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Messner EM, Sturm N, Terhorst Y, Sander LB, Schultchen D, Portenhauser A, Schmidbaur S, Stach M, Klaus J, Baumeister H, Walter BM. Mobile Apps for the Management of Gastrointestinal Diseases: Systematic Search and Evaluation Within App Stores. J Med Internet Res 2022; 24:e37497. [PMID: 36197717 PMCID: PMC9582913 DOI: 10.2196/37497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/30/2022] [Accepted: 07/29/2022] [Indexed: 11/29/2022] Open
Abstract
Background Gastrointestinal diseases are associated with substantial cost in health care. In times of the COVID-19 pandemic and further digitalization of gastrointestinal tract health care, mobile health apps could complement routine health care. Many gastrointestinal health care apps are already available in the app stores, but the quality, data protection, and reliability often remain unclear. Objective This systematic review aimed to evaluate the quality characteristics as well as the privacy and security measures of mobile health apps for the management of gastrointestinal diseases. Methods A web crawler systematically searched for mobile health apps with a focus on gastrointestinal diseases. The identified mobile health apps were evaluated using the Mobile Application Rating Scale (MARS). Furthermore, app characteristics, data protection, and security measures were collected. Classic user star rating was correlated with overall mobile health app quality. Results The overall quality of the mobile health apps (N=109) was moderate (mean 2.90, SD 0.52; on a scale ranging from 1 to 5). The quality of the subscales ranged from low (mean 1.89, SD 0.66) to good (mean 4.08, SD 0.57). The security of data transfer was ensured only by 11 (10.1%) mobile health apps. None of the mobile health apps had an evidence base. The user star rating did not correlate with the MARS overall score or with the individual subdimensions of the MARS (all P>.05). Conclusions Mobile health apps might have a positive impact on diagnosis, therapy, and patient guidance in gastroenterology in the future. We conclude that, to date, data security and proof of efficacy are not yet given in currently available mobile health apps.
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Affiliation(s)
- Eva-Maria Messner
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Niklas Sturm
- Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
| | - Yannik Terhorst
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany.,Department of Research Methods, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Lasse B Sander
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University Freiburg, Freiburg at Breisgau, Germany
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Alexandra Portenhauser
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Simone Schmidbaur
- Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
| | - Michael Stach
- Institute of Databases and Information Systems, University of Ulm, Ulm, Germany
| | - Jochen Klaus
- Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Benjamin M Walter
- Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
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Schmidbaur S, Wannhoff A, Walter B, Meier B, Schäfer C, Meining A, Caca K. Risk of appendicitis after endoscopic full-thickness resection of lesions involving the appendiceal orifice: a retrospective analysis. Endoscopy 2021; 53:424-428. [PMID: 32894866 DOI: 10.1055/a-1227-4555] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Conventional endoscopic resection of lesions affecting the appendiceal orifice is difficult. Endoscopic full-thickness resection (EFTR) is a novel technique in interventional endoscopy. As EFTR near the appendiceal orifice is associated with a subtotal appendectomy, it remains unclear whether the risk of developing appendicitis is increased. We conducted a retrospective analysis of lesions involving the appendiceal orifice treated by EFTR. METHODS This was a multicenter retrospective analysis of patients (n = 50) treated with EFTR for lesions involving the appendiceal orifice between 2014 and 2019. The objective was to evaluate the occurrence of appendicitis. RESULTS Acute appendicitis occurred in seven patients (14 %) during follow-up. Conservative treatment was sufficient in four cases, and three patients underwent appendectomy. CONCLUSIONS EFTR of lesions involving the appendiceal orifice may be associated with an imminent risk of developing appendicitis and a consecutive need for appendectomy. Patients should be informed about this specific risk prior to resection. It is unclear why some patients develop appendicitis while the majority remains asymptomatic.
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Affiliation(s)
| | - Andreas Wannhoff
- Klinikum Ludwigsburg, Klinik für Innere Medizin, Gastroenterologie, Hämato-Onkologie, Pneumologie, Diabetologie und Infektiologie, Ludwigsburg, Germany
| | - Benjamin Walter
- Universitätsklinik Ulm, Klinik für Innere Medizin I, Ulm, Germany
| | - Benjamin Meier
- Klinikum Ludwigsburg, Klinik für Innere Medizin, Gastroenterologie, Hämato-Onkologie, Pneumologie, Diabetologie und Infektiologie, Ludwigsburg, Germany
| | - Claus Schäfer
- Kliniken des Landkreises Neumarkt i.d. OPf., Neumarkt, Germany
| | - Alexander Meining
- Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Gastroenterologie, Würzburg, Germany
| | - Karel Caca
- Klinikum Ludwigsburg, Klinik für Innere Medizin, Gastroenterologie, Hämato-Onkologie, Pneumologie, Diabetologie und Infektiologie, Ludwigsburg, Germany
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Walter B, Schmidbaur S, Rahman I, Albers D, Schumacher B, Meining A. The BougieCap - a new method for endoscopic treatment of complex benign esophageal stenosis: results from a multicenter study. Endoscopy 2019; 51:866-870. [PMID: 31342473 DOI: 10.1055/a-0959-1535] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND A major limitation of current treatment strategies for nonmalignant upper gastrointestinal stenoses is the lack of either optical or haptic feedback during dilation. Wire guidance and fluoroscopy is often necessary to control the position. METHODS A novel device for endoscopic dilation, the BougieCap (Ovesco Endoscopy AG, Tübingen, Germany) was evaluated in a prospective multicenter trial. Primary outcome was successful dilation of stenosis and secondary outcome was alteration in dysphagia symptoms in short-term follow-up. RESULTS: 50 patients with benign esophageal strictures were included. Endoscopic bougienage was successful in 96 %. Bougienage failed in two cases because of high resistance. Symptoms of dysphagia decreased significantly after bougienage (59.0 points at Day 0 vs. 28.6 points at Day 14; P < 0.001). Adverse events were loss of BougieCap into the stomach in two cases; no severe adverse events were reported. CONCLUSIONS Endoscopic treatment of benign stenoses using the BougieCap enabled direct visual control of the bougienage procedure. This might help to adapt treatment more precisely to the stricture. Symptoms of dysphagia were improved in short-term follow-up. Additional wire guidance may be used for selected cases (e. g. narrow lumen, pediatric scope).
