptake of and adherence to HIV pre-exposure prophylaxis. Sex Health.
   2018;15:587–594. doi: 10.1071/SH18120. [DOI] [PubMed] [Google Scholar]
 * 65.Courtenay T, Baraitser P. Improving online clinical sexual and
   reproductive health information to support self-care: a realist review. Digit
   Heal. 2022;8:20552076221084464. [Google Scholar]
 * 66.Bahadori S, Wainwright TW, Ahmed OH. Smartphone apps for total hip
   replacement and total knee replacement surgery patients: a systematic review.
   Disabil Rehabil. 2018;42(7):983–988. doi: 10.1080/09638288.2018.1514661.
   [DOI] [PubMed] [Google Scholar]
 * 67.Schnall R, Bakken S, Rojas M, Travers J, Carballo-Dieguez A. mHealth
   technology as a persuasive tool for treatment, care and management of persons
   living with HIV. AIDS Behav. 2015;19:81–89. doi: 10.1007/s10461-014-0984-8.
   [DOI] [PMC free article] [PubMed] [Google Scholar]


ASSOCIATED DATA

This section collects any data citations, data availability statements, or
supplementary materials included in this article.


SUPPLEMENTARY MATERIALS

12911_2022_2029_MOESM1_ESM.docx (25.2KB, docx)

Additional file 1: The Feature-Based Application Rating Method (the FARM) Tool.


DATA AVAILABILITY STATEMENT

Data sharing is not applicable to this article as no datasets were generated or
analysed during the current study.

--------------------------------------------------------------------------------

Articles from BMC Medical Informatics and Decision Making are provided here
courtesy of BMC


ACTIONS

 * View on publisher site
 * PDF (855.0 KB)
 * Cite
 * Collections
 * Permalink
   
   
   PERMALINK
   
   Copy


RESOURCES


SIMILAR ARTICLES




CITED BY OTHER ARTICLES




LINKS TO NCBI DATABASES




ON THIS PAGE

 * Abstract
 * Background
 * Methods
 * Results
 * Discussion
 * Strengths and limitations of the study
 * Conclusions
 * Supplementary Information
 * Acknowledgements
 * Abbreviations
 * Author contributions
 * Funding
 * Availability of data and materials
 * Declarations
 * Footnotes
 * Contributor Information
 * References
 * Associated Data


CITE

 * Copy
 * Download .nbib .nbib
 * Format: AMA APA MLA NLM




ADD TO COLLECTIONS

Create a new collection
Add to an existing collection
Name your collection *
Choose a collection
Unable to load your collection due to an error
Please try again
Add Cancel
Follow NCBI
NCBI on X (formerly known as Twitter) NCBI on Facebook NCBI on LinkedIn NCBI on
GitHub NCBI RSS feed

Connect with NLM

NLM on X (formerly known as Twitter) NLM on Facebook NLM on YouTube

National Library of Medicine
8600 Rockville Pike
Bethesda, MD 20894

 * Web Policies
 * FOIA
 * HHS Vulnerability Disclosure

 * Help
 * Accessibility
 * Careers

 * NLM
 * NIH
 * HHS
 * USA.gov


Back to Top