54 Chapter 2 Communication The commonly known app “WhatsApp” was evaluated as a communication tool among surgeons.48 In this study, surgeons treated patients in two cohorts:1) surgeons who communicated using traditional procedures, such as e-mail, phone calls, and collegial meetings, or 2) surgeons who used the “WhatsApp Surgery Group”, in which surgeons could communicate with each other. No differences in surgical clinical outcomes were reported between the two groups. The app of Doğan et al. enabled bariatric patients to have a live consultation with researchers and contained educational materials.49 The app did not improve self-care, quality of life and the self-body image. Although significant differences in BMI were reported between the intervention and the control group, the weight loss towards the preoperative weight was not analysed. Moon et al. developed a peer support app for patients with low anterior resection syndrome.50 The app consisted of information modules and a peer support forum in which patients could communicate with mentors monitored by a team of HCP’s. The app will be evaluated in a RCT on its impact on patients-reported outcomes. Prognosis The app of Gabriel et al. contained a prediction model of the 5 years overall survival of postoperative patients with stage II or III colon cancer which was based on a large retrospective cohort study.51 However, the app itself has not been tested on its usability, effectiveness and reliability in clinical care. The already available “AWARE” app collected behavioural data of patients after pancreatic surgery, which was used in combination with an activity tracker to predict postoperative symptoms with a 73.5% accuracy.52 However, the prediction was calculated afterwards and was not included in the app. Thus, the clinical relevance of the app has not been evaluated. Clinical decision-making The app “Pancreatic Surgery” contained a multimodal algorithm for early recognition and minimally invasive management of postoperative complications after pancreatic surgery, in which the HCP were instructed to enter data daily. The app was evaluated in a RTC, and patients who were treated in accordance with the algorithm in the app had significantly less postoperative complications than those who received usual care.53 The app is freely available in the app stores.
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