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Consumer Health Apps: Concerns about reliability and safety

The market for consumer health apps has grown tremendously in the past few years. Health, fitness, and diet apps, in particular, are frequently listed as popular app downloads in stores like iTunes and Google Play. As these apps become more widely used it may be prudent to ask if consumer health apps are reliable and safe to use.

In past few years there have been some exciting developments in the world of mobile health technology. There are now smartphone apps and attachments that allow physicians to monitor a patient’s condition outside of the hospital, conduct eye exams in resource-poor areas, and provide access to medical information from almost anywhere.[i] A recent study demonstrated that using a diet and activity monitoring app, like Lose It!, can help people keep better track of what they eat and can aid in weight loss.[ii] New apps are being constantly published to help both clinicians and consumers better understand and manage healthcare.

However, despite some exciting advances in mobile medicine, there are still concerns about whether consumer health apps may end up doing more harm than good. Part of this concern stems from the fact that most medical apps are not regulated by the FDA. Only a small number of apps—those that meet strict medical device criteria—are required to be evaluated and approved by the FDA.  This means that an app developer can create a medical app (for consumers or clinicians) without needing to pass a vetting process, and can do so without any medical experience or background.

A recent study published in BMC Medicine highlights the potential dangers of unregulated health apps. [iii] The authors found that insulin dose calculator apps, used by both clinicians and patients, were seriously flawed. They concluded that “the majority of insulin dose calculator apps provide no protection against, and may actively contribute to, incorrect or inappropriate dose recommendations that put current users at high risk of both catastrophic overdose and more subtle harms resulting from suboptimal glucose control.”  

Another concern arises when consumer health apps claim to perform functions that have not been validated. iMedical apps highlighted a blood pressure app called “Instant blood pressure” that was supposed to measure a patient’s blood pressure by just using the camera and microphone on an iPhone.[iv] There is no evidence that this method can provide a reliable blood pressure reading, and if patients used this app to monitor their blood pressure they would likely be collecting incorrect and potentially harmful data.

There are many positive uses and potential benefits of using medical apps, but consumers and clinicians need to look at apps with a critical eye. Here are some questions that everyone should ask before using a medical app:

  • Was the app created by a physician or other member of the medical community? Are the author's credentials listed clearly in the app details?
  • Does that app cite sources used to create the content of the app?
  • Do advertisements pop up in the app? Are the ads for pharmaceuticals or other items related to the content of the app? Does the app feel more like a commercial than an objective source of information?
  • Is the app being used to monitor or answer questions pertaining to serious or chronic health conditions (e.g. diabetes, high blood pressure)? If so, consumers might want to consult a physician before relying on the app and should not use it alone to make healthcare decisions.

If you would like to learn more about mobile medicine apps please consult Becker Library’s Mobile Medicine Libguide. You can also learn more about consumer health apps from the Consumer Health Libguide appliography.

Sources:


[i] Some examples: The FDA-approved AliveCor device and app allows patients and physicians to monitor heart rate activity; the FDA-approved iExaminer device and app allows physicians to perform eye exams using an iPhone, and consumer and physicians can access medical information from a variety of different apps and database resources.

[ii] Wharton, C, Johnston, C., Cunningham, B. and Sterner. D.(2014) Dietary self-monitoring, but not dietary quality, improves with use of smartphone app technology in 8-week weight loss trial. Journal of Nutrition Education and Behavior 46 (5). PubMed record: http://www.ncbi.nlm.nih.gov/pubmed/25220777

[iii] Huckvale, K., Adomaviciute, S., Prieto, J., Leow, M., and Car, J. (2015). Smartphone apps for calculating insulin dose: A systematic assessment. BMC Medicine; 13: 106. Free full text available at: http://www.biomedcentral.com/1741-7015/13/106/abstract

[iv] Husain, I. (2014). Top 10 downloaded iPhone health app can cause significant patient harm. Accessed 5/13/2015 at http://www.imedicalapps.com/2014/07/iphone-health-app-patient-harm/

 

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