#rctforapps - a twitter discussion

@amcunningham	We need a hashtag .... #rctforapps ? (Wed, 22 Feb 2012 10:41:58 +0000)
@amcunningham	#rctforapps RT @AliHandscomb : @amcunningham what would be the purpose and value of doing this? Who would benefit? (Wed, 22 Feb 2012 10:42:36 +0000)
@amcunningham	#rctforapps RT @JosephFreeman : What sort of harm? Do you mean apps giving false info/assurances? Agree there needs to be control. (Wed, 22 Feb 2012 10:43:03 +0000)
@amcunningham	#rctforapps RT @frozenwarning : @amcunningham Not sure I agree that apps should be prescribed tbh. (Wed, 22 Feb 2012 10:43:24 +0000)
@amcunningham	#rctforapps MT @martinwhite33 Because of risk of harm and opportunity cost - if ineffective wastes everyone's time (Wed, 22 Feb 2012 10:44:22 +0000)
@amcunningham	#rctforapps RT @PatParslow : if they can't cause harm it seems unlikely that they could cause benefit... (Wed, 22 Feb 2012 10:44:51 +0000)
@amcunningham	Ok, so if necessary to have #rctforapps before being prescribed, should they be available to public to pay without regulation by MHRA, say? (Wed, 22 Feb 2012 10:46:38 +0000)
@JosephFreeman	@amcunningham @PatParslow Really depends on what the app is doing, and how much influence it has over a person's health. #rctforapps (Wed, 22 Feb 2012 10:48:52 +0000)
@amcunningham	@helenareeves I'd guess possible harm from an app for health is poorer QoL, lower self-estee, lower self-efficacy #rctforapps (Wed, 22 Feb 2012 10:49:12 +0000)
@amcunningham	. @helenareeves I'd guess possible harm from an app for health is poorer QoL, lower self-estee, lower self-efficacy #rctforapps (Wed, 22 Feb 2012 10:49:42 +0000)
@TheLancetTech	Establishment of an evidence base for medicine has been slow/painful. Let's not throw that away when it comes to shiny new tech. #rctforapps (Wed, 22 Feb 2012 10:50:12 +0000)
@Suziebells	RT @amcunningham : We need a hashtag .... #rctforapps ? (Wed, 22 Feb 2012 10:51:42 +0000)
@amcunningham	Who should regulate health apps? Do we regulate self-help books? MT @lygidakis : Agree! Trials & regulation framework needed! #rctforapps (Wed, 22 Feb 2012 10:51:42 +0000)
@amcunningham	#rctforapps RT @frozenwarning : @amcunningham We have enough drug reps sniffing around, don't need app sellers too. (Wed, 22 Feb 2012 10:52:25 +0000)
@butlerceri	#rctforapps evidence on user involvement indicates variation in involvement based on condition/severity. Same might be case for apps. 1/2 (Wed, 22 Feb 2012 10:53:18 +0000)
@amcunningham	#rctforapps I agree MT @frozenwarning : Cost of testing wld be astronomical compared to probable benefit. App writers aren't going to fund (Wed, 22 Feb 2012 10:53:36 +0000)
@butlerceri	#rctforapps Pts like to see and be reassured by doctors which costs more than an app. so danger is app see as cost effective solution. 2/2 (Wed, 22 Feb 2012 10:53:55 +0000)
@martinwhite33	@amcunningham @helenareeves #rctforapps & could fail 2 help u: lose wt, reduce alc, stop smoking, be active, reduce UV exp, have safe sex... (Wed, 22 Feb 2012 10:54:33 +0000)
@amcunningham	#rctforapps RT @MAC_Research : @amcunningham offering credibility to apps could open the door to ""cowboy"" apps too. (Wed, 22 Feb 2012 10:54:34 +0000)
