Study Selection and Data Extraction

Screening of records by title and abstract were completed independently by two authors (DB and BS). An adjudication process was used by the two authors, where they met face-to-face to review screened records. When the authors did not agree on a record, they came to a consensus together through discussion and re-review of the record. The same process was used when evaluating full articles for inclusion and when categorizing the final included articles with the Oxford Centre for Evidence-based Medicine (OCEBM) Levels of Evidence system. Both reviewers independently reviewed full articles and completed data extraction. Using a standard approach, they extracted study design, intervention type, technology type, population diagnoses, mean age of population, mean Mini-Mental Status Examination (MMSE) or comparable cognitive exam, health outcomes, and information on the effectiveness of the mHealth app. Study quality was assessed and categorized using the OCEBM Levels of Evidence System, where studies are categorized into one of five levels of evidence, with one being the strongest level [31]. Levels of evidence using the OCEBM system are (1) level 1: systematic reviews of randomized controlled trials (RCTs), individual RCTs, and all-or-none case series; (2) level 2: systematic reviews of cohort studies, individual cohort studies, and “outcomes” research; (3) level 3: systematic review of case-control studies and individual case-control studies; (4) level 4: case-series and poor quality cohort studies; and (5) level 5: expert opinion. Recommendation grades are listed as consistent level 1 studies (“A”), consistent level 2 or 3 studies or extrapolations from level 1 studies (“B”), level 4 studies or extrapolations from level 2 or 3 studies (“C”), and level 5 evidence or troubling inconsistent or inconclusive studies of any level (“D”) [31].