Lupton Deborah, Jutel Annemarie
News & Media Research Centre, Building 9, Faculty of Arts & Design, University of Canberra, Australia; Graduate School of Nursing, Midwifery and Health, Wellington Hospital Clinical Services Block, Victoria University of Wellington, New Zealand.
Soc Sci Med. 2015 May;133:128-35. doi: 10.1016/j.socscimed.2015.04.004. Epub 2015 Apr 3.
More than 100,000 mobile phone software applications ('apps') have been designed for the dissemination of health and medical information and healthcare and public health initiatives. This article presents a critical analysis of self-diagnosis smartphone apps directed at lay people that were available on the Apple App Store and Google Play in mid-April 2014. The objective of the analysis is to contribute to the sociology of diagnosis and to critical digital health studies by investigating the phenomenon of digitised diagnosis via apps. We adopted a perspective that views apps as sociocultural artefacts. Our analysis of self-diagnosis apps suggests that they inhabit a contested and ambiguous site of meaning and practice. We found that app developers combined claims to medical expertise in conjunction with appeals to algorithmic authority to promote their apps to potential users. While the developers also used appeals to patient engagement as part of their promotional efforts, these were undermined by routine disclaimers that users should seek medical advice to effect a diagnosis. More research is required to investigate how lay people are negotiating the use of these apps, the implications for privacy of their personal data and the possible effects on the doctor-patient relationship and medical authority in relation to diagnosis.
超过10万款手机软件应用程序（“应用”）被设计用于传播健康与医学信息以及医疗保健和公共卫生倡议。本文对2014年4月中旬在苹果应用商店和谷歌应用商店上可供普通大众使用的自我诊断智能手机应用进行了批判性分析。该分析的目的是通过调查应用程序数字化诊断现象，为诊断社会学和批判性数字健康研究做出贡献。我们采用了一种将应用视为社会文化产物的视角。我们对自我诊断应用的分析表明，它们处于一个充满争议且意义和实践模糊的领域。我们发现，应用开发者将对医学专业知识的宣称与对算法权威性的诉求相结合，向潜在用户推广他们的应用。虽然开发者在推广活动中也采用了吸引患者参与的方式，但这些都被常规的免责声明削弱了，即用户应寻求医疗建议以进行诊断。需要更多研究来调查普通大众如何应对这些应用的使用、其个人数据隐私问题以及对医患关系和诊断方面医疗权威的可能影响。