@butlerceri	@amcunningham @frozenwarning #rctforapps mobile tech is becoming widespread in community care so already apps/software sellers around 1/2 (Wed, 22 Feb 2012 10:55:01 +0000)
@amcunningham	@martinwhite33 failure to help isn't harm... many medical interventsion don't help people #rctforapps (Wed, 22 Feb 2012 10:55:14 +0000)
@butlerceri	@amcunningham @frozenwarning #rctforapps eg iNurse and other products developed by Advanced Health and Care. See EHI for more info 2/2 (Wed, 22 Feb 2012 10:55:35 +0000)
@amcunningham	#rctforapps RT @thomasllewis : @amcunningham yup absolutely. Also need regulation in the same way drugs are regulated. (Wed, 22 Feb 2012 10:55:41 +0000)
@JosephFreeman	@amcunningham @frozenwarning I think prescribing is prob wrong but being encouraged to use to monitor health is a good thing? #rctforapps (Wed, 22 Feb 2012 10:56:14 +0000)
@amcunningham	#rctforapps RT @Neil_Mehta : @amcunningham do they need RCTS? ""GPs in UK 'to prescribe health apps"" see this http://t.co/YfjXu469 (Wed, 22 Feb 2012 10:56:22 +0000)
@amcunningham	#rctforapps RT @lygidakis : True we don't regulate self-help books but apps have immense power compared to them (Wed, 22 Feb 2012 10:56:53 +0000)
@JosephFreeman	RT @amcunningham : #rctforapps RT @MAC_Research : @amcunningham offering credibility to apps could open the door to ""cowboy"" apps too. (Wed, 22 Feb 2012 10:57:56 +0000)
@martinwhite33	@amcunningham #rctforapps DH wants GPs to Rx Apps. We have to protect patients from harm & false promise. NHS shouldn't promote profiteering (Wed, 22 Feb 2012 11:00:08 +0000)
@amcunningham	If we need #rctforapps then maybe only people with as much money as pharna might be able to afford evaluation? @andrewspong (Wed, 22 Feb 2012 11:00:34 +0000)
@PCTCassander	. @amcunningham If apps to be prescribed, also need #equality assessment - will vulnerable grps be excluded? #rctforapps (Wed, 22 Feb 2012 11:01:14 +0000)
@amcunningham	RT @PCTCassander : . @amcunningham If apps to be prescribed, also need #equality assessment - will vulnerable grps be excluded? #rctforapps (Wed, 22 Feb 2012 11:01:31 +0000)
@PCTCassander	. @amcunningham also, would hope there'd be some good #opensource health apps available w/o cost. #NHS #opendata could feed. #rctforapps (Wed, 22 Feb 2012 11:02:15 +0000)
@amcunningham	#rctforapps RT @frozenwarning : Encourage to take up GP health checks better. Excessive home monitoring might create influx of worried well? (Wed, 22 Feb 2012 11:03:02 +0000)
@thomasllewis	#rctforapps apps need some form of regulation as drs need to be able to have accurate reliable apps (Wed, 22 Feb 2012 11:03:37 +0000)
@JosephFreeman	Of course this does all seem to be Mr Lansley using apps as a way to save money by keeping patients out of the GP surgery... #rctforapps (Wed, 22 Feb 2012 11:04:36 +0000)
@thomasllewis	#rctforapps Apps can be notoriously insecure-need regulation to protect patient data and confidentiality (Wed, 22 Feb 2012 11:04:40 +0000)
@JosephFreeman	And the idea of someone using a blood pressure app to monitor their health does scare me #rctforapps (Wed, 22 Feb 2012 11:05:12 +0000)
@amcunningham	#rctforapps RT @frozenwarning : @PCTCassander @amcunningham Opensource apps would still need testing and costs would be high. (Wed, 22 Feb 2012 11:05:23 +0000)
