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Effective? Engaging? Secure? Applying the ORCHA-24 framework to evaluate apps for chronic insomnia disorder
  1. Simon Leigh1,
  2. Jing Ouyang2,
  3. Chris Mimnagh3
  1. 1 Lifecode Solutions, Liverpool, UK
  2. 2 Innovation Hub, Alder Hey Children’s Hospital, Liverpool, UK
  3. 3 Wingate Medical Centre, Liverpool, UK
  1. Correspondence to Simon Leigh, Lifecode Solutions, Liverpool L1 0AB, Merseyside, UK; simon{at}


Background Mobile health offers many opportunities; however, the ‘side-effects’ of health apps are often unclear. With no guarantee health apps first do no harm, their role as a viable, safe and effective therapeutic option is limited.

Objective To assess the quality of apps for chronic insomnia disorder, available on the Android Google Play Store, and determine whether a novel approach to app assessment could identify high-quality and low-risk health apps in the absence of indicators such as National Health Service (NHS) approval.

Methods The Organisation for the Review of Care and Health Applications- 24 Question Assessment (ORCHA-24), 24 app assessment criteria concerning data privacy, clinical efficacy and user experience, answered on a ‘yes’ or ‘no’ and evidence-driven basis, was applied to assess 18 insomnia apps identified via the Android Google Play Store, in addition to the NHS-approved iOS app Sleepio.

Findings 63.2% of apps (12/19) provided a privacy policy, with seven (36.8%) stating no user data would be shared without explicit consent. 10.5% (2/19) stated they had been shown to be of benefit to those with insomnia, with cognitive behavioural therapy apps outperforming hypnosis and meditation apps (p=0.046). Both the number of app downloads (p=0.29) and user-review scores (p=0.23) were unrelated to ORCHA-24 scores. The NHS-approved app Sleepio, consistently outperformed non-accredited apps across all domains of the ORCHA-24.

Conclusions Apps for chronic insomnia disorder exhibit substantial variation in adherence to published data privacy, user experience and clinical efficacy standards, which are not clearly correlated with app downloads or user-review scores.

Clinical implications In absence of formal app accreditation, the ORCHA-24 could feasibly be used to highlight the risk–benefit profiles of health apps prior to downloading.

  • mHealth
  • health-apps
  • insomnia
  • quality assessment.

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  • Funding This analysis was funded by a research grant from ORCHA Healthcare Ltd.

  • Competing interests SL reports grants from ORCHA Healthcare Limited, from null, during the conduct of the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.