Background and objective

Pain spans a broad spectrum of diseases and types that are highly prevalent and cause substantial disease burden for individuals and society. Up to 40% of people affected by pain receive no or inadequate treatment. Providing a scalable, time-, and location-independent way for pain diagnostic, management, prevention and treatment mobile health applications (MHA) might be a promising approach to improve health care for pain. However, the commercial app market is rapidly growing and unregulated, resulting in an opaque market. Studies investigating the content, privacy and security features, quality and scientific evidence of the available apps are highly needed, to guide patients and clinicians to high quality MHA.

Contributing to this challenge, the present study investigates the content, quality, and privacy features of pain apps available in the European app stores.

Methods

An automated search engine was used to identify pain apps in the European Google Play and Apple App store. Pain apps were screened and checked for systematic criteria (pain-relatedness, functionality, availability, independent usability, English or German). Content, quality and privacy features were assessed by two independent reviewers using the German Mobile Application Rating Scale (MARS-G). The MARS-G assesses quality on four objectives (engagement, functionality, aesthetics, information quality) and two subjective scales (perceived impact, subjective quality).

Results

Out of 1034 identified pain apps 218 were included. Pain apps covered eight different pain types. Content included basic information, advice, assessment and tracking, and stand-alone interventions. The overall quality of the pain apps was average M = 3.13 (SD = 0.56, min = 1, max = 4.69). The effectiveness of less than 1% of the included pain apps was evaluated in a randomized controlled trial. Major problems with data privacy were present: 59% provided no imprint, 70% had no visible privacy policy.

Conclusion

A multitude of pain apps is available. Most MHA lack scientific evaluation and have serious privacy issues, posing a potential threat to users. Further research on evidence and improvements privacy and security are needed. Overall, the potential of pain apps is not exploited.

中文翻译：

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对欧洲应用商店中英语和德语疼痛应用程序的内容和质量进行系统评估

背景和目标

疼痛涵盖广泛的疾病和类型，这些疾病和类型非常普遍，给个人和社会造成沉重的疾病负担。高达 40% 的疼痛患者没有接受治疗或治疗不足。为疼痛诊断、管理、预防和治疗移动健康应用程序 (MHA) 提供可扩展、独立于时间和位置的方式可能是改善疼痛医疗保健的一种有前景的方法。然而，商业应用市场正在快速增长且不受监管，导致市场不透明。非常需要对可用应用程序的内容、隐私和安全功能、质量和科学证据进行研究，以指导患者和临床医生获得高质量的 MHA。

为了应对这一挑战，本研究调查了欧洲应用商店中可用的疼痛应用程序的内容、质量和隐私功能。

方法

使用自动搜索引擎来识别欧洲 Google Play 和 Apple App 商店中的疼痛应用程序。疼痛应用程序经过系统标准筛选和检查（疼痛相关性、功能、可用性、独立可用性、英语或德语）。内容、质量和隐私功能由两名独立评审员使用德国移动应用评级量表 (MARS-G) 进行评估。MARS-G 根据四个目标（参与度、功能性、美观性、信息质量）和两个主观尺度（感知影响、主观质量）评估质量。

结果

在 1034 个已识别的疼痛应用程序中，有 218 个被纳入其中。疼痛应用程序涵盖八种不同的疼痛类型。内容包括基本信息、建议、评估和跟踪以及独立干预措施。疼痛应用程序的整体质量平均为 M = 3.13（SD = 0.56，最小值 = 1，最大值 = 4.69）。一项随机对照试验评估了不到 1% 的疼痛应用程序的有效性。存在数据隐私方面的主要问题：59% 没有提供任何印记，70% 没有明显的隐私政策。

结论

有多种疼痛应用程序可供使用。大多数MHA缺乏科学评估，存在严重的隐私问题，对用户构成潜在威胁。需要进一步研究证据并改进隐私和安全。总体而言，疼痛应用程序的潜力尚未得到开发。