@thomasllewis	#rctforapps also what about conflict of interest. Imagine if pharma-sponsored app recommended its own drugs over other (better) Rx (Wed, 22 Feb 2012 11:06:49 +0000)
@andrewspong	@butlerceri I'm sure #rctforapps must already have addressed that question, however :) @amcunningham (Wed, 22 Feb 2012 11:07:38 +0000)
@amcunningham	#rctforapps RT @andrewspong : Which does prompt Q: bearing in mind v high # downloads, but very low continuing use, is evaluation feasible? (Wed, 22 Feb 2012 11:07:57 +0000)
@JBBC	RT @thelancettech : Estab. of evidence base for medicine has been slow Let's not throw that away when it comes to shiny new tech. #rctforapps (Wed, 22 Feb 2012 11:08:03 +0000)
@amcunningham	@andrewspong well I started form position that #rctforapps were not feasible as tech shfts by time RCT is reported unless we change methods (Wed, 22 Feb 2012 11:08:46 +0000)
@MAC_Research	RT @thomasllewis : #rctforapps also what about conflict of interest. Imagine if pharma-sponsored app recommended its own drugs over other (better) Rx (Wed, 22 Feb 2012 11:10:05 +0000)
@butlerceri	@andrewspong @amcunningham granted this is not a full RCT but would provide sufficient evidence to support case for futher study #rctforapps (Wed, 22 Feb 2012 11:11:27 +0000)
@drcjar	MT @PCTCassander : @amcunningham wd hope for some good #opensource health apps avail #NHS #opendata #rctforapps <- http://t.co/0xhERXSU (Wed, 22 Feb 2012 11:14:06 +0000)
@lygidakis	opensource apps can still offer tailored help potentially harmful to consumers MT @amcunningham @frozenwarning @PCTCassander #rctforapps (Wed, 22 Feb 2012 11:14:45 +0000)
@amcunningham	#rctforapps RT @thomasllewis : There are specialist journals such as JMIR which try rush app analysis to combat the problem you describe (Wed, 22 Feb 2012 11:15:44 +0000)
@nigelpraities	RT @amcunningham : #rctforapps RT @frozenwarning : @amcunningham We have enough drug reps sniffing around, don't need app sellers too. (Wed, 22 Feb 2012 11:15:56 +0000)
@amcunningham	@thomasllewis if data was reported live as trial was ongoing them peole could make up their mind? #rctforapps (Wed, 22 Feb 2012 11:16:35 +0000)
@amcunningham	#rctforapps RT @ellyob : re regulation -hv u seen this? 'first app to be registered as a medical device by the MHRA' - http://t.co/ER3a04LC (Wed, 22 Feb 2012 11:18:58 +0000)
@butlerceri	@andrewspong @amcunningham #rctforapps RCTs are not the only way of proving impact. Small scale is probably the most viable way forward here (Wed, 22 Feb 2012 11:19:36 +0000)
@thomasllewis	@amcunningham Not a bad idea at all. JMIR is on twitter- @JMedInternetRes #rctforapps (Wed, 22 Feb 2012 11:19:51 +0000)
@andrewspong	@thomasllewis w/ regard to # apps published vs # apps reviewed, cd this ever be anything other than a partial solution, though? #rctforapps (Wed, 22 Feb 2012 11:20:15 +0000)
@dean_jenkins	Agree! @amcunningham . Without #rctforapps patients are going to be fobbed off with stuff as ineffective and distracting as homeopathy. (Wed, 22 Feb 2012 11:20:15 +0000)
@amcunningham	""Regulation of health apps: a practical guide"" http://t.co/CUAjBXrH #rctforapps via @ellyob (Wed, 22 Feb 2012 11:20:27 +0000)
@amcunningham	@dean_jenkins oops- apologies! I thought you said it was a RT of me... you haven't :) #rctforapps (Wed, 22 Feb 2012 11:21:34 +0000)
