An App a Day will (Probably Not) Keep the Doctor Away: An Evidence Audit of Health and Medical Apps Available on the Apple App Store

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NSTL
Springer Nature

外文摘要：There are more than 350,000 health apps available in public app stores. The extolled benefits of health apps are numerous and well documented. However, there are also concerns that poor-quality apps, marketed directly to consumers, threaten the tenets of evidence-based medicine and expose individuals to the risk of harm. This study addresses this issue by assessing the overall quality of evidence publicly available to support the effectiveness claims of health apps marketed directly to consumers. To assess the quality of evidence available to the public to support the effectiveness claims of health apps marketed directly to consumers, an audit was conducted of a purposive sample of apps available on the Apple App Store. We find the quality of evidence available to support the effectiveness claims of health apps marketed directly to consumers to be poor. Less than half of the 220 apps (44%) we audited state that they have evidence to support their claims of effectiveness and, of these allegedly evidence-based apps, more than 70% rely publicly on either very low or low-quality evidence. For the minority of app developers that do publish studies, significant methodological limitations are commonplace. Finally, there is a pronounced tendency for apps-particularly mental health and diagnostic apps—to either borrow evidence generated in other (typically offline) contexts or to rely exclusively on unsubstantiated, unpublished user metrics as evidence to support their effectiveness claims. Health apps represent a significant opportunity for individual consumers and healthcare systems. Nevertheless, this opportunity will be missed if the health apps market continues to be flooded by poor quality, poorly evidenced, and potentially unsafe apps. It must be accepted that a continuing lag in generating high-quality publicly available evidence of app effectiveness and safety is not inevitable: it is a choice. Just because it will be challenging to raise the quality of the evidence base publicly available to support the claims of health apps, this does not mean that the bar for evidence quality should be lowered. Innovation for innovation’s sake must not be prioritized over public health and safety.

外文关键词：

AuditDigital healthEvidence-based medicineHealth appsSoftware as a medical device

作者：

Jessica Morley、Joel Laitila、Joseph S. Ross、Joel Schamroth、Joe Zhang、Luciano Floridi

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作者单位：

Digital Ethics Center, Yale University, 85 Trumbull Street, New Haven, CT 06511, USA

Section of General Medicine, Department of Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06519, USA

Faculty of Population Health Sciences, University College London, Gower Street, London WC1E 6BT, UK

London AI Centre, Guy’s and St. Thomas’ Hospital, London SE1 7EH, UK||Institute of Global Health Innovation, Imperial College London, London SW7 2AZ, UK

Digital Ethics Center, Yale University, 85 Trumbull Street, New Haven, CT 06511, USA||Alma Mater Studiorum - Universita di Bologna, Via Zamboni, 33, 40126 Bologna, Italy

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出版年：

2025

DOI：

10.1007/s11023-025-09710-7

Minds and machines

ISSN：0924-6495

年,卷(期)：2025.35(1)

参考文献量106