Quality Evaluation of Gamified Blood Donation Apps

using ISO/IEC 25010 Standard

Ali Idri

, Lamyae Sardi

and José Luis Fernández-Alemán

Software Project Management Research Team, ENSIAS, Mohammed V University, Rabat, Morocco

Department of Informatics and Systems, Faculty of Computer Science, University of Murcia, Murcia, Spain

Keywords: ISO/IEC 25010, Blood Donation, Mobile Application, Gamification, Software Quality.

Abstract: In the light of the tremendous interest that gamified blood donation (BD) mobile applications (apps) started

to gain, it is necessary to consider the quality assessment of the requirements implemented in this apps. In

this paper, we provide a general overview of requirements for gamified BD apps, which have been retrieved

from literature and extracted from the existing apps on the market. Using the ISO/IEC 25010 quality model,

a checklist was established to analyse the influence of the identified requirements on 30 software product

quality characteristics. The results obtained show a significant variability in the degree of impact of the

various requirements. In particular, users’ actions and App’s features are the blocks of requirements that

reached a very high degree of influence on quality characteristics. The only sub-characteristic affected by

the whole range of requirements is Appropriateness of Functional Suitability. 92% of requirements

influenced Operability characteristic whereas the lowest degrees of impact were noted for Compatibility

(16%) and Transferability (11%). Blood donation apps’ developers and stakeholders may consider the

degree of impact analysis reported in this study to identify software quality requirements which could be

included in the quality assessment of these apps.

1 INTRODUCTION

Blood donation (BD) is portrayed as a prosocial

activity and maintaining a motivated pool of

voluntary blood donors is the key perspective of any

blood donation service. It is therefore important to

understand factors that encourage individuals to

donate blood and develop interventions to increase

and manage their motivations (Goette et al., 2010).

With the rapid prevalence of smart mobile devices

and the proliferation of the new technologies in

healthcare domain, BD mobile applications (apps)

embody a promising approach for recruitment and

retention of potential and regular blood donors

(Yuan et al., 2016). Blood donation apps have the

potential to reduce the resources required for donor

recruitment. Find donations centres and eligible

donors, keep records of BD activities and learn

useful information about BD process are some of the

main functionalities integrated in BD apps (Ouhbi et

al., 2015). A further step towards enhancing the

retention rates of blood donors involves applying

gamification techniques. Vivid gamification

interventions can be found in various domains such

as education, marketing, training and digital

healthcare (Sardi et al., 2017). In general,

gamification is the process of applying game-design

thinking and game mechanics to serious purposes.

Besides making activities more appealing and fun,

gamification is a powerful tool to boost engagement

and increase motivations. A potent gamification

design draws upon a collection of game aspects

including points, badges, leaderboards, avatars,

among others. These elements induce feelings of

mastery, progress and self-esteem. The use of

gamification in blood donation has significantly

increased during the last decade, therefore, diverse

gamified mobile solutions intended to blood donors

have emerged in research and practice. Several

studies have been published investigating

fundamental functionalities, characteristics and

requirements of gamified BD apps (Domingos et al.,

2016; Sabani et al., 2016; Sardi et al 2017b).

Typical inherent requirements should be taken into

consideration prior the development of any software

product. As health-related mobile applications

become more popular and widely claimed, it will be

essential to apply software engineering (SE)

Idri, A., Sardi, L. and Fernández-Alemán, J.

Quality Evaluation of Gamiﬁed Blood Donation Apps using ISO/IEC 25010 Standard.

DOI: 10.5220/0006724806070614

In Proceedings of the 11th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2018) - Volume 5: HEALTHINF, pages 607-614

ISBN: 978-989-758-281-3

607

processes to assure the development of secure, high-

quality apps. Besides the specification of functional

requirements, eliciting Software Quality

Requirements (SQR) represents a crucial part of the

SE process as it determines the overall quality of the

software product. As SQR started to gain increasing

attention, the international research standardisation

project SQuaRE (Software Quality Requirements

and Evaluation) has developed a consistent standard

series ISO/IEC 250xx for the software product

quality, evaluated from the users and stakeholders

point of view.

