中國地區心血管疾病行動醫療應用程式現況分析

Status analysis of medical mobile applications for cardiovascular diseases in China

中國地區患有心血管疾病人數正快速成長，透過行動醫療應用程式能輔助自我健康管理，確保行動 醫療提供之相關訊息質量並能符合使用者需求是現今應用程式開發的首要重點。 研究目的：本研究調查中國地區相關心血管疾病的手機應用程式進行系統性評估，評估分析應用程式中提供的 健康訊息內容質量與類型涵蓋範圍，以透過行動醫療進行自我健康管理決策。 研究方法：本研究於2018年10月至12月間透過IOS Apple store 安卓（豆莢兩大下載平台搜尋關鍵字包含” 冠心病、心臟病、心血管疾病、藥物及 coronary healt disease-healt diseage pedication cardiovascular disease''： 下載 134 App，排除重複，無法開啟並多階段篩選程式內容相關性後共58 個 App 進行心血管疾病相關 智能手機應用程式分析，評估分析（1） 應用程式類型（2） Siliber Score 訊息內容質量評估（3）世界街 生組織及歐洲心血管疾病指引進行內容涵蓋範圍。 研究結果：研究結果分為三大類：（1）應用程式功能類型：36 個應用程式（62.1%）提供生理監測數值記錄功能， 值 20 （34.5%）應用程式具反饋追蹤功能，警示功能，其次是提供線上諮詢服務及與網友間互動反饋 功能（28/58，48.3%），再則為生活型態管理，其中包含：飲食有關（458，6.9%），運動有關（9758，15.5%）、 體重控制有關（13/58，22.4%）及戒菸管理有關（2/58.3.4%）。一般衛教資訊（22/58/37.99%）、線上購物（藥 功能（16/58，27.6%）及用藥管理功能（7/58，12.1%）|僅有1個（1.7%）應用程式能將記錄數等與親友 分享以相互追蹤提醒監測（2） Siliberg Score 訊息內容質量評估：平均 Silberg Score 得分為1.72 + 1.67（總 分9分，最高得分為7分。82.8%App 於作者訊息項文中得分，但皆未公開作者相關證書。僅有 8.6% App 有載明資料內容來源出處及載明所有權與贊助聲明：25.9%應用程式於一個月內有更新修改訊息及標明更 新修改時間。（3）內容涵蓋項目共計9項：58 個 App 中僅有1個涵蓋6個項目（1.7%）：7個涵蓋4-5個 項目（12.1%）|16 個涵蓋2-3個項目（36.2%）|41.49. App 僅具有一個項目，8.68 App未具評估項目中 任何一項。本研究顯示當前中國地區心血管疾病相關應用程式資訊來源質量的隱憂及自我健康管理涵蓋範圍的 缺乏：應用程式的開發應謹慎使達具信度之實證醫學訊息並結合國際指引方針，以透過行動醫療用程 式有效輔助進行自主健康管理。然而在科技應用快速發展下，確保行動醫療提供之相關訊息質量並能符 合使用者需求是現今應用程式開發的首要重點，對於應用程式開發的審核需更嚴格的評估與監控，以避 免提供應用程式用戶具潛在性傷害的訊息內容：在中國文化背景下，家庭參與醫療決策是影響醫療決策 重要的一環，然而應用程式的設計開發卻未充分融入家庭成員間的互動功能，未來程式開發可增強此類 互動分享並增加結合當地衛生醫療機構，強化患者、家庭及醫療機構三方的主動與被動互動反酬追蹤機 制，以達行動醫療科技的最大效益。

The number of people with cardiovascular disease in China is growing rapidly. Self-health management can be supported through mobile health applications. Ensuring the quality of relevant information provided by mobile health and meeting user needs are the top priorities in application development today. Purpose: This study investigated mobile phone applications for cardiovascular diseases in China. A systematic assessment was conducted in order to evaluate the quality and type of health information provided and the self-management decision-making through mobile health. Research methods: This study searched from October to December 2018 for cardiovascular disease-related smartphone applications through the China regional web platforms and downloaded 134 apps, exclude duplicates, unable to opened, after multi-stage screening of program content relevance, a total of 58 apps for cardiovascular disease-related smartphone app analysis, evaluation analysis (1) App type| (2)Siliberg score| and (3) the scope of information covered by the World Health Organization and the European Cardiovascular Disease Guidelines. Findings: We found 36 (62.1%) applications provide physiological monitoring numerical recording. 20 (34.5%) applications have functions of feedback tracking and alerts, followed by online consulting services and interactive feedback with users (28/58, 48.3%). This is followed by lifestyle management, which includes: diet-related (4/58,6.9%), exercise-related (9/58, 15.5 %), weight control (13/58, 22.4%) and smoking cessation management related (2/58,3.4%). General health information (22/58, 37.9%), online shopping (drug) function (16/58, 27.6%) and drug management function (7/58, 12.1%). The Siliberg score message content quality assessment: the average Silberg score was 1.72 ±1.67 (full score 9), and the highest score of all investigated applications was 7. 82.8% of Apps scored on the author message item, but none of them disclosed the author-related certificates. Only 8.6% of apps have information on the origin of the data content and a statement of ownership and sponsors hip, and 25.9% of apps have updated and updated within a month. The content covers 9 items: only 1 of 58 Apps cover 6 (1.7 %)| Sixteen covering 2-3 (36.2 %)| 41.4 per cent of Apps have only one and 8.6 %t do not have any of the item evaluated. Conclusion: This study showed that the current cardiovascular disease-related applications in China don’t have sufficient information of self-management. Application development should carefully convey an empirical medical messag e and combine international guidelines to effectively assist autonomous health management through mobile medi cal applications. However, with the rapid development of applications, how to ensure the quality of relevant information provided and how to meet user needs are the top priorities in application development . Audit for application requires more rigorous evaluation and monitoring to avoid providing information about pot ential harm to users. In Chinese culture, family participation in medical decision-making is important, but the de sign and development of study applications are not fully integrated into the interactive need within family members. Future app should enhance interactive capability, integrate with local health care institutions, strengthen patients, families and medical institutions to maximize the benefits of mobile medical technology.