iMedicalApps » App Store

Medical section for iPhone is plagued by non-medical apps

Iltifat Husain — Thu, 01 Jul 2010 08:02:39 +0000

There are well over 3,000 apps in the “medical” section of the App Store for the iPhone. Unfortunately, a growing number of them aren’t medical apps. It’s already difficult enough to parse through the litany of apps available to find quality apps – and then when you add apps that shouldn’t even be in the medical category, it makes the job that much harder.

Lets start with the “top 10 downloaded free iphone medical apps” in the App Store. Notice how the word “downloaded” is in bold. By no means do we think these apps are the best free iphone medical apps – we’ve already chronicled that list in another post.

These are the top 10 downloaded free medical apps in the App Store: Medscape, Sex-Facts, Epocrates, Medpage Today, Marijuana Truth, iAugment, Dream Meaning, Medical Encyclopedia, Body Systems – Anatomy Quiz, and Best Diet foods. Note, Medscape, Epocrates, and Medpage Today are extremely legitimate apps – they even made our top 10 free iphone medical apps list. Sex-Facts, Marijuana Truth, iAugment, Dream Meaning, and Best diet foods will never make any top 10 list of ours.

By our calculations, 12 of the top 25 downloaded medical apps, 48 percent, are mis-categorized and should not be in the medical section. So we looked into this a bit further.

What about the “paid” medical apps section. Surely the paid section would be more populated with apps in the right section – and it was. But again, some very odd choices for “medical apps”. Emergency radio, the 6th most downloaded paid medical app, and Police radio, the 17th most downloaded paid medical app, should clearly not be in the medical section of the App Store. It seems as if the developers threw in the word “EMT”, and Apple figured it sounded “medical enough”.

It’s not as if these apps don’t have other sections they could go in. There are 20 other categories in the App Store, and the apps I mentioned at the beginning could clearly go into the healthcare section.

As the App Store continues to grow at a rapid rate, it would be great if Apple did some housekeeping, and fixed its categories, or at least defined them better. The longer they let apps that shouldn’t belong in the medical section blossom, the more cumbersome the process of going through the apps becomes. Let’s hope this happens sooner than later.

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Acne “treatment” apps could be taking advantage of patients

Satish Misra, MD — Wed, 19 May 2010 11:00:41 +0000

Getting a new medication or medical device approved in the United States requires embarking on path so nightmarish it makes Dante’s Inferno look like the yellow brick road. And while most clinicians and bureaucrats would agree that we need to find a better way, its not hard to imagine how we ended up with such a complex regulatory structure. Going back over 2,000 years to the Hippocratic Oath, the practice of medicine has rested largely on two principles – beneficence and non-maleficence. The latter refers to the idea that we, as clinicians, first do no harm while the former requires that we act foremost in the best interest of the patient. In attempting to uphold these principles, we have created an enormous regulatory structure intended to act as a sieve allowing only those interventions of proven benefit to reach the general public.

I don’t claim its anywhere close to a perfect system. And as there are enormous amounts of money at stake, often involving a very vulnerable group of people, its our responsibility to stay vigilant against those who attempt to manipulate the system as well as treatments that are of questionable value. And there are a small group of app developers whose apps may fall into the latter category with claims to treat acne with light – well, that is unless a patient is willing to hold their iPhone to their face for the next 100 years.

Acne is an incredibly common condition which can significantly degrade quality of life. Up to 10% of Americans experience forms severe enough to leave permanent physical and psychological scars. While many therapies exist, escalation of therapy often involves significant risk. One emerging therapy is in phototherapy – basically using specific wavelengths of light to treat the skin. With a minimal side effect profile, results are promising. A recent review in the British Journal of Dermatology describes a number of small trials that show lesion reduction after treatment with phototherapy. For example, one trial found a blue-red light combination treatment to be more effective than a common topical treatment. Another found no difference between blue light treatment and a topical antibiotic. Its important to note that these trials were small and often poorly controlled, so the best conclusion that can be drawn is that these therapies are promising and warrant further study.

