Evaluating digital health interventions: key questions and approaches
Evaluating digital health interventions: key questions and approaches
Digital health interventions have enormous potential as scalable tools to improve health and healthcare delivery by improving effectiveness, efficiency, accessibility, safety, and personalization. Achieving these improvements requires a cumulative knowledge base to inform development and deployment of digital health interventions. However, evaluations of digital health interventions present special challenges. This paper aims to examine these challenges and outline an evaluation strategy in terms of the research questions needed to appraise such interventions. As they are at the intersection of biomedical, behavioral, computing, and engineering research, methods drawn from all of these disciplines are required. Relevant research questions include defining the problem and the likely benefit of the digital health intervention, which in turn requires establishing the likely reach and uptake of the intervention, the causal model describing how the intervention will achieve its intended benefit, key components, and how they interact with one another, and estimating overall benefit in terms of effectiveness, cost effectiveness, and harms. Although RCTs are important for evaluation of effectiveness and cost effectiveness, they are best undertaken only when: (1) the intervention and its delivery package are stable; (2) these can be implemented with high fidelity; and (3) there is a reasonable likelihood that the overall benefits will be clinically meaningful (improved outcomes or equivalent outcomes at lower cost). Broadening the portfolio of research questions and evaluation methods will help with developing the necessary knowledge base to inform decisions on policy, practice, and research.
Editorial
843-851
Murray, Elizabeth
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Hekler, Eric B.
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Andersson, Gerhard
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Collins, Linda M.
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Doherty, Aiden
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Hollis, Chris
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Rivera, Daniel E.
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West, Robert
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Wyatt, Jeremy C.
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November 2016
Murray, Elizabeth
cb300780-9041-44af-9ae5-e13531eb23b8
Hekler, Eric B.
6134e43f-db87-4030-bea4-c14fda161c98
Andersson, Gerhard
1965d18a-9891-41f3-8149-ce6aebe2f5ff
Collins, Linda M.
d4858ad1-1a84-4cb2-9738-16a2ff3736a7
Doherty, Aiden
0f35611f-0424-48be-ab2a-39bf71635e85
Hollis, Chris
fe8adc7a-cfcd-4966-b397-1dd22048bbc8
Rivera, Daniel E.
78f30e50-6fee-464f-ae08-b9d56c0b360d
West, Robert
de79ca55-bbe3-415f-bec6-a78f6ebb3d9f
Wyatt, Jeremy C.
8361be5a-fca9-4acf-b3d2-7ce04126f468
Murray, Elizabeth, Hekler, Eric B., Andersson, Gerhard, Collins, Linda M., Doherty, Aiden, Hollis, Chris, Rivera, Daniel E., West, Robert and Wyatt, Jeremy C.
(2016)
Evaluating digital health interventions: key questions and approaches.
American Journal of Preventive Medicine, 51 (5), .
(doi:10.1016/j.amepre.2016.06.008).
Abstract
Digital health interventions have enormous potential as scalable tools to improve health and healthcare delivery by improving effectiveness, efficiency, accessibility, safety, and personalization. Achieving these improvements requires a cumulative knowledge base to inform development and deployment of digital health interventions. However, evaluations of digital health interventions present special challenges. This paper aims to examine these challenges and outline an evaluation strategy in terms of the research questions needed to appraise such interventions. As they are at the intersection of biomedical, behavioral, computing, and engineering research, methods drawn from all of these disciplines are required. Relevant research questions include defining the problem and the likely benefit of the digital health intervention, which in turn requires establishing the likely reach and uptake of the intervention, the causal model describing how the intervention will achieve its intended benefit, key components, and how they interact with one another, and estimating overall benefit in terms of effectiveness, cost effectiveness, and harms. Although RCTs are important for evaluation of effectiveness and cost effectiveness, they are best undertaken only when: (1) the intervention and its delivery package are stable; (2) these can be implemented with high fidelity; and (3) there is a reasonable likelihood that the overall benefits will be clinically meaningful (improved outcomes or equivalent outcomes at lower cost). Broadening the portfolio of research questions and evaluation methods will help with developing the necessary knowledge base to inform decisions on policy, practice, and research.
Text
Murray et al - Evaluation of digital interventions - AJPM 2016
- Accepted Manuscript
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e-pub ahead of print date: 13 October 2016
Published date: November 2016
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Editorial
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Local EPrints ID: 413481
URI: http://eprints.soton.ac.uk/id/eprint/413481
ISSN: 0749-3797
PURE UUID: dc093a0d-62ef-4dd9-bfdf-3faf42493295
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Date deposited: 24 Aug 2017 16:31
Last modified: 16 Mar 2024 05:23
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Author:
Elizabeth Murray
Author:
Eric B. Hekler
Author:
Gerhard Andersson
Author:
Linda M. Collins
Author:
Aiden Doherty
Author:
Chris Hollis
Author:
Daniel E. Rivera
Author:
Robert West
Author:
Jeremy C. Wyatt
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