Design and evaluation of a mobile application to assist the self-monitoring of the chronic kidney disease in developing countries.
Design and evaluation of a mobile application to assist the self-monitoring of the chronic kidney disease in developing countries.
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DOI：
10.1186/s12911-018-0587-9
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发表时间：
2018-01-12
影响因子：
3.5
通讯作者：
Cunha P
中科院分区：
文献类型：
--
作者：
Sobrinho A;da Silva LD;Perkusich A;Pinheiro ME;Cunha P
慢性肾脏病（CKD）是一个世界性的严重问题，特别是在发展中国家。CKD患者通常在晚期开始开始治疗，这需要透析和肾移植，因此影响死亡率。这个问题是由一个移动的健康（mHealth）应用程序（app），旨在帮助早期诊断和自我监测疾病的进展所面临的。以用户为中心的设计（UCD）方法涉及卫生专业人员（护士和肾病学家）和目标用户，指导了2012年至2016年期间应用程序的开发过程。在整个需求获取过程中，与医疗保健专业人员进行了沿着的深入访谈和原型设计。引发的需求被转化为针对Android平台的原生mHealth应用程序。之后，科恩的Kappa系数统计被应用于评估应用程序和三名肾病学家之间的一致性，他们分析了从60份病历中收集的测试结果。最后，八名用户测试了该应用程序，并就可用性和用户感知进行了采访。mHealth应用程序旨在帮助CKD早期诊断和自我监测，同时考虑安全性、有效性和可用性等质量属性。总体Kappa值为0.7119，显示该应用程序与三位肾病学家之间存在相当程度的一致性。与目标用户的面对面访谈结果表明，良好的用户满意度。然而，CKD自我监测的任务被证明是困难的，因为大多数用户不完全理解特定生物标志物的含义（例如，肌酸酐）。UCD方法提供了基于用户真实的需求开发应用程序的机制。即使没有完美的Kappa一致度，结果也是令人满意的，因为它的目的是在早期阶段将患者转诊给肾脏科医生，在那里他们可以确认CKD的诊断。
The chronic kidney disease (CKD) is a worldwide critical problem, especially in developing countries. CKD patients usually begin their treatment in advanced stages, which requires dialysis and kidney transplantation, and consequently, affects mortality rates. This issue is faced by a mobile health (mHealth) application (app) that aims to assist the early diagnosis and self-monitoring of the disease progression. A user-centered design (UCD) approach involving health professionals (nurse and nephrologists) and target users guided the development process of the app between 2012 and 2016. In-depth interviews and prototyping were conducted along with healthcare professionals throughout the requirements elicitation process. Elicited requirements were translated into a native mHealth app targeting the Android platform. Afterward, the Cohen’s Kappa coefficient statistics was applied to evaluate the agreement between the app and three nephrologists who analyzed test results collected from 60 medical records. Finally, eight users tested the app and were interviewed about usability and user perceptions. A mHealth app was designed to assist the CKD early diagnosis and self-monitoring considering quality attributes such as safety, effectiveness, and usability. A global Kappa value of 0.7119 showed a substantial degree of agreement between the app and three nephrologists. Results of face-to-face interviews with target users indicated a good user satisfaction. However, the task of CKD self-monitoring proved difficult because most of the users did not fully understand the meaning of specific biomarkers (e.g., creatinine). The UCD approach provided mechanisms to develop the app based on the real needs of users. Even with no perfect Kappa degree of agreement, results are satisfactory because it aims to refer patients to nephrologists in early stages, where they may confirm the CKD diagnosis.
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