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“信任但要验证”——确保医疗应用程序安全的五种方法。

'Trust but verify'--five approaches to ensure safe medical apps.

作者信息

Wicks Paul, Chiauzzi Emil

机构信息

155 2nd Street, PatientsLikeMe, Cambridge, MA, 02141, USA.

出版信息

BMC Med. 2015 Sep 25;13:205. doi: 10.1186/s12916-015-0451-z.

Abstract

Mobile health apps are health and wellness programs available on mobile devices such as smartphones or tablets. In three systematic assessments published in BMC Medicine, Huckvale and colleagues demonstrate that widely available health apps meant to help patients calculate their appropriate insulin dosage, educate themselves about asthma, or perform other important functions are methodologically weak. Insulin dose calculators lacked user input validation and made inappropriate dose recommendations, with a lack of documentation throughout. Since 2011, asthma apps have become more interactive, but have not improved in quality; peak flow calculators have the same issues as the insulin calculators. A review of the accredited National Health Service Health Apps Library found poor and inconsistent implementation of privacy and security, with 28% of apps lacking a privacy policy and one even transmitting personally identifying data the policy claimed would be anonymous. Ensuring patient safety might require a new approach, whether that be a consumer education program at one extreme or government regulation at the other. App store owners could ensure transparency of algorithms (whiteboxing), data sharing, and data quality. While a proper balance must be struck between innovation and caution, patient safety must be paramount.Please see related articles: http://dx.doi.org/10.1186/s12916-015-0444-y , http://www.biomedcentral.com/1741-7015/13/106 and http://www.biomedcentral.com/1741-7015/13/58.

摘要

移动健康应用程序是指可在智能手机或平板电脑等移动设备上使用的健康与保健程序。在发表于《BMC医学》的三项系统评估中,哈克维尔及其同事证明,那些旨在帮助患者计算合适的胰岛素剂量、自我了解哮喘或执行其他重要功能的广泛使用的健康应用程序,在方法学上存在缺陷。胰岛素剂量计算器缺乏用户输入验证,给出了不恰当的剂量建议,且全程缺乏文档记录。自2011年以来,哮喘应用程序变得更具交互性,但质量并未提高;峰值流量计算器存在与胰岛素计算器相同的问题。对经认可的国民保健服务健康应用程序库的一项审查发现,隐私和安全方面的实施情况不佳且不一致,28%的应用程序缺乏隐私政策,甚至有一个应用程序传输了其政策声称将是匿名的个人身份数据。确保患者安全可能需要一种新方法,一端可以是消费者教育计划,另一端可以是政府监管。应用商店所有者可以确保算法透明度(白盒化)、数据共享和数据质量。虽然必须在创新与谨慎之间取得适当平衡,但患者安全必须是首要的。请参阅相关文章:http://dx.doi.org/10.1186/s12916-015-0444-yhttp://www.biomedcentral.com/1741-7015/13/106http://www.biomedcentral.com/1741-7015/13/58

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