A systematic review of how studies describe digital health educational interventions: stage one of the development of the STEDI guideline

Article type
Authors
Posadzki P1, Tudor-Car L1, Semwal M1, Car J1
1Lee Kong Chian School Of Medicine NanYang Technological University
Abstract
Background:
Digital health education (DHE) is an umbrella term encompassing a broad spectrum of educational interventions that are commonly evaluated in randomised controlled trials (RCTs). To the best of our knowledge, there are no guidelines outlining the key reporting items for studies on DHE interventions for either healthcare professionals or patients.
Objectives:
The objective of this systematic review (SR) was to identify the quality of reporting in RCTs of DHE interventions. This review was the first step in an attempt to develop reporting recommendations for RCTs of DHE for health professionals and patients that would supplement/extend the 25-item CONSORT (Consolidated Standards of Reporting Trials) guidelines. (STEDI: Standards for Reporting of Digital Health Education Intervention Trials).

Methods:
We searched the following databases from January 1990 to August 2017: MEDLINE (Ovid), Embase (Elsevier), the Cochrane Central Register of Controlled Trials (CENTRAL) (Wiley), PsycINFO (Ovid), ERIC (Ovid), CINAHL (Ebsco), Web of Science Core Collection (Thomson Reuters) and the International Clinical Trials Registry Platform and metaRegister of Controlled Trials. We selected a random sample of 50 RCTs published in the first and the second quarter of 2017.

Results:
Forty studies (80%) evaluated medical doctors and the remaining 20% allied health professionals. The following DHE interventions were included: online, offline, mobile learning (m-learning), virtual patients, virtual reality environments, serious gaming, psychomotor skills trainers and augmented reality. The most commonly underreported items were context/adaptability of the interventions (100%), adverse effects (96%), fidelity and economics (each 92%), infrastructure (91%), trial registration (82%), security arrangements (78%) and interactivity (66%).

Conclusion:
The quality of reporting in RCTs of DHE is poor. This in turn impedes the development of DHE research. The standardised reporting of DHE research is therefore needed to help advance the field and guide future researchers, funders and publishers.

Patient or healthcare consumer involvement:
This reporting guideline intends to 1) benefit many important stakeholders in the field including researchers, educators, health professionals, editors, review authors and students, 2) facilitate transparency in describing RCTs of DHE interventions, 3) strengthen manuscripts methodologically and 4) streamline grant applications.