key: cord-0759905-bza9agzo
authors: Davalbhakta, S.; Advani, S.; Kumar, S.; Agarwal, V.; Bhoyar, S.; Fedirko, E.; Misra, D.; Goel, A.; Gupta, L.
title: A systematic review of the smartphone applications available for coronavirus disease 2019 (COVID19) and their assessment using the mobile app rating scale (MARS)
date: 2020-07-04
journal: medRxiv : the preprint server for health sciences
DOI: 10.1101/2020.07.02.20144964
sha: 0f83cae8534eed2a09b5142c0a9cb52a1a0cb4cf
doc_id: 759905
cord_uid: bza9agzo

The global impact of COVID-19 pandemic has increased the need to rapidly develop and improve utilization of mobile applications across the healthcare continuum to address rising barriers of access to care due to social distancing challenges and allow continuity in sharing of health information, assist with COVID-19 activities including contact tracing, and providing useful information as needed. Here we provide an overview of mobile applications being currently utilized for COVID-19 related activities. We performed a systematic review of the literature and mobile platforms to assess mobile applications been currently utilized for COVID-19, and quality assessment of these applications using the Mobile Application Rating Scale (MARS) for overall quality, Engagement, Functionality, Aesthetics, and Information. Finally, we provide an overview of the key salient features that should be included in mobile applications being developed for future use. Our search identified 63 apps that are currently being used for COVID-19. Of these, 25 were selected from the Google play store and Apple App store in India, and 19 each from the UK and US. 18 apps were developed for sharing up to date information on COVID-19, and 8 were used for contact tracing while 9 apps showed features of both. On MARS Scale, overall scores ranged from 2.4 to 4.8 with apps scoring high in areas of functionality and lower in Engagement. Future steps should involve developing and testing of mobile applications using assessment tools like the MARS scale and the study of their impact on health behaviors and outcomes.

English or Hindi were included in the study. Those applications that were duplicates and pay to download were by 4 i.e. 4 domains. The App subjective quality section and App specific section was calculated similarly.

of MARS using a 37-minute video available on YouTube 12 which was followed by an independent review 146 exercise of a common app and discussion of scores to assess consensus. Disagreements were discussed with a 147 third reviewer, and ambiguous MARS items were clarified to ensure full comprehension of the scale. 11 148 Statistical analysis 149 Unpaired students t-test was performed to analyse the difference in the means obtained in each section by Asian, 

The screening process was conducted by two review team members using the keywords: "Covid", 160 "Corona", "Pandemic", "Covid-19", "SARS-COV2", "Novel coronavirus", "2019-nCoV", and "smartphone".

The articles were screened for relevance by title, abstract and eventually full-text review was performed for 162 included abstracts (Figure 1b) . Articles in languages other than English were excluded. Those studies in which 163 the subject matter was unrelated to the use of smartphone apps in Covid-19 were excluded. was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint (which this version posted July 4, 2020. 

Apps from Asia scored higher in functionality (mean difference 0.54 (± 0.13) 95% CI= 0.3 to 0.8, p= information subscale (mean difference 0.6 (± 0.2) 95% CI= -1.0 to -0.1, p= 0.01). Aesthetics, engagement and 217 total scores did not differ between the western and Asian Apps. Thus, the apps based in the Indian subcontinent 218 were sufficiently interactive and functioned smoothly, but lacked in either quality, or quantity of information was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint (which this version posted July 4, 2020. . https://doi.org/10.1101/2020.07.02.20144964 doi: medRxiv preprint study. For example, those articles which focused on specialty practice during COVID-19 and telemedicine, 299 smartphone enabled technology that did not involve an application, or studies that utilized apps to assess for 300 mental health outcomes among COVID-19 patients.

A total of ten studies were found on this subject and have been detailed in was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint (which this version posted July 4, 2020. . was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint (which this version posted July 4, 2020. . https://doi.org/10.1101/2020.07.02.20144964 doi: medRxiv preprint was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. Apps excluded (n=12) (inter-regional duplicates) All rights reserved. No reuse allowed without permission.

was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. : Assesses the level of entertainment provided, whether interesting to use, lity, interactivity, and appropriateness of app content for target audience.

ity: Assesses the performance, ease of use, navigation, and gestural design.

Assesses the layout, quality of graphics, and overall visual appeal : Assesses the accuracy of the app description in the app store, whether the goals of the ific, measurable and achievable, quality and quantity of information, visual on of the information, source of information, and the level of evidence available for the pp All rights reserved. No reuse allowed without permission. was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. 

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