Smartphone apps for calculating insulin dose : a systematic assessment
Background: Medical apps are widely available, increasingly used by patients and clinicians, and are being actively promoted for use in routine care. However, there is little systematic evidence exploring possible risks associated with apps intended for patient use. Because self-medication errors ar...
Saved in:
Main Authors: | , , , , |
---|---|
Other Authors: | |
Format: | Article |
Language: | English |
Published: |
2015
|
Subjects: | |
Online Access: | https://hdl.handle.net/10356/103731 http://hdl.handle.net/10220/25816 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Institution: | Nanyang Technological University |
Language: | English |
id |
sg-ntu-dr.10356-103731 |
---|---|
record_format |
dspace |
spelling |
sg-ntu-dr.10356-1037312022-02-16T16:29:51Z Smartphone apps for calculating insulin dose : a systematic assessment Huckvale, Kit Adomaviciute, Samanta Prieto, José Tomás Leow, Melvin Khee-Shing Car, Josip Lee Kong Chian School of Medicine (LKCMedicine) Lee Kong Chian School of Medicine DRNTU::Science::Medicine::Computer applications Background: Medical apps are widely available, increasingly used by patients and clinicians, and are being actively promoted for use in routine care. However, there is little systematic evidence exploring possible risks associated with apps intended for patient use. Because self-medication errors are a recognized source of avoidable harm, apps that affect medication use, such as dose calculators, deserve particular scrutiny. We explored the accuracy and clinical suitability of apps for calculating medication doses, focusing on insulin calculators for patients with diabetes as a representative use for a prevalent long-term condition. Methods: We performed a systematic assessment of all English-language rapid/short-acting insulin dose calculators available for iOS and Android. Results: Searches identified 46 calculators that performed simple mathematical operations using planned carbohydrate intake and measured blood glucose. While 59% (n = 27/46) of apps included a clinical disclaimer, only 30% (n = 14/46) documented the calculation formula. 91% (n = 42/46) lacked numeric input validation, 59% (n = 27/46) allowed calculation when one or more values were missing, 48% (n = 22/46) used ambiguous terminology, 9% (n = 4/46) did not use adequate numeric precision and 4% (n = 2/46) did not store parameters faithfully. 67% (n = 31/46) of apps carried a risk of inappropriate output dose recommendation that either violated basic clinical assumptions (48%, n = 22/46) or did not match a stated formula (14%, n = 3/21) or correctly update in response to changing user inputs (37%, n = 17/46). Only one app, for iOS, was issue-free according to our criteria. No significant differences were observed in issue prevalence by payment model or platform. Conclusions: The majority of insulin dose calculator apps provide no protection against, and may actively contribute to, incorrect or inappropriate dose recommendations that put current users at risk of both catastrophic overdose and more subtle harms resulting from suboptimal glucose control. Healthcare professionals should exercise substantial caution in recommending unregulated dose calculators to patients and address app safety as part of self-management education. The prevalence of errors attributable to incorrect interpretation of medical principles underlines the importance of clinical input during app design. Systemic issues affecting the safety and suitability of higher-risk apps may require coordinated surveillance and action at national and international levels involving regulators, health agencies and app stores. Published version 2015-06-08T01:43:17Z 2019-12-06T21:19:02Z 2015-06-08T01:43:17Z 2019-12-06T21:19:02Z 2015 2015 Journal Article Huckvale, K., Adomaviciute, S., Prieto, J. T., Leow, M. K.-S., & Car, J. (2015). Smartphone apps for calculating insulin dose : a systematic assessment. BMC medicine, 13(106). 1741-7015 https://hdl.handle.net/10356/103731 http://hdl.handle.net/10220/25816 10.1186/s12916-015-0314-7 25943590 en BMC medicine © 2015 Huckvale et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. 10 p. application/pdf |
institution |
Nanyang Technological University |
building |
NTU Library |
continent |
Asia |
country |
Singapore Singapore |
content_provider |
NTU Library |
collection |
DR-NTU |
language |
English |
topic |
DRNTU::Science::Medicine::Computer applications |
spellingShingle |
DRNTU::Science::Medicine::Computer applications Huckvale, Kit Adomaviciute, Samanta Prieto, José Tomás Leow, Melvin Khee-Shing Car, Josip Smartphone apps for calculating insulin dose : a systematic assessment |
description |
Background: Medical apps are widely available, increasingly used by patients and clinicians, and are being actively promoted for use in routine care. However, there is little systematic evidence exploring possible risks associated with apps intended for patient use. Because self-medication errors are a recognized source of avoidable harm, apps that affect medication use, such as dose calculators, deserve particular scrutiny. We explored the accuracy and clinical suitability of apps for calculating medication doses, focusing on insulin calculators for patients with diabetes as a representative use for a prevalent long-term condition. Methods: We performed a systematic assessment of all English-language rapid/short-acting insulin dose calculators available for iOS and Android. Results: Searches identified 46 calculators that performed simple mathematical operations using planned carbohydrate intake and measured blood glucose. While 59% (n = 27/46) of apps included a clinical disclaimer, only 30% (n = 14/46) documented the calculation formula. 91% (n = 42/46) lacked numeric input validation, 59% (n = 27/46) allowed calculation when one or more values were missing, 48% (n = 22/46) used ambiguous terminology, 9% (n = 4/46) did not use adequate numeric precision and 4% (n = 2/46) did not store parameters faithfully. 67% (n = 31/46) of apps carried a risk of inappropriate output dose recommendation that either violated basic clinical assumptions (48%, n = 22/46) or did not match a stated formula (14%, n = 3/21) or correctly update in response to changing user inputs (37%, n = 17/46). Only one app, for iOS, was issue-free according to our criteria. No significant differences were observed in issue prevalence by payment model or platform. Conclusions: The majority of insulin dose calculator apps provide no protection against, and may actively contribute to, incorrect or inappropriate dose recommendations that put current users at risk of both catastrophic overdose and more subtle harms resulting from suboptimal glucose control. Healthcare professionals should exercise substantial caution in recommending unregulated dose calculators to patients and address app safety as part of self-management education. The prevalence of errors attributable to incorrect interpretation of medical principles underlines the importance of clinical input during app design. Systemic issues affecting the safety and suitability of higher-risk apps may require coordinated surveillance and action at national and international levels involving regulators, health agencies and app stores. |
author2 |
Lee Kong Chian School of Medicine (LKCMedicine) |
author_facet |
Lee Kong Chian School of Medicine (LKCMedicine) Huckvale, Kit Adomaviciute, Samanta Prieto, José Tomás Leow, Melvin Khee-Shing Car, Josip |
format |
Article |
author |
Huckvale, Kit Adomaviciute, Samanta Prieto, José Tomás Leow, Melvin Khee-Shing Car, Josip |
author_sort |
Huckvale, Kit |
title |
Smartphone apps for calculating insulin dose : a systematic assessment |
title_short |
Smartphone apps for calculating insulin dose : a systematic assessment |
title_full |
Smartphone apps for calculating insulin dose : a systematic assessment |
title_fullStr |
Smartphone apps for calculating insulin dose : a systematic assessment |
title_full_unstemmed |
Smartphone apps for calculating insulin dose : a systematic assessment |
title_sort |
smartphone apps for calculating insulin dose : a systematic assessment |
publishDate |
2015 |
url |
https://hdl.handle.net/10356/103731 http://hdl.handle.net/10220/25816 |
_version_ |
1725985516288999424 |