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From the mHealth Summit: Do Cell Phones Really Make a Difference in Health Programs?

Ed note.  The mHealth Summit celebrates innovations in mobile technology that are improving health outcomes. This year, for the first time, the mHealth Summit includes a dedicated global health track. UN Dispatch welcomes freelance journalist Lois Parshley, who is reporting from the convention floor.You can follow her on Twitter at @loisparshley.  – Mark 

It’s a subversive question to be asking at a mobile health conference. After all, mHealth is a booming field and the writing seems on the wall for the future of global health; according to a recent PEW study, as many as 1 in 3 cell phone owners in the U.S. have used their phone for health-related information. But no matter what the ubiquity, Francis Collins, Director of the National Institutes of Health, says surprisingly few mobile health programs have actually been tested.

Although practical and observational studies can generate useful data and help doctors formulate hypotheses, they aren’t sufficient. To really be able to tell whether or not a program is effective, scientists conduct systematic studies called randomized clinical trials, which have a number of safeguards in place to keep both the experimenters’ and the subjects’ biases from affecting the data. These rigorous studies often take years to design and complete, and in part because mobile health is based on new and rapidly changing technology, they are not often conducted on mobile health programs.

In fact, in the few studies that have been tested, few mobile programs have clear statistical results. As Collins reported at the mHealth Symposium, between 2008 and 2012, only 20 such trials were published in peer-reviewed literature. Of those, over half failed to document an effect, and only 6 showed a clear benefit to using mobile technology.

That’s not to discount the field: One promising review conducted by the Cochrane Library combined 5 studies that used mobile phone-based interventions for smoking cessation. Collectively, these studies had 9,000 participants, and were able to demonstrate that there was a clear statistical result – less people were smoking – with high confidence levels – showing mobile phone programs were the cause of the smoking cessation. But in order to justify the expense of these programs, and to accelerate the understanding of what does and doesn’t work, this quality of review needs to become the standard in mobile health.

At the symposium, there are as many heartwarming stories about the potential for mobile health programs as there are symposium participants. Pictures of mothers and babies with cell phones abound; in some presentations, these photos populate every other slide. But as Collins says, “The plural of anecdotes is not data.” And what healthcare and mobile technology rely on are the cold, hard facts.


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