News

17-07-2016

The number of health-related apps available on smartphones increases daily, they are relatively inexpensive, widely available , accessible and cover many areas, from tracking sleep patterns  to monitoring pulse and blood pressure or assisting with mental health conditions. It is difficult to determine whether an app has sound evidence of benefit or not, although some are difficult to accept as scientifically accurate from their description , for example the Instant Blood Pressure app claims to read blood pressure with  no cuff required, instead , it uses the phone's microphone pressed against the chest and a finger over the camera. Independent testing published in the JAMA Internal Medicine March, found the app failed to identify high blood pressure in over 80% of true cases.


To date, the area relating to health and medical  apps is largely unregulated,  Authorities have pursued health apps from a consumer rights and  misleading advertising basis rather than a medical safety perspective. In The US, the Food and Drug Authority ( FDA )  have been responsible for approving medical devices, however apps allowing a smartphone to become a medical device do not fall under any current American or Australian watchdog. The FDA have issued guidelines, but compliance is voluntary. Most apps offer fine print disclaimers in the description in the app store , such as " not FDA cleared" and " for entertainment purposes". Some suggestions when considering using a medical/health associated app are:

1. Does the app make a diagnosis?

Medical diagnostic equipment often requires regular calibration, is highly specialised and specific and interpreted by professionals taking many things into consideration in addition to a reading made. It is unlikely a smartphone app can reproduce this combination using a commercial algorithm, microphone and camera.

2 Does the app provide treatment?

Many apps claim to treat pain, acne and seasonal affective disorder for example using vibration and/or screen light , there is no scientific evidence and the intensity and therapeutic quality is unlikely to be enough to provide benefit. Mental health apps are commonly recommended, however, of the 27 mental health apps endorsed and recommended via the NHS in the United Kingdom, only 4 currently provide hard evidence of results reported by real-world users and only 2 use the NHS accredited ways of measuring the effectiveness of mental health treatments. Apps that are supported by a health practitioner have been found to be more than twice as effective than those without a health professional's input

3. Is the app from a reliable source?

Association with a reputable peak body, university or government department suggests trustworthiness, however some app developers have inaccurately associated their app with leading universities.

4. Does the app use self-help methods?

Goal-setting, self-monitoring and feedback are well  established techniques for helping to change behaviours and improving motivation. These techniques are commonly offered in health apps and are likely to be of use for people working on health goals and self- managing  a health condition in association with their doctor or other health professional, for example dietician or exercise physiologist

5. What do the reviews say?

Bad reviews suggest the app does not work well, but a good review does not necessarily mean an app in trustworthy

6. Does the app cause you to delay contact with a doctor?

Many apps contain very accurate medical information, but are not a substitute for a medical consultation regarding a health concern

7. Is the app easy to use and enjoyable?

VicHealth has launched a Healthy living apps guide, regularly reviewing effectiveness in helping people lead healthier lifestyles ( vichealth.vic.gov.au see Healthy Living Apps Guide ), but there is no Australian, American or British body assessing the thousands of health associated apps available. The NHS in the UK  ran a library of 220 approved health-related apps that it encouraged for use from 2013, but it was closed in 2015 due to negative publicity from consumers  after studies demonstrated that many of the apps had minimal benefit and leaked sensitive personal data. 

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