Validate an App: How to Design Your Study and Get Published

Dr Orrin Franko MD^2
1Lead App Editor, Journal of Mobile Technology in Medicine, ²Dept of Orthopaedic Surgery, University of California, USA.
Corresponding Author: ofranko@ucsd.edu
Journal MTM 1:2:1-4, 2012
doi:10.7309/jmtm.9

The last two years have demonstrated an exponential growth in the use of smartphones and tablets by medical professionals, a trend that has led to medical apps developed specifically for patients and physicians.<sup>1-71. Azark R. Smartphone apps for your practice. CDS Rev 2011;104:12-13.
2. Bhansali R, Armstrong J. Smartphone applications for pediatric anesthesia. Paediatr Anaesth 2012;22:400-404.
3. Franko OI. Smartphone apps for orthopaedic surgeons. Clin Orthop Relat Res 2011;469:2042-2048.
4. Franko OI, Bhola S. iPad apps for orthopedic surgeons. Orthopedics 2011;34:978-981.
5. Oehler RL, Smith K, Toney JF. Infectious diseases resources for the iPhone. Clin Infect Dis 2010;50:1268-1274.
6. Rosser BA, Eccleston C. Smartphone applications for pain management. J Telemed Telecare 2011;17:308-312.
7. Franko OI, Tirrell TF. Smartphone App Use Among Medical Providers in ACGME Training Programs. J Med Syst 2011.</sup> Not surprisingly, because most app developers are unverified sources of medical information, recent publications have emphasized the importance of peer-review validation.<sup>7-107. Franko OI, Tirrell TF. Smartphone App Use Among Medical Providers in ACGME Training Programs. J Med Syst 2011.
8. Boulos MN, Wheeler S, Tavares C, Jones R. How smartphones are changing the face of mobile and participatory healthcare: an overview, with example from eCAALYX. Biomed Eng Online 2011;10:24.
9. Hamilton AD, Brady RR. Medical Professional Involvement in Smartphone Apps in Dermatology. Br J Dermatol 2012.
10. Kabachinski J. Mobile medical apps changing healthcare technology. Biomed Instrum Technol 2011;45:482-486.</sup>  In addition to safety concerns, the validation of mobile apps in the health care setting provides an opportunity for younger physicians, often medical students and residents, to contribute to the medical community by demonstrating the efficacy and validity of these new technologies.  However, many trainees and practicing physicians are unfamiliar with scientific validation methodology.  This editorial outlines a structure that can be used to assist with the design, execution, and publication of a validation study for mobile technology.

Validation refers to proving a tool’s ability to report the absolute “truth” as much as it can be measured.  Various forms of validity exist that, when combined, allow a tool to be considered “valid” by the medical community.  To clarify various forms of validation, I will share examples from the current literature, which can serve as guides for providers interested in designing a study of their own.

Principles of Security for the use of Mobile Technology in Medicine

Dr Chandrashan Perera MBBS^1,2
1Editor-In-Chief, Journal of Mobile Technology in Medicine, ²Austin Hospital, Melbourne, Australia
Corresponding Author: editor@journalmtm.com
Journal MTM 1:2:5-7, 2012
doi:10.7309/jmtm.10

The rapid uptake of mobile technologies has allowed a number of innovations in the medical field^{1Luanrattana R, Win KT, Fulcher J, Iverson D. Mobile technology use in medical education. J Med Syst. 2012 Feb.;36(1):113–22.,2Zurovac D, Talisuna AO, Snow RW. Mobile phone text messaging: tool for malaria control in Africa. PLoS Med. 2012 Feb.;9(2):e1001176.} .  However, as with any new technology, there are a number of security concerns that need to be acknowledged and addressed in order for these technologies to be implemented safely^{3Fernando JIE. Clinical software on personal mobile devices needs regulation. Med J Aust. 2012 Apr. 17;196(7):437.} .  This is of particular significance in the medical realm where confidentiality of patient data needs to be preserved.  Whilst data security is considered a more sensitive topic with evolving technologies, it is important to also consider the security benefits provided by mobile technologies.

The Evolution of E-Health – Mobile Technology and mHealth

Dr Chandrashan Perera MBBS^1,2
1Editor-In-Chief, Journal of Mobile Technology in Medicine, ²Austin Hospital, Melbourne, Australia
Corresponding Author: editor@journalmtm.com
Journal MTM 1:1:1-2, 2012
http://dx.doi.org/10.7309/jmtm.1

Medicine has always been an information intensive field from the first days of practice, when pearls of wisdom were passed along the generations as word of mouth. Throughout history, informatics has been an integral part of medicine, facilitating the storage and accession of vast amounts of data. This has come to the culmination of present day medical practice, which is built on the foundations of Electronic-Health (E-Health). New information is rapidly disseminated through electronic access to medical journals and other relevant sources of information. Patient data is increasingly stored electronically, and reference information including textbooks are stored electronically in websites.  The E-Health revolution digitized the world, and medicine has benefited immensely. Whilst having this information available electronically has numerous benefits, the delivery of this information to medical staff has been less than ideal, requiring doctors to be tied down to devices such as immobile desktop computers. The next stage in digital informatics is to gain rapid access in both storing and creating material in a convenient manner; and smartphones have been an instrumental tool in this evolution.

The Need for an Evidence-Base in Mobile Technology in Medicine

Dr Rahul Chakrabarti MBBS^1,2
1`Editor-In-Chief, Journal of Mobile Technology in Medicine, ²Royal Eye & Ear Hospital, Australia
Corresponding Author: rahul@journalmtm.com
Journal MTM 1:1:3-4, 2012
http://dx.doi.org/10.7309/jmtm.2

Modern medical practice is undergoing a transformation in the way it communicates and provides healthcare. The evolution in medicine has been advanced by the human desire to provide and receive a high standard of affordable medical care within an appropriate time. A significant contribution to this has been facilitated by advances in modern technology and telemedicine. Whilst a tsunami of easily accessible technology has engaged the attention of the medical community and improved access to medical care, particularly in remote areas, there is always an element of concern regarding safety, reliability, reproducibility and accuracy of telemedicine methods.

The (Ultra)sound of Things to Come

Dr Carlos Cabalag MBBS^1,2
1Editor, Journal of Mobile Technology in Medicine, ²Monash Medical Centre, Melbourne, Australia
Corresponding Author: carlos@journalmtm.com
Journal MTM 1:1:5-7, 2012
http://dx.doi.org/10.7309/jmtm.3

The use of mobile technology in medicine is not limited to the tablet computer or the use of the ever-popular Apple® iPhone.  As semi-conductors become smaller, various devices are being redeveloped and transformed into portable miniature versions of their old previously large and cumbersome counterparts. In particular, we have seen the advancement and miniaturisation of piezoelectric transducers in the recent decade, leading to the development of portable ultrasound machines that can be utilised virtually anywhere and in settings of dire need.  The most tragic and recent of those events was the Haitian earthquake in 2010, where 230,000 people lost their lives with many more injured in a background of crucial infrastructural destruction that was seemingly endless to the naked eye.^{1RCA. Haiti Earthquake Appeal, 2010. http://www.redcross.org.au/haiti-earthquake-appeal-2010.aspx: Red Cross Australia, 2010.}  Notably, one of the devices that had shaped the humanitarian effort to save lives, was (and still is) the humble portable ultrasound. (Refer to Figure 1).  Are clinicians ready for the next diagnostic tool, some branding it as the next ‘pocket stethoscope’?