This story about the potential use of smartphone apps to monitor how well patients stick to their prescriptions is clear that the technology still has to prove itself. It includes concerns about privacy and data security.
But, the story did not adequately report relationships between some sources and app developers. Also, the story could have done a better job highlighting the possibility that these apps may not provide the benefits that fans hope for, especially for people who have limited access to smartphones (or limited ability to use them).
News stories do not always need to wait for conclusive studies before reporting on new medical interventions, but when reporters tackle speculative topics it is important to balance the promises offered by advocates with a clear discussion of the potential for failure. Readers should have been told about existing studies of similar technologies that failed to demonstrate benefits or found ways that things could go wrong.
Although the story does include some discussion of costs, the specifics implied that smartphone app systems are inherently less expensive than alternatives. However, as the story points out, the actual costs and effectiveness of the apps discussed are still being studied. The hoped-for cost savings might not materialize. It’s possible that the apps might be cheaper, but also less effective, perhaps leading to more expensive remedial interventions or poorer health outcomes. The story did not address several important cost questions. Even if insurers or public programs paid for the apps, who would pay for the smartphones, data plans and other costs? For people with low incomes, these costs could create barriers to treatment.
The story does not claim that smartphone apps are beneficial, just that the potential benefits are being studied.
The story noted privacy and data security concerns near the top and expanded on them in the body of the piece. The story would have been more balanced if it had declared more strongly that while these apps could be helpful, until studies are done, it is also just as possible that they could be useless or even harmful in ways that were not discussed in the story, such as diverting patients from proven interventions.
The story clearly states that the smartphone apps still need to be studied. It labeled supporters as “fans,” which helps to convey that their arguments are at least partly based on beliefs that go beyond the available evidence.
But, the story should have provided more context for readers by noting the disappointing results of evidence that has been completed. For example, in a UCSF study, “participants were unable to fully navigate the apps’ functions, and most expressed frustration and disappointment with the experience.” A recent study of medication adherence apps, the subject of this story, found a “concerning lack of [health care professional] involvement in app development and evidence base of effectiveness.”
The story uses examples of health conditions in which medication adherence is known to affect outcomes. It could have been clearer that treatment for tuberculosis is temporary, whereas treatment for opioid use disorder may be more extended and thus affect retention rates.
While the story does include a couple of independent sources, it could have done a better job identifying the connections between other sources and industry. The story does not tell readers that Dr. Judith Tsui is an advisor to the company developing the app she is studying. Another quoted source, Alain Litwin, appears to have received consulting fees from several pharmaceutical companies. The story does identify one proponent of smartphone apps, Dr. Richard Garfein, as a co-developer of an app.
We will give the story a satisfactory rating on this criterion because it does discuss existing methods for monitoring medication adherence and it makes clear that the apps mentioned still need to be studied. However, the overall tone of the story implies confidence that the apps will prove themselves to be more efficient than current methods, which is a proposition that has yet to be adequately tested.
The story reports that these apps are available in pilot programs and studies. It also refers to Skype, which most readers will know is generally available. One issue that remains to be seen is how accessible these apps will be to lower-income or homeless people, or those who have limited technology experience and/or limited eyesight.
The story describes how proponents of smartphone apps describe what’s new about these smartphone apps.
The story discusses a number of different apps and quotes sources from a variety of institutions.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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