Trials of mobile technologies fail to deliver

PLoS Med2013;10:e1001362OpenUrlCrossRef

PLoS Med2013;10:e1001363OpenUrlCrossRef

Plenty of trials have tested the use of mobile technologies, such as smart phones, in healthcare, but twin systematic reviews found few that were good enough to inform policy or practice, particularly in low and middle income countries. The most secure findings to emerge from the first review of 75 trials were that supportive text messages can help smokers quit (two trials: relative risk 2.16, 95% CI 1.77 to 2.62) and encourage adults with HIV to take their antiretroviral drugs (one trial: relative risk of high viral load 0.85, 0.72 to 0.99).

Text messages also looked useful in the second review of 42 trials, which studied processes of care rather than clinical outcomes. Text reminders slightly improved attendance at appointments in eight trials, although the messages didn’t prevent cancellations. In other analyses, text reminders worked no better than phone calls or letters.

Two trials in this review reported significant harms associated with using mobile phones to transmit clinical photographs to off-site specialists. Diagnoses of fractures and skin lesions were significantly less accurate when done this way, compared with diagnoses made by specialists examining radiographs or patients.

Mobile technologies are developing rapidly and research is failing to keep up, say the authors. Smarter interventions and better trials are needed.