There is an App for That

By J. Ron Eaker, M.D.

Need groceries delivered…there’s an app for that.
Want to name a new kitten…there’s an app for that.
Want to get pregnant… there’s an app for that, but it turns out it’s probably not very helpful.

A new study out of the Georgetown School of medicine suggests that the majority of fertility apps blanketing the market are of minimal usefulness in either predicting fertility or timing to prevent pregnancy.

This study, published in the Journal of the American Board of Family Medicine, looked at ninety five fertility apps that were commonly available on sites such as iTunes or Google Play.  The number of apps available in this one area should raise a red flag from the outset, but then, when scrutinized, the study’s authors noted over half of the apps had a disclaimer that stated the app should either not be used to prevent pregnancy or admitted to using non-scientifically based data.  It appeared that many of these apps were little more than games and gimmicks with no real medical value.

In fact, only six of the ninety five apps reviewed correctly predicted a woman’s fertile days, according to the authors.  Lead author Dr.Marguerite Duane stated, “The effectiveness of fertility awareness-based methods depends on women observing and recording fertility biomarkers and following evidence-based guidelines. Apps offer a convenient way to track fertility biomarkers, but only some employ evidence-based data.”  In other words, some of the apps are little more than calendars in which you can record your cycle days and have little to do with true predictability of fertility.

This is but one example of where the explosion of health apps has largely gone unregulated and has led to the potential for disastrous health consequences.  It’s one thing to have an unfettered market for games or news sites, but apps that claim to offer health advice need to be held to a more stringent standard.

By some estimates, 20% of cell phone users have downloaded at least one health related app.  That adds up to 500 million users worldwide that could be getting health information or using health related tools to monitor everything from blood sugar levels to blood pressure.  The IMS Institute for Healthcare Informatics recently looked at over 40,000 health related apps and found that only 16,000 had any relevance to a patient’s well being and treatment whereas the others (almost 24,000) had no impact on patient wellness or health.

One example sited in another study specifically looked at apps to help diagnose skin melanoma.  Essentially you upload a photo of a lesion and then the app follows an algorithm and tells you the likelihood of the lesion being cancer.  The team found that even the most accurate of the apps that used algorithms missed 18 of the 60 lesions diagnosed as melanoma and deemed them low-risk for cancer.   The danger in these and apps like it is not so much in the inaccurate information, but the potential delay in treatment or diagnosis due to complacency or false reassurance.

As previously noted, part of the problem with health apps is there is virtually no guidelines regulating what can be promoted as accurate health information.  Some government entities, such as the FDA, are attempting to set up guidelines for reliability, but they are hampered by the volume  and diversity of existing sites.

On the flip side, there are some apps that are incredibly useful and are having a very positive impact on patients’ health.  Many of these are of the genre of data collection in which things like blood pressure, pulse, respiratory effort, blood sugar levels and even heart tracings (EKG) can be accumulated and transmitted to a health care provider, thus allowing for a productive interaction in a more convenient and timely fashion.  Many of those at the forefront of virtual medicine technologies predict that these types of apps (data collection) may revolutionize patient care, especially in rural or underdeveloped areas where health care access is a challenge.  For example, getting serial blood pressure information to a health care provider days, maybe even weeks, before a patient may be able to come into a clinic or office can facilitate quick and effective interventions that may prevent future complications.

The use of health care apps is best served by the adage “buyer beware” as a healthy dose of skepticism is critical to safe and effective usage.  Do your homework.  Review what you are wanting to accomplish and research what a app can actually do…or not do.  There are plenty of websites that regularly review apps for accuracy and reliability.

And, of course, there is an app for that.