Bits Blog: Report Questions Whether Health Apps Benefit Healthy People

Photo Dr. Iltifat Husain is the editor-in-chief of iMedicalApps.com, a review site for medical professionals.Credit Wake Forest Baptist Health

Consumers looking to use their mobile devices to improve their health — or at least maintain their well-being — have tens of thousands of choices.

But if those consumers are already healthy, the apps won't necessarily do them any good, according to a new report in The BMJ, a British medical journal.

On Tuesday afternoon, for instance, the top 10 free health and fitness apps for iPhones included MyFitnessPal, a calorie counter and diet tracker; the FitBit activity tracker; Pacer, a pedometer and blood pressure tracker; and Period Tracker Lite, a menstrual-cycle tracker, according to data compiled by App Annie, an analytics firm.

For consumers with concerns of a more medical nature, apps in the Google Play store, among others, offer all kinds of advice, self-diagnosis and treatment. One is marketed as an HIV risk calculator, another is a self-described self-test for erectile dysfunction, and a third purports to offer home remedies for cold sores, colitis, conjunctivitis and constipation.

An article published in The BMJ on Tuesday evening, however, questions whether such consumer health apps provide any real health value to already-healthy consumers – and whether the apps could even cause harm by stoking unneeded anxiety among the worried well.

Doctors don't yet have definitive answers to these questions, partly because smartphone apps are so new and partly because government health authorities regulate consumer health apps at their own discretion, depending on the possible risks to users. As a result, many health and fitness apps lack rigorous clinical evidence to demonstrate they can actually improve health outcomes.

The medical journal article, titled "Can Healthy People Benefit From Health Apps?," lays out arguments for and against the apps by juxtaposing the opposing views of two doctors.

Arguing in favor, Dr. Iltifat Husain, the editor in chief of iMedicalApps.com, a review site for medical professionals, contended that some apps, by encouraging healthy behavior, could hold great potential to reduce the rate of illness and death.

"They can help people to correlate personal decisions with health outcomes," Dr. Husain wrote, "and they can help doctors to hold patients accountable for their behavior."

He recommended that doctors become more involved in educating the public on which health details to track and which apps to use. If doctors waited for scientific studies to prove the benefits of health apps, he added, they could lose their power to influence patients to "the industry dictating which tools people should use."

To provide a dissenting perspective, The BMJ enlisted Dr. Des Spence, a general practitioner in Glasgow. He argued that many health tracking apps encouraged healthy people to unnecessarily record their normal activities and vital signs — turning users into continuously self-monitoring "neurotics." He recommended people view these new technologies with skepticism.

"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."

Although both doctors agreed there was no evidence that health apps had caused harm, federal regulators in the United States have been cracking down on health apps that make deceptive claims — an issue with the potential to cause mistreatment or misdiagnosis of medical problems.

In 2011, the Federal Trade Commission accused the developers of two acne apps of falsely claiming they could treat acne by shining colored light onto users' skin.

This year, the agency accused two melanoma app marketers of deceptively claiming that their products could accurately analyze skin moles for the risk of melanoma, even in its early stages. Regulators said the marketers did not have sufficient evidence to support those medical claims.

"If an app claims to treat, diagnose or prevent a disease or a health condition, it needs to have serious evidence to back up those claims," Mary K. Engle, associate director of the F.T.C.'s division of advertising practices, said in a phone interview this year. "We hope marketers will take heed of that and do their homework before they get into the marketplace."

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