@thomasllewis	#rctforapps @amcunningham Check out @devices4 and http://t.co/FrZjbneH (Wed, 22 Feb 2012 11:21:36 +0000)
@amcunningham	@thomasllewis yes, I've just linked to that! #rctforapps (Wed, 22 Feb 2012 11:21:53 +0000)
@mdTalk	#rctforapps There are specialist journals such as JMIR which try rush app analysis to combat the problem ... http://t.co/KRwpLpqi (Wed, 22 Feb 2012 11:22:07 +0000)
@thomasllewis	@andrewspong Good question. Key is to have sites like @iMedicalApps and teach drs skills required to critically appraise apps #rctforapps (Wed, 22 Feb 2012 11:23:02 +0000)
@lygidakis	I think there's supposed to be a revised 2012 guide to address the issue of apps as medical device RT @amcunningham @ellyob #rctforapps (Wed, 22 Feb 2012 11:23:32 +0000)
@thomasllewis	#rctforapps I think we need a fundamental shift in attitude towards #medapps if we are to integrate successfully into modern healthcare (Wed, 22 Feb 2012 11:25:06 +0000)
@lygidakis	RT @thomasllewis : #rctforapps I think we need a fundamental shift in attitude towards #medapps if we are to integrate successfully into modern healthcare (Wed, 22 Feb 2012 11:25:52 +0000)
@martinwhite33	RT @PCTCassander : . @amcunningham If apps to be prescribed, also need #equality assessment - will vulnerable grps be excluded? #rctforapps (Wed, 22 Feb 2012 11:26:11 +0000)
@jonathanmason	@amcunningham @ellyob #rctforapps whether an app needs to be registered/regulated should depend on what the app is for - is it a device? (Wed, 22 Feb 2012 11:29:05 +0000)
@thomasllewis	@lygidakis @amcunningham @ellyob @devices4 I think that will make for some very interesting reading! #rctforapps (Wed, 22 Feb 2012 11:29:46 +0000)
@martinwhite33	RT @amcunningham : ""Regulation of health apps: a practical guide"" http://t.co/CUAjBXrH #rctforapps via @ellyob (Wed, 22 Feb 2012 11:30:46 +0000)
@richardblogger	As a software dev, and someone familiar with software life cycle, I am not sure #rctforapps is a good idea (Wed, 22 Feb 2012 11:35:10 +0000)
@JBBC	RT @amcunningham : ""Regulation of health apps: a practical guide"" http://t.co/YY8zHONn #rctforapps via @ellyob (Wed, 22 Feb 2012 11:36:34 +0000)
@richardblogger	Healthcare apps need extensive usability testing - of representative users NOT randomised #rctforapps (Wed, 22 Feb 2012 11:36:36 +0000)
@andrewspong	@thomasllewis Objectively, 'eEmninence based' revs of http://t.co/m2KXUk2m little better than gameable 'thumbing' of pocket.md #rctforapps (Wed, 22 Feb 2012 11:36:44 +0000)
@NHSHackDay	RT @drcjar : MT @PCTCassander : @amcunningham wd hope for some good #opensource health apps avail #NHS #opendata #rctforapps <- http://t.co/0xhERXSU (Wed, 22 Feb 2012 11:37:15 +0000)
@andrewspong	@thomasllewis No offence intended to either service. Just thought I'd point that out :) #rctforapps (Wed, 22 Feb 2012 11:37:32 +0000)
@doctorinsulin	Doctors told to prescribe smartphone apps to patients http://t.co/TZ9jErbg good comments from patients. #rctforapps (Wed, 22 Feb 2012 11:39:23 +0000)
@richardblogger	In software you start with a functional spec - work out what you want it to do before you start. That's where focus should be #rctforapps (Wed, 22 Feb 2012 11:39:37 +0000)