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Affiliation(s)
- Benjamin Walter
- InExEn, Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm, Germany
| | - Simone Schmidbaur
- InExEn, Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm, Germany
| | - Imdadur Rahman
- University Hospital of Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - David Albers
- Klinik für Innere Medizin und Gastroenterologie, Elisabethkrankenhaus, Essen, Germany
| | - Brigitte Schumacher
- Klinik für Innere Medizin und Gastroenterologie, Elisabethkrankenhaus, Essen, Germany
| | - Alexander Meining
- InExEn, Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm, Germany
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Walter B, Schmidbaur S, Krieger Y, Meining A. Improved endoscopic resection of large flat lesions and early cancers using an external additional working channel (AWC): a case series. Endosc Int Open 2019; 7:E298-E301. [PMID: 30746432 PMCID: PMC6368484 DOI: 10.1055/a-0824-6912] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/10/2018] [Indexed: 02/07/2023] Open
Abstract
Background En-bloc resection of large, flat lesions or early stages of cancer is challenging. No bimanual tasks are possible using standard endoscopes. Dual-channel endoscopes are not available everywhere and have a small distance between the channels. Patients and methods A new external additional working channel (AWC) (Ovesco, Tuebingen, Germany) was designed and developed potentially enabling bimanual tasks. Fixed to the tip of a standard gastroscope or pediatric colonoscope, a second endoscopic tool can be inserted through the AWC and used for tissue retraction during endoscopic resection. Results In the upper and lower gastrointestinal tract, endoscopic mucosal resection (EMR) with a modified grasp-and-snare technique and endoscopic submucosal dissection (ESD) were performed successfully using the AWC in eight patients. Complications were acute arterial bleeding post-EMR in two cases treated by endoscopic clipping. Conclusions We conclude that a newly developed external additional working channel (AWC) enables endoscopic resection of large lesions in the upper and lower gastrointestinal tract. Potential benefits are its suitability for EMR and ESD, no need for a dual-channel endoscope and an adjustable distance of working channels.
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Affiliation(s)
- Benjamin Walter
- Clinic for Internal Medicine I, Department of Gastroenterology, InExEn, University Hospital Ulm, Ulm, Germany,Corresponding author Dr. med. Benjamin M. Walter Uniklinik UlmKlinik für Innere Medizin IAlbert-Einstein-Allee 2389081 Ulm+0049 731/500 44502
| | - Simone Schmidbaur
- Clinic for Internal Medicine I, Department of Gastroenterology, InExEn, University Hospital Ulm, Ulm, Germany
| | - Yannick Krieger
- Institute of Microtechnology and Medical Device Technology, Technical University of Munich, Munich, Germany
| | - Alexander Meining
- Clinic for Internal Medicine I, Department of Gastroenterology, InExEn, University Hospital Ulm, Ulm, Germany
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Kreutzer T, Walter B, Schmidt A, Meier B, Wannhoff A, Schmidbaur S, Meining A, Caca K. Untersuchung des Appendizitis-Risiko nach endoskopischer Vollwandresektion von Adenomen im Bereich der Appendix mit dem FTRD-System. Z Gastroenterol 2018. [DOI: 10.1055/s-0038-1669128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- T Kreutzer
- Klinikum Ludwigsburg, Medizinische Klinik I, Ludwigsburg, Deutschland
| | - B Walter
- Universitätsklinikum Ulm, Klinik für Innere Medizin I, Ulm, Deutschland
| | - A Schmidt
- Universitätsklinikum Freiburg, Klinik für Innere Medizin II, Freiburg, Deutschland
| | - B Meier
- Klinikum Ludwigsburg, Medizinische Klinik I, Ludwigsburg, Deutschland
| | - A Wannhoff
- Klinikum Ludwigsburg, Medizinische Klinik I, Ludwigsburg, Deutschland
| | - S Schmidbaur
- Universitätsklinikum Ulm, Klinik für Innere Medizin I, Ulm, Deutschland
| | - A Meining
- Universitätsklinikum Ulm, Klinik für Innere Medizin I, Ulm, Deutschland
| | - K Caca
- Klinikum Ludwigsburg, Medizinische Klinik I, Ludwigsburg, Deutschland
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