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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

5 news outlets
3 blogs
61 tweeters
5 Facebook pages

Readers on

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

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


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 61 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 270 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 2 <1%
United Kingdom 2 <1%
Brazil 1 <1%
Austria 1 <1%
Netherlands 1 <1%
Canada 1 <1%
Spain 1 <1%
Malaysia 1 <1%
Unknown 260 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 67 25%
Student > Ph. D. Student 38 14%
Researcher 29 11%
Student > Bachelor 27 10%
Student > Postgraduate 19 7%
Other 56 21%
Unknown 34 13%
Readers by discipline Count As %
Medicine and Dentistry 82 30%
Nursing and Health Professions 32 12%
Computer Science 26 10%
Social Sciences 17 6%
Engineering 16 6%
Other 50 19%
Unknown 47 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 98. 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 30 January 2020.
All research outputs
of 15,542,315 outputs
Outputs from BMC Medicine
of 2,422 outputs
Outputs of similar age
of 231,613 outputs
Outputs of similar age from BMC Medicine
of 1 outputs
Altmetric has tracked 15,542,315 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 2,422 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 37.1. 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 231,613 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