Will an app a day, keep the doctor away? A critical look at BPS based phone apps.

And some more. The app is also big on forgiveness and how that helps heal conditions. They quote some research in their app.

Also here’s an email about how it helps M.E
 

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lunarainbows said:
Yes.
So they have a curable fear busting workshop for around $90

And curable “groups” which is like an exclusive group you can join with other people and do extra sessions together and have group chats over 12 weeks, it costs I think somewhere around $1600 or $1800
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That's a lot of potential income then.

I can't see anything on the apple apps preview page that advises people to see a doctor to make sure their chronic pain isn't a serious condition before using the Curable app.

So it seems that doctors are now offering treatment to patients that they haven't seen. How is that ethical - or legal?
 
Curable is mentioned in this study;

Evaluation of Self-Management Support Functions in Apps for People With Persistent Pain: Systematic Review

Hemakumar Devan et al Feb 2019

https://mhealth.jmir.org/2019/2/e13080/

Comment from conclusion;

Although 2 apps (Headspace and SuperBetter) were validated to show improved health outcomes, none were tested in people with persistent pain. Both users and clinicians should be aware of such limitations and make informed choices in using or recommending apps as a self-management tool.
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The lead author of the above study is developing an app specifically for New Zealanders;

Devan is now involved in a Health Research Council-funded project to create an online self-help tool based on the 12-week pain-management programme offered by Wellington’s Capital & Coast DHB. The idea is that this can be used for ongoing support by patients who have been through a programme or by those still struggling to access one.
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One of the keys of self-management is understanding the mechanisms of chronic pain,” he says. “People often think of it as more of an acute-pain model: rest and recover. But for chronic pain, rest doesn’t work. It makes it worse.
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https://www.noted.co.nz/health/health-health/chronic-pain-how-online-tools-can-help-manage
 
New Zealand again. (@Hutan, above post as well.)

Despite the lack of evidence that it works...

https://www.healthnavigator.org.nz/apps/c/curable-app/

While it does mention some cons, there is this review by a doctor;

Overall, curable is a comprehensive pain education tool with a focus on the psychology of pain and emotions. I would highly recommend it to anyone with chronic pain who would like to try tackle the psychology of their pain.
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https://www.healthnavigator.org.nz/apps/c/curable-app/?tab=22799
 
One of the keys of self-management is understanding the mechanisms of chronic pain,” he says. “People often think of it as more of an acute-pain model: rest and recover. But for chronic pain, rest doesn’t work. It makes it worse.
Click to expand...
That is a very sweeping statement. It may be true for some pain conditions, but it's certainly not my experience with ME. The more I push myself to my energy limits, the worse my pain.
 
“People often think of it as more of an acute-pain model: rest and recover. But for chronic pain, rest doesn’t work. It makes it worse.
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This is a complete garbage statement.

Its not the pain, its the condition underlying the pain which dictates what someones ceiling level of exertion is. That underlying condition dictates recovery times of tissue and therefore if your recovery time is longer than a healthy person by definition you will be "resting" more.

I can just see the think bubble coming out of this guys head....

People who can exert themselves to the maximum level don't have pain therefore people who have pain should exert themselves to the maximum.....
 
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Sly Saint said:
article about another app
The UX-Design of the ME/CFS-app Life Peers
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Looks like it's a very early stage prototype. From what I saw it seems the idea is people input their diagnoses, symptoms, treatments and how well they work. Then the technology works out which other user have the closest match for symptoms and diagnoses, and tells you what treatments they have found effective and ineffective.

I can only imagine this working if there are hundreds of thousands of participants. Even then, the detail needed for each would be huge.

A little oddity - the only treatment mentioned in the article is 'cycling'.

Sounds like a recipe for spreading quackery to me.
 
Trish said:
Looks like it's a very early stage prototype. From what I saw it seems the idea is people input their diagnoses, symptoms, treatments and how well they work. Then the technology works out which other user have the closest match for symptoms and diagnoses, and tells you what treatments they have found effective and ineffective.

I can only imagine this working if there are hundreds of thousands of participants. Even then, the detail needed for each would be huge.

A little oddity - the only treatment mentioned in the article is 'cycling'.

Sounds like a recipe for spreading quackery to me.
Click to expand...
The real challenge with projects like this is quality of content. It takes a huge effort to ensure that, with associated costs that are pure loss and those don't scale well, not much economies of scale. To work properly it would need serious public money and backing from institutions, as they would otherwise not trust the data.

And there are plenty of those already, fragmenting an existing pool of competitors facing the same challenge. PatientsLikeMe has been operating for 15 years. It's neat, but without involvement from medical or public health institutions it amounts to nothing. Bit like Wikipedia. It's useful but don't cite it in serious work.

However it would work better as a disease-specific app, rather than a generic one. There's just too much data to work with when you try to account for every medical concept and, oddly enough, huge variations in what basic terms even mean, making those that are common hard to compare. But that only solves one part, I'm not sure who the target population for the aggregate data would be.
 
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