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Usually, online searches in an app store only allow entering simple search terms without being able to use logical operations, i. Conclusion Which measures should developers and distributors implement to aid potential customers? If apps are to be perceived as serious and reliable offers for providing aid for medical and health related questions, it will be necessary to professionalize both the development of such apps as well as the way they are distributed.
This should concern all stakeholders alike and includes ensuring trustworthiness as well as reliability on the development side, but also easy discovery of apps in the stores for both professional users as well as laypersons on the store side by providing potential users with comprehensive information about the apps in a transparent manner. As far as possible, this transparency should mirror what has been established for other health related products.
These categories and criteria for inclusion and exclusion could for example be based on whether specific MeSH terms are matched or not. There should also be a rigorous review of whether appropriate categories have been assigned in order to prevent classifications that are either chosen out of ignorance or with the aim of increasing sales. Aside from observing regulatory aspects that also depend on the requirements of the involved jurisdictions , as previously mentioned by Albrecht and colleagues [ Albrecht, a ; Albrecht et al.
In contrast, medicine aims at providing a clear diagnosis and an appropriate therapy, and the purpose of medical apps should be to support this process.
A good differentiation between both types of apps can also server to heighten transparency since it makes it more obvious what an app can and may do. Developers are called upon and the store owners should encourage this to provide users with extensive and transparent information about their app that lets them more easily judge whether an app matches their needs.
This could for example be done based on a standardized reporting tool, e.
Applying these criteria is in the best interest of all stakeholders. Even high quality apps for common diseases must first be found by users and deemed trustable in order to obtain good ratings, which in turn will further raise their visibility and possibly generate higher revenue; for less common conditions as they are also found in endocrinology , due to their smaller user base, observing the aforementioned points is even more important.
What do users need to consider when searching for specific apps?
While applying a good search strategy is already half the job for identifying apps fitting the desired purpose, users should remain aware of many additional aspects before they place their trust in an app that may very well have a negative influence on their health in the case of patients or on their work and thus their patients for professional users. Although many of the apps we came across during our evaluation especially those performing some sort of calculation for diagnosis or therapy could be perceived as medical products — depending on the jurisdiction they are used in — and would thus have to undergo regulatory processes if their manufacturers had assigned them an official medical purpose, such a designation is rarely done: This would necessitate at least a basic conformity evaluation before such apps could be put on the market.
Nevertheless, there was only one diabetes management app where this was mentioned. Since there is no overseeing authority, private certification initiatives for medical apps are also not always reliable; a prime example for this was when Happtique suspended its health app certification program after an independent evaluation had found serious flaws in apps they had certified [ Misra, ]. Are there any inherent limitations and potential risks and are corresponding concerns adequately addressed by the manufacturer?
Is there any information about the information sources used to build the app, about who is responsible for the content authors and development developers , and about their qualifications?
What measures are taken to address data protection and privacy concerns? If the app records any data: do users remain in control of their data, are they asked for permission before anything is transmitted if at all and are they informed about their due rights?
Are appropriate measures taken to ensure secure storage and transmission encryption? Final remarks Despite the benefits mobile apps may offer for medical professionals and patients alike, many questions still remain open, e.
In this context, endocrinology related apps are no exception. Unfortunately, clear criteria for medical and health apps are lacking for all stakeholders, although there are many projects or initiatives that have this objective [ Albrecht, a ].
For apps where regulation applies, some of the risks may be mitigated but, as we noted in our attempt to determine how well the field of endocrinology is represented app-wise, regulation is currently rarely observed. Of all endocrinology related apps found in our evaluation, compliance with regulation was only stated for one app. We therefore advise that, until standardized mechanisms have been firmly integrated, for example, by better adapting the distribution process to the needs of the field, apps should be used with caution by medical professionals as well as patients.
We hope that the points mentioned above may be a building block in the process of professionalizing the distribution and use of medical apps. Footnotes Conflict of interest statement: The authors declare no conflict of interest in preparing this article.
Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. References Apps. J Med Internet Res e