Strong agreement that a criterion is met (ie, clarity in whether a feature is present) is not necessarily equivalent to meeting the criterion to a high degree. These guidelines use a “Strongly agree” to “Strongly disagree” Likert scale to rate each criterion, which does not provide an indication of their quality. Guidelines for evaluating the usability of mHealth apps were also compiled by the Health Care Information and Management Systems Society (HIMSS). Furthermore, the matrix omits any evaluation of the visual aesthetics of the app as a criterion. While this matrix provides comprehensive criteria for rating app quality, the complex and time-consuming nature of the evaluation scheme would be difficult to apply in routine practice and research. Khoja et al described the development of a matrix of evaluation criteria, divided into seven themes for each of the four stages of an app’s life-cycle: (1) development, (2) implementation, (3) integration, and (4) sustained operation. While these criteria may cover important aspects of quality, no rationale for these specific criteria was provided. Handel reviewed 35 health and well being mobile apps based on user ratings of: (1) ease of use, (2) reliability, (3) quality, (4) scope of information, and (5) aesthetics. While many website criteria may be applicable to mobile apps, there is a need to consider whether a specific quality rating scale may be needed for apps.Īttempts to develop mobile health (mHealth) evaluation criteria are often too general, complex, or specific to a particular health domain. However, 33 criteria were unable to be grouped and were coded as “miscellaneous ”, highlighting the complexity of the task. A synthesis of website evaluation criteria conducted by Kim et al shortlisted 165 evaluation criteria, grouped in 13 groups (eg, design and aesthetics, ease of use). Website quality can be described as a function of: (1) content, (2) appearance and multimedia, (3) navigation, (4) structure and design, and (5) uniqueness. Much of the published literature focuses on technical aspects of websites, presented mostly in the form of checklists, which do not assess the quality of these features. Selecting apps on the basis of popularity yields little or no meaningful information on app quality. Little information on the quality of apps is available, beyond the star ratings published on retailers’ Web pages, and app reviews are subjective by nature and may come from suspicious sources. Given the rapid proliferation of smart phone apps, it is increasingly difficult for users, health professionals, and researchers to readily identify and assess high quality apps. The capabilities (eg, sensors) of smart phones can also enhance the delivery of these health resources. The portability of smart phones provides access to health information and interventions at any time in any context. There were 13.4 billion apps that were downloaded in the first quarter of 2013, with projected figures of 102 billion for the whole year. Between 20 the global use of smart phones increased by 406 million, reaching 1.82 billion devices (up 5% in a year), and Internet usage via mobile devices has increased by 81% in one year. The use of mobile apps for health and well being promotion has grown exponentially in recent years.
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