Compliance with WHO mERA and CONSORT-EHEALTH in mobile app stroke interventions: a systematic review of randomized and controlled clinical trials

Abstract

Mobile application interventions for stroke management are expanding, yet compliance with reporting guidelines remains unclear. This study systematically reviewed the reporting compliance of publications on mobile applications interventions for stroke management with the standard reporting guideline: the WHO mERA and the Consolidated Standards of Reporting Trials of Electronic and Mobile Health Applications and Online Telehealth (CONSORT-EHEALTH). A review of literature was conducted in PubMed, EMBASE, Web of Science and Cochrane databases from January 2011 to April 2025. Randomized controlled trials or controlled clinical trials publications reporting mobile application interventions among stroke survivors and focused on medication adherence, functional outcomes, cardiovascular risk factors, quality of life, and knowledge of stroke were included. Two independent reviewers screened against eligibility criteria and the mERA and CONSORT-EHEALTH guidelines. 27 studies (21 Randomised Controlled Trials and 6 Controlled Clinical Trials) were included. Mean mERA compliance was 44.9% (18.8–75.0%), with cost assessment and infrastructure ( n = 2) least reported. Mean CONSORT-EHEALTH compliance was 69.8% (59.4–81.0%), with items 7b, 11b, 17b, 19 and 24 least reported. Comparing the earlier (2016–2020, n = 17) and more recent (2021–2025, n = 10) publication periods, mean mERA compliance remained low and increased slightly from 44.5% to 45.6%, while CONSORT-EHEALTH compliance remained comparatively high, from 69.3% to 70.7%. Positive correlation between mERA and CONSORT-EHEALTH compliance was weak ( r = 0.16, p = 0.42; ρ = 0.24, p = 0.22). Compliance with mERA and CONSORT-EHEALTH guidelines remains suboptimal. This emphasizes the urgent need to improve reporting quality in mobile health stroke trials.