Systematic Evaluation of Smartphone Applications for the Medical Management of Nephrolithiasis

Objective: The aim of this study was to comprehensively evaluate the quality of patient-oriented, mobile health applications (apps) available for medical management of kidney stone disease (KSD). Materials and Methods: A systematic search was performed to identify apps from the Apple and Google Play app stores. Eligible apps were divided into two categories: (1) fluid apps and (2) dietary apps. Descriptive characteristics were summarized and app quality was independently evaluated on the basis of technical quality, usability, clinical value, and privacy/security. The validated Mobile App Rating Scale (MARS) was the backbone for the evaluation framework. Results: In total, 31 apps (18 fluid apps and 13 dietary apps) were included. Fluid apps outscore dietary apps in all dimensions of MARS quality. All but one fluid app exceeded the minimum acceptable MARS score of 3.0 vs 46% of dietary management apps. Dietary apps feature less functionality and most are limited to noninteractive informational content. While most data-capturing apps provide a privacy policy and ensure that security measures are taken to protect user identity, only 36% offer users choice or consent for secondary use of their data after data have already been collected. Overall, only one app has undergone any form of real-world clinical investigation. Conclusions: Fluid management apps outperform dietary apps in technical quality, usability, and clinical value at the cost of greater privacy/security risks. Despite not being targeted to patients with KSD, they are higher in most quality measures and offer greater functionality to support long-term disease management compared with dietary apps.