Do health apps need endorsement? Challenges for giving advice about which health apps are safe and effective to use

Abstract

Two decades ago, during the rapid emergence of the worldwide web as a popular source of health informa-tion, there was widespread anxiety among health prac-titioners, and especially the medical profession, that poor quality information on the internet could cause significant harm. 1 Although there was never any con-sistent systematic evidence of harm beyond a few indi-vidual case reports, 2 one response by many national health agencies was to call for, and in some cases develop, quality rating schemes. 3,4 In 2000, an editorial in The BMJ by Tony Delamothe described these initia-tives as 'kitemarking the west wind', referring to the difficulties in rating the quality of online health infor-mation and providing kitemarks for websites, and arguing that such schemes needed to demonstrate their benefit to population health before being pursued further. 5 Just as the first generation of web technologies pro-vided users with access to a vast quantity of online health information, now web2.0 interactivity and the rapid uptake of smartphones have led to an explosion in digital applications for health and wellbeing. An esti-mated 165,000 health apps were available in 2015 to the public, patients, health professionals and researchers. 6