This paper aims to propose a comprehensive set of

gamified BD apps requirements drawn out from

literature and existing apps on the market and to

identify which requirements should be implemented

in the software product quality evaluation of a

gamified blood donation app. The paper also

analyses the influence of these requirements on

software product quality characteristics by using the

ISO/IEC 25010 standard.

The remainder of this paper is structured as follows:

Section 2 presents an overview of the quality

standards used and outlines the related work on the

use of the software quality model for the evaluation

of mobile applications. Section 3 describes how the

requirements of gamified BD apps were extracted

from literature and existing apps. Section 4 provide

an analysis of the impact of the gamified blood

donation apps requirements on software product

quality. Major findings of the analysis are presented

in Section 5 and thoroughly discussed in Section 6.

Finally, Section 7 provides some final conclusions

and directions for future work.

2 BACKGROUND AND RELATED

WORK

This section provides a brief description of the

standards used and draws an overview of studies that

approaches the assessment of the quality

characteristics of heath apps.

2.1 Standards Used: ISO/IEC 25010,

ISO/IEC 25023 and ISO/IEC 25030

The ISO/IEC 25010 is part of the SQuaRE

(Software product Quality Requirements and

Evaluation) series of International Standards which

was launched in 2011 to supersede the ISO/IEC

9126 that was technically revised and republished in

2001. In ISO/IEC 25010 standard, software quality

is divided into two broad dimensions: product

quality and quality in use. The software product

quality model is composed of eight characteristics

which are further subdivided into sub-characteristics

that can be measured internally or externally. The

internal quality measures are static attributes used to

measure inherent properties of a software work

product that are typically available during

development. The external quality measures, for

their part, are dynamic attributes that are used to

address properties related to the execution of the

software product in the system environment in

which it is intended to operate. The other sub-model

of the IEC/ISO 25010 ‘quality in use’ relates to the

outcome of human interaction with the software and

has five characteristics, which are further divided

into a set of sub-characteristics (ISO/IEC-25010,

2011). This sub-model is not tackled in this study.

The ISO/IEC 25023:2016 is part of the SQuaRE

series of standards that cancels and replaces the ISO

9126-2 and ISO 9126-3. Although it is primarily

intended to be used together with ISO/IEC 25010, it

can also be used in conjunction with ISO/IEC 2503n

and the ISO/IEC 2504n standards to address general

needs with regard to system quality and software

product. ISO/IEC 25023 describes a set of measures

and provides guidance for quantitatively evaluating

system and software product quality in terms of

characteristics and sub-characteristics defined in

ISO/IEC 25010 (ISO/IEC-25023, 2016).

To ensure the quality of the software, it is paramount

to specify the right software quality requirements

that will be the bedrock of the desired quality of the

final product. The standard ISO/IEC 25030 uses the

standard ISO/IEC 25020 to define which measures

should be adopted for each characteristic and sub-

characteristic identified in the standard ISO/IEC

25010 in order to specify the software quality

requirements. It is the only standard of SQuaRE

Series that is dedicated to identifying and specifying

system/software quality requirements. The

application of this international standard can help

ensure that software quality requirements are clearly

stated, correct and correspond to stakeholders’

needs.

2.2 Overview of Related Work

Investigators and experts used a myriad of methods

to evaluate the quality of health-related software

products. Several studies prioritized usability as a

referential concept for quality evaluation.

Reynoldson et al. evaluated apps for pain self-

management using quality assessment criteria and

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testing usability with potential users (Reynoldson et

al., 2014). A study by (Ouhbi et al., 2015) reported a

quality assessment of a total of 133 free BD apps

using a questionnaire concerning the compliance of

these apps with mobile OS usability guidelines. In

the same vein, (Zapata et al., 2014) assessed the

accordance of 24 mobile Personal Health Records

with iOS and Android usability guidelines. Another

study aimed at the examination of multiple

parameters around the quality of the most popular

dietary weight-loss mobile apps available to the

pubic using comprehensive quality assessment

criteria (Chen et al., 2015). Moreover, a study was

about proposing a rating tool to provide a

multidimensional measure of the quality indicators

of health apps (Stoyanov et al., 2015). Furthermore,

papers within the evaluation of the quality of apps

used software quality models proposed by the series

of ISO/IEC standards.

