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Economic Evaluation Associated with Clinical-Grade Mobile App-Based Digital Therapeutic Interventions: Systematic Review

This study, published in the Journal of Medical Interest and Research, aimed to systematically review and summarize the published evidence regarding cost-effectiveness of clinical-grade mobile app-based DTx and explore the factors affecting such evaluations.

A systematic review of economic evaluations of clinical-grade mobile app-based DTx was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. Major electronic databases, including PubMed, Cochrane Library, and Web of Scienced, were searched for eligible studies published from inception to 28 October 2022[YK1] . Two independent reviewers evaluated the eligibility of all the retrieved articles for inclusion in the review, while methodological quality and risk of bias were assessed for each included study.


A total of 18 studies were included in this review. Of the 18 studies, 7 were nonrandomized study-based economic evaluations, 6 were model-based evaluations, and 5 were randomized clinical trial-based evaluations. The DTx intervention subject to assessment was found to be cost-effective in 12 studies, cost saving in 5 studies, and cost-effective in 1 study in only 1 of the 3 countries where it was being deployed in the final study. Qualitative deficiencies in methodology and substantial potential for bias, including risks of performance bias and selection bias in participant recruitment, were identified in several included studies.


This study was co-authored by RFI (Joanne Yoong), National University of Singapore (Yoann Sapanel, Xavier Tadeo, Alexandria Remus, Agatha Blasiak, Dean Ho), University of Toronto (Connor T A Brenna), IU Internationale Hochschule GmbH (Florian Koerber), University of Quebec (L Martin Cloutier), and Cytel Canada Health Inc (Gabriel Tremblay).

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