title: Smartphone breast applications - what's the evidence?
abstract: BACKGROUND
  There are around 40,000 healthcare applications (apps) available for smartphones. Apps have been reviewed in many specialties. Breast cancer is the most common malignancy in females with almost 1.38 million new cases a year worldwide. Despite the high prevalence of breast disease, apps in this field have not been reviewed to date. We have evaluated apps relevant to breast disease with an emphasis on their evidence base (EB) and medical professional involvement (MPI).
  
  
  METHODS
  Searching the major app stores (apple iTunes, Google Play, BlackBerry World, Windows Phone) using the most common breast symptoms and diseases identified relevant apps. Extracted data for each app included target consumer, disease focus, app function, documentation of any EB, documentation of MPI in development, and potential safety concerns.
  
  
  RESULTS
  One-hundred-and-eighty-five apps were reviewed. The majority focused on breast cancer (n = 139, 75.1%). Educational (n = 94) and self-assessment tools (n = 30) were the most common functions demonstrated. EB and MPI was identified in 14.2% and 12.8% of apps respectively. Potential safety concerns were identified in 29 (15.7%) apps.
  
  
  CONCLUSIONS
  There is a lack of EB and MPI in the development of current breast apps. Safety concerns highlight the need for regulation, full authorship disclosure and clinical trials. A robust framework for identifying high quality applications is necessary. This will address the current barrier pertaining to a lack of consumer confidence in their use and further aid to promote their widespread implementation within healthcare.
authors.affiliation: Department of Surgery & Cancer, Imperial College London, UK. Electronic address: m.mobasheri@imperial.ac.uk.
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Mobasheri
authors.affiliation: Department of Surgery & Cancer, Imperial College London, UK. Electronic address: m.johnston@imperial.ac.uk.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Johnston
authors.affiliation: Institute of Global Health Innovation, Imperial College London, UK. Electronic address: dominic.king@imperial.ac.uk.
authors.forename: Dominic
authors.initials: D
authors.lastname: King
authors.affiliation: Institute of Global Health Innovation, Imperial College London, UK. Electronic address: d.leff@imperial.ac.uk.
authors.forename: Daniel
authors.initials: D
authors.lastname: Leff
authors.affiliation: Department of Breast Surgery, Imperial College London, UK. Electronic address: paul.thiruchelvam@ic.ac.uk.
authors.forename: Paul
authors.initials: P
authors.lastname: Thiruchelvam
authors.affiliation: Institute of Global Health Innovation, Imperial College London, UK. Electronic address: a.darzi@imperial.ac.uk.
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis; D040421:Cell Phone; D054626:Consumer Health Information / Q000592:standards / Q000706:statistics & numerical data; D059026:Diagnostic Self Evaluation; D055317:Evidence-Based Practice; D005260:Female; D006801:Humans; D063731:Mobile Applications / Q000592:standards* / Q000706:statistics & numerical data; D017216:Telemedicine / Q000592:standards / Q000706:statistics & numerical data
keywords: Apps; Breast disease; Cancer; Mobile health; Smartphone; mHealth