Your smartphone may be great for getting the latest movie listings and even providing directions to get you to the theater, but how well can it help you detect skin cancer? Not so well, according to researchers at the University of Pittsburgh.
Their study, published in JAMA Dermatology, found that "the performance of smartphone applications in assessing melanoma risk is highly variable, and three of four smartphone applications incorrectly classified 30% or more of melanomas as unconcerning."
The researchers say relying on the app instead of having a medical consultation often delays the diagnosis and can potentially harm users. They looked at four smartphone apps that evaluate melanoma, a potentially life-threatening form of skin cancer.
The apps work by having the user take a picture of a suspicious mole. Some of the apps were free, others charged a small fee, and the ones that actually send the image to a physician to evaluate cost $5.
Dr. Laura Ferris, a dermatologist and co-author of the study, along with her colleagues, evaluated photos of close to 200 moles to test four different skin cancer apps. Three of them provided instant diagnosis via algorithm, while one sent the mole image to a board-certified dermatologist for review. Those results often took up to 24 hours to get back.
Ferris reports the highest-performing of the instant apps missed 30% of the melanoma cases, while the worst-performing missed 93%. The app that used actual physicians to diagnose the melanomas worked well, correctly identifying more than 98% of the submitted images. The researchers didn't name the apps they tested in the study.
Ferris writes she's concerned a misdiagnosis can cause harm to patients, especially those who might not have medical insurance. "This potential is of particular concern in times of economic hardship, when uninsured and even insured patients, deterred by the cost of copayments for medical visits, may turn to these applications as alternatives to physician evaluation."
The idea of an app to evaluate a mole may be appealing to many users. Often times getting an appointment with a dermatologist can take days, if not weeks, and not everyone knows what to look for. With apps that help us measure our heart rate and glucose level and track daily caloric intake, one would think an app to evaluate the symmetry of a mole would be advantageous.
But Ferris says, in this instance, nothing really replaces the eyes of a trained doctor. "Reliance on these applications, which are not subject to regulatory oversight, in lieu of medical consultation can delay the diagnosis of melanoma and harm users."
However, since the app that used board-certified doctors to examine the moles correctly diagnosed the melanoma 98% of the time, perhaps virtual medical kiosks like the HealthSpot, and other telehealth options, will make skin cancer detection easier in the future. For now, it seems, for detecting skin cancer —there's not an app for that.
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