Translation and validation of the Italian version of the user version of the Mobile Application Rating Scale (uMARS)


user version mobile application rating scale


Background. Health sciences are steadily developing apps to help people to have correct lifestyle and to help physicians to follow patients with chronic diseases. However, a proper validated tool to evaluate patients’ perception of apps’ still lacks in many languages. Currently, there is an English validated questionnaire called User Version of the Mobile Application Rating Scale (uMARS). Aim of the study is to translate and validate uMARS in Italian.

Methods. uMARS questionnaire have been translated into Italian by an official translator from English. Then, questionnaire has been administrated to 100 smartphone users to evaluate the same App at time 1 and at time 2 (after 2 weeks). Paired t test, Pearson Correlation Coefficient, Intraclass Correlation Coefficient (ICCs) and Cronbach’s Alpha were used to evaluate Italian uMARS reliability and validity.

Results. Subjects were 100, 52 males (52%) and 48 females (48%). Mean age was 22.8 (SD: 3.4). All the enrolled subjects answered to all questions both at time 0 and at time 1. Paired t test showed no statistically significant difference for each answer or answers group between time 0 and 1 (P>0.05). Cronbach’s alpha was 0.945, as all patients answered to all questions. Each question was furtherly assessed through Pearson correlation coefficient, which demonstrated high reliability, with significant P (<0.05) and Pearson Coefficients higher than 0.7. Similarly, ICC, which was always higher than 0.750.

Conclusions. Our results allow the validation of uMARS in Italian language and it may become a reliable and useful tool to evaluate health app.


[1] Early, J., Gonzalez, C., Gordon-Dseagu, V. and Robles-Calderon, L. (2019) Use of Mobile Health (mHealth) Technologies and Interventions Among Community Health Workers Globally: A Scoping Review. Health Promotion Practice, United States. 20, 805–17.
[2] Wattanapisit, A., Teo, C.H., Wattanapisit, S., Teoh, E., Woo, W.J. and Ng, C.J. (2020) Can mobile health apps replace GPs? A scoping review of comparisons between mobile apps and GP tasks. BMC Medical Informatics and Decision Making, 20, 5.
[3] EUROSTAT. (2019) Key figures on enlargement countries 2019 edition.
[4] Chen, X., Koskela, M. and Hyväkkä, J. (2010) Image based information access for mobile phones. Proceedings - International Workshop on Content-Based Multimedia Indexing, 3, 130–5.
[5] Byambasuren, O., Beller, E. and Glasziou, P. (2019) Current Knowledge and Adoption of Mobile Health Apps Among Australian General Practitioners: Survey Study. JMIR Mhealth Uhealth, 7, e13199.
[6] Khachatryan, K. (2015) MEDICAL DEVICE REGULATION IN THE INFORMATION AGE: A MOBILE HEALTH PERSPECTIVE. Jurimetrics, American Bar Association. 55, 477–507.
[7] Modave, F., Bian, J., Leavitt, T., Bromwell, J., Harris Iii, C. and Vincent, H. (2015) Low Quality of Free Coaching Apps With Respect to the American College of Sports Medicine Guidelines: A Review of Current Mobile Apps. JMIR MHealth and UHealth, 3, e77.
[8] Cline, R.J. and Haynes, K.M. (2001) Consumer health information seeking on the Internet: the state of the art. Health Education Research, England. 16, 671–92.
[9] Stoyanov, S.R., Hides, L., Kavanagh, D.J., Zelenko, O., Tjondronegoro, D. and Mani, M. (2015) Mobile app rating scale: a new tool for assessing the quality of health mobile apps. JMIR MHealth and UHealth, Canada. 3, e27.
[10] Domnich, A., Arata, L., Amicizia, D., Signori, A., Patrick, B., Stoyanov, S. et al. (2016) Development and validation of the Italian version of the Mobile Application Rating Scale and its generalisability to apps targeting primary prevention. BMC Medical Informatics and Decision Making, 16, 83.
[11] Makanjuola, J.K., Rao, A.R., Hale, J., Bultitude, M., Challacombe, B. and Dasgupta, P. (2012) UROLOGY APPS: A REVIEW OF ALL APPS AVAILABLE FOR UROLOGISTS. BJU International, John Wiley & Sons, Ltd. 110, 475–7.
[12] Martin Payo, R., Fernandez Álvarez, M.M., Blanco Díaz, M., Cuesta Izquierdo, M., Stoyanov, S.R. and Llaneza Suárez, E. (2019) Spanish adaptation and validation of the Mobile Application Rating Scale questionnaire. International Journal of Medical Informatics, Ireland. 129, 95–9.
[13] Messner, E.-M., Terhorst, Y., Barke, A., Baumeister, H., Stoyanov, S., Hides, L. et al. (2020) The German Version of the Mobile App Rating Scale (MARS-G): Development and Validation Study. JMIR MHealth and UHealth, 8, e14479.
[14] Tency, I., Van Hecke, A., Derycke, J. and Coorevits, P. (2019) Development and validation of the Dutch version of the Mobile Application Rating Scale (MARS): A pilot study on pregnancy apps.
[15] Bardus, M., Awada, N., Ghandour, L.A., Fares, E.-J., Gherbal, T., Al-Zanati, T. et al. (2020) The Arabic Version of the Mobile App Rating Scale: Development and Validation Study. JMIR MHealth and UHealth, 8, e16956.
[16] Stoyanov, S.R., Hides, L., Kavanagh, D.J. and Wilson, H. (2016) Development and Validation of the User Version of the Mobile Application Rating Scale (uMARS). JMIR MHealth and UHealth, Canada. 4, e72.
[17] Panatto, D., Domnich, A., Gasparini, R., Bonanni, P., Icardi, G., Amicizia, D. et al. (2016) An eHealth Project on Invasive Pneumococcal Disease: Comprehensive Evaluation of a Promotional Campaign. Journal of Medical Internet Research, 18, e316.
[18] George, D. and Mallery, P. (2003) SPSS for Windows Step by Step Simple Eleventh Edition.
[19] Hallgren, K.A. (2012) Computing Inter-Rater Reliability for Observational Data: An Overview and Tutorial. Tutorials in Quantitative Methods for Psychology, 8, 23—34.
[20] Eurostat. (2019) Mobile_phone_penetration,_2007_and_2017_(number_of_subscriptions_per_1_000_inhabitants)_CPC19.
[21] Eurostat. (2019) Digital economy and society statistics-households and individuals, Statistics Explained. 2008, 1–15.
[22] Education First. (2019) Education First: English Proficiency Index 2019. 52.
[23] Bujang, M.A., Omar, E.D. and Baharum, N.A. (2018) A Review on Sample Size Determination for Cronbach’s Alpha Test: A Simple Guide for Researchers. The Malaysian Journal of Medical Sciences : MJMS, 25, 85–99.