Meta-Analysis of Studies on the Effects of Digital Therapeutics
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Selection and Data Extraction
- Participants: The focus was on patients necessitating treatment through DTx.
- Intervention: The study encompassed DTx-based experimental interventions.
- Comparison: Comparative data were extracted from experimental groups subjected to DTx.
- Outcome: The primary focus was on assessing the therapeutic effects of DTx.
- Study Design: Studies utilizing randomized controlled trials (RCTs) and pre-post designs were included.
2.2. Study Quality Assessment
2.3. Data Analysis
3. Results
3.1. Quality Assessment of the Selected Papers
3.2. Meta-Analysis
4. Discussion and Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study | System Used | Subgroup | Follow-Up Duration | Target | Indicators | N (Control/ Post) | N (Experiment/Post) |
---|---|---|---|---|---|---|---|
Prochaska et al. [18] | Woebot-SUDs (W-SUDs) | Substance abuse | 30 days | Screened positive for substance misuse (CAGE-AID > 1) | GAD-7 | 71 (−1.6 ± 0.6) | 81 (−0.70 ± 0.50) |
Kor and Shoshani [19] | School-based Positive Psychology Addiction Prevention (PPAP) | Substance abuse | 12 months | School children | GSI | 833 (15.06 ± 12.57) | 837 (21.04 ± 15.71) |
Ahlers et al. [20] | CANreduce 2.0 | Substance abuse | 6 weeks | Cannabis use at least once weekly over the last 30 days (adults) | GAD-7 | 94 (4.71 ± 3.53) | 273 (6.37 ± 3.56) |
Mujcic et al. [21] | MyCourse, a digital AM (alcohol moderation) intervention | Substance abuse | At 3, 6, 9, and 12 months | Adult 10-year cancer survivors drinking over the Dutch-recommended drinking guidelines (≤7 standard units (10 g of alcohol) per week) with the intention to moderate or quit drinking | AUDIT | 53 (10.0 ± 6.0) | 50 (9.30 ± 5.10) |
Nelligan et al. [22] | Custom-built website with information on OA | Musculoskeletal | 24 weeks | Clinical criteria for knee OA in communities across Australia from July 2018 to August 2019 | AQoL-6D | 103 (0.75 ± 0.16) | 103 (0.69 ± 0.20) |
Tore et al. [23] | Video conference | Musculoskeletal | 8 weeks | Diagnosed with moderate/mild KOA | HADS | 24 (7.00 ± 4.07) | 24 (12.33 ± 5.66) |
Weise et al. [24] | Digital home exercise program | Musculoskeletal | 12 weeks | Participants with unspecific and degenerative back pain aged ≥ 18 years | German VNRS | 105 (−0.91 ± 1.50) | 108 (−3.35 ± 2.05) |
Gold et al. [25] | VR intervention | Anxiety | 3 months | Patients aged 10 to 21 years who were undergoing PIVC placement | FPS-P | 53 (1.09 ± 1.82) | 54 (2.19 ± 2.21) |
Roy et al. [26] | The app-delivered MT program | Anxiety | 2 months | Using social media advertisements | GAD-7 | 28 (4.8 ± 4.1) | 33 (10.60 ± 3.50) |
Shaffer et al. [27] | Behavioral therapy for insomnia (CBT-I) | Anxiety | Up to 12 months | Adults aged ≥ 55 with insomnia | HADS | 192 (5.26 ± 3.56) | 97 (6.42 ± 3.60) |
Kannampallil et al. [28] | Virtual voice-based coach | Anxiety | 16 weeks | Adults with mild-to-moderate depression and/or anxiety | HADS | 40 (−2.52 ± 4.48) | 21 (0.14 ± 5.11) |
Espie et al. [29] | Digital cognitive behavioral therapy (dCBT) | Mental Health | 24 weeks | Just recruited | GAD-7 | 853 (4.70 ± 4.21) | 858 (6.05 ± 4.50) |
Araya et al. [30] | CONEMO (English translation, emotional control) | Mental Health | 3 months (Sao Paulo) | Being treated for hypertension and/or diabetes | EQ-5D | 389 (0.68 ± 0.19) | 396 (0.65 ± 0.19) |
Han et al. [31] | Conference software, Tencent | Mental Health | 3 months | LGBTQ+ young adults aged between 18 and 29 who scored moderate or above on at least one dimension of the Depression Anxiety Stress Scale 21 and did not have help-seeking experiences in the past 12 months | GHSQ | 68 (2.95 ± 0.50) | 69 (2.77 ± 0.56) |
