Americans love technology. We love our iPods, our tablets and our smartphones. At the swipe of a finger, we can map a route, make a reservation, buy a pair of boots and, now, cure what ails us.
Or can we?
Published in the Washington Post, an investigation by the New England Center for Investigative Reporting not only calls into question the quality of much of the health information available via phone app, but sounds an alert about the risks of such “flimsy science.”
As the story notes, “When the iTunes store began offering apps that used cellphone light to cure acne, federal investigators knew that hucksters had found a new spot in cyberspace.” The Federal Trade Commission (FTC) shuttered two such apps, and the FDA is now grappling with how to regulate the industry. “[B]oth the iTunes store and the Google Play store are riddled with health apps that experts say do not work and in some cases could even endanger people,” the story says.
Who wouldn’t jump at the chance to lose weight, relieve arthritis pain, cure a stutter with a quick-fix treatment delivered on your phone? But if the prescription isn’t based on established medical practice and tested by professional researchers whose work is reviewed by their peers, like traditional medical interventions, their patients are, at best, delaying appropriate treatment, and, at worst, threatening their health.
The cost of health apps range from minimal (or free) to hundreds of dollars. The Center reviewed 1,500 health apps available since mid-2011; more than 1 in 5 claimed to treat or cure a medical problem. More than 4 in 10 of the 331 therapeutic apps relied on cellphone sound; 12 required the light from the phone; 2 used phone vibrations. “Scientists say none of these methods could possible work for the conditions in question,” the story says.
The Center makes clear that many outstanding health apps are available, especially for health-care providers. For example, the story recommends:
- Lose It for weight loss;
- Azumio to measure heart rates;
- iTriage to check symptoms and locate hospitals with the shortest emergency room wait times.
But in the absence of government oversight and objective testing of product claims, patients have no way to confirm the useful from the bogus. Reliance on product promotion and online reviews are hardly the gold standard of standards. But, really, common sense is all you need to assess most of these tools.
Satish Misra, a physician at Johns Hopkins Hospital and the managing editor of iMedicalApps, which reviews medical and health-care apps, told the Center that he’s concerned most about apps that claim to test or treat people for serious diseases. Not only can they give inaccurate information, they can encourage patients to ignore symptoms they shouldn’t.
Cardiac Stress Test is once such app, according to the Center. It promises to clear you to participate in sports or not after you do 30 squats in less than a minute, then enter your heart rate into the calculator. As Misra notes, assessing cardiac status is more complicated than just computing heart rate.
In the case of the “cure acne with your cellphone light,” the FTC “false or misleading” charge reflected this product claim: “Rest the iPhone against your skin’s acne-prone areas for two minutes daily to improve skin health without prescription drugs.” Still, according to the FTC, the app was downloaded 11,600 times.
Other apps advise the use of cellphone lights to treat seasonal affective disorder (SAD), a type of depression that strikes in the low light of winter. Although SAD is treated with light therapy, people who treat the disorder, according to the story, say cellphone lights are far too weak to treat depression. Even its manufacturers know they’re dishing out a load of bunk: There’s a disclaimer on the iTunes site that reads, “IMPORTANT. The iSAD Lamp is meant for entertainment purposes … We are not responsible for any misuse or failure.”
Talk about entertainment-Breast Augmentation is positively laughable. It’s based on the fact that breast-feeding women have larger breasts. Duh … they’re filled with milk. But the app claims that women can become better endowed by listening to the sounds of a crying baby at least 20 times a day.
Neither Apple nor Google would discuss with Center reporters their apps or app development. Apple’s guidelines for app developers, according to the story, “say it will reject apps that crash, have bugs, do not perform as advertised or are sexually explicit.” Google’s guidelines ban “sexually explicit material, gratuitous violence or anything that may damage users’ devices.”
In bureaucracy-as-usual, proposed FDA regulations requiring health apps to get government approval are mired in debates, hearings and deep-thinking about whether government oversight would stifle innovation
If you want to learn more about a health app, visit iMedicalApps, an online resource for both medical professionals and patients. Its producers are health-care professionals with no commercial app interests. They follow strict conflict-of-interest policies in order to provide an unbiased view of mobile medical technology.
Another resource identified by the Center, Happtique, comes from the Greater New York Hospital Association. Once launched, it will be the first app certification service for evaluating safety and effectiveness.