Decision support systems and applications in ophthalmology: literature and commercial review focused on mobile apps.

The growing importance that mobile devices have in daily life has also reached health care and medicine. This is making the paradigm of health care change and the concept of mHealth or mobile health more relevant, whose main essence is the apps. This new reality makes it possible for doctors who are not specialist to have easy access to all the information generated in different corners of the world, making them potential keepers of that knowledge. However, the new daily information exceeds the limits of the human intellect, making Decision Support Systems (DSS) necessary for helping doctors to diagnose diseases and also help them to decide the attitude that has to be taken towards these diagnoses. These could improve the health care in remote areas and developing countries. All of this is even more important in diseases that are more prevalent in primary care and that directly affect the people's quality of life, this is the case in ophthalmological problems where in first patient care a specialist in ophthalmology is not involved. The goal of this paper is to analyse the state of the art of DSS in Ophthalmology. Many of them focused on diseases affecting the eye's posterior pole. For achieving the main purpose of this research work, a literature review and commercial apps analysis will be done. The used databases and systems will be IEEE Xplore, Web of Science (WoS), Scopus, and PubMed. The search is limited to articles published from 2000 until now. Later, different Mobile Decision Support System (MDSS) in Ophthalmology will be analyzed in the virtual stores for Android and iOS. 37 articles were selected according their thematic (posterior pole, anterior pole, Electronic Health Records (EHRs), cloud, data mining, algorithms and structures for DSS, and other) from a total of 600 found in the above cited databases. Very few mobile apps were found in the different stores. It can be concluded that almost all existing mobile apps are focused on the eye's posterior pole. Among them, the most intended are for diagnostic of diabetic retinopathy. The primary market niche of the commercial apps is the general physicians.