What's the Evidence that Health Apps Work? A Scoping Study of Evidence of Effectiveness for Direct-to-Consumer Apps on the App Store
23 Pages Posted: 15 Jun 2021
Date Written: May 22, 2021
‘First, do no harm,’ is the cornerstone of contemporary Western medical ethics. The practice of evidence-based medicine supports this principle by advocating for the full and timely publication of all studies examining effectiveness and safety of different interventions and treatments. Given how important robust and valid evidence is to upholding the first-principle, it is surprising that policymakers, regulators and legislators appear to have paid so little heed to the way in which new technologies – particularly digital health interventions (exemplified by health apps which make claims of efficacy) – are changing the value, nature and reliability of medical evidence. Individuals are being encouraged to become ‘empowered’ to manage their own health through the use of often poorly evidenced and barely governed digital health interventions (health apps). This raises questions of trust and has the potential for widespread direct or indirect harm. In order to contribute to this task, the article sets out to establish the baseline quality of evidence available to support the claims made by apps on the Apple App Store. It does so by conducting a scoping study of the evidence available to support a purposive sample of apps on the Apple App Store. The results show that the evidence available to support the claims made by the health apps analysed is often unavailable or of questionable quality. The article concludes with X=number specific actions that should be taken to improve the quality of evidence available for health apps and thus protect individuals and groups from harm.
Keywords: Digital health; digital ethics; medical ethics; health apps; evidence-based medicine
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