Patient Centric App Review Series

App Reviewed: UMSkinCheck Version 1.1
Last Updated: June 20, 2012
Compatibility: iOS 4.0 or later
Requires: iPhone/iPad with camera, Android app is in the works
Reviewed on: iPad

Goals of app review:

  • Can this app provide education to users about skin cancer and assist them in documenting and following skin lesions over time?
  • Would physicians find it helpful to have patients utilize this app before they come in for skin checks?

Introduction:

According to the National Cancer Institute there will be 76250 new cases of melanoma in 2012 in the US and 9180 patients will die from the disease. Melanoma is curable only when found early in the disease process. The University of Michigan Multi-disciplinary Melanoma Clinic created this app to help identify early melanoma and increase chances of cure.

It also contains educational material regarding skin exposure and cancer.

On opening the app the first time there is an introduction to the “meat” of the app and a recommendation on how to use it. When beginning from this screen the user is taken to a “roller” to choose how often the self-exam will be repeated.

 

The app recommends repeating a skin survery every 60 days. The user can choose up to every 90 days and will be reminded to repeat it on that date.

The survey takes twenty minutes to complete  23 photos and the app recommends a partner to take the pictures. These are very intimate pictures and within the information section it advises the patient that the photos are not stored in the photo area of the device and that the app can be password protected.

Unless the user is 100% certain no one else will have access to the app, password protection is a good idea.

In addition to the skin survey, the user can photograph a mole to follow over time and pinpoint it on a body illustration using a “push pin”. A series of eight “yes or no” questions are asked, such as “does the lesion have sharp borders”. Depending on the answers, the user is reassured or instructed to discuss with their primary care doctor or dermatologist.

On the “About UMSkinCheck” page there is a short informational video regarding the purpose of the app. This page has a link to the user guide as well. On the “info” tab, there are clicks to melanoma characteristics with photos, as well as other skin cancers, information on being safe in the sun, and tips on sunscreen.

In the “Tools” section, the user can calculate risk of melanoma in the next five years based on eight characteristics. The source of this calculation is not given.


There is also a “Links” page which takes the user to the device browser and various skin-related sites including the National Cancer Institute and the American Cancer Society

Healthcare goals of app:

Since early detection is the only hope for surviving melanoma, this app attempts to address the issue by having the user perform their own skin survey and track lesions over time. It also has educational sun-related and skin cancer information.

Evidence to support goals:

The USPTF presently gives melanoma screening an “I” for insufficient evidence to recommend for whole body skin exam for the prevention of melanoma or other skin cancers. The most interesting study this reviewer found was a meta-analysis of several skin-cancer screening studies that appear to be at best inconclusive as to the benefit of skin cancer screening [1].

Most clinicians agree that particularly in high risk populations, skin screening may be cost effective and appropriate. There are several high-risk characteristics and having three or more of them increases personal risk to more than 20 times the general population[2].  

Price:

  • Free

Likes:

  • User interface is straightforward. Skin survey and lesion photography is well illustrated
  • Time intensive but very user-friendly. An iPad would be much easier for visualization of the skin and worrisome lesions than an iPhone, but the phone is easier for taking pictures
  • The app is new but supported by a multi-specialty melanoma clinic at a large university (University of Michigan) and an android app is in the making.
  • Password protected

Dislikes:

  • Unsure how practical it is to expect patients to do a 20-minute skin survey involving another person taking intimate photos every 90 days (much less the recommended 60 days by the app)
  • The reviewer was able to crash the app (unintentionally) and other users have had some issues with the photography portion of the app (its main focus). It would be exasperating to spend twenty minutes doing the photo survey and then have to reload the app, thereby losing all saved data

What providers would benefit from app?

  • Dermatology
  • Family Practice
  • Internal Medicine
  • Oncology

What patient would benefit from app?

  • This app would particularly benefit patients at higher risk for skin cancer

Conclusions:

  • UMSkinCheck was created for patients to use in partnership with their physician to detect skin cancers at their earliest appearance
  • Pros: well-designed, easy to use app that educates patients and has the potential to save lives
  • Cons: It is not difficult to use the app but it is very time intensive. Expecting patients to recheck a skin survey every 60 days may be unrealistic.
  • Anyone can use the app but may be particularly suited to individuals with multiple risk factors for skin cancer, particularly melanoma

Bottom Line:

UMSkinApp is loaded with good information, well-designed, well-executed and very user friendly. Although evidence is insufficient to recommend this app to the general population, clinicians could consider it in individuals at high risk of skin cancer, especially melanoma, a cancer that is difficult to treat in all but its earliest manifestations.

iTunes link

References:
[1] Helfand M, Mahon SM, Eden KB, Frame PS, Orleans CT. Screening for skin cancer. Am J Prev Med 2001;20(3S):47-58. http://archive.ahrq.gov/clinic/ajpmsuppl/helfand1.htm#section12
[2] Rigel  DS, Carucci  JA.  Malignant melanoma: prevention, early detection, and treatment in the 21st century.  CA Cancer J Clin.  2000;50:215–36.

Disclaimer:
This post does not establish, nor is it intended to establish, a patient physician relationship with anyone. It does not substitute for professional advice, and does not substitute for an in-person evaluation with your health care provider. It does not provide the definitive statement on the subject addressed. Before using these apps please consult with your own physician or health care provider as to the apps validity and accuracy as this post is not intended to affirm the validity or accuracy of the apps in question. The app(s) mentioned in this post should not be used without discussing the app first with your health care provider.