Advancing Methods and Approaches for the Evaluation of Digital Health

Digital healthcare technologies and solutions range from apps for risk reduction and self-management to electronic patient records, ePrescribing or telemedicine systems, surgical robots and AI based image analysis and decision support. Digital healthcare is a significant economic activity and forms a major cost to health systems, but there is continuing uncertainty over how to develop and select systems that are cost effective and safe. While a wide range of evaluation methods are used for healthcare technology appraisal, some of these methods, such as randomised trials, face challenges when applied to ubiquitous fast-changing technologies such as electronic patient records or AI. Used too early, an RCT can even demonstrate that a promising technology has no benefits merely because a relatively minor usability issue was not addressed in time.

So, we need to remind ourselves about the full range of evaluation methods from formative to summative and qualitative to quantitative, and identify which to use at what stage in the technology development lifecycle. We also need to identify and promote methods drawn from fields outside healthcare – such as ethnography, psychology, economics and econometrics – that can be usefully applied in digital healthcare. Examples of these methods could include Wizard of Oz experiments, user experience design, within-subject before-after studies, intervention modelling and instrumental variable studies, but there are many more.

We therefore invite authors to submit articles focussing on the appropriateness and weaknesses of evaluation methods used to support the development and appraisal of digital healthcare technologies. Some articles will naturally focus on the methods that we currently use in digital healthcare, offering reasoned justification for them or arguments against them –preferably with empirically based examples. Articles that propose either entirely new evaluation methods (with reasoned justification) or methods imported from disciplines outside healthcare will also be welcome.

The aim of this research topic is to support development of the field of digital health through the development of a range of more appropriate and rigorous evaluation methods. For this reason, it is important to report on both successful and failed methodological approaches (where the original research was well desgined). Regarding reporting on failures, we are interested in examples of failed evaluations rather than failed interventions.

This research topic focuses on the strengths and weaknesses of different evaluation methods in digital healthcare, with an emphasis on methodology rather than on study results. While all Frontiers in Digital Health sections welcome articles describing evaluation studies of digital health technology, only those that specifically examine strengths and weaknesses of new or current evaluation methods will be considered in this topic. Other evaluation studies will be reviewed for publication in the journal's general sections.

Topics of interest include but are not limited to:
- Examples of novel RCTs;
- Point of care trials;
- Ways to make conventional RCTs easier to carry out e.g. novel recruitment strategies;
- Smart randomizations;
- Process evaluations (costs- benefits);
- Multiphase optimization strategy (what works best for whom and why).

Keywords: digital health, evaluation methods, evidence, development, appraisal

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.