|LETTER TO EDITOR
|Year : 2016 | Volume
| Issue : 4 | Page : 302
The unhealthy side of mHealth: A cautionary note
Rakesh Agarwal1, Rashmi Agarwal2
1 Department of General Medicine, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
2 Department of Obstetrics and Gynaecology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
|Date of Web Publication||14-Sep-2016|
Department of General Medicine, IPGME and R and SSKM Hospital, Kolkata, West Bengal
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Agarwal R, Agarwal R. The unhealthy side of mHealth: A cautionary note. CHRISMED J Health Res 2016;3:302
Medicine today stands at the cusp of a mobile revolution. Mobile phones capable of running applications (smartphones) have rapidly become very popular and are being used by doctors and the common public alike. The use of medical health apps or mHealth apps has become popular with the increasing use of smartphones. These include, for example, apps that calculate severity or likelihood of disease on the basis of clinical scoring systems. Some, like up-to-date and Medscape, provide valuable inputs to doctors. Some provide, or claim to provide, diagnostic capabilities.
Leading people from the medical and technology sectors have endorsed the idea that mHealth can transform medicine. However, a recent research article published in the Journal of American Medical Association calls for caution in this regard. It has shown that blood pressure (BP) measurements from a widely circulated health app, the Instant BP app (IBP) were highly inaccurate, with a sensitivity and specificity of 0.22 and 0.92, respectively. Moreover, 77.5% individuals with hypertension would be falsely reassured of having normal BP levels.
The IBP app was one of the top selling iPhone apps for 156 days, selling at least 950 copies at a price of 4.99$, on each of those days. And it failed the test of technology that it was purchased for. However, the app was no longer available after July 30, 2015, for unknown reasons.
However, a number of similar apps, including BP pocket, quick BP measure, and monitor, are still available on android, iOS, and Windows platforms and are being widely used. Most of them have not been validated.
Pfizer warned in 2011 that its Rheumatology Calculator app was generating falsely high and low scores for arthritis patients as much as 50% on occasions. Diabetes app by Aventis was recalled because it miscalculated insulin doses, which could be life threatening. Melanoma prediction apps have already been shown to be inaccurate having incorrectly classified 30% or more of melanomas as unconcerning.
At the same time, however, some apps have been claimed to be 100% accurate. Some apps form the basis of day-to-day caregiving by doctors by acting as a quick reference. Smartphones could be used for reminding patients about medications, or follow-up, and in monitoring medical conditions or maintaining health records. Some apps could be used for sharing medical information quickly.
Although a great majority of mHealth apps are very low-risk, this new evidence points to the fact that products may not work as claimed. However, considering the potential risks involved, both the physician and patients should be careful before blindly using mHealth apps.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Plante TB, Urrea B, MacFarlane ZT, Blumenthal RS, Miller ER 3rd
, Appel LJ, et al.
Validation of the instant blood pressure smartphone app. JAMA Intern Med 2016;176:700-2.
Wolf JA, Moreau JF, Akilov O, Patton T, English JC 3rd
, Ho J, et al.
Diagnostic inaccuracy of smartphone applications for melanoma detection. JAMA Dermatol 2013;149:422-6.
Bierbrier R, Lo V, Wu RC. Evaluation of the accuracy of smartphone medical calculation apps. J Med Internet Res 2014;16:e32.