How to choose a health app

In recent times, the number of health apps and their usage has surged. While health apps can be useful, a poorly designed health app has the potential to cause harm. So how do you know if the app you’re downloading is trustworthy? If it contains reliable information? If it's safe? The following FAQ will provide some guidance.

What is a health app?

A health app is a piece of software designed to provide information, advice and feedback on health, fitness or wellbeing that you can download onto your smart phone or other mobile device.

Are health apps helpful?

Health apps have the potential to positively impact your health and wellbeing by encouraging lifestyle changes such as increased fitness and providing understandable health information. However, a poorly designed health app has the potential to cause harm. For example, some apps may provide incorrect advice or measurements which are unreliable.

Are all health apps equal?

Not all health apps are created equal. There is no legal requirement for health apps to meet any set criteria to ensure their credibility, reliability and security. In addition, there is limited rigorous, scientific evaluation about the safety and effectiveness of digital apps. 

Are health apps reviewed?

A few organisations have attempted to review health apps to provide users with some guidance, but with the huge number of health apps constantly entering the market, and existing apps undergoing upgrades periodically, it is near impossible to keep up. Therefore, it is important for you to have some idea of what to consider in a health app. The following tips provide some guidance. 

Points to consider when choosing a health app

Why do you need the app?

Health apps are generally designed to fulfil one or more of the following functions:

  • Provide health information and advice.
  • Track your personal health information, such as diet and physical activity.
  • Perform calculations and analyses, e.g. calculating insulin doses or analysing an image of a skin lesion.
  • Link to social media, e.g. sharing and comparing running times.
  • Provide entertainment for health purposes, e.g. carbohydrate counting games for people with diabetes.

When deciding on a suitable health app, it is important to have an idea of how you attend to use the app and to choose a few functions that are important to you. You will then be able to assess how well the app meets these functions, and this will also enable you to better compare apps with each other.

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Who is the app sponsored by?

Generally, apps that are sponsored by a reputable, independent organisation (such as a respected patient group, a medical school or university, nonprofit healthcare organisation, or government agency) tend to be more likely to be based on sound evidence. However, even these might not have gone through rigorous evaluation to determine that they actually work to change behaviour and improve health outcomes.

Be aware  that some organisations or companies may have an “ulterior motive”, for example, a pharmaceutical company who manufacturers a medicine related to the topic of the app.

Where did the app developers get their information from?

Since there is no legal requirement for health apps to meet any set or predefined criteria to ensure their credibility, it is important to check if the app mentions where the information provided comes from. Check whether the source is appropriate – such as a clinical practice guideline – and whether it is regularly updated. If you are unsure, it may be a good idea to talk to your health care provider.

Can I trust the information provided by a health app?

It is important not to base any treatment decisions based on the information from the app without first checking with your health care provider. For example:

  • do not change the dose of  your medicine on the basis of an app.
  • if the app takes physiological measurements, be aware that these may not be accurate and should not be relied upon.

Is the app content and advice suitable for New Zealanders?

Some health apps may not be very suitable for and relevant to New Zealanders.

For example, information related to the management of a health condition covered by the app may not be appropriate, or align well with New Zealand guidelines, if apps are designed for an overseas market.

Another area for confusion are the differences in measurements. In New Zealand, we use the metric system where weight is measured in kilograms and height in centimeters. Some countries use the imperial system where weight is measured in pounds and height in inches. Some apps provide the user with the option of choosing the settings of the measurements, but some don't and the conversion calculations may be challenging for some people.

Similarly, other measurements such as blood sugar and blood cholesterol are different in some countries. For example, in New Zealand, blood cholesterol is measured in mmol/L but in other countries it may be measured in mg/dL. These units of measurement are not identical and special calculations are required when converting from one to another.

Does the app record your data?

If an app records your data such as food intake, an exercise log, location data or health information, it is important that you assess the level of privacy and security of the app. Sometimes this information may be used to target advertisements to you.

How reliable are user reviews?

In most app stores, user reviews and ratings drive what you see in searches. The ratings you see are often gut or early reactions to the apps, as very few people go back and change their ratings on devices.

Learn more 

The following links provide more detailed information points to consider when choosing a health app:

Understanding mobile apps Consumer Information Federal Trade Commission
How to choose health apps North Caroline Health Info 
Choose Wisely: Selecting mobile health apps NMC Public Health Centre
The big problem with mobile health apps Medscape
Mobile health and fitness apps: What are the privacy risks? Privacy Rights Clearinghouse

References

  1. Upfront: Personal technology for health: curiosity or clinically useful? BPAC, 2015, December