Scimex: A debate between US and UK scientists has looked at the benefits and
pitfalls of health apps. One researcher writes that the apps have the
potential to encourage better health and habits, while the second refers
to the lack of evidence saying the apps are effective, raising the
question as to whether they might cause unnecessary anxieties. Health apps have the potential to make a broad impact on the health of
the general population, argues one expert. But another explains that
there is not enough evidence to support such claims and suggests that
health apps may even be harmful.
Widely available on smartphones, health apps aim to encourage people to
adopt healthy behaviours ranging from weight loss to physical activity,
and to help patients to manage conditions such as diabetes and high
blood pressure.
Health apps have been around for more than 10 years and tens of
thousands are available on smartphones, making them easy to access and
use.
Some have been shown to improve health outcomes and have "great
potential to reduce morbidity and mortality," argues Iltifat Husain,
editor of iMedicalApps.com, and assistant professor of emergency
medicine, Wake Forest School of Medicine, North Carolina, USA.
He notes two randomised controlled trials that have demonstrated that
weight loss apps on traditional personal digital assistants increased
compliance and improved weight loss when compared to traditional
programmes.
While health apps are relatively new to researchers and few studies
exist to demonstrate positive outcomes, doctors should not wait for
scientific studies to prove benefits because these have already been
shown and many people are currently using these in large numbers, he
argues.
Despite no evidence of harm, there still may be drawbacks of using
health apps and research has demonstrated some conflicting results, he
adds. For example, research has shown that the fitness apps "Fitbit" and
"Jawbone" accurately count users' steps and physical activity, but
results did not find improved outcomes or exercise rates.
Many apps have not been tested and may not be useful or effective, he
notes. He explains that the US Food and Drug administration only
regulates apps that turn smartphones into medical devices so industry
can sell untested apps or make unvalidated health claims.
He calls on doctors to take a proactive approach and recommend apps which can help people to stay healthy.
In a second article, Des Spence, a general practitioner, argues that
most health apps are "mostly harmless and likely useless", but he warns
of the rise of apps used alongside wearable devices that monitor heart
rate, blood pressure and so on.
These are untested and unscientific, and play on the fears of an
"unhealthily health obsessed generation", he explains, adding that these
can "ignite extreme anxiety" and "medical harm" through overdiagnosis
of health conditions.
Medical technologies are already overused for magnetic resonance imaging
and blood tests, for example, and "we should be sceptical of more
medical technology," he cautions.
The series of articles includes a personal commentary by a healthy user
of a health apps. Sylvia Warman, an office based worker in London,
describes her daily experience of using the fitness app "FitBit One", a
pedometer that measures the number of steps taken and monitors sleep
patterns.
Warman writes that she finds the app easier to use than traditional
pedometers, and can see averages, make comparisons, and measure calories
burnt. As a result, she has become more active on a day-to-day basis.
She also documents her sleeping patterns, and explains that the app
links to others to compare walking routes, and record food and alcohol
intake. Consequently, Warman abstained from alcohol use for six weeks as
an experiment and found that this helped her to sleep better. She has
also improved her diet.