Evidence gap: What we don’t know about health apps

Smart phones have changed our society in a myriad of ways, making it faster and easier to communicate with each other, conduct research, access entertainment, and navigate the world.

The health care industry has also capitalized on this new technology. Today, there are dozens of apps designed to help people improve their fitness, lose weight and monitor medical conditions. But do they actually work?

The truth is, there is very little scientific evidence on the use of health and fitness apps to monitor and treat disease, encourage exercise and promote healthy eating. Systematic reviews on mobile health apps have generally concluded that more data are needed.

For example, one review found some early indications that mobile apps can help improve nutrition, but concluded that we need more data to draw firm conclusions. Another found limited evidence that mobile apps can help patients manage chronic health conditions. And a third found that mobile phone messages may boost preventative health behaviors, such as quitting smoking, but more data are needed to know for sure.

The question remains, are these health apps worth our time? Last week, the British Medical Journal published an opinion article in which two medical doctors debate the benefits and drawbacks of healthy people using health and fitness apps.

In the article, Dr. Iltifat Husain, the editor of iMedicalApps.com, argues that well-designed apps hold the potential of reducing rates of sickness and death by encouraging users to adopt healthy behaviors. His web site reviews medical apps for doctors and has just launched a new site that evaluates consumer-based health applications so that doctors can recommend them to patients.

He wrote: “Health apps on smartphones are here to stay, and some at least have great potential to reduce morbidity and mortality by encouraging healthy behavior…And their low cost and availability means that they have the potential to benefit broad demographics. If we wait for scientific studies to prove the benefit of apps, we’re going to get left behind—not only by our patients who are already using them but also by the industry dictating which tools people should use.”

Dr. Des Spence, a primary care doctor in Scotland, argued the counter point. He made the case that health-tracking apps encourage healthy people to unnecessarily record their normal activities and vital signs, which can make them feel anxious or neurotic.

“The truth is that these apps and devices are untested and unscientific, and they will open the door of uncertainty,” Dr. Spence wrote. “Make no mistake: Diagnostic uncertainty ignites extreme anxiety in people.”

Unfortunately, the jury is still out on this topic. The good news is, there is no evidence that shows mobile health apps do any harm to those who use them. For more definitive evidence, we will have to wait for the research to catch up with technology.