Our team's recent paper explores digital health privacy as a global health concern through a careful examination of reading levels and privacy policies of smartphone apps in India for mental health and diabetes.. The required college reading level of these privacy policies reduces transparency and precludes informed decision making around adoption of health apps. Read the full paper for free at the JMIR website LINK
Which mental health apps are useful and safe? Which not so? There are many approaches to this problem and in our new paper - we outline many. Read the full text HERE:
Come join our symposium at IEEE EMBS 2018: "Digital Psychiatry: Smartphones, Sensors, And Signal Processing For Improving Detection And Outcomes In Serious Mental Illness" https://embc.embs.org/2018/mini-symposia/
Our team's recent piece co-written with Dr. Honor Hsin of Verily explores: "Creating boundaries to empower digital health technology" and is free to read in BJPsych Open: LINK
Link to full text: LINK. Story by Erene Stergiopoulous on TheOutLine.com
From the moment he wakes up to the time he goes to sleep, Spencer Roux keeps a digital remote in his pocket. The remote keeps a tally: each time he presses the button, it updates a daily count and uploads it to an online dashboard . Roux, a 29-year old engineer living in Dover, New Hampshire, was diagnosed with schizophrenia six years ago. He uses the remote to keep track of his auditory hallucinations — how many he hears every day, and at what times......
This spring, Torous and his collaborators published a three-month pilot study showing Beiwe’s ability to predict relapse in people with schizophrenia, which is crucial because earlier intervention means catching symptoms sooner, before they become harder to treat.
Link to read-only full text: HERE
Headache diaries are a mainstay of migraine management, and many commercial smartphone apps have been developed to help people track their pain. A new Headache study found that such apps often share information with third parties, posing privacy risks partly because there are few legal protections against the sale or disclosure of data from medical apps to third parties.
Of 14 diary apps analyzed, all collected medical information from the user with 57% (8/14) offering the capability to store patient diary data on the app providers' servers, 14% (2/14) not providing clear statements as to whether patient data would be stored locally or remotely, and others storing data locally on the user's device and/or in Dropbox's 'cloud.'
'In 2018, it is estimated that nearly half of 3.4 billion smartphone users will use health-related apps, and currently, there are a wide range of apps on the market for various neurologic and pain conditions,' said lead author Dr. Mia Minen, of NYU Langone Medical Center, in New York. 'We think our study may have widespread implications for people suffering from various chronic conditions.'
We are pleased to welcome several new members to our team this summer. We are also excited to offer a refresh of our website, with the goal of offering more updated content.
On Feb 1st, The February issue of World Psychiatry will be available free online. Until then, please find attached a copy of our editorial piece, "Bridging the dichotomy of actual versus aspirational digital health".
[A repost written by our team in 2016]
Everyone agrees about the potential of mHealth and apps to revolutionize psychiatric care. Yet at the clinical level, we are still waiting for the revolution to arrive. While a complete discussion on why would be too long - let's focus on one key area: sustainability. Sustainability needs to be understood for two perspectives - that of the patient and that of the clinic/healthcare system. We actually know very little about long term use of apps and interest in mHealth for psychiatric patients. How many patients are still using an app at 6 weeks....at 6 months? But we know even less about long term use of apps and interest in mHealth for psychiatric clinics. Why are these clinics not adopting mHealth and offering apps to their patients on a regular basis? Two published articles may give us the first clue.
In May 2014 the prestigious medical journal JAMA Psychiatry published an article entitled "A Smartphone Application to Support Recovery from Alcoholism: A Randomized Clinical Trial" . The paper showed how the app, called A-CHESS, can be effective for patients with alcohol use disorders (see title figure for some of the result). To date this remains one of most scientific efforts to really understand an app and produce valid clinical outcomes data. But what happened to A-CHESS outside of a clinical study and instead in the 'real world.' Thankfully, a second published paper was recently released about this in August 2015. The same team let 14 clinics/agencies use A-CHESS and then checked back in with them two years to see how many were still using the app.  Only 2 of the 14, 21%, of clinics/agencies were still using the app at two years. The article explore various reasons for this low rate of sustainability from a healthcare perspective and identifies many important external and internal barriers. One barriers that stands out is financial. Those two clinics that were able to keep app use sustainable at two years found sources of external funding to support the app program.
At least in this present landscape - mHealth apps for psychiatry may not yet be actually saving clinics money if you look at the story told by the A-CHESS app. A great app with great clinical data still had difficulties being sustainable. But landscapes do change, and this story is more complex that outlined above. There are several more factors important to consider when thinking about the adoption of mHealth in psychiatry; and in future posts I will outline more of them.
The efficacy of smartphone-based mental health interventions for depressive symptoms: a meta-analysis of randomized controlled trials
Our team helped research and write this new paper, published in the journal World Psychiatry, that is largest meta-analysis to date on the efficacy of smartphone-based mental health interventions for depressive symptoms, looking at randomized controlled trials. The paper, free to access and read, is attached below. To quote from the paper directly "Our systematic search identified 18 RCTs, examining 22 mental health interventions delivered via smartphone devices, across a total of 3,414 participants....The main analysis found that smartphone interventions had a moderate positive effect on depressive symptoms, with no indication of publication bias affecting these findings"