Technology makes it increasingly possible to self-manage our healthcare, but whilst there has been huge growth in the number of apps and tools available to support us, the quality of those tools varies considerably.

A recent study led by the University of Sydney examined the market for self-management of back pain.  It found that there was little guidance offered to users on the best apps to use, and the apps themselves were often poor quality with little clinical scrutiny applied to them.

61 different apps were analyzed across their content, quality, functionality and the evidence-based interventions they recommended.

“Treatment guidelines often recommend self-management for the symptoms of back pain, and mobile apps can represent a useful and convenient way to help people manage their own condition, however, consumers need to be aware that there is minimal regulatory control over their content,” the authors say.  “In this study, apps generally offered questionable and poor quality information, lacked engaging and customisable features, and had poor visual appeal and questionable credibility.”

The researchers were particularly scathing about the quality of information provided, with few of the apps directly tested for effectiveness.  What’s more, the ratings given by users of each app were also little indication of the overall quality of the app, although there did appear to be more correlation between the price of the app and its effectiveness, with paid apps tending to be higher quality.

“App developers need to work closely with healthcare professionals, researchers, and patients to ensure app content is accurate, evidence based, and engaging to improve the quality of existing apps for low back pain,” the researchers say.

Shaky ground

Alas, a second study suggests that things are barely any better with other personal medical devices.  A team from the University of Alberta examined the leading home blood pressure monitors and found that the readings are widely inaccurate in at least 70% of them.

“High blood pressure is the number one cause of death and disability in the world,” the authors say. “Monitoring for and treating hypertension can decrease the consequences of this disease. We need to make sure that home blood pressure readings are accurate.”

The researchers tested a few dozen home monitors, with the vast majority failing to get within five mmHg, with many off by 10 mmHg.  Given the number of people that are asked to monitor their blood pressure from home, the results are worrying. What’s more, the devices also seemed to be less accurate in men than in women, potentially due to differences in size and shape of the arm. Thankfully, the team are optimistic that steps can be taken to improve matters.

“Compare the blood pressure machine measurement with a blood pressure measurement in clinic before exclusively relying upon home blood pressure readings,” they say. “What’s really important is to do several blood pressure measurements and base treatment decisions on multiple readings. Taking home readings empowers patients and is helpful for clinicians to have a bigger picture rather than just one snapshot in time.”

Taking readings in isolation however seems to be fraught with peril, and the authors urge both clinicians and users not to base decisions on isolated readings.  They also suggest that more work needs to be done by both industry and academia to ensure that future devices are as accurate as possible.