Doctors are concerned that health apps and fitness trackers are creating more ‘worried well’ than ever before. But is that really the case?
In recent weeks there has been a spate of articles arguing, as Dr Des Spence wrote in the BMJ, that health apps and fitness tracking devices such as the Fitbit and the Apple Watch are ‘untested and unscientific’, and that they could create “extreme anxiety” in a new generation of the “worried well”.
I won’t dispute that some technology companies talk about their health gadgets as if they’ve reinvented penicillin, but these are the sort of companies that will hold a huge event to announce a slightly improved phone as “a shining jewel”; they talk about everything as if they’ve just reinvented penicillin. But I would argue that health apps are, for the most part, fairly simple and genuinely useful.
Google’s list of the 10 most popular health apps of 2014 includes nine that track walking, running or healthy eating, and one for tracking periods. They all work in the same way, recording data about you and then presenting the results in an intelligible way. They give you facts on how much you weigh, or how much exercise you’re getting, how much alcohol you really drink, or when you’re likely to be most fertile. Facts on their own don’t tend to make people anxious unnecessarily. Ask anyone who’s taken a course for fear of flying, and they’ll tell you it’s mostly just learning interesting facts about air travel. Uncertainty, on the other hand, is great at making you anxious.
Dr Richard Harkness, a Durham GP who writes about technology for GP magazine, confirms it’s not so much that there’s been an increase in Worried Well patients, but he does say that the sources of anxiety are changing. “It used to be 'I read in the paper' but increasingly patients have heard [about an illness] on TV, websites and Google”, says Dr Harkness. Other results back him up: of the 300 GPs polled for the Astellas Innovation Debate in January, 76% reported a ‘marked increase’ in patients self-diagnosing from the internet in the past year.
Is this necessarily a bad thing? The Googling done by Dr Harkness’ patients may fuel a certain amount of hypochondria, but in other cases it’s about gathering facts and saving time. “People are using online tools to score symptoms, and they are the exactly the same scales we use as doctors. A good example of this is the PHQ 9 score for depression.” Some have even successfully treated themselves: “One patient I saw correctly diagnosed themselves with vertigo after Googling their symptoms- they read about vestibular exercises, performed them and quickly resolved the problem. They came to see me because the vertigo had returned, so they very sensibly came to check they were doing the right thing.”
10 best homes fitness equipment
10 best homes fitness equipment
1/10 Double-grip medicine ball
Medicine balls are gym staples nowadays, and work well in home gyms. The double grip helps you to manage heavier weights and increase control for overhead and dynamic lifts.£44.99, fitness-mad.com
2/10 Wahoo! Fitness KICKR
In a perfect world we’d be out in all weathers, but … This is a great way to keep up your training regime without cluttering up your home. Just replace the back wheel of your bike with the KICKR, and you can sync with smartphones or tablets to monitor progress. £949.99, uk.wahoofitness.com
3/10 Lonsdale Kettle Bell
Kettle bells are a great alternative to dumbbells if you want to improve core strength, balance and agility. Swinging movements help to work different muscle groups, and these have comfortable handles and stow away neatly. Available in 3, 6 & 9kg. From £11.99, lonsdale.com
4/10 Manduka beLONG body roller
Foam rolling is the cool-down essential after running or weight training, easing muscles and tension, and boosting circulation. Combined with dynamic stretching, it can help prevent injuries. This one is an environmentally friendly alternative to the classic.£24, yogamatters.com
5/10 BOSU Balance Trainer
If you only have one fitness gadget, it should be this. It can be used in a variety of ways, either solid-base-down or balanced on its dome, for challenging planks, crunches, press ups, toning and cardio. Comes with a wall chart and DVD too. £80, physicalcompany.co.uk
6/10 The Pop-Up Gym
This handy little book helps people make the most of the space they have available in the home, office or park, using home-made weights such as rucksacks and water bottles. £10, amazon.co.uk
7/10 Bodyism Resistance Bands
These unassuming bands could be your exercise secret weapon. Used in the right way, they enable you to tone and strengthen with just micro-movements that are far tougher than they actually appear. They are developed by James Duigan, the man who looks after the body of, erm, The Body, Elle Macpherson, so, they must be good. £34.95 for three, bodyism.com
8/10 Tanita Calorie Jump
So old-school it’s cool again. According to the British Rope Skipping Association, 10 minutes of skipping can have the same health benefits as a 45-minute run, burning up to 700 calories per hour. The Tanita has a calorie and jump counter if you need a tech fix.£8.99, amazon.co.uk
9/10 TRX HOME suspension trainer
This is one scary-looking piece of kit, but, designed specially for the home, it will transform any space into a multi-functional gym. Suspension training uses resistance and your own body weight across hundreds of exercises for strength, stability and flexibility. Includes workout cards and videos.£198, amazon.co.uk
10/10 Torq-King omni trainers
These are not your bog-standard dumbbells. The Torq-King – used by the Manchester United team – is composed of an omni-wheel system meaning a 360-degree range of movement – and a killer workout. It forces your core to engage to help balance and helps to target specific muscle groups. You can adapt exercises to your own strength and fitness levels. £210, torq-king.com
The combination of ubiquitous smartphone cameras and increasingly clever image searches is also become a force for good in the GP’s surgery. “Patients are using their phones to capture rashes or document changing lumps and bumps”, says Harkness. “As smartphone cameras improve, this is increasingly helpful.”
Harkness reports that patients also learn from each other through support forums. “They can present with a narrative that they have read online which led to a diagnosis after a long and involved pathway, and use this to avoid the same experience. Sometimes these aren't always appropriate for them, but it opens a dialogue about how we can help.”
There is definitely no denying the anxiety that Googling your symptoms can cause. If you’re in the 30% of people who have searched their symptoms before going to the doctor, you’ll know how the more frightening articles get more of your attention. Attention is the main factor search engines use to decide which page goes to the top of your search results – just as attention-grabbing health scare headlines help decide who sells the most newspapers – so the process feeds a kind of crowdsourced anxiety. But while certain editors are unlikely to give up front-page splashes about statins, Google is taking steps to make symptom-searching less scary by adding sensible medical advice, written by its team of doctors, above search results for common illnesses. This is currently being trialled in the US, but you’ll see it in you search results soon.
If anyone has a reason to worry about the growing influence of technology on your visit to the GP, it’s your GP. While gadgets like the Apple Watch excel at providing information, you still need a qualified practitioner to interpret it, and that will mean more work for doctors. “There is a tidal wave of medical data coming our way”, says Harkness, “and most doctors will know little or nothing of the devices it has been generated by. To my knowledge there is no guidance on how to deal with this new wave of patient-generated content.”
For health tech to genuinely change things, the huge technology firms providing the means for people to generate this giant increase in medical data must also help doctors to interpret it. If they can – and, by the look of programmes like Apple’s HealthKit platform, they’re certainly spending a lot on trying – then apps may undergo an upgrade from generally useful to genuinely lifesaving.
Will Dunn is the editor of Stuff magazine. To see Stuff’s recommendations for wearable and health-tracking technology, click here.Reuse content