3 REQUIREMENTS OF A

GAMIFIED BD APP

This section summarises the main requirements of a

gamified BD app considering system features and

gamification aspects. The requirements elicitation

phase was processed through reviewing related

literature and evaluating the existing solutions in app

repositories. The extraction was, particularly, based

on studies targeting BD apps such as: 1) the study by

(Foth et al., 2013) that proposes a design

implications of a BD system based on their research

findings on the necessary features for a BD app, and

2) the study by (Yuan et al., 2016) in which the

authors determined the most relevant functions of

BD apps to potential users besides investigating the

degree of receptiveness of donors toward apps.

Several studies focusing on gamification in blood

donation solutions were also reviewed. For instance,

the paper by (Domingos et al., 2016) presents the

design of a gamified BD app that facilitates the

interaction between users and blood centres. Another

study by (Sabani et al., 2016) which focuses on

integrating gamification elements into iOS BD apps

to encourage donors and help end blood shortage.

Furthermore, the findings of a previous review on

gamified BD apps were used to extend the list of

system requirements and gamification techniques

(Sardi et al., 2017b). Given that the results of the

aforementioned were obtained in 2016, a similar

search was performed between August and Septem-

ber 2017 following the same search procedure in

order to update the pre-obtained list of gamified BD

apps. Two more apps were found relevant on the

market. Nine apps, of which five on Android and

four on iOS were therefore included in the current

study. A list of these apps is available upon request

by email to the authors.

The main requirements of gamified BD apps were

selected and regrouped in five clusters: App’s

accessibility, donor’s personal information, user’s

actions and app’s components.

3.1 App’s Accessibility

App’s accessibility is one of the important factors to

consider when developing a mobile application. It

gathers a bunch of requirements related to the

availability of the app for users either before or after

installation. The accessibility requirements are as

follow: AA1. The operating system (OS) type. This

requirement regards the app’s availability in the

well-known app repositories (iOS, Android,

Blackberry, Windows Phone). AA2. The OS

version. Given that new features are consistently

added to the OS, new versions are being launched

accordingly. Although it is not necessary to upgrade

the OS, the user might be obliged to perform the

upgrade to be able to install a specific app. Hence,

the AA2 concerns the compatibility of the app with

OS version. AA3. Cost. In app repositories, there are

free and paid apps. Although paid apps have high

value content and features, free apps are the most

popular because users are less willing to purchase

apps. In-App Purchases (IAPs) remain a prominent

alternative for users seeking low price but advanced

features. AA4. Language. Several apps provide the

possibility to change the language from an in-app

setting or by adjusting the phone’s selected

language. AA5. Geographical limitation. It is

important to define whether the app should have a

restricted availability for users in certain countries,

or should be accessible from all over the world.

AA6. Internet access. This requirement indicates

whether the app requires internet connection to

function. Building an app that works in both online

and offline modes is considered as an effective

feature.

3.2 Donor’s Personal Information

Author(s) Mobile applications usually require users

to offer up a certain amount of information to get the

full experience with the app. Unregistered donors

are therefore requested to create a user profile that

contain their following personal details (PD): PD1.

Quality Evaluation of Gamiﬁed Blood Donation Apps using ISO/IEC 25010 Standard

609

Full name, PD2. Gender, PD3. Date of birth, PD4.

Email, PD5. Address, PD6. Phone number.

3.3 User’s Actions

User’s actions (UA) constitute a set of inherent

actions that should be specified in the requirements

document. It should be indicated whether the user

can or cannot perform these actions: UA1. Be

authenticated using login credentials, UA2. Add

information, UA3. Modify information, UA4. Delete

information. UA5. Share information, UA6. Upload

images.

3.4 App’s Components

This block of requirements includes both the

service-oriented features and the common

gamification elements of BD apps.

