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Currently submitted to: JMIR mHealth and uHealth

Date Submitted: Jun 10, 2019
Open Peer Review Period: Jun 13, 2019 - Aug 8, 2019
(currently open for review and needs more reviewers - can you help?)

Mobile apps in rheumatology: review and analysis using the Mobile App Rating Scale (MARS)

  • Johannes Knitza; 
  • Koray Tascilar; 
  • Eva-Maria Messner; 
  • Marco Meyer; 
  • Diana Vossen; 
  • Almut Pulla; 
  • Philipp Bosch; 
  • Julia Kittler; 
  • Arnd Kleyer; 
  • Philipp Sewerin; 
  • Johanna Mucke; 
  • Isabell Haase; 
  • David Simon; 
  • Martin Krusche



Chronic rheumatic diseases need long-term treatment and professional supervision. Mobile applications promise to improve the lives of patients as well as physicians. In routine practice, however, rheumatology apps are largely unknown and little is known about their quality and safety.


The aim of this study was to provide an overview of the mobile rheumatology applications currently available in the German app stores, to evaluate the app quality using the Mobile App Rating Scale (MARS) and to compile brief, ready-to-use descriptions for patients as well as rheumatologists.


The German Google Play and Apple app stores were systematically searched to identify German rheumatology mobile applications applying to patients as well as physicians. MARS was used to independently assess app quality by a total of 8 physicians, 4 using Android and 4 using iOS smartphones. Apps were randomly assigned so that 4 apps were rated by all raters and the remaining apps were rated by two Android and two iOS users. Furthermore, brief app descriptions including app developers, app categories and features were compiled to inform potential users and developers.


In total, 128 and 63 apps were identified in the German Google Play and Apple app stores, respectively. After removing doublets and only including apps that were available in both stores, 28 apps remained. Sixteen apps met the inclusion criteria, which were: (1) German language; (2) availability in both app stores; (3) targeting patients or physicians as users; and (4) clearly including rheumatology or rheumatic diseases as subject matter. Exclusion criteria were: (1) congress apps and (2) company apps with advertisements. Nine apps addressed patients and 7 apps addressed physicians. No clinical studies to support the effectiveness and safety of these apps could be found. Pharmaceutical companies were the main developers of two apps. Rheuma-Auszeit was the only app mainly developed by a patient organisation. This app, had the highest overall MARS score (4.19/5). Three out of nine patient apps featured validated questionnaires. The median overall MARS score was 3.85/5, ranging from 2.81/5 to 4.19/5. One patient targeted app and one physician-targeted app had a MARS score >4/5. No significant gender or platform (iOS/Android) differences could be observed. The overall correlation between app store ratings and MARS scores was low and inconsistent between platforms.


This is the first study, which systematically identified and evaluated mobile applications in rheumatology for patients, as well as physicians, available in German app stores. We found a lack of supporting clinical studies, use of validated questionnaires and involvement of academic developers. Overall app quality was very heterogeneous. To create high-quality apps a closer cooperation lead by patients and physicians is vital.


Please cite as:

Knitza J, Tascilar K, Messner E, Meyer M, Vossen D, Pulla A, Bosch P, Kittler J, Kleyer A, Sewerin P, Mucke J, Haase I, Simon D, Krusche M

Mobile apps in rheumatology: review and analysis using the Mobile App Rating Scale (MARS)

JMIR Preprints. 10/06/2019:14991

DOI: 10.2196/preprints.14991


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