ReviewNPJ digital medicine2023
Can Apple and Google continue as health app gatekeepers as well as distributors and developers?
Review in NPJ digital medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed.
- Value in app store metadata and user reviews: A dual perspective on quality of Parkinson's and dementia apps.PLOS digital health · 2026Article
- Mobile applications for atrial fibrillation self-management: A systematic search and evaluation.Heart rhythm O2 · 2026Article
- Designing an mHealth App to Encourage Uptake of Muscle-Strengthening Exercise in Older Adults: Co-Design Focus Group Study.JMIR aging · 2026Article
- Active remote monitoring of long-term conditions with mobile devices: a systematic review of cost-effectiveness analyses.NPJ digital medicine · 2025Article
- Expert evaluation of mobile health apps for breast cancer management: a feature-based analysis using the Mobile Application Rating Scale (MARS).BMC health services research · 2025Article
- Gamification in mHealth Apps for Rehabilitation: Protocol for a Scoping Review.JMIR research protocols · 2025Article
- Policing the Boundary Between Responsible and Irresponsible Placing on the Market of Large Language Model Health Applications.Mayo Clinic proceedings. Digital health · 2025Review
- Assessment of Eye Care Apps for Children and Adolescents Based on the Mobile App Rating Scale: Content Analysis and Quality Assessment.JMIR mHealth and uHealth · 2024Article
- The regulatory status of health apps that employ gamification.Scientific reports · 2024Article
- Digital Health Applications (DiGAs) on a Fast Track: Insights From a Data-Driven Analysis of Prescribable Digital Therapeutics in Germany From 2020 to Mid-2024.Journal of medical Internet research · 2024Article
- Colonialism in the new digital health agenda.BMJ global health · 2024Review
- Assessment of healthcare application quality: Development of a standardized methods for healthcare professionals.MethodsX · 2023Article
- Continuous Improvement of Digital Health Applications Linked to Real-World Performance Monitoring: Safe Moving Targets?Mayo Clinic proceedings. Digital health · 2023Review
- "All Day, Every Day, Listening to Trauma": Investigating Features of Digital Interventions for Empathy-Based Stress and Burnout.Proceedings of the SIGCHI conference on human factors in computing systems. CHI ConferenceArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Mobile apps are the