3.4.1 App’s Features

App’s features (AF) define the requirements related

to the characteristics of the app. It contains: AF1.

Search and geolocation of local blood drives and

nearby donation centres. AF2. Search for blood

donors. AF3. Blood calculation. This feature

provides users with their estimated blood type

considering their relatives’ blood types. AF4.

Connection with blood centres. AF5. Scheduling

and management of donation appointments. AF6.

Push notifications for blood donation events. The

donor may receive alert messages for blood

campaigns and for special blood shortage. AF7.

Reminders. These help users remember their

scheduled appointments or their next date of

eligibility to donate blood. AF8. Information on

blood, its types and the blood donation process.

These can help donors make their blood donation

experience as safe and pleasant as possible. AF9.

Social media. Users can share blood donation

experience on social media sites, to raise awareness

and encourage others to donate. AF10. Donation

history. Users can keep track of the history of their

blood donations. AF11. Blood donors’ teams. Users

can create/join a team of donors to AF12. In-App

FAQ (Frequently Asked Questions section that

improve user’s experience.

3.4.2 Gamification Elements

This sub-block identifies the gamification aspects

implemented in the app. It includes: GE1. Points.

Users can earn points after each donation, which can

be redeemed for real-world items. GE2. Special

incentives when donating upon emergency blood

shortage calls. GE3. Status. Users obtain a new

status every time they reach a blood donation

milestone. GE4. Rewards for referring others. GE5.

Tracking of donations’ progress. GE6. Users’ ran-

king on leaderboard to encourage friendly compete-

tion. GE8. Visualization of achievements including

collected badges, points earned and lives saved.

4 IMPACT ANALYSIS OF

GAMIFIED BD APPS

This section describes the analysis process used to

measure the impact of the requirements defined for

gamified BD apps on software product quality. The

analysis process was founded on that of previous

studies (Idri et al., 2016; Idri et al., 2013; Ouhbi et

al. 2015), but was readjusted to the field of gamified

blood donation to answer the following research

question:

RQ: What influence do requirements of gamified

BD apps have on software product quality?

The analysis process consisted on carrying out three

steps:

Step 1. Analysis of the Product Quality

Characteristics and Sub-characteristics.

The ISO/IEC 25010 was analysed in order to

understand the meaning of each external

characteristic and sub-characteristic. In conjunction

with this standard, the ISO/IEC 25023 standard was

used to grasp the definitions of the quality measures

used for quantitatively evaluating system and

software product quality in terms of characteristics

and sub-characteristics.

Step 2. Checklist of Gamified BD Apps’

Requirements using ISO/IEC 25010 Software

Product Quality Model.

The two first authors built a checklist to determine

the potential impact of each pre-identified

requirement on external sub-characteristics of the

product quality model. The checklist is available

upon request by email to the authors. There were no

discrepancies between the authors during the

process. The checklist was revised and verified by

the third author in a way that respects the following

instruction: A software product quality sub-

characteristic is considered to be affected by a

requirement if the variables used in the calculation

of the external metric are affected by this

requirement.

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Step 3. Calculation of the Degree of Impact of

Gamified BD Apps’ Requirements on Software

Product Quality.

Three degrees of impact are calculated:

1. DI(EC,B): degree of impact of a block of

requirements B on an external characteristic EC.

This degree is calculated according to the following

equation: = where

is the total number of requirements

in the block B.

2. DI(EC,R): degree of impact of a requirement R on

an external characteristic EC. This degree is

calculated according to the following equation:

where N(EsC, R)

is the number of sub-characteristics of EC that are

affected by R and N(EsC) is the number of sub-

characteristics comprised in EC.

3. : degree of impact of a block of

requirements B on an external sub-characteristic

EsC. This degree is calculated according to the

following equation:

where is the

degree of impact of requirement R on an external

sub-characteristic EsC.

N(EsC) and N(R) are obtained from the checklist

established in step 2.

