From: Smartphone apps for calculating insulin dose: a systematic assessment
Frequency by platform (%) | Frequency by cost (%) | |||||||
---|---|---|---|---|---|---|---|---|
Comment | All apps (n = 46) | Android (n = 21) | iOS (n = 25) | P value* | Free (n = 21) | Paid (n = 25) | P value* | |
Input issues | 44 (96%) | 21 (100%) | 23 (92%) | 0.493 | 20 (95%) | 24 (96%) | 1.000 | |
Numeric validation lacking | Inputs unconstrained by physiologically or logically plausible limits, for example, negative values accepted. | 42 (91%) | 21 (100%) | 21 (84%) | 20 (95%) | 22 (88%) | ||
No validation of any input | For example, textual values allowed in all numeric fields. | 24 (52%) | 14 (67%) | 10 (40%) | 12 (57%) | 12 (48%) | ||
Some validation | Inconsistency reflecting use of validation for only some inputs. | 18 (39%) | 7 (33%) | 11 (44%) | 8 (38%) | 10 (40%) | ||
Calculation despite missing inputs | For example, correction bolus calculated even though insulin to blood glucose ratio not provided. | 27 (59%) | 14 (67%) | 13 (52%) | 10 (48%) | 17 (68%) | ||
Ambiguous terminology | Use of ambiguous labeling or descriptions creates risk of misinterpretation. | 22 (48%) | 8 (38%) | 14 (56%) | 8 (38%) | 14 (56%) | ||
Data entry issues | User data cannot be entered faithfully or are not stored correctly for calculation. | 6 (13%) | 3 (14%) | 3 (12%) | 4 (19%) | 2 (8%) | ||
Precision issues | For example, a data field for measurements in mmol/L that accepts only whole integers. | 4 (9%) | 1 (4%) | 3 (14%) | 4 (19%) | 0 (0%) | ||
Data not stored correctly | Data change unexpectedly, for example, transposed into a different data field. | 2 (4%) | 2 (8%) | 0 (0%) | 0 (0%) | 2 (8%) | ||
Output issues | 31 (67%) | 17 (81%) | 14 (56%) | 0.115 | 14 (67%) | 17 (68%) | 1.000 | |
Clinical model violation | Calculation does not conform to principles of underlying clinical conceptual model, for example, by assuming an omitted blood glucose implies a measured value of zero. | 22 (48%) | 13 (62%) | 9 (36%) | 10 (48%) | 12 (48%) | ||
Formula inconsistency † | Calculation does not proceed in accordance with the stated formula. | 3 (14%) | 1 (11%) | 2 (17%) | 0 (0%) | 3 (23%) | ||
Input–output mismatch | Calculator output is not consistently synchronized with changing user inputs. | 17 (37%) | 9 (43%) | 8 (32%) | 8 (38%) | 9 (36%) | ||
Automatic calculator | A calculator which normally refreshes output automatically in response to changing inputs does not under certain circumstances. | 3 (7%) | 2 (10%) | 1 (4%) | 0 (0%) | 3 (12%) | ||
Manual calculator | App does not respond reliably to manual commands to recalculate dose, for example, tapping a “Calculate” button. | 14 (30%) | 7 (33%) | 7 (28%) | 8 (38%) | 6 (24%) | ||
Other software errors | Software unexpectedly crashes or becomes unresponsive during normal use. | 11 (24%) | 8 (38%) | 3 (12%) | - | 4 (19%) | 7 (28%) | - |