iMedicalApps editors challenge medical app developers to improve quality in JAMA Dermatology article

iMedicalApps is a proponent of mHealth and the utilization of mobile apps in healthcare amongst medical professionals and patients.

Medical apps can be valuable clinical references at the point-of-care with the potential to improve efficiency and quality of care; in addition, patients are increasingly adopting apps for personal health management. On the heels of a recently published study looking at apps related to melanoma, iMedicalApps editors sought to bring more attention to this issue in a Viewpoint publication in JAMA Dermatology.

At this current time, the creation of mobile medical applications has a low-barrier to entry due to the app store reviewing process.

While this can be a positive factor for encouraging rapid development of apps, it may also lead to poor app quality and design.

As recent research has demonstrated, many apps lack the authority necessary to guide practice and provide a level of care currently accepted. This is due in part to a lack of evidence to back up the information provided within the apps, lack of medical involvement in the creation of apps, and poor design to execute desired outcomes.

One example includes recent studies demonstrating poor efficacy in the detection of melanoma. Perhaps, the best example is the study by Wolf et al. in JAMA Dermatology. The study demonstrated such a large range of sensitivity and specificity that it becomes questionable whether these apps should be available on the market.

As mentioned by one of our Editors, Dr. Satish Misra, in this article, due to the fact that early detection of melanoma is key, if patients using these apps are not seeking proper medical attention due to an app, there could be some negative outcomes. Presently, there is no data to demonstrate that apps may lead to poor outcomes; however, this possibility cannot be denied.

iMedicalApps editors sought to address this issue in a viewpoint at JAMA Dermatology. We urge clinicians to properly educate their patients about medical apps, and we encourage developers and medical organizations to stake a claim in creating high quality applications through our proposals of areas that need to be addressed.

This is a necessary endeavor that must be carried out in order to safeguard patients from potential negative outcomes and ensure the best utilization of available technology. Issues that could arise if steps are not taken could be due to medical practitioners that use faulty information from an application that was not carefully created to serve their needs with accurate information, or as mentioned above, screening tools for the public that may dissuade patients from seeking proper medical attention.

It is our hope at iMedicalApps that as more research is published and greater attention is drawn to this nascent market, the medical community and developers may work together to address the current downfalls of the mobile medical application market. They would do this to ensure that the high expectations being set are reached. May we all work together toward such a goal.

1. Wolf JA, Moreau JF, Akilov O, et al. Diagnostic inaccuracy of smartphone applications for melanoma detection. JAMA Dermatol. 2013;149(4):422-6.
2. Misra S, Lewis TL, Aungst TD. Medical application use and the need for further research and assessment for clinical practice: creation and integration of standards for best practice to alleviate poor application design. JAMA Dermatol. 2013;149(6):661-2.


Timothy Aungst, PharmD

Digital Pharmacist seeking to integrate technology and mHealth into pharmacy practice and patient care. Assistant Professor by day, blogger and writer by night.

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3 Responses to iMedicalApps editors challenge medical app developers to improve quality in JAMA Dermatology article

  1. Mel Hernandez August 1, 2013 at 11:29 am #

    And how about your reviews of several mole detection apps endorsing to some extent their use, after no sound clinical testing ?

  2. Tom Lewis August 4, 2013 at 8:03 am #

    I think you raise an interesting point, I think that studies like the original Wolf et al. prove that apps to be used in clinical settings do require some kind of formal clinical research evaluation which we (at iMedicalApps) currently do not provide. Arguably apps with poor quality standards may not be immediately apparent at the time of initial review. An interesting example of this is the range of opiate conversion apps available which individually do not raise many concerns however when combined together as a group, it is clear there are many inaccuracies.

    In regular medicine, there are lots of conclusions drawn which are subsequently changed when further evidence comes to light and I don’t see why that should be so different in medical apps.

    With specific regards to the mole detection apps, one term used was ‘remarkably good at detecting malignant lesions’ which is perhaps interpreted as a formal recommendation and endorsement. However there are certainly plenty of other sections in the articles which argue that these particular apps are untested, need further assessment and do not replace the opinion of a qualified healthcare professional.

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