After that the calculation of these degrees was

performed, the results were classified into five

groups: Very high if the result is between 0.90 and

1.00; High if the result is between 0.7 and 0.89;

Moderate if the result is between 0.4 and 0.69; Low

if the result is between 0.2 and 0.39; and Very low if

the result is between 0 and 0.19.

5 RESULTS

As an attempt to answer the research question

defined for this study, this section presents the

results of the impact analysis of gamified BD apps’

requirements on software product quality

characteristics. The checklist comprises 30 external

sub-characteristics and a total of 37 requirements

specified for gamified BD apps. As shown in Figure

1, The block AA has the lowest degree of impact on

software quality characteristics. Compatibility and

Maintainability are the least influenced by the blocks

of requirements among eight quality characteristics

as their degrees can be described as low and very

low. Functional Suitability is moderately influenced

by AA and PD blocks. All the blocks have low to

very low degree of impact of Security characteristic.

Transferability is only influenced by AA block with

a low degree. UA, PD, AF and GE blocks have a

moderate degree of influence on Operability and a

very high degree of impact on Performance

Efficiency. Figure 2 presents the degree of impact of

each requirement of gamified BD apps on the

external characteristics. Functional Suitability is the

only characteristic that is influenced by all the

requirements. 91% of requirements affect the

Operability characteristic. Performance Efficiency is

influenced by 86% and Reliability by 84%. For

Maintainability and Security, the impact is measured

considering 54% and 35% of the requirements,

respectively. The lowest degrees of impact are

obtained for Compatibility (16%) and

Transferability (11%). The requirements AF4 and

AF5 have the most impact on software quality

followed by UA1 and AF10. In contrast, AA3 is the

requirement that have the least influence on the

quality characteristics. Detailed insight into the

impact of the blocks of requirements on each

external sub-characteristic is illustrated in Figure 3.

Appropriateness is the only sub-characteristic

that is affected by the whole range of requirements.

Whereas, none of the requirements has an impact on

three sub-characteristics of Maintainability, namely

Analyzability, Changeability and Testability in

addition to one Compatibility sub-characteristic

(Replaceability). Confidentiality is the most affected

Security sub-characteristic. PD, UA, AA and GE

blocks have an equal degree of impact on

Figure 1: Impact of a block of requirements on an external characteristic.

Quality Evaluation of Gamiﬁed Blood Donation Apps using ISO/IEC 25010 Standard

611

Performance Efficiency sub-characteristics. Among

Operability’s sub-characteristics, Technical accessi-

bility and Appropriateness recognizability are the

most affected by all the blocks of requirements.

Maintainability is roughly influenced through

Modularity sub-characteristic. Learnability, Reusabi-

lity and Modification stability are only influenced by

one requirement: AA3, AA2 and AA6, respectively.

6 DISCUSSION

This section discusses the results and the main

findings of this study and presents their implications

for developers of gamified BD apps.

6.1 Main Findings

This study lists a set of requirements of gamified BD

apps that were drawn out from literature and from

the existing gamified BD solutions in app

repositories. Among this compilation of

requirements, (AF1) Search and geolocation of

donations centres and (AF2) Search for blood donors

were the features that are predominantly included in

the gamified BD apps. One important aim of

developing a mobile app in the area of blood

donation is facilitating communication between

blood donors, recipients, and donation centres

(Mostafa et al., 2014). All the requirements

underwent the analysis process described in section

4 in order to obtain their degrees of impact on the

external quality characteristics. With the exception

of the OS version (AA2) and cost (AA3), all the

requirements can be considered as software quality

requirements. After performing the impact analysis,

the blocks UA, AF and GE were found to have an

important impact on the quality characteristics.

Considering the UA block, UA1: to be authenticated

is the requirement that mostly affect software

product quality, followed by UA6: Upload images.