@andrewspong	Suffice to say: IMO, the idea of 'prescribing' health apps hasn't been thought through adequately. #hcsmeu #ebm #patient #safety #rctforapps (Wed, 22 Feb 2012 11:40:32 +0000)
@thomasllewis	@andrewspong I'd never even heard of pocket.md before! I think these sites offer drs constructive advice about #medapps #rctforapps (Wed, 22 Feb 2012 11:41:00 +0000)
@BrianSMcGowan	Perhaps it isn't #rctforapps that is needed, but an open & connected 'big data' play that ensures app data can be analyzed in real time? (Wed, 22 Feb 2012 11:41:18 +0000)
@TheLancetTech	RT @thomasllewis : #rctforapps I think we need a fundamental shift in attitude towards #medapps if we are to integrate successfully into modern healthcare (Wed, 22 Feb 2012 11:42:19 +0000)
@JBBC	Great convo - thanks for the #rctforapps discussion @lygidakis @andrewspong @amcunningham (Wed, 22 Feb 2012 11:45:12 +0000)
@westr	RT @amcunningham : ""Regulation of health apps: a practical guide"" http://t.co/CUAjBXrH #rctforapps via @ellyob (Wed, 22 Feb 2012 11:46:07 +0000)
@DoktorAsa	RT @amcunningham : ""Regulation of health apps: a practical guide"" http://t.co/CUAjBXrH #rctforapps via @ellyob (Wed, 22 Feb 2012 11:48:15 +0000)
@safetymd	RT @amcunningham : ""Regulation of health apps: a practical guide"" http://t.co/CUAjBXrH #rctforapps via @ellyob (Wed, 22 Feb 2012 11:50:09 +0000)
@BrianSMcGowan	perhaps GPs need to explain to patients the difference b/w evidence-base and experiential medicine.... #rctforapps (Wed, 22 Feb 2012 12:03:09 +0000)
@BrianSMcGowan	@amcunningham - it is not the apps themselves, but the act of prescribing that drives the need for #rctforapps , right? (Wed, 22 Feb 2012 12:04:07 +0000)
@BrianSMcGowan	@amcunningham - and would apps be paid for by payors? then what evidence might they need. and what of payors developing apps? #rctforapps (Wed, 22 Feb 2012 12:04:58 +0000)
@devices4	@lygidakis @thomasllewis @amcunningham @ellyob Late to the discussion here - thanks for the mentions. #rctforapps (Wed, 22 Feb 2012 12:08:53 +0000)
@devices4	@lygidakis A new MEDDEV was released by the EU on the classification of standalone software in healthcare http://t.co/EcQVRkbE #rctforapps (Wed, 22 Feb 2012 12:12:16 +0000)
@devices4	@thomasllewis Agree. See our recent blogs on clinician involvement http://t.co/uWb3tF2D and letter to BMJ http://t.co/cTNXfIiZ #rctforapps (Wed, 22 Feb 2012 12:17:55 +0000)
@lygidakis	RT @devices4 : New MEDDEV was released by the EU on the classification of standalone software in healthcare http://t.co/x96fWnFo #rctforapps (Wed, 22 Feb 2012 12:19:01 +0000)
@terrieynon	RT @PCTCassander : . @amcunningham If apps to be prescribed, also need #equality assessment - will vulnerable grps be excluded? #rctforapps (Wed, 22 Feb 2012 12:20:59 +0000)
@jonescarwyn	RT @amcunningham : #rctforapps RT @frozenwarning : @amcunningham We have enough drug reps sniffing around, don't need app sellers too. (Wed, 22 Feb 2012 12:41:19 +0000)
@jonescarwyn	RT @amcunningham : If we need #rctforapps then maybe only people with as much money as pharna might be able to afford evaluation? @andrewspong (Wed, 22 Feb 2012 12:41:42 +0000)
@devices4	@amcunningham @TheLancetTech Need for clinical trials is a function of whether the app is a device and its risk class under MDD #rctforapps (Wed, 22 Feb 2012 13:22:37 +0000)
