This evidence map focuses on the effectiveness of mobile health (mHealth) interventions for the self-management of different chronic health conditions as assessed in 99 systematic reviews, as well as the strength of evidence underlying those findings. Read more about Using This Map and overarching Research Insights gained from this map. For the best map interaction experience, we recommend viewing this evidence map on desktop-sized devices in a Chrome, Safari, or Firefox browser.

Notes
ECRI investigators performed the strength of evidence assessment. Definitions for strength of evidence terms are as follows:
High – We are very confident in the stated direction of effect.
Moderate – We are moderately confident in the stated direction of effect, but a possibility exists that the true effect is substantially different from the estimate.
Low – Our confidence in the stated direction of effect is limited; the true effect may be substantially different from the estimate.
Very low – We have very little confidence in the stated direction of effect; the true effect is likely to be substantially different from the estimate.
For further information, please refer to the Methods section of the accompanying Summary Report.

The ECRI Institute-Penn Medicine Evidence-based Practice Center developed this map for PCORI.
 

Using This Map

Axes: The x-axis (horizontal axis along the bottom) displays categories of chronic health conditions (e.g., cancer). The y-axis (vertical axis on the right) depicts the effect (which ranges from no effect to unclear effect to a positive effect). 

Bubbles: Different bubble colors represent the strength of the evidence, classified as very low to high. (Definitions of these terms are provided in the Notes). This allows for the creation of packed bubbles (e.g., multiple smaller colored bubbles within a lighter shaded circle), which describe specific subsets of systematic reviews that are available for a given chronic condition, effect, and strength of evidence.

Hovering over a given bubble allows one to obtain more detailed information about the evidence available for that chronic condition category. For example, for obesity and a positive effect, there are three systematic reviews concluding with a moderate strength of evidence and one systematic review concluding with a low strength of evidence (for a total of four unique systematic reviews). Hovering also allows one to click links to the systematic review abstracts in PubMed.

Filters: The filters above the map allow for customization of the presented data in the map by inclusion of vulnerable populations, age range, outcome assessed, functionality of the mHealth intervention, type of technology, and specific chronic condition.  

Research Insights

  • For almost every chronic condition, most systematic reviews had “unclear” findings regarding intervention efficacy and assessed the available strength of evidence as “low.” These findings were similar across different age groups, outcomes, technologies, and technology functions.
  • For some chronic conditions, the strength of evidence and the potential effect varied substantially among systematic reviews. Explanations include differences in:
    • Study inclusion criteria 
    • Instruments used to assess the risk of bias 
    • Outcomes evaluated
    • Specific chronic conditions (e.g., different mental disorders) evaluated. 
  • Some systematic reviews with a “moderate” strength of evidence rating did find evidence to suggest a positive effect of mHealth interventions. Examples include:
    • Systematic reviews that found text messaging helps maintain adherence to medication in patients with HIV, diabetes and asthma
    • Systematic reviews that found text messaging and mobile apps were associated with short-term weight loss in individuals who are overweight/obese.

Posted: March 6, 2019

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