Security and privacy constitute an essential part of

mobile applications systems development,

particularly health applications that store several

data regarding patients’ health status (Martínez-

pérez et al., 2015). Improper implementation of

security information can have severe repercussions

on users and stakeholders alike. Authentication

(UA4) represents a crucial source of security

shortcomings and has therefore a notable impact on

software product quality. A secure authentication

can be achieved through adding another layer of

security over the user credentials, this can include

one of the three authentication’ classes, such as

asking a secret question, using a smart card or

implementing biometric authentication (Kjeldgaard

et al., 2012). With regard to the requirements

considered as apps’ features, connection with

donation centres (AF5) is one of the AF block

requirements to have a great influence on software

product quality. One of the most interesting aspects

of the mobile health sphere is its ability to promote

communication across the healthcare sector from

caregivers and patients. Nonetheless, the lack of a

standardized and efficient form of data exchange is

one of the most critical issues encountered by health

apps’ developers (Al-habsi & Seldon, 2013).

Scheduling appointments (AF4) is another aspect of

connecting to donation centres. The possibility of

tracking donations history (AF10) is another

requirement that threaten the software product

quality of mobile applications as it implies privacy

issues. Lastly, a notable and equal impact on

software product quality was identified for all the

requirements of gamification elements block (GE).

Although the application of gamification to BD apps

has various benefits, it can be rendered ineffective if

poorly implemented. Using gamification

mechanisms that do not mesh the audience’s need

and burdening the app with a plethora of

gamification elements are some of the problems that

negatively impact the overall quality of the software

product (Pereira et al., 2014). Moreover, the results

show that along with Functional Suitability,

Reliability and Performance Efficiency are the

external characteristics which are highly affected by

requirements of BD apps. Frequent disconnection

and limited energy autonomy are some of the

limitations of mobile environments that have

significant influence on Reliability characteristic.

Whereas Performance Efficiency is affected by

limited storage capacity and lower bandwidth. On

that account, it is critical to take into consideration

these limitations at requirements elicitation phase.

According to the checklist, Operability sub-

characteristics were fairly affected by gamified BD

apps’ requirements. The limitation of user

smartphone interface is one of the obstacles that may

be encountered by Operability characteristics (Idri et

al., 2013).

6.2 Implications for Research and

Practice

This study has identified a range of requirements for

gamified BD apps, which developers and evaluators

can translate to SQR for the assessment of software

product quality. Software product quality evaluation

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Figure 2: Impact of a requirement on an external quality characteristic.

Figure 3: Impact of a block of requirements on an external sub-characteristic.

can be undertaken during or after the development

or acquisition process. The requirements of gamified

BD apps for external quality characteristics should

be quantitatively described in the SQR. The

checklist established in this study on the influence of

BD requirements on quality characteristics may be

of significant use to developers of gamified BD

apps. Stakeholders could take advantage of the

suggestions made in this study to draw up the

requirements the essential requirements that help

augment the overall quality of gamified BD apps.

7 CONCLUSION AND FUTURE

WORK

In this paper, a compilation of 37 requirements for

gamified BD apps were extracted from literature and

from the few available apps in iOS and android

repositories. A software quality assessment was

performed using the ISO/IEC 25010 quality model

in conjunction with ISO/IEC 25023 standard. A

checklist was therefore established aiming at

calculating the degree of influence of the gamified

BD apps requirements on 30 quality characteristics.

According to the outcomes of this study, some

quality characteristics, through certain sub-

characteristics, were more impacted by BD apps

requirements than others, namely, Functional

Suitability, Operability, Reliability, Performance

Efficiency and Security. One limitation of this study

is that it may have disregarded relevant requirements

for gamified BD apps. Nevertheless, a thorough

review of literature and extensive search in app

repositories were undertaken to alleviate this threat.

Future work will involve several research lines. We

intent to perform an empirical evaluation of existing

gamified BD apps using the results of this study. We

also consider assessing the quality-in use of

gamified BD apps using the ISO/IEC 25010 quality

model. Another interesting future perspective would

be that of investigating the disparity in the degrees

of the impact of requirements for BD apps.

ACKNOWLEDGEMENTS

This research is part of the mPHR project in

Morocco financed by the Ministry of Higher

education and Scientific research in Morocco

PPR1/09, and part of the GEODAS-REQ project

(TIN2012-37493-C03-02) supported by the Spanish

Ministry of Economy and Competitiveness and

European FEDER funds.

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613

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