However, at least two app developers have decided to go ahead and bring this therapy to market – FunVid Apps with Acne Light Waves and Archibald Industries with Acne Away Premium. For $2 or $5, respectively, they claim that acne sufferers can watch their acne disappear in as little as 3 days simply by holding their iPhones to the affected area for as little as 1 minute twice a day. Wow!

When I first saw these apps, I was skeptical but decided to give them the benefit of the doubt. Surely, they would back up these claims with some evidence suggesting it works. Unfortunately, the website links on iTunes just go to the developer pages where the apps are not even mentioned. No luck here.

Then I thought maybe the developers had almost stumbled onto a low-cost, effective treatment for acne and further study would vindicate these apps. So I decided to compare the phototherapy these apps provided with that provided in one of the clinical trials. Unfortunately, the dosing of light in these trials is measured in irradiance (J/m2) and the only description of light output I could find for the iPhone was in illuminance (llux/umens) – the key difference between the two is that illuminance is more a measure of what our eyes perceive while irradiance is more a measure of the energy carried by the light. So at best, there is currently no way to show that the iPhone is even capable of delivering the doses of light that have been shown to have some effect in our small trials. At worst, based on my calculations, it would take over 100 years to achieve the same dosage of energy used in a single treatment in one trial of blue light phototherapy (see below for details on calculations).

So where does that leave us? Phototherapy is an unproven but promising medical therapies aimed at managing a condition with potentially severe physical and psychological consequences. I suspect these apps are likely cheap knockoffs of potentially beneficially therapy while providing no supporting evidence of their own.

Knowing that some medical therapies of acne make skin photosensitive, these apps are potentially harmful to patients who use them without a physicians knowledge. In addition, they more than likely provide no benefit to a patient suffering from acne. While these developers do not claim to be medical professionals, they do claim to treat a medical condition and should be held to the same Hippocratic standards that we hold all others in the medical field.

As such, I hope that one of two things would happen here. My preference would be that someone, preferably the developers, prove me wrong – give me some reason to believe that a reasonable argument could be made that these apps are effective. I promise I’d happily recant everything I’ve said. Otherwise, I hope someone – the developers themselves or Apple – pull these apps out of the app store, thereby preventing vulnerable patients on wasting their money on what is likely just a glorified mood light.

Appendix: What follows is the result of my attempt to convert the 207 lux output of the iPhone into an estimate of its irradiance. I include it only in the hopes that someone with a stronger physics background will either confirm or correct my calculations. At 207 lux and a screen area of 0.00425 m2, the illuminance of the iPhone screen is 0.87975 lumens. Using the phototopic luminosity function value of 0.1 at a wavelength of 420 nm, which is used in at least one trial of blue light, the conversion factor for a narrow band light would be 6830 lm/(W/m2). The irradiance would therefore be 0.00012881 W/m2 or 0.000000012881 W/cm2. So to reach the 40 J/cm2 per treatment that was used in the above referenced trial, it would take 126 years.

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How to sync the right user with the right medical app for their iPhone, iPod Touch, and the upcoming iPad

Satish Misra, MD — Mon, 01 Feb 2010 02:33:25 +0000

With over 100,000 apps available for the iPhone/iPod Touch and billions of downloads since the App Store opened just under two years ago, the market is clearly hot. And with the release of the iPad, expect a new flood of apps into the market. However, a recent article in the New York Times suggests that even with the wealth of options, people generally use only five apps despite having downloaded far more.

The average iPhone or iPod Touch owner uses 5 to 10 apps regularly, according to Flurry, a research firm that studies mobile trends. This despite the surfeit of available apps: some 140,000 and counting.

Another finding that the article notes is that even thought hundreds of thousands of apps are available, the entire user group is generally exposed to the same few thousand apps.

