With a few swipes of her finger, Raquel Taylor can count calories, track her exercise and see how she's doing in reaching her target weight, thanks to a weight loss app on her smartphone.

 

Taylor, who works in financial services at the Georgia Department of Public Health (DPH), started using the app, SparkPeople, last May. She entered her height and weight, and the app calculated how many pounds she needed to lose to reach a healthy weight. Now, each healthy choice she makes earns her points in the app. So does reading the app's fitness or nutrition tips, which come from sources such as the American College of Sports Medicine and the National Institutes of Health (NIH), according to SparkPeople's website.

 

But how many of these apps actually produce results for their users?Surprisingly few are evaluated using the testing standards required for other medical devices and health aids. Many experts are calling for more rigorous testing of mobile health apps to determine their actual health effects and how they match up to developers' claims.

 

Taylor said she tried another weight loss app before SparkPeople, but it didn't really help her and she eventually lost interest. She said she likes SparkPeople a lot more, though her weight has gone down and up since she started using it.

 

"But it keeps me accountable," Taylor said. "And it's really kind of fun to use."

 

More people than ever are turning to their smartphones, tablets or other mobile devices to keep their health on track, sparking exponential growth in mobile health technology, or mhealth. Just over 20 percent of U.S. adults use some form of technology to track their health data, according to a Pew Research Center survey of more than 3,000 people published in January. A November 2012 Pew survey found that 19 percent of smartphone users have at least one health app on their devices.

 

Certainly the most popular types of mhealth are apps that track physical activity, diet and weight loss. But thousands also target a wide range of major medical conditions, such as diabetes, HIV and depression. In mid-2012, the U.S. Food and Drug Administration (FDA) counted 17,288 health and fitness apps and 14,558 medical apps on the market.

 

Patricia Mechael, executive director of mHealth Alliance, an organization that advocates for better research on mhealth platforms, said technology developers usually have good intentions when developing their health apps. They research their target audience and the medical condition or health behavior they are trying to address.

 

But once the app has been designed, Mechael said too few developers continue to evaluate how their app performs to see if it delivers the outcomes they thought it would.

 

"Without rigorous evaluation to demonstrate the app's impact on its intended user, it is difficult to determine whether the app is improving health outcomes, having no impact or, in rare cases, even having a negative impact," Mechael said.

 

Recent data show that many apps flat-out fail to produce results. British researchers reviewed 334 reports of tests of mobile health apps. Only 75 of the tests met the rigorous standards medical researchers use to evaluate how an intervention affects health.Of those studies with optimal design, only three showed reliable signs of success. The study was published in the journal PLoS Medicine in January.

 

The problem, said Elizabeth Mynatt, executive director of Georgia Tech's Institute for People and Technology, is that tech developers and health scientists usually operate in two very different, very separate worlds of research. It's hard to design a piece of interactive technology while conducting a rigorous clinical trial.

 

"It's a bridging of two different research cultures," Mynatt said. "But we're making progress in that regard."

 

Organizations like NIH are launching projects to find what works and what doesn't when it comes to apps. Lawmakers and many industry groups are calling on the FDA, which regulates the manufacture of medical devices, to step up its role in regulating mhealth. A bill introduced in Congress in 2012 would create an FDA Office of Mobile Health, charged with creating guidelines for app developers and certifying certain types of mhealth.

 

Despite the need for improvement, experts stress that some apps now on the market are still useful. Many can improve health by making people aware of their good and bad habits. A handful of studies have shown that apps are a useful weight loss aid when added to nutrition and exercise counseling.

 

"If an app will help someone be more physically active, or track their eating and encourage them to make healthier choices, I think that's a positive thing," said Dr. Kimberly Redding, director of Health Promotion and Disease Prevention Section at DPH.

 

Mynatt said some of the most beneficial apps are those that guide users to healthy choices when they are in the moment, such as helping them choose the healthiest item on a restaurant menu or picking out a walking path to get in extra exercise--what Mynatt calls "just-in-time" decision-making.

 

She said future innovations in mhealth have the potential to dramatically improve health care. For example, Myantt said pharmaceutical companies may create an app for every drug, designed to help patients take the correct dose at the right time and improve adherence to proper treatment.

 

Until mhealth makes greater progress, consumers should look for apps that use information from reliable health sources, such as the U.S. Centers for Disease Control and Prevention (CDC) or the American Diabetes Association. Pay attention to any red flags raised in user reviews or trade publications. And remember that many apps still can't replace a doctor's guidance when it comes to managing health conditions.

 

-Story by Carrie Gann, DPH Communications