RT journal article
T1 Dropout Rate in Digital Health Interventions for the Prevention of Skin Cancer: Systematic Review, Meta-analysis, and Metaregression
A1 Hernández Rodríguez, Juan Carlos
A1 García Muñoz, Cristina
A1 Ortiz Álvarez, Juan
A1 Saigí Rubió, Francesc
A1 Conejo Mir, Julián
A1 Pereyra Rodriguez, José Juan
A2 Enfermería y Fisioterapia
K1 skin cancer
K1 digital health
K1 dropout
K1 prevention
K1 dermatology
K1 digital intervention
K1 digital treatment
K1 eHealth
K1 randomized controlled trial
AB Background: Digital strategies are innovative approaches to the prevention of skin cancer, but the attrition following this kindof intervention needs to be analyzed.Objective: The aim of this paper is to assess the dropouts from studies focused on digital strategies for the prevention of skincancer.Methods: We conducted this systematic review with meta-analyses and metaregression according to the PRISMA (PreferredReporting Items for Systematic Reviews and Meta-Analyses) statements. Search terms for skin cancer, digital strategies, andprevention were combined to search PubMed, Scopus, Web of Science, CINAHL, and Cochrane Library from inception untilJuly 2022. Randomized clinical trials that reported dropouts of participants and compared digital strategies with other interventionsto prevent skin cancer in healthy or disease-free participants were included. Two independent reviewers extracted data for analysis.The Revised Cochrane Collaboration Bias tool was employed. We calculated the pooled dropout rate of participants through ameta-analysis of proportions and examined whether dropout was more or less frequent in digital interventions against comparatorsvia an odds ratio (OR) meta-analysis. Data were pooled using a random-effects model. Subgroup meta-analyses were conductedin a meta-analysis of proportions and OR meta-analysis to assess the dropout events when data were sorted by digital interventionsor control comparator. A univariate metaregression based on a random-effects model assessed possible moderators of dropout.Participants’ dropout rates as pooled proportions were calculated for all groups combined, and the digital and comparator groupsseparately. OR>1 indicated higher dropouts for digital-based interventions. Metaregressions were performed for age, sex, lengthof intervention, and sample size.Results: A total of 17 studies were included. The overall pooled dropout rate was 9.5% (95% CI 5.0-17.5). The subgroupmeta-analysis of proportions revealed a dropout rate of 11.6% for digital strategies (95% CI 6.8-19.0) and 10.0% for comparators(95% CI 5.5-17.7). A trend of higher dropout rates for digital strategies was observed in the overall (OR 1.16, 95% CI 0.98-1.36)and subgroup OR meta-analysis, but no significant differences were found between the groups. None of the covariates moderatedthe effect size in the univariate metaregression.Conclusions: Digital strategies had a higher dropout rate compared to other prevention interventions, but the difference wasnot significant. Standardization is needed regarding reporting the number of and reasons for dropouts.Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO) CRD42022329669;https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=329669
PB JMIR Publications
SN 1438-8871
YR 2022
FD 2022-12-09
LK http://hdl.handle.net/10498/31129
UL http://hdl.handle.net/10498/31129
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 09-nov-2026