A survey of iPhones, iPod Touch and Android users conducted in July 2009 by AdMob, an advertising network that helps people promote their applications on smartphones, found that people discover apps most often by browsing app stores. And even though the iTunes store is bloated with offerings, people tend to gravitate to the most popular….
“…The top apps featured at the store do change out,” Mr. Putney said. “But most users will never see more than 1 percent of the total apps available.”

These findings are important for iPhone/iPod Touch/iPad users, app developers, and even us here at iMedicalApps, and here’s why. For users, this means that finding the best apps requires some work – a conscious effort to search the app store for things that interest you. That includes looking beyond the most popular medical apps. For developers, this means that reaching potential customers requires finding ways to climb that popularity ladder. For the Malcolm Gladwell enthusiasts, this means finding the Mavens, Connectors, and Salesman (from Tipping Point) – basically the people with large social (or professional) networks who are most likely to adopt early and spread the message about your great app. And for us here at iMedicalApps, it means actively looking for that diamond in the rough, languishing at the bottom of the popularity rankings, and helping our readers discover useful apps they wouldn’t have seen otherwise.

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What Exactly are the App Store’s Medical Standards?

Iltifat Husain — Sat, 05 Sep 2009 04:59:00 +0000

Recently, I posted on a controversial healthcare application that claims to treat seasonal depression. In my post, I talked about the ridiculous app and wondered if the App Store approval process needed to be tweaked when it came to medical and healthcare apps. Then I started wondering if there are actual medical standards the App Store has in place. There was a nice write up done by PC World talking about how the lack of overall set standards are hurting developers and the end users. But what about medical standards in the App Store Approval process? That’ll be the discussion of this post.

PC World:

It’s OK to post an iPhone app that guides users to (legal) marijuana suppliers, but it’s not OK to post a goofy little app that turns the iPhone into a simulated pot pipe. What’s the difference? Beats me, but it’s becoming clearer and clearer that Apple’s App Store ayatollahs are way too heavy handed and need to lighten up. They are hurting consumers, developers, and ultimately, the company they’re supposed to protect.

The problem is Apple refuses to tell what the OVERALL standards clearly are. They have some set rules, but their approach to controversial issues is to handle them on a case by case basis. The lack of standards can clearly hurt when it comes to apps such as the "Blue Light Therapy" App.

The description of the blue light therapy app is in itself hilarious. (iTunes link). "…clinically proven to fight seasonal depression…." Then a the end "….not intended to diagnose, treat, or cure any disease…". So….Apple rejects goofy apps that mimic a hookah burning tobacco because it doesn’t meet their "standards", but an app that contradicts it’s purpose in it’s own description is totally okay? Interesting….

There is actually a nice site that describes a lot of the App Store rules and how the approval process works/doesn’t work. I searched the web trying to see if there were any sort of standards for Medical/Healthcare Applications submitted to the App Store but I couldn’t find any. If there aren’t even a set of clearly defined standards for the overall app store, then one would assume there definitely wouldn’t be any sort of of higher standards for healthcare or medical apps.

The beauty of the App Store is that anyone with an innovative idea can develop an application. At the same time, anyone with a shady idea, especially medically or healthcare related can develop an application as well. The problem with medical and healthcare apps is, it’s harder for people outside of healthcare to see if they are actually useful. Bringing more scrutiny to the Medical or Healthcare approval process could lead to bigger headaches and issues with an all too familiar slippery slope.

Medicine is a constantly changing field, and there are medical applications in the App Store that are clearly outdated. It should be up to healthcare provider to realize this and it would be too difficult for Apple to police these applications. They don’t exactly know what standard of care is. I don’t think

Apple needs to have a doctor or healthcare provider on their approval board, but for apps in the medical or healthcare category, why not have a simple link in the iTunes description where you can voice a complaint easily? Or better yet, why not reject apps that contradict their healing powers in their own description? Until then, we’ll be here trying to keep you up to date….

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