Health Apps Are Potentially Dangerous

The “Inappropriate Touch Screen Files” has documented many cases of poor design of mobile and wearable apps, and I have pointed out more than once the bogosity of unvalidated cargo cult environment sensing.

This month Eliza Strickland writes in IEEE Spectrum about an even more troubling ramification of these bad designs and pseudoscientific claims: “How Mobile Health Apps and Wearables Could Actually Make People Sicker” [2].

 Strickland comments that the “quantified self” craze has produced hundreds of thousands of mobile apps to track exercise, sleep, and personal health. These apps collect and report data, with the goal of detecting problems early and optimizing exercise, diet, and other behaviors. Other apps monitor the environment, providing data on pollution and micro climate. (And yet others track data such as hair brushing techniques.)

These products are supposed to “provide useful streams of health data that will empower consumers to make better decisions and live healthier lives”.

But, Strickland says, “the flood of information can have the opposite effect by overwhelming consumers with information that may not be accurate or useful.

She quotes David Jamison of the ECRI Institute comments that many of these apps are not regulated as medical devices, so they have not been tested to show that they are safe and effective.

Jamison is one of the authors of an opinion piece in the JAMA, “The Emerging Market of Smartphone-Integrated Infant Physiologic Monitors[1]. In this article, the authors strongly criticize the sales of monitoring systems aimed at infants, on two grounds.

First, the devices have not been proven accurate, safe, or effective for any purpose, let alone the advertised aid to parents. Second, even if the devices do work, there is considerable danger of overdiagnosis. If a transient and harmless event is detected, it may trigger serious actions such as an emergency room visit. If nothing else, this will cause needless anxiety for parents.

I have pointed out the same kind of danger from DIY environmental sensing: if misinterpreted, a flood of data may produce either misplaced anxiety about harmless background level events or misplaced confidence that there is no danger if the particular sensor does not detect any threat.

An important design question in these cases is, “is this product good for the patient (or user)”?  More data is not better, if you don’t know how to interpret it.

This is becoming even more important than the “inappropriateness” of touchscreen interfaces:  the flood of cargo cult sensing in the guise of “quantified self” is not only junk, it is potentially dangerous.

  1. Christopher P. Bonafide, David T. Jamison, and Elizabeth E. Foglia, The Emerging Market of Smartphone-Integrated Infant Physiologic Monitors. JAMA: Journal of the American Medical Association, 317 (4):353-354, 2017.
  2. Eliza Strickland, How Mobile Health Apps and Wearables Could Actually Make People Sicker, in The Human OS. 2017, IEEE Spectrum.


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