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Development of a novel mobile application to detect urine protein for nephrotic syndrome disease monitoring

BACKGROUND: Home monitoring of urine protein is a critical component of disease management in childhood nephrotic syndrome. We describe the development of a novel mobile application, UrApp – Nephrotic Syndrome Manager, to aid disease monitoring. METHODS: UrApp was iteratively developed by a panel of...

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Autores principales: Wang, Chia-shi, Boyd, Richard, Mitchell, Russell, Wright, W. Darryl, McCracken, Courtney, Escoffery, Cam, Patzer, Rachel E., Greenbaum, Larry A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543567/
https://www.ncbi.nlm.nih.gov/pubmed/31146731
http://dx.doi.org/10.1186/s12911-019-0822-z
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author Wang, Chia-shi
Boyd, Richard
Mitchell, Russell
Wright, W. Darryl
McCracken, Courtney
Escoffery, Cam
Patzer, Rachel E.
Greenbaum, Larry A.
author_facet Wang, Chia-shi
Boyd, Richard
Mitchell, Russell
Wright, W. Darryl
McCracken, Courtney
Escoffery, Cam
Patzer, Rachel E.
Greenbaum, Larry A.
author_sort Wang, Chia-shi
collection PubMed
description BACKGROUND: Home monitoring of urine protein is a critical component of disease management in childhood nephrotic syndrome. We describe the development of a novel mobile application, UrApp – Nephrotic Syndrome Manager, to aid disease monitoring. METHODS: UrApp was iteratively developed by a panel of two pediatric nephrologists and three research engineers from May 2017 to October 2018 for Apple iPhones. App features were devised by this expert panel to support urine monitoring and other home care tasks. Each feature and user-app interface element was systematically reviewed by the panel and iteratively redesigned to remove anticipated use issues. The app prototype was then refined based on two rounds of usability testing and semi-structured user interviews with a total of 20 caregivers and adolescent patients. The analytic function of UrApp in providing a camera read of the urine test strip was compared to a standard urinalysis machine using 88 patient urine samples and three iPhones, model versions 6S and 7. Exact agreement and weighted kappa were calculated between the UrApp and urinalysis machine reads. RESULTS: The final UrApp features include: camera read of a urine test strip; analysis of urine protein trends and alerts for new disease relapse/remission; transmission of urine protein results to providers; education materials; and medication reminders. During the second round of UrApp usability testing, all users were able to perform each of the functions without error and all perceived UrApp to be helpful and indicated that they would use UrApp. UrApp camera results had 97% exact agreement and an overall weighted kappa value of 0.91 (95% CI, 0.85–0.97) compared with standard urinalysis machine interpretation. CONCLUSIONS: UrApp was specifically designed to support patients and families living with nephrotic syndrome by supporting disease monitoring and home management tasks. The technically innovative feature that makes this possible is the use of a smartphone camera to read the urine test strip. This novel tool has the potential to improve disease monitoring and reduce management burden. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12911-019-0822-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-65435672019-06-04 Development of a novel mobile application to detect urine protein for nephrotic syndrome disease monitoring Wang, Chia-shi Boyd, Richard Mitchell, Russell Wright, W. Darryl McCracken, Courtney Escoffery, Cam Patzer, Rachel E. Greenbaum, Larry A. BMC Med Inform Decis Mak Technical Advance BACKGROUND: Home monitoring of urine protein is a critical component of disease management in childhood nephrotic syndrome. We describe the development of a novel mobile application, UrApp – Nephrotic Syndrome Manager, to aid disease monitoring. METHODS: UrApp was iteratively developed by a panel of two pediatric nephrologists and three research engineers from May 2017 to October 2018 for Apple iPhones. App features were devised by this expert panel to support urine monitoring and other home care tasks. Each feature and user-app interface element was systematically reviewed by the panel and iteratively redesigned to remove anticipated use issues. The app prototype was then refined based on two rounds of usability testing and semi-structured user interviews with a total of 20 caregivers and adolescent patients. The analytic function of UrApp in providing a camera read of the urine test strip was compared to a standard urinalysis machine using 88 patient urine samples and three iPhones, model versions 6S and 7. Exact agreement and weighted kappa were calculated between the UrApp and urinalysis machine reads. RESULTS: The final UrApp features include: camera read of a urine test strip; analysis of urine protein trends and alerts for new disease relapse/remission; transmission of urine protein results to providers; education materials; and medication reminders. During the second round of UrApp usability testing, all users were able to perform each of the functions without error and all perceived UrApp to be helpful and indicated that they would use UrApp. UrApp camera results had 97% exact agreement and an overall weighted kappa value of 0.91 (95% CI, 0.85–0.97) compared with standard urinalysis machine interpretation. CONCLUSIONS: UrApp was specifically designed to support patients and families living with nephrotic syndrome by supporting disease monitoring and home management tasks. The technically innovative feature that makes this possible is the use of a smartphone camera to read the urine test strip. This novel tool has the potential to improve disease monitoring and reduce management burden. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12911-019-0822-z) contains supplementary material, which is available to authorized users. BioMed Central 2019-05-30 /pmc/articles/PMC6543567/ /pubmed/31146731 http://dx.doi.org/10.1186/s12911-019-0822-z Text en © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Technical Advance
Wang, Chia-shi
Boyd, Richard
Mitchell, Russell
Wright, W. Darryl
McCracken, Courtney
Escoffery, Cam
Patzer, Rachel E.
Greenbaum, Larry A.
Development of a novel mobile application to detect urine protein for nephrotic syndrome disease monitoring
title Development of a novel mobile application to detect urine protein for nephrotic syndrome disease monitoring
title_full Development of a novel mobile application to detect urine protein for nephrotic syndrome disease monitoring
title_fullStr Development of a novel mobile application to detect urine protein for nephrotic syndrome disease monitoring
title_full_unstemmed Development of a novel mobile application to detect urine protein for nephrotic syndrome disease monitoring
title_short Development of a novel mobile application to detect urine protein for nephrotic syndrome disease monitoring
title_sort development of a novel mobile application to detect urine protein for nephrotic syndrome disease monitoring
topic Technical Advance
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543567/
https://www.ncbi.nlm.nih.gov/pubmed/31146731
http://dx.doi.org/10.1186/s12911-019-0822-z
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