Medical apps for smartphones: lack of evidence undermines quality and safety. Evid Based Med

Department of Neurology, Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands.
Evidence-based medicine 08/2012; 18(3). DOI: 10.1136/eb-2012-100885
Source: PubMed


Increasing numbers of healthcare professionals are using smartphones and their associated applications (apps) in daily clinical care. While these medical apps hold great potential for improving clinical practice, little is known about the possible dangers associated with their use. Breaches of patient confidentiality, conflicts of interests and malfunctioning clinical decision-making apps could all negatively impact on patient care. We propose several strategies to enhance the development of evidence-based medical apps while retaining their open nature. The increasing use of medical apps calls for broader discussion across medicine's organising and accrediting bodies. The field of medical apps is currently one of the most dynamic in medicine, with real potential to change the way evidence-based healthcare is delivered in the future. Establishing appropriate regulatory procedures will enable this potential to be fulfilled, while at all times ensuring the safety of the patient.

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Available from: Benjamin Jelle Visser, May 24, 2014
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    • "With this growing market and the overwhelming diversity of applications, there is a need to recognize which applications are safe and trustworthy. In the recent literature, potential dangers and reliability of some health-related applications were investigated [10] [11] [12]. Various aspects of mobile health applications have been called into question, including medical professional involvement in the development of the applications [13], the accuracy and reliability of the content of the applications used in diagnosis and patient management [14], the potential danger of camera function in mobile devices to judge weather skin lesions are suspicious [15] [16], deficiencies in self-management applications in diabetes [17] and asthma [18]. "
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    ABSTRACT: Health-related mobile applications (apps) have been shown to improve the quality of health and patient care. Their use in clinical and health-related environments is becoming more considerable. The number of health-related apps available for download has considerably increased, while the regulatory position of this new industry is not well known. Despite this lack of regulation, measuring the usability score of these apps is not difficult. We compared two samples of twenty health-related applications each. One of the samples contained the apps with top-rated usability scores, and the other contained the apps with lowest-rated usability scores. We found that a good usability score correlates with a better medical reliability of the app's content (p<0.005). In the period in which a valid regulation is still lacking, calculation and attribution of usability scores to mobile applications could be used to identify apps with better medical quality. However, the usability score method ought to be rigorous and should not be rounded off with a simple five stars rating (as is the case in the classic app stores).
    Full-text · Article · Aug 2015 · Studies in health technology and informatics
    • "Smartphone or tablet-based hearing tests may be an alternative in such situations, facilitating hearing loss identification and early treatment of potential threatening situations such as sudden sensorineural hearing loss (SSNHL) [5] [7] [8]. However, lack of evidence and regulation has undermined the quality and safety of software applications until now [2] [3] [9] [10]. Therefore, an application designed to assist otolaryngologists in their daily activity was developed according to currently available industry and government guidelines. "
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    ABSTRACT: The application described in this study appears to be accurate and valid, thus allowing calculation of a hearing handicap and assessment of the pure-tone air conduction threshold with iPhone/iPad devices. To develop and evaluate a newly developed professional, computer-based hearing handicap calculator and a manual hearing sensitivity assessment test for the iPhone and iPad (AudCal). Multi-center prospective non-randomized validation study. One hundred and ten consecutive adult participants underwent two hearing evaluations, a standard audiometry and a pure-tone air conduction test using AudCal with an iOS device. The hearing handicap calculation accuracy was evaluated comparing AudCal vs a web-based calculator. Hearing loss was found in 83 and 84 out of 220 standard audiometries and AudCal hearing tests (Cohen's Kappa = 0.89). The mean difference between AudCal and standard audiogram thresholds was -0.21 ± 6.38 dB HL. Excellent reliability and concordance between standard audiometry and the application's hearing loss assessment test were obtained (Cronbach's alpha = 0.96; intra-class correlation coefficient = 0.93). AudCal vs a web-based calculator were perfectly correlated (Pearson's r = 1).
    No preview · Article · Jul 2015 · Acta oto-laryngologica
    • "A study by Lister et al. [4] revealed that commercial bias of health-related apps is a general concern of consumers. With currently no official certification, peer review system or regulatory guidance in place [30], quality, reliability and safety of apps can only be guaranteed by developers themselves, who are nevertheless interested in financial success of their apps. A recent study by Martínez-Pérez et al. [55] "
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    ABSTRACT: More and more users are using mobile apps to achieve changes in their lives related to their health. Given the complex task of accomplishing long-term behavioural change, developers have started to incorporate game elements into their apps as motivational tools and to increase user engagement. However, with increasing number of health-related apps available on mobile platforms every day, several issues have started to arise. In this paper, we critically review the health app landscape from several perspectives. We underline the current lack of scientific theory usage in app development, inefficient and selective embedding of gamification, low levels of personalization and potential privacy and trust issues in this domain. Given the multi-disciplinary nature of this set of problems, we propose integrated and user-centred frameworks as one potential solution direction to resolve problems both users and app-developers are facing today.
    No preview · Article · Jul 2015 · Entertainment Computing
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