@flupianez	RT @amcunningham : #rctforapps RT @frozenwarning : @PCTCassander @amcunningham Opensource apps would still need testing and costs would be high. (Wed, 22 Feb 2012 13:26:49 +0000)
@dpguinee	All HCPs! @BrianSMcGowan : perhaps GPs need to explain to patients the difference b/w evidence-base and experiential medicine.... #rctforapps (Wed, 22 Feb 2012 13:27:45 +0000)
@GeorgeJulian	Killer question from @amcunningham - shd apps be available without testing? #rctforapps reckon wld be hard define medical from behavioural? (Wed, 22 Feb 2012 13:40:30 +0000)
@GeorgeJulian	RT @amcunningham : ""Regulation of health apps: a practical guide"" http://t.co/CUAjBXrH #rctforapps via @ellyob (Wed, 22 Feb 2012 13:40:41 +0000)
@amcunningham	#rctforapps RT @flupianez : @amcunningham apps are not pills, RCT as a golden standard but new methods are indeed needed (Wed, 22 Feb 2012 14:15:03 +0000)
@amcunningham	@PatParslow do self-help books have disclaimers? has anyone ever sued one? #rctforapps (Wed, 22 Feb 2012 14:53:01 +0000)
@GeorgeJulian	@mikey3982 my point was more that behaviour change stuff isn't regulated eg weight watchers, exercise promotion #rctforapps @amcunningham (Wed, 22 Feb 2012 14:57:43 +0000)
@amcunningham	@BrianSMcGowan yes, that's what I was thinking:) #rctforapps (Wed, 22 Feb 2012 14:57:55 +0000)
@GeorgeJulian	@mikey3982 also have some concerns re the number of well meaning #ServiceDesign solutions without clear evidence #rctforapps @amcunningham (Wed, 22 Feb 2012 14:59:02 +0000)
@amcunningham	Think those interested in #rctforapps and #mapsandapps might like this research on 'book prescription' http://t.co/wwr5LS8o (Wed, 22 Feb 2012 15:03:19 +0000)
@KentBottles	RT @amcunningham : Think those interested in #rctforapps and #mapsandapps might like this research on 'book prescription' http://t.co/wwr5LS8o (Wed, 22 Feb 2012 15:08:35 +0000)
@marktully_qub	Due to speed of development, results from #rctforapps would be meaningless in time. We need to ID & test the underlying behavioural theory (Wed, 22 Feb 2012 15:21:33 +0000)
@amcunningham	RT @marktully_qub : Due to speed of development, results from #rctforapps would be meaningless in time. We need to ID & test the underlying behavioural theory (Wed, 22 Feb 2012 17:30:55 +0000)
@amcunningham	@SR_disrupt did you see the discussion around #rctforapps ? views? #mapsandapps (Wed, 22 Feb 2012 20:07:48 +0000)
@amcunningham	@markhawker ha! did you see our #rctforapps discussion? might blog! (Wed, 22 Feb 2012 20:31:43 +0000)
@markhawker	@amcunningham A friend reviewed a document on this. In some instances paper with calculations could be a medical device. #rctforapps (Wed, 22 Feb 2012 20:32:41 +0000)
@markhawker	@amcunningham Something about if the health professional validates the ""data"" then it becomes a medical device. #rctforapps (Wed, 22 Feb 2012 20:33:12 +0000)
@markhawker	@amcunningham Was just a proposal, I think. #rctforapps (Wed, 22 Feb 2012 20:33:21 +0000)
@JosephFreeman	""An app a day keeps the doctor away"". Some thoughts (and questions) on GPs prescribing apps to patients: http://t.co/Rch3ScUn #rctforapps (Thu, 23 Feb 2012 10:01:46 +0000)
@amcunningham	Nice! Post from @JosephFreeman on #rctforapps http://t.co/ZOfTgv5C #mapsandapps - good questions discussed here! (Sun, 26 Feb 2012 23:35:11 +0000)