57 2 Mobile applications in gastrointestinal surgery: a systematic review published, to shape the proof of evidence of apps. It is recommended that medical apps used in research or clinical practice comply with the suggestions summarised in Table 4. Table 4: Suggestions for future research and/or practice. Process Suggestions App development An ‘expert’ healthcare provider should be involved to safeguard medical content and to ensure that apps are well researched and vetted. Medical apps should also be compensated for patients with low digital literacy. App evaluation in clinical research All medical apps should be evaluated on their effectiveness and safety in quality studies in which a control group, objective outcomes on effectiveness of apps and valid and reusable questionnaires are used. The development process of medical apps should be completely described so that it is possible to assess whether all conditions are met. Regulations in app stores All medical apps should provide evidence on their effectiveness and safety before the app stores accept their publications. Clinical practice Healthcare providers and patients must be aware of the level of evidence of apps that they prescribe or use. Only well-validated medical apps should be used in clinical practice, as high level of evidence is needed to guarantee their efficacy, quality and, safety. CONCLUSION Healthcare providers and patients must be aware of the level of evidence of apps that they prescribe or use. Although apps may offer great potential to improve gastrointestinal surgical care, only a limited number of available gastrointestinal surgical apps have been researched and described in peer-reviewed literature to date. It is of great concern that most studies evaluating gastrointestinal surgical apps fail to generate a high level of scientific evidence, needed to guarantee the efficacy, quality and safety of apps. To fully utilize the potential of gastrointestinal surgical apps in standard surgical care, more and higher quality of research is needed.
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