10 Health Apps That Might Make You Sick
As government and industry groups debate the best way to oversee healthcare apps, some questionable software hits the market.
![](https://eu-images.contentstack.com/v3/assets/blt69509c9116440be8/blt280958b0628a39ad/64cb576aeace7c29df479d5d/Sick-Phone.jpg?width=700&auto=webp&quality=80&disable=upscale)
Before even more mobile health products flood the market and formats expand into currently unimagined designs, it's imperative for the government to improve how it oversees and regulates healthcare apps and devices, a growing number of industry experts say.
Without a new approach, consumers risk aggravated conditions or even death due to poorly designed, fraudulent, or dangerous technologies, these critics say. Healthcare providers, too, find it increasingly difficult to discern valid from invalid apps, making it tougher to recommend mHealth apps to motivated patients. The market for mHealth apps, expected to reach $26 billion by 2017, needs more oversight -- even as proponents worry about constrictive bureaucracy that strangles innovation and investment.
Some apps disappear naturally, while others were pulled after government intervention. Yet users can still buy apps claiming to "cure" chronic pain, tinnitus, or phobias. Certain apps that claimed to analyze urine or read EKGs are no longer available.
Yet if a developer removes an app from an online store, users can still use the poorly designed or faulty software if they already own it, say Benjamin Jelle Visser and Johnathan Bourman on Medscape. Nor is there always a simple way for consumers to discover any conflict of interest an app developer might have, they said. Privacy concerns abound, and some apps may collect personal health information insecurely. Of the more than 43,000 mHealth apps available on iTunes in mid-2013, most do little more than provide information, with only 16,275 directly related to health and treatment, according to IMS Institute for Healthcare Informatics, in "Patient Apps for Improved Healthcare."
To improve adoption, IMS recommends: "There must be recognition of the role apps can play in healthcare by payers and providers, as well as regulators and policymakers; security and privacy guidelines and assurances established among providers, patients and app developers; a systematic evaluation of apps to inform their appropriate use; and the effective integration of apps with other aspects of patient care."
Today, the Food and Drug Administration (FDA) ensures medical devices are safe and perform as advertised. In April, a federal advisory panel published the "FDASIA Health IT Report," which reported the FDA cleared approximately 100 mHealth apps -- including remote blood pressure, heart rhythm, and patient monitors, plus phone-based ultrasounds, electrocardiographic, and glucose devices. The Office of the National Coordinator for Health Information Technology (ONC), which historically focused on electronic health records, is authorized to certify other forms of healthcare technology. In addition, the Federal Communications Commission, which often works closely with the FDA, has jurisdiction over equipment that uses radio frequencies.
Industry advocates contend too much oversight will stunt the innovation needed for app development. They worry layers of bureaucracy, red tape, or lack of technology understanding will generate unnecessary reviews for even the most mundane upgrade. On average, it takes more than five months for the FDA to clear a 501(k) medical device application, according to Emergo Group's review, based on FDA applications between 2006 and 2013. In both 2012 and 2013, it took an average of 166 days, the survey of more than 24,000 submissions found.
Time is only one consideration -- especially when consumers' health could be at risk, said a recent article in the New England Journal of Medicine (subscription required). More FDA oversight will help protect the public health, increase consumer confidence, and encourage even more innovations, wrote Nathan Cortez, an associate professor of law at Southern Methodist University Dedman School of Law, in NEJM. While the FDASIA report includes a small FDA role, Cortez and his peers recommend a "robust FDA."
Although the department would require more resources, the government could expand the FDA's role to include the existing gray area of mHealth apps: programs that qualify as devices but are believed to pose less risk because they track attacks, check symptoms, or involve behavior modification for patients with psychiatric conditions, the Journal article said.
Some devices, which now fall under the discretionary category of exempt products, according to FDA guidelines, could create consumer confusion or a false sense of comfort (or worry). Some apps the FDA approved are considered "substantially equivalent" to earlier devices; at times, an earlier device may refer to something developed before apps became available, Cortez wrote.
The FDA is acting appropriately to safeguard consumers and provide users with plenty of new options, Jeffrey Shuren, director of the FDA's Center for Devices and Radiological Health told The Hill.
"We have worked hard to strike the right balance, reviewing only the mobile apps that have the potential to harm consumers if they do not function properly," he said. "Our mobile medical app policy provides app developers with the clarity needed to support the continued development of these important products."