Comtois et al. [32] | App-based | Mental Health | 4 weeks | Unemployed because of COVID-19, or were COVID-19-designated essential workers | GAD-7 | 151 (7.80 ± 5.60) | 151 (7.30 ± 5.80) |
Category | Control | Experiment |
---|---|---|
N | 204 | 210 |
Mean | 4.00 | 5.45 |
Standard Deviation | 3.52 | 3.83 |
Author and Year | 1.1 Was the Allocation Sequence Random? | 1.2 Was the Allocation Sequence Concealed Until Participants Were Enrolled and Assigned to Interventions? | 1.3 Did Baseline Differences between Intervention Groups Suggest a Problem with the Randomization Process? | Risk of Biased Judgment |
---|---|---|---|---|
Prochaska et al. [18] | PN | Y | Y | Some concerns |
Kor and Shoshani [19] | Y | Y | N | Low Risk |
Ahlers et al. [20] | Y | Y | N | Low Risk |
Mujcic et al. [21] | Y | Y | Y | Low Risk |
Nelligan et al. [22] | Y | Y | Y | Low Risk |
Tore et al. [23] | Y | Y | Y | Low Risk |
Weise et al. [24] | Y | Y | Y | Low Risk |
Gold et al. [25] | Y | Y | Y | Low Risk |
Roy et al. [26] | Y | Y | Y | Low Risk |
Shaffer et al. [27] | Y | Y | Y | Low Risk |
Kannampallil et al. [28] | Y | Y | N | Some concerns |
Espie et al. [29] | Y | Y | Y | Low Risk |
Araya et al. [30] | PN | Y | Y | Some concerns |
Han et al. [31] | Y | Y | Y | Low Risk |
Comtois et al. [32] | Y | Y | Y | Low Risk |
Studies | Subgroup | ds | 95% CI | Weight (%) | p | |
---|---|---|---|---|---|---|
LL | UL | |||||
Ahlers et al. [20] | Substance abuse | 0.466 | 0.229 | 0.703 | 7.14 | <0.001 |
Mujcic A et al. [21] | Substance abuse | −0.125 | −0.511 | 0.263 | 6.41 | 0.526 |
Nelligan RK et al. [22] | Musculoskeletal | −0.330 | −0.605 | −0.055 | 6.98 | 0.018 |
Tore NG et al. [23] | Musculoskeletal | 1.064 | 0.453 | 1.664 | 5.17 | <0.001 |
Gold JI et al. [25] | Anxiety | 0.539 | 0.152 | 0.924 | 6.41 | 0.006 |
Shaffer KM et al. [27] | Anxiety | 0.324 | 0.078 | 0.569 | 7.11 | 0.01 |
Kannampallil T et al. [28] | Anxiety | 0.502 | −0.036 | 1.036 | 5.56 | 0.064 |
Espie CA et al. [29] | Mental health | 0.310 | 0.214 | 0.405 | 7.58 | <0 .001 |
Araya R et al. [30] | Mental health | −0.158 | −0.298 | −0.018 | 7.48 | 0.027 |
Han M et al. [31] | Mental health | −0.337 | −0.674 | 0.001 | 6.67 | 0.049 |
Roy A et al. [26] | Mental health | −0.088 | −0.313 | 0.138 | 7.19 | 0.447 |
Comtois KA et al. [32] | Anxiety | 1.512 | 0.935 | 2.080 | 5.35 | <0 .001 |
Prochaska et al. [18] | Substance abuse | 1.631 | 1.261 | 1.997 | 6.51 | <0.001 |
Kor and Shoshani [19] | Substance abuse | 0.420 | 0.323 | 0.517 | 7.58 | <0.001 |
Weise et al. [24] | Musculoskeletal | −1.351 | −1.647 | −1.052 | 6.87 | <0 .001 |
Subgroups | Studies (df) | Effect Size | 95% CI | p | Q2 | Q2-p | I2 | T2 | |
---|---|---|---|---|---|---|---|---|---|
LL | UL | ||||||||
Substance Abuse | 4 (3) | 0.591 | 0.133 | 1.049 | 0.011 | 16.100 | <0.001 | 93.789 | 0.221 |
Musculoskeletal | 3 (2) | −0.320 | −0.873 | 0.232 | 0.256 | 28.518 | <0.001 | 96.494 | 0.904 |
Anxiety | 4 (3) | 0.681 | 0.194 | 1.168 | 0.006 | 4.668 | 0.003 | 78.576 | 0.156 |
Mental Health | 4 (3) | −0.059 | −0.507 | 0.389 | 0.796 | 13.519 | <0.001 | 92.603 | 0.089 |
Overall | 15 (14) | 0.255 | 0.000 | 0.389 | 0.049 | 20.176 | <0.001 | 95.044 | 0.221 |
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Seo, Y.-C.; Yong, S.Y.; Choi, W.W.; Kim, S.H. Meta-Analysis of Studies on the Effects of Digital Therapeutics. J. Pers. Med. 2024, 14, 157. https://doi.org/10.3390/jpm14020157
Seo Y-C, Yong SY, Choi WW, Kim SH. Meta-Analysis of Studies on the Effects of Digital Therapeutics. Journal of Personalized Medicine. 2024; 14(2):157. https://doi.org/10.3390/jpm14020157
Chicago/Turabian StyleSeo, Young-Chul, Sang Yeol Yong, Won Woo Choi, and Sung Hoon Kim. 2024. "Meta-Analysis of Studies on the Effects of Digital Therapeutics" Journal of Personalized Medicine 14, no. 2: 157. https://doi.org/10.3390/jpm14020157