The evolution of mobile apps for asthma: an updated systematic assessment of content and tools

Table 4 Consistency of information apps with evidence-based recommendations

	2011			New 2013 ¤			All 2013 ¤
Statement	n ^†	Consistent	% ^‡	n	Consistent	%	n	Consistent	%
Removal of pets from the home (Qualified benefit)	3	1	33%	7	1	14%	8	1	13%
Fungal allergen avoidance and control measures (Qualified benefit)	8	0	0%	9	0	0%	13	0	0%
Cockroach avoidance and control measures (Qualified benefit)	6	0	0%	4	0	0%	7	0	0%
Cessation of active smoking (Beneficial)	7	7	100%	14	14	100%	19	19	100%
Avoidance of passive smoking (Beneficial)	8	8	100%	15	15	100%	21	21	100%
Avoidance of exposure to air pollution (Qualified benefit)	8	1	13%	14	1	7%	17	2	12%
Immunotherapy in atopic asthma (Beneficial)	1	1	100%	4	4	100%	5	5	100%
Weight reduction in obese patients (Beneficial)	3	3	100%	4	4	100%	7	7	100%
Seasonal influenza vaccination (Qualified benefit)**	4	1	25%	8	2	25%	10	2	20%

The table compares the proportion of apps containing particular management advice that is consistent with evidence-based recommendations between 2011 and 2013. The expected advice is shown in parentheses. We use the term ‘qualified benefit’ when additional factors, such as personal sensitivity to particular allergens or aspects of personal choice, are relevant concerns and unconditional recommendations are therefore inappropriate. Apps focusing solely on complementary and alternative medicine were excluded. Statistical comparison between apps in 2011 and new apps in 2013 was performed but is not shown because all comparisons, performed using Fisher’s exact test, yielded an exact probability of 1.0.
^†The number of apps that took a stance on a given topic, for example, by stating that a given action is definitely effective in controlling asthma symptoms.
^‡The proportion of apps whose stance is consistent with the evidence base.
¤ New 2013, Apps available in 2013 that were not available in 2011; All 2013, All apps available in 2013, excluding those available in 2011 that were subsequently discontinued.
**Seasonal influenza vaccination is routinely offered to asthmatic patients; however, it is unclear if vaccination reduces the severity or frequency of flu-related asthma exacerbations [44].

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