Complementary options include sites featuring independent reviews by medical professionals or healthcare organizations' use of enterprise app stores that include only tested and validated apps. It's unlikely many of the following apps will appear in those stores. Click the first slide to find out more.
Suffer from migraines, fibromyalgia, or chronic pain? Several developers claim their apps help allay these conditions, much to the concern of some medical professionals. "Pain apps appear to be able to promise pain relief without any concern for the effectiveness of the product, or for possible adverse effects of product use. In a population often desperate for a solution to distressing and debilitating pain conditions, there is considerable risk of individuals being misled," according to researchers at the Centre for Pain Research, University of Bath, England.
Today, consumers can choose apps like Pain Killer 2.0, which claims: "If you have chronic pain or ANY pain -- you need this. Put your headphones on and tap Start. Your pain melts away in minutes. It's that easy." Or they could select Pain Relief 2.0, PainKill Free WellWave, which has "beneficial sounds for pain relieving," or Headache Rife, which uses color and sound to target headache pain.
(Source: PainKiller 2.0)
A 99¢ app heralded as a way to treat chronic ringing in the ears was, apparently, too good to be true. Inner Ear Solutions began offering iTinnitus Solutions in 2010 via iTunes. The app used "validated sound therapy techniques applied to dynamic tinnitus tracking [to] improve the degree of perceived tinnitus." The program helps users mask and inhibit the ringing, the developer said.
However, at least one medical site and some sufferers were skeptical. Wrote Dr. Satish Misra in iMedicalApps: "Let's be clear -- I'm all for innovative solutions to medical problems. But I think this will prove to be a gimmick, which at best will cause unsuspecting patients to waste a dollar or at worst convince patients to attempt to self-treat rather than visiting a physician to receive real care for their condition. I'd love to be wrong about this and see even a small trial suggesting this iPhone based therapy works. But I'm not holding my breath."
The app is no longer available on iTunes.
(Source: Inner Ear Solutions/Photobucket)
Last year, the FDA wrote to BioSense Technologies wondering why its uChek urinalysis system had not gone through the FDA's approval process. Users dip special, FDA-approved strips in urine and use the smartphone's camera to check levels of glucose, protein, ketone, and other measures, according to the developer. The app, used in conjunction with a color-coded mat, compares strip colors against swatches to analyze users' results.
Startup Petnostics targets pet owners with a similar approach. Owners collect a sample from their dog or cat, (using the company's $14.99 cat litter) using Petnostics' urine collection cup ($14.99 for one) that features "colormetric chemical" test strips. Using the developer's free iOS app, the app "will inform pet owners whether the animal has any potential diseases or ailments, such as a urinary tract infection, dehydration, or diabetes," wrote company founder Stephen Chen, in a blog.
(Source: Petnostics)
When researchers at the University of Pittsburgh tested several apps that claimed to detect skin cancer, they found three out of four apps incorrectly classified 30% of melanomas as "unconcerning" -- potentially putting those users at risk if they did not pursue medical care after this digital diagnosis. The best-performing app missed almost one-third of melanoma cases. The worst caught only 2%, according to dermatologist Dr. Laura Ferris, who co-authored the report.
There are several free and inexpensive apps available that go beyond tracking consumers' skin. Mole Detective ($4.98), for example, claims to use the "dermatologist ABCDE method and gives you a risk factor based on the symptoms your mole may or may not be showing." Doctor Mole ($4.99) "uses advanced real-time computer vision technology to scan your moles in real time and give you instant risk feedback on Asymmetry, Border, Color, Diameter and Risk (ABCDE)."
(Source: Doctor Mole)
Some apps claim they can help would-be parents have a child or choose their baby's gender -- and that worries the American Fertility Association, which hopes people don't use these apps to avoid having a child who risks a gender-specific genetic condition. Some might lead to nutritional, psychological, or emotional issues if they don't deliver on their promise.
The StorkDiet app, for iOS and Android, says it uses "a specific maternal diet and conception timing" to help determine a child's gender. The $9.99 app, which recommends women see a doctor before beginning the program, comes in boy and girl versions, and includes special diets based on the chosen gender.
(Source: StorkDiet)
Apps designed to monitor vitals, such as heart rate, can lull patients into a false sense of security or set off unnecessary alarms, said Dr. Satish Misra, managing editor of iMedicalApps on the New England Center for Investigative Journalism website.
