Are Mobile Applications in Laryngology Designed for All Patients?

TitleAre Mobile Applications in Laryngology Designed for All Patients?
Publication TypeJournal Article
Year of Publication2023
AuthorsOdigie E, Andreadis K, Chandra I, Mocchetti V, Rives H, Cox S, Rameau A
JournalLaryngoscope
Volume133
Issue7
Pagination1540-1549
Date Published2023 Jul
ISSN1531-4995
KeywordsComprehension, Health Literacy, Humans, Language, Mobile Applications, Reproducibility of Results
Abstract

OBJECTIVES: Mobile applications (apps) are multiplying in laryngology, with little standardization of content, functionality, or accessibility. The purpose of this study is to evaluate the quality, functionality, health literacy, readability, accessibility, and inclusivity of laryngology mobile applications.

METHODS: Of the 3230 apps identified from the Apple and Google Play stores, 28 patient-facing apps met inclusion criteria. Apps were evaluated using validated scales assessing quality and functionality: the Mobile App Rating Scale (MARS) and the Institute for Healthcare Informatics App Functionality Scale. The Clear Communication Index (CDC) Institute of Medicine Strategies for Creating Health Literate Mobile Applications, and Patient Education Materials Assessment Tool (PEMAT) were used to evaluate apps health literacy level. Readability was assessed using established readability formulas. Apps were evaluated for language, accessibility features, and representation of a diverse population.

RESULTS: Twenty-six apps (92%) had adequate quality (MARS score > 3). The mean PEMAT score was 89% for actionability and 86% for understandability. On average, apps utilized 25/33 health literate strategies. Twenty-two apps (79%) did not pass the CDC index threshold of 90% for health literacy. Twenty-four app descriptions (86%) were above an 8th grade reading level. Only 4 apps (14%) showed diverse representation, 3 (11%) had non-English language functions, and 2 (7%) offered subtitles. Inter-rater reliability for MARS was adequate (CA-ICC = 0.715).

CONCLUSION: While most apps scored well in quality and functionality, many laryngology apps did not meet standards for health literacy. Most apps were written at a reading level above the national average, lacked accessibility features, and did not represent diverse populations. Laryngoscope, 133:1540-1549, 2023.

DOI10.1002/lary.30465
Alternate JournalLaryngoscope
PubMed ID36317789
PubMed Central IDPMC10149562
Grant ListK76 AG079040 / AG / NIA NIH HHS / United States
K76 AG079040 / AG / NIA NIH HHS / United States