Laird Harrison

May 15, 2015

SAN FRANCISCO — Smartphone applications that track a woman's reproductive health are proliferating, but some provide inaccurate or misleading information, according to a recent survey.

"I was surprised by the lack of quality," said Michelle Moglia, MS, from Planned Parenthood in Easton, Pennsylvania.

She and her colleague conducted a survey of such apps, and found that only 12% were developed with the involvement of healthcare providers. And a literature search turned up only one journal article providing a qualitative analysis of select menstrual cycle and fertility apps.

However, more and more women are using these apps to determine when they are most fertile or to predict their menstrual period, she told Medscape Medical News. As a result, women are showing up at clinics with questions and, sometimes, false information.

Moglia presented results from the survey here at the American Congress of Obstetricians and Gynecologists Annual Clinical Meeting 2015.

She and her colleague searched the iTunes store for English-language menstrual cycle and fertility tracking apps using the search terms "menstrual cycle," "period," "fertility," and "menstrual calendar."

It's hard for consumers to find good-quality apps. I'm not sure how people are picking the ones they use.

They found 262 unique apps for menstrual cycle or fertility tracking, 238 of which were categorized as health and fitness or medical.

The features and functions of the apps varied widely, from creating alerts to averaging cycles, operating in pregnancy mode, and allowing for irregular cycles.

"There is a lot of weird stuff," Moglia reported. One app promises to help the user determine the days on which she is most likely to conceive a boy or a girl, she reported.

Some apps protect data with a password, some allow users to back data up to another device, and some allow users to export data through email or social media.

In the iTunes store, there were user ratings for 155 apps. Of these, each had a median of 35 ratings, and the median rating was 4 stars out of 5.

Half the apps were free for initial download. The others ranged in price from $0.99 to $19.99; the mean price was $2.54. For one-quarter of the apps, additional information or functions were available at prices ranging from $0.99 to $68.90.

Only 30% of the apps had health-related disclaimers, and 70% contained advertisements or promotions.

One app, Knowhen Saliva Fertility Monitor, has been approved by the US Food and Drug Administration.

The market for such apps is huge, said Hans Raffauf, cofounder of Clue, a company in Berlin that makes an app for tracking fertility. He explained that he attended the presentation to get a better understanding of how to make apps "scientifically objective."

Menstrual period and pregnancy is already one of the biggest categories of apps, he said. "This affects 2 billion women, of whom about 1 billion have apps," he told Medscape Medical News.

"It's hard for consumers to find good-quality apps," said Moglia. "I'm not sure how people are picking the ones they use."

Our job is to be knowledgeable about what's out there and to guide women to the apps that are accurate and reliable and reproducible.

This poster was one of multiple studies on reproductive health apps for consumers and clinicians at the meeting, but the presentation by Moglia drew the largest crowd during the session.

She said she hopes to work on standards that clinicians can use to advise their patients who are choosing and using reproductive health apps.

Standards are needed, said Lizellen La Follette, MD, from Greenbrae, California, because "women are coming to us with information about themselves from apps."

However, "we have no information about whether it's accurate," she told Medscape Medical News. "Our job is to be knowledgeable about what's out there and to guide women to the apps that are accurate and reliable and reproducible."

Ms Moglia and Dr La Follette have disclosed no relevant financial relationships. Mr Raffauf is founder and chief operation officer of Clue.

American Congress of Obstetricians and Gynecologists (ACOG) Annual Clinical Meeting 2015: Abstract 111. Presented May 3, 2015.


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