CardioMood is designed to evaluate users' stress levels and estimate the health of their hearts, the developer said. The free app, which requires a heart sensor, analyzes users' energy levels -- "good for fitness," the site said. Usually, however, fitness experts recommend people undergo a doctor's physical exam before beginning a new exercise regimen. Cardiograph measures and tracks users' heart rates, and Skeeper uses "sound processing technology" so users can listen to their own heartbeats.
(Source: CardioMood)
Apps that claim to measure users' blood pressure without a cuff can be dangerous if consumers believe the numbers they show and, as a result, don't seek professional help.
Search "measure blood pressure" on Google Play or Apple iTunes and you'll find plenty of free and paid options that require only an app and smartphone. While some are useful -- they help consumers track their blood pressure measurements when taken from legitimate medical devices -- others, including Instant Blood Pressure ($3.99) and Instant Blood Pressure Pro ($1.99), could place someone in the emergency room, warned Dr. Iltifat Husain in Wired.
(Source: Instant Blood Pressure)
When the developers of Acne App and Acne Pwner claimed their Android and iOS apps treated acne, the Federal Trade Commission wanted evidence. When it didn't get the proof it needed, in 2011 the FTC told the developers to stop selling the apps, which used colored lights emanating from a smartphone that users held up to the affected areas of their face.
The FTC ordered Koby Brown and Gregory Pearson, doing business as DermApps, to pay $14,294, and Andrew Finkle, doing business as Acne Pwner, to pay $1,700.
(Source: Niels Olson/Flickr)
Those who fear spiders, flying, open spaces, or leaving their homes can seek help from apps that claim to treat myriad phobias. For $3.99, Phobia Free, for example, uses systematic desensitization to help those with arachnophobia and stress, and is working on an app for agoraphobics. It's only available for iPhone, though an Android version is under development.
Likewise, Overcome Phobias by British hypnotherapist Glenn Harrold -- available for $5.99 iOS and Android, claims to help listeners cope with many fears, including heights, flying, dentists, claustrophobia, needles, snakes, social situations, and even obscure phobias.
While self-help -- through apps, books, videos, or other media -- may help, individuals with crippling phobias require professional assistance, analytical psychologist Elizabeth Gray told the BBC. Patients need professional help determining the cause of a phobia before they can truly be considered cured, she added.
(Source: Phobia Free)
Early studies indicate people who receive encouraging text messages while quitting smoking are more likely to succeed than those who don't get the electronic missives. Yet apps that promise to help smokers stop reaching for their cigarettes are typically less useful, according to a study of 47 apps in 2009. While the study is old, apps failed because they did not follow "evidence-based practices for smoking cessation," the paper said.
Many apps in this category simply track cigarettes, cravings, and dollar savings, and educate users about the health benefits of quitting. Several -- like Quit Smoking, Quit Smoking Hypnosis, and Stop Smoking! use variations on self-hypnosis, which appears to work on some users. But Alchemy's Quit Smoking Free uses noise to negate nicotine cravings, the developer wrote.
The Google Play description says: "With this app, the speaker will emits special beeps that relaxes the 'Nicotine hungry' of the body. You can keep the volume of this app very low (subliminal) and it will give the same effect. Specific audio waves are produced by this application, they transmits the body a feeling of contentment. This audio signals stimulates brain waves of fulfillment and stops body addiction of nicotine. Do not play this app before meals, it can reduce the normal appetite."
(Source: Quit Smoking Free)
Early studies indicate people who receive encouraging text messages while quitting smoking are more likely to succeed than those who don't get the electronic missives. Yet apps that promise to help smokers stop reaching for their cigarettes are typically less useful, according to a study of 47 apps in 2009. While the study is old, apps failed because they did not follow "evidence-based practices for smoking cessation," the paper said.
Many apps in this category simply track cigarettes, cravings, and dollar savings, and educate users about the health benefits of quitting. Several -- like Quit Smoking, Quit Smoking Hypnosis, and Stop Smoking! use variations on self-hypnosis, which appears to work on some users. But Alchemy's Quit Smoking Free uses noise to negate nicotine cravings, the developer wrote.
The Google Play description says: "With this app, the speaker will emits special beeps that relaxes the 'Nicotine hungry' of the body. You can keep the volume of this app very low (subliminal) and it will give the same effect. Specific audio waves are produced by this application, they transmits the body a feeling of contentment. This audio signals stimulates brain waves of fulfillment and stops body addiction of nicotine. Do not play this app before meals, it can reduce the normal appetite."
(Source: Quit Smoking Free)
-
About the Author(s)
You May Also Like