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Smartphone apps for calculating insulin dose: a systematic assessment

Overview of attention for article published in BMC Medicine, May 2015
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (98th percentile)

Mentioned by

news
4 news outlets
blogs
3 blogs
twitter
65 tweeters
facebook
5 Facebook pages

Citations

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93 Dimensions

Readers on

mendeley
237 Mendeley
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Title
Smartphone apps for calculating insulin dose: a systematic assessment
Published in
BMC Medicine, May 2015
DOI 10.1186/s12916-015-0314-7
Pubmed ID
Authors

Kit Huckvale, Samanta Adomaviciute, José Tomás Prieto, Melvin Khee-Shing Leow, Josip Car

Abstract

Medical apps are widely available, increasingly used by patients and clinicians, and are being actively promoted for use in routine care. However, there is little systematic evidence exploring possible risks associated with apps intended for patient use. Because self-medication errors are a recognized source of avoidable harm, apps that affect medication use, such as dose calculators, deserve particular scrutiny. We explored the accuracy and clinical suitability of apps for calculating medication doses, focusing on insulin calculators for patients with diabetes as a representative use for a prevalent long-term condition. We performed a systematic assessment of all English-language rapid/short-acting insulin dose calculators available for iOS and Android. Searches identified 46 calculators that performed simple mathematical operations using planned carbohydrate intake and measured blood glucose. While 59% (n = 27/46) of apps included a clinical disclaimer, only 30% (n = 14/46) documented the calculation formula. 91% (n = 42/46) lacked numeric input validation, 59% (n = 27/46) allowed calculation when one or more values were missing, 48% (n = 22/46) used ambiguous terminology, 9% (n = 4/46) did not use adequate numeric precision and 4% (n = 2/46) did not store parameters faithfully. 67% (n = 31/46) of apps carried a risk of inappropriate output dose recommendation that either violated basic clinical assumptions (48%, n = 22/46) or did not match a stated formula (14%, n = 3/21) or correctly update in response to changing user inputs (37%, n = 17/46). Only one app, for iOS, was issue-free according to our criteria. No significant differences were observed in issue prevalence by payment model or platform. The majority of insulin dose calculator apps provide no protection against, and may actively contribute to, incorrect or inappropriate dose recommendations that put current users at risk of both catastrophic overdose and more subtle harms resulting from suboptimal glucose control. Healthcare professionals should exercise substantial caution in recommending unregulated dose calculators to patients and address app safety as part of self-management education. The prevalence of errors attributable to incorrect interpretation of medical principles underlines the importance of clinical input during app design. Systemic issues affecting the safety and suitability of higher-risk apps may require coordinated surveillance and action at national and international levels involving regulators, health agencies and app stores.

Twitter Demographics

The data shown below were collected from the profiles of 65 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 237 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Canada 2 <1%
United States 2 <1%
United Kingdom 2 <1%
Brazil 1 <1%
Malaysia 1 <1%
Netherlands 1 <1%
Austria 1 <1%
Spain 1 <1%
Unknown 226 95%

Demographic breakdown

Readers by professional status Count As %
Student > Master 59 25%
Student > Ph. D. Student 41 17%
Researcher 27 11%
Unspecified 25 11%
Student > Bachelor 21 9%
Other 64 27%
Readers by discipline Count As %
Medicine and Dentistry 74 31%
Unspecified 36 15%
Nursing and Health Professions 29 12%
Computer Science 27 11%
Social Sciences 18 8%
Other 53 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 94. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 August 2018.
All research outputs
#170,302
of 13,434,786 outputs
Outputs from BMC Medicine
#153
of 2,135 outputs
Outputs of similar age
#3,685
of 228,318 outputs
Outputs of similar age from BMC Medicine
#1
of 1 outputs
Altmetric has tracked 13,434,786 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,135 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 35.0. This one has done particularly well, scoring higher than 92% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 228,318 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them