by Nancy Ryerson
, Staff Writer | January 22, 2013
Your phone might be right about the weather, but don't trust it when it comes to your health. Three apps that claim to diagnose skin cancer by analyzing a user-provided picture were found to mis-classify at least 30 percent of cancerous lesions as benign, a new study from the University of Pittsburgh found.
The study, published online January 16 in JAMA Dermatology, sought to discover the efficacy of dermatology smartphone apps. The team evaluated four unnamed apps that allowed users to upload a picture of a mole or lesion they were concerned about. Three of the apps used an algorithm to identify the lesion, while one sent the image to a real dermatologist to evaluate it and send results back within 24 hours.
A total of 188 lesions, 60 of which were cancerous, were evaluated using the four apps. The three apps that did not involve a dermatologist all missed 30 percent or more of melanomas. The fourth app correctly identified 98 percent of melanomas, but costs $5 per diagnosis; the other apps ranged in cost from free to $4.99 for unlimited diagnoses.
While the apps contained disclaimers that they were for "educational use only" and should not be used to replace a doctor's visit, the study authors were concerned that users would still take the results as medical advice.
"This potential is of particular concern in times of economic hardship, when uninsured and even insured patients, deterred by the cost of copayments for medical visits, may turn to these applications as alternatives to physician evaluation," the study analysis said.
The study notes that because skin cancer is often self-identified, leading to a doctor's visit, it's especially dangerous for an app to delay important early diagnosis.
There are more than 13,000 health care apps available for consumers, the study says, many of which are everyday programs like calorie counters or fertility calendars. Apps for doctors are sometimes evaluated by medical journals, and the FDA regulates clinical apps that are already associated with medical equipment, like radiologic imaging devices.
But most consumer apps don't go through any scrutiny beyond a few customer reviews. In June 2012, Congress passed an act that will allow the FDA to regulate some medical apps on smartphones, but the results of that act are not yet clear.
The study calls for increased regulation of health apps, especially those that claim to diagnose.
"Technologies that improve the rate of melanoma self-detection have potential to improve mortality due to melanoma and would be welcome additions to our efforts to decrease mortality through early detection," the authors wrote in the study's conclusion. "However, extreme care must be taken to avoid harming patients in the process."
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