A Top Downloaded iPhone App Can Cause Patient Harm

July 16, 2014
Iltifat Hussain, MD

An app that had been among Apple's top 10 paid claims it can monitor your blood pressure using only an iPhone. Can it really, though?

This article published with permission from iMedicalApps.com.

I was going through the Apple App Store’s Health & Fitness category last week, when I noticed an interesting health app that had made it into the top 10 “Paid” and “Top Grossing” sections. The app’s name is: “Instant Blood Pressure—Monitor Blood Pressure Using Only Your iPhone.”

(As of publish, the app is currently in the top 30 “Paid” section of the Health and Fitness section of the App Store, and the top 30 for “Top Grossing.”)

The following screenshots show the initial description you get of the app in iTunes or the App Store on your iPhone.

The app touts a patent-pending process and states it’s developed by a team from Johns Hopkins—going on to say how Johns Hopkins is a leader in health innovation.

The app costs $3.99 to download and—as you can see in the above descriptions of which I have taken screenshots—promises to measure your blood pressure using just your iPhone. I downloaded the app, and there were 2 tasks it required. First, it asks you to place your finger on the camera (measuring your heart rate), and, second, you have to place your phone’s microphone on your heart.

There are no disclaimers in the app stating how the app might not work, is in testing mode, or is for entertainment purposes.

Rather, the app’s introduction screen touts how you don’t need to use a cuff. You just need your iPhone.

So, are people actually using this app? Yes! If you look at the comments section in iTunes it’s clear this app is being used to manage people’s hypertension.

Click to enlarge

The first comment above is the most interesting. It basically lets everyone know again how the app works, and that it is from Johns Hopkins University. (It’s actually not from Johns Hopkins University—I’ll explain that later.)

There is even a comment from a medic (firefighter) that states he/she is in the medical field and he/she feels confident using the app.

In general, the comments give a favorable review of the app, with many people stating how they are using the app. There are some terrifying comments of people stating the app doesn’t correlate—one person wrote his/her BP cuff was giving 170 systolic readings while the app was giving normal readings. There are also comments implying this is a fake app, that it’s ridiculous the developers are charging $3.99 for something like this, and that it should be removed from the App Store because it can cause serious harm.

So can your iPhone accurately measure your blood pressure by using your phone’s camera and its microphone?

You get the answer when you click the “more” section in the description. The last few lines of the description explain everything.

“Instant Blood pressure is for entertainment purposes only”

So how does an app make it into the top 10 paid section, competing among the likes of “Fitness Buddy,” “7-minute workout challenge”—and apps that even Apple has pushed from a fitness standpoint—all while explaining it will measure your blood pressure in a few paragraphs and then at the end giving a line explaining it is “for entertainment purposes”?

I reached out to the developers of this app to get a better idea. Ryan Archdeacon is the founder and chief executive officer of Aura Labs, which makes the app. I had a phone conversation with him and also exchanged several messages via email.

Basically, he told me he is a biomedical engineer trained at Johns Hopkins University. The app itself is not from Johns Hopkins University even though it is somewhat implied in the description section (in the comments section people actually think it’s from the University). Ryan wanted to stress to me how the app is currently only for entertainment purposes and shouldn’t be used by people to measure their blood pressure. When I asked him why there is no disclaimer in the app, he felt this is something that might be included in future updates.

He was very straightforward with telling me that he could not explain how the app works—basically, stating it is a patent-pending process that he can’t get into at all. I was particularly interested to find out why an app that is in “beta” mode, or for entertainment purposes only, is charging $3.99. He stated the following:

“We have given a lot of thought to our pricing model. Of note, there are broad sections of our test data that fall well within the accuracy parameters laid out in the my last e-mail. However, we have identified certain areas that do fall outside of those parameters and other weaknesses in need of improvement. So the app certainly does work for the majority of our users as reflected in our data and our user feedback. With that said we have been definitely taking feedback regarding our pricing into our considerations for potential future adjustments.”

Ryan requested I not do an article on their app—stating how they did not feel the app was ready for press yet. He told me that if I held off on publishing a story, he would give me an exclusive when they have more data on the app.

According to articles in the American Heart Association and the Cleveland Clinic, there is no correlation between blood pressure and heart rate. I’m not going to comment on the physiology of heart rate and blood pressure correlation (the app implies that it measures your heart rate as a parameter for blood pressure), or my personal opinions on using an iPhone microphone to measure your blood pressure.

If you tell any physician that you’re using your iPhone’s camera and microphone to measure blood pressure, they would recommend against it. I was hoping to have solid data from Ryan to back up the claims, and he stated they had based the app on 254 readings across 181 subjects, with ages ranging from 18 to 105. No literature to back up the app was or has been provided.

Read more.

Iltifat Husain, MD, is the founder and editor-in-chief of iMedicalApps.com. He is an emergency medicine faculty member and the director of mobile app curriculum at Wake Forest University School of Medicine.