The Impact of mHealth Interventions: Systematic Review of Systematic Reviews

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A classic case of error carried forward in this paper published today in the “JMIR mhealth and uhealth” Journal.

mHealth Insights

“Conclusions: Although mHealth is growing in popularity, the evidence for efficacy is still limited”

How can anyone hold this opinion in 2018? Surely it’s blatantly obvious that billions of citizens use mobile phones and healthcare roles are critical to the adoption (the fastest and most pervasive ever adoption of tech in the history of mankind).

Even if you’re a Doctor who works all day in a clinic with a queue out the door it’s likely your mobile phone is the only thing you have that you would return home for if you forgot it on your way to work.

“In general, the methodological quality of the studies included in the systematic reviews is low.”

Aren’t the reasons for this obvious?

If you appreciate the mHealth opportunities and are unscrupulous and unethical you can make yourself a huge financial fortune trading Patient data (like they do at the big Cancer Charities or Google eg. they got the EHR for millions of NHS Patients without their consent for free in exchange for building the NHS a basic app for dialysis Patients and most of the public haven’t the first idea about how they are tracking internet use and abusing the sensitive data they are compiling to make £millions in profits from the sale of highly targeted adverts that have created a industry of referral agents masquerading as ‘free helplines’ etc).

If you on the other hand appreciate the mHealth opportunities and are ethical and want to make a good living and do some good why not just implement even the most basic innovation with the supercomputers we are all now carrying in our pocket instead of publishing another critical research paper looking at the failure of other academics to see the opportunities to use the newest and least understand mass media? It’s not like it’s a hard to uncover secret that for most Patients today the consults they have with their Doctors are little more than encounters with strangers that are undocumented, it’s not as though it’s a secret that most qualified Doctors are still wedded to outdated tech like fax machines and don’t even think to use their Mobiles with Patients, no one is really surprised to learn that most Doctors don’t even use or share digital content with Patients/Carers, etc, etc.

“For some fields, its impact is not evident, the results are mixed, or no long-term studies exist. Exceptions include the moderate quality evidence of improvement in asthma patients, attendance rates, and increased smoking abstinence rates”

This is a common conclusion from people who can’t see the wood for the trees. They should try and think what would happen if you turned off the mobile phone networks and tried to run a modern healthcare service. Perhaps the author has little/no clinical experience but here in Ireland the entire out of hours GP service would fall over (as it’s organised via SMS) and within a few minutes Patients lives would be lost.

I wonder how the authors think their locality (Washington DC) would respond to a major public health emergency eg. like the ‘Ballistic missile threat’ SMS transmission in Haiwaii last week.

“Most studies were performed in high-income countries, implying that mHealth is still at an early stage of development in low-income countries”

I would  rephrase this statement as follows: Most studies were published in high-income countries where there is a huge profitable industry for academic institutions that pay money to have their papers published in expensive journals. In low-income countries people just get on with using the tools of our time as explained in this great TedX talk from 2011 by Alexandra Oswald:

It’s interesting to note that a scam industry has grown in low income regions where they think the publication system in more affluent countries is so ridiculously wasteful that they create and run very lucrative predatory conferences and journals that play on the interest ‘academics’ have for getting their egos massaged.

About David Doherty
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