JMIR Publications

ABSTRACT

Background:

Mobile health applications (mHealth Apps) are increasingly used post-operatively to monitor, educate and rehabilitate. The ‘usability’ of mHealth Apps is critical to their implementation.

Objective:

This systematic review evaluates (1) methodology of usability analyses; (2) domains of usability being assessed; (3) results of usability analyses.

Methods:

The AMSTAR checklist was consulted. The PRISMA reporting guideline was adhered to. Screening was undertaken by two independent reviewers. All included studies were assessed for risk. Domains of usability were compared with the gold-standard mHealth App Usability Questionnaire (MAUQ).

Results:

33/720 identified studies were included for data extraction. Of the 5 included randomised control trials (RCTs), usability was never the primary end-point. Methodology of usability analyses included interview (10/32), self-created questionnaire (18/32) and validated questionnaire (9/32). Of the 3 domains of usability proposed in the MAUQ, ‘satisfaction’ was assessed in 28/32 studies, ‘system information arrangement’ was assessed in 11/32 studies; ‘usefulness’ was assessed in 18/32 studies. Usability of mHealth Apps was above industry average, with median Systems Usability Scores ranging from 76/100 to 95/100.

Conclusions:

Current analyses of mHealth App usability are substandard. RCTs are rare, and validated questionnaires are infrequently consulted. Of the 3 domains of usability, only ‘satisfaction,’ is regularly assessed. There is significant bias throughout the literature, particularly with regards to conflict of interest. Future studies should adhere to the MAUQ to assess usability and improve the utility of mHealth Apps.