Smartphone applications for melanoma detection by community, patient and generalist clinician users: a review

Smartphone health applications (‘apps’) are widely available but experts remain cautious about their utility and safety. We reviewed currently available apps for the detection of melanoma (July 2014), aimed at general community, patient and generalist clinician users. A proforma was used to extract and assess each app that met the inclusion criteria, and we undertook content analysis to evaluate their content and the evidence applied in their development. Thirty‐nine apps were identified with the majority available only for Apple users. Over half (n = 22) provided information or education about melanoma, ultraviolet radiation exposure prevention advice, and skin self‐examination strategies, mainly using the ABCDE (A, Asymmetry; B, Border; C, Colour; D, Diameter; E, Evolving) method. Half (n = 19) helped users take and store images of their skin lesions either for review by a dermatologist or for self‐monitoring to identify change, an important predictor of melanoma; a similar number (n = 18) used reminders to help users monitor their skin lesions. A few (n = 9) offered expert review of images. Four apps provided a risk assessment to patients about the probability that a lesion was malignant or benign, and one app calculated users’ future risk of melanoma. None of the apps appeared to have been validated for diagnostic accuracy or utility using established research methods. Smartphone apps for detecting melanoma by nonspecialist users have a range of functions including information, education, classification, risk assessment and monitoring change. Despite their potential usefulness, and while clinicians may choose to use apps that provide information to educate their patients, apps for melanoma detection require further validation of their utility and safety.

[1]  P. S. Pandher,et al.  Smartphone applications for seizure management , 2016, Health Informatics J..

[2]  Cokky A. R. Hilhorst,et al.  Adopting Health Apps, What’s Hindering Doctors and Patients? , 2014 .

[3]  A. Amin,et al.  Attitudes and Preferences on the Use of Mobile Health Technology and Health Games for Self-Management: Interviews With Older Adults on Anticoagulation Therapy , 2014, JMIR mHealth and uHealth.

[4]  Peter Murchie,et al.  Using technology to deliver cancer follow-up: a systematic review , 2014, BMC Cancer.

[5]  M. Janda,et al.  Skin cancer detection by one click — are we any closer? , 2013, The Medical journal of Australia.

[6]  J. L. Bender,et al.  A Lot of Action, But Not in the Right Direction: Systematic Review and Content Analysis of Smartphone Applications for the Prevention, Detection, and Management of Cancer , 2013, Journal of medical Internet research.

[7]  R. Dellavalle,et al.  Mobile applications in dermatology. , 2013, JAMA dermatology.

[8]  P. Schulz,et al.  Mapping mHealth Research: A Decade of Evolution , 2013, Journal of medical Internet research.

[9]  J. Emery,et al.  Using the 7-point checklist as a diagnostic aid for pigmented skin lesions in general practice: a diagnostic validation study. , 2013, The British journal of general practice : the journal of the Royal College of General Practitioners.

[10]  J. Wolf,et al.  Diagnostic inaccuracy of smartphone applications for melanoma detection. , 2013, JAMA dermatology.

[11]  A. Pandey,et al.  Smartphone Apps as a Source of Cancer Information: Changing Trends in Health Information-Seeking Behavior , 2013, Journal of Cancer Education.

[12]  Monika Janda,et al.  Enhanced skin self-examination: a novel approach to skin cancer monitoring and follow-up. , 2013, JAMA dermatology.

[13]  Emily C. Pike,et al.  Mobile Phone Applications for the Care and Prevention of HIV and Other Sexually Transmitted Diseases: A Review , 2013, Journal of medical Internet research.

[14]  Carrie L Kovarik,et al.  Application of mobile teledermatology for skin cancer screening. , 2012, Journal of the American Academy of Dermatology.

[15]  R. Brady,et al.  Colorectal smartphone apps: opportunities and risks , 2012, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[16]  D. Roberts,et al.  Caution in melanoma risk analysis with smartphone application technology , 2012, The British journal of dermatology.

[17]  A. Hamilton,et al.  Medical professional involvement in smartphone ‘apps’ in dermatology , 2012, The British journal of dermatology.

[18]  G. Hartvigsen,et al.  Features of Mobile Diabetes Applications: Review of the Literature and Analysis of Current Applications Compared Against Evidence-Based Guidelines , 2011, Journal of medical Internet research.

[19]  C. Eccleston,et al.  Smartphone applications for pain management , 2011, Journal of telemedicine and telecare.

[20]  K. Senior,et al.  Smart phones: new clinical tools in oncology? , 2011, The Lancet. Oncology.

[21]  R. Hofmann-Wellenhof,et al.  Mobile teledermatology for skin tumour screening: diagnostic accuracy of clinical and dermoscopic image tele‐evaluation using cellular phones , 2011, The British journal of dermatology.

[22]  P. Cuijpers,et al.  Supportive Accountability: A Model for Providing Human Support to Enhance Adherence to eHealth Interventions , 2011, Journal of medical Internet research.

[23]  Carrie Kovarik,et al.  Mobile teledermatology in the developing world: implications of a feasibility study on 30 Egyptian patients with common skin diseases. , 2011, Journal of the American Academy of Dermatology.

[24]  B. O'Neill,et al.  Auditing the diagnosis of cancer in primary care: the experience in Scotland , 2009, British Journal of Cancer.

[25]  B Rachet,et al.  What if cancer survival in Britain were the same as in Europe: how many deaths are avoidable? , 2009, British Journal of Cancer.

[26]  Rainer Hofmann-Wellenhof,et al.  Melanoma Screening with Cellular Phones , 2007, PloS one.

[27]  Jonathan M. Samet,et al.  Food and Drug Administration , 2020, Definitions.

[28]  A. Kopf,et al.  ABCDE--an evolving concept in the early detection of melanoma. , 2005, Archives of dermatology.

[29]  A. Bandura Health Promotion by Social Cognitive Means , 2004, Health education & behavior : the official publication of the Society for Public Health Education.

[30]  T. Bodenheimer,et al.  Patient self-management of chronic disease in primary care. , 2002, JAMA.

[31]  L. Thomas,et al.  Semiological Value of ABCDE Criteria in the Diagnosis of Cutaneous Pigmented Tumors , 1998, Dermatology.

[32]  J. Bourke,et al.  An evaluation of the revised seven‐point checklist for the early diagnosis of cutaneous malignant melanoma , 1994, The British journal of dermatology.

[33]  R. Ceilley Use of Photographs Illustrating ABCDE Criteria in Skin Self-examination , 2010 .