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You bet: there's an app for that!

About this time last year, Apple reported selling the 500 millionth iPhone[TM]. When the first iPhone was released in 2007, I was fascinated with all that it could do. However, at the time, I gave little thought about its potential in the health care arena.

According to The Economist (2015), one in five Americans use health apps on their smartphones. Apps can be connected to sensors worn on the body to monitor vital signs. Some apps assist with diagnostics, such as using the phone's camera to analyze the color of test strips dipped in samples. Other apps use plugin devices to enable phones to take biological measurements directly. A recent iPhone upgrade includes the app "Health." I now have an app that keeps track of how many steps I take each day and graphs the details in a weekly spread.

In the past, parents often turned to books, friends, or family members for health care advice. With the explosion of technology in recent decades, parents now have access to up-to-the-minute information--some of a better quality than others--on just about any topic imaginable. Google and other search engines offer many answers in a matter of seconds. And with smartphones providing Internet access, this vast body of knowledge can be carried around in a purse or pocket.

Apps for Strep Season

This time of year, especially, a sore throat might mean a strep infection. Parents are advised to contact their child's pediatrician for a sore throat that lasts more than 24 hours or is accompanied by fever, headache, rash, stomach pain, or vomiting (Trachtenberg, 2010). The American Academy of Pediatrics (AAP) (2003) recommends that children under 15 years of age be tested for strep regardless of other symptoms because bacterial infection is more common in younger children and tends to be more serious. However, for children over 15 years, there is a handful of evidence-based apps that could prove helpful for parents in deciding whether or not their older child should visit a health care provider for testing.

"Strep Prob" quickly calculates the likelihood of a patient having streptococcal pharyngitis using a few simple clinical criteria (Strep Prob, n.d.). Based on the likelihood, "Strep Prob" will also give the recommended treatment. The criteria are in line with the publication of this formula in the Journal of the American Medical Association (McIsaac, Kellner, Aufricht, Vanjaka, & Low, 2004).

Physician designed "MedZam Strep Throat" guides the user to check symptoms and evaluate for key indicators of strep (MedZam, n.d.). Also included is health and wellness education to help guide users to prevent infection, seek treatment for illness, and achieve relief from sickness. The app also contains a journal to manage and track evaluation and remedy data including options to review and export past answers to share with the doctor. MedZam delivers a free comprehensive resource of healthcare information, advice and frequently asked questions.

"Home Score," an app developed by two physicians at Boston Children's Hospital, brings patient-contributed data and public health "big data" together to assess an individual's risk for strep (Fine, Nizet, & Mandl, 2013). The score is calculated using a patient's symptoms (i.e., presence or absence of fever and/or cough) and age, and incorporates a statistic that captures the recent strep incidence in the patient's geographic area. If a patient's home score is low, then his or her risk of having an active strep infection is also low. Because the method does not require a clinical examination, information about the patient could be collected during a telephone conversation. If packaged as an app or online tool and fed data from available surveillance sources, the "Home Score" could allow individuals with a sore throat to learn whether they should consider getting a strep test without leaving home.

App for the Future

Lab-type diagnostics may soon be available to almost any population with access to a smartphone. Such devices would be particularly useful for health care providers working in remote and resource-poor areas.

Descue Medical, a Salt Lake City-based startup founded by two brothers, has developed a product to test for strep called iTest (The Economist, 2015). The brothers, both biomedical-engineering students, hope to have their first test-kit on sale in 2016 after obtaining clearance from America's Food and Drug Administration.

The iTest, designed to diagnose strep throat, includes a kit with a swab that is rubbed against an infected patch of throat. This is placed into a vial containing a liquid, which washes the sample into solution. The vial is then fitted into the iTest device, which then is plugged into a phone. The device uses a technique called voltammetry, which measures the current in a sample as a function of the voltage applied to it. Although rapid strep tests are not new, they usually involve mixing solutions and looking for a visible reaction.

Thousands of new apps are submitted each day. Let's hope that many more of them will benefit children and their families."

References

American Academy of Pediatrics (AAP). (2003). Group A streptococcal infections. In Red book. Report of the Committee on Infectious Diseases (25th ed., 573-584). Elk Grove Village, IL: Author.

Fine, A., Nizer, V., & Mandl, K. (2013). Participatory medicine: A home score for streptococcal pharyngitis enabled by real-time biosurveillance. A cohort study. Annals of Internal Medicine, 159, 577583.

McIsaac, W., Kellner, J., Aufricht, P, Vanjaka, A., & Low, D. (2004). Empirical validation of guidelines for the management of pharyngitis in children and adults. Journal of the American Medical Association, 291(13), 1587-1595.

MedZam Strep Throat, (n.d.). Home page. Retrieved from http://appcrawlr.com/ios/medzam-strep-throat-checker-for

Strep Prob. (n.d.). Download Strep Prob iPhone iPad iOS. Retrieved from http://appfinder.lisisoft.eom/a/strep-prob.html

The Economist. (2015, March 7). Smartphone diagnosis. Retrieved from http://www.economist.com/news/technology-quarterly/2164 5503-exposure-nasty-throat-infection-or-confirmation-heartattack

Trachtenberg, J. (2010). The smart parent's guide to getting through checkups, illnesses, and accidents. New York: Free Press.

Judy A. Rollins, PhD, RN
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Title Annotation:From the Editor
Author:Rollins, Judy A.
Publication:Pediatric Nursing
Article Type:Editorial
Date:Mar 1, 2015
Words:988
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