{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T22:14:49Z","timestamp":1780611289410,"version":"3.54.1"},"reference-count":23,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,11,20]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate mobile health product use in Australia and societal and clinician perceptions towards smartphone based visual acuity (VA) assessment tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Quantitative analysis of a cross-sectional survey delivered to the general public and thematic analysis of in-depth interviews of eye health clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Online survey within Australia and face-to-face in-depth interviews of clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>1016 adults were recruited via Survey Monkey Audience, social media (Facebook and Twitter), Rotary Australia and Lions Clubs Australia. Six clinicians were recruited from private and public settings in Melbourne, Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The study assessed socio-demographic characteristics, history of mobile health product use and perceived advantages and potential drawbacks of smartphone based VA assessment tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 14.4% of the study population had previously used a mobile-based health product. After adjusting for covariates, younger age (p=0.001), male gender (p=0.01) and higher income (&gt;$45 000) were associated with increased likelihood of having used a mobile health product (p=0.005). Seventy-two per cent of participants would use an automated smartphone based VA assessment tool, provided that the accuracy was on par to that of human assessors. Convenience (37.3%) and cost-savings (15.5%) were ranked as the greatest perceived advantages. While test accuracy (50.6%), a lack of personal contact with healthcare providers (18.3%) and data security (11.9%) were the greatest concerns. Themes to emerge from clinician qualitative data included the potential benefits for identifying refractive error in patients, as well as the ability to self-monitor vision. Concerns were raised over the potential misuse of self-testing vision apps and the inability to detect pathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggest that a substantial proportion of the Australian population do not use mobile health products. Furthermore, there remains notable concerns, including test accuracy and data privacy, with smartphone-based VA assessment tools by both clinicians and the public.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-024266","type":"journal-article","created":{"date-parts":[[2019,3,23]],"date-time":"2019-03-23T12:45:18Z","timestamp":1553345118000},"page":"e024266","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Utilisation and perceptions towards smart device visual acuity assessment in Australia: a mixed methods approach"],"prefix":"10.1136","volume":"9","author":[{"given":"Stuart","family":"Keel","sequence":"first","affiliation":[{"name":"Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Scheetz","sequence":"additional","affiliation":[{"name":"Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith","family":"Holloway","sequence":"additional","affiliation":[{"name":"Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaotong","family":"Han","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Yan","sequence":"additional","affiliation":[{"name":"Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Mueller","sequence":"additional","affiliation":[{"name":"Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingguang","family":"He","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China"},{"name":"Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Vic, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,3,23]]},"reference":[{"key":"2025120619073565000_9.3.e024266.1","doi-asserted-by":"crossref","first-page":"2682","DOI":"10.1001\/jama.2015.15855","article-title":"Smartphone-based visual acuity measurement for screening and clinical assessment","volume":"314","author":"Brady","year":"2015","journal-title":"JAMA"},{"key":"2025120619073565000_9.3.e024266.2","unstructured":"James B , Benjamin L . E-Book-ophthalmology: investigation and examination techniques: Elsevier Health Sciences, 2006."},{"key":"2025120619073565000_9.3.e024266.3","doi-asserted-by":"publisher","DOI":"10.1007\/BF00422033"},{"key":"2025120619073565000_9.3.e024266.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-1313.1988.tb01176.x"},{"key":"2025120619073565000_9.3.e024266.5","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(82)90197-0"},{"key":"2025120619073565000_9.3.e024266.6","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1038\/npp.2016.7","article-title":"Harnessing smartphone-based digital phenotyping to enhance behavioral and mental health","volume":"41","author":"Onnela","year":"2016","journal-title":"Neuropsychopharmacology"},{"key":"2025120619073565000_9.3.e024266.7","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1001\/jamaophthalmol.2015.1468","article-title":"Development and validation of a smartphone-based visual acuity test (peek acuity) for clinical practice and community-based fieldwork","volume":"133","author":"Bastawrous","year":"2015","journal-title":"JAMA Ophthalmol"},{"key":"2025120619073565000_9.3.e024266.8","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1038\/eye.2015.60","article-title":"The eye phone study: reliability and accuracy of assessing snellen visual acuity using smartphone technology","volume":"29","author":"Perera","year":"2015","journal-title":"Eye"},{"key":"2025120619073565000_9.3.e024266.9","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1038\/eye.2015.138","article-title":"Effectiveness of a smartphone application for testing near visual acuity","volume":"29","author":"Tofigh","year":"2015","journal-title":"Eye"},{"key":"2025120619073565000_9.3.e024266.10","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"2025120619073565000_9.3.e024266.11","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.f6009","article-title":"Regulating medical apps: which ones and how much?","volume":"347","author":"Kamerow","year":"2013","journal-title":"BMJ"},{"key":"2025120619073565000_9.3.e024266.12","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1038\/eye.2015.168","article-title":"Comment on \u2019The Eye Phone Study: reliability and accuracy of assessing Snellen visual acuity using smartphone technology'","volume":"29","author":"Rodr\u00edguez-Vallejo","year":"2015","journal-title":"Eye"},{"key":"2025120619073565000_9.3.e024266.13","unstructured":"Fox S , Duggan M . Mobile health 2012. Washington, DC: Pew Internet and American Life Project, 2013."},{"key":"2025120619073565000_9.3.e024266.14","doi-asserted-by":"crossref","DOI":"10.2196\/mhealth.4924","article-title":"Health app use among US mobile phone owners: a national survey","volume":"3","author":"Krebs","year":"2015","journal-title":"JMIR Mhealth Uhealth"},{"key":"2025120619073565000_9.3.e024266.15","doi-asserted-by":"publisher","DOI":"10.1037\/0882-7974.21.2.333"},{"key":"2025120619073565000_9.3.e024266.16","unstructured":"Organization WH. Universal eye health: a global action plan 2014-2019. 2013."},{"key":"2025120619073565000_9.3.e024266.17","unstructured":"Deloitte. Mobile consumer survey 2017: the Australian cut. 2017."},{"key":"2025120619073565000_9.3.e024266.18","doi-asserted-by":"publisher","DOI":"10.1016\/S1056-8727(01)00167-2"},{"key":"2025120619073565000_9.3.e024266.19","doi-asserted-by":"crossref","first-page":"5630","DOI":"10.1167\/iovs.15-17576","article-title":"The relationship between visual acuity and the reproducibility of visual field measurements in glaucoma patients","volume":"56","author":"Matsuura","year":"2015","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2025120619073565000_9.3.e024266.20","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-014-0523-3"},{"key":"2025120619073565000_9.3.e024266.21","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1145\/1785414.1785449","article-title":"Creating the experience economy in e-commerce","volume":"53","author":"Chang","year":"2010","journal-title":"Commun ACM"},{"key":"2025120619073565000_9.3.e024266.22","first-page":"115","article-title":"Marketing design elements of mobile fashion retail apps","volume":"17","author":"Magrath","year":"2013","journal-title":"J of Fashion Marketing and Management: An International Journal"},{"key":"2025120619073565000_9.3.e024266.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jretai.2012.03.001"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-024266","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T03:07:45Z","timestamp":1765076865000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-024266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":23,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3,23]]},"published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1136\/bmjopen-2018-024266"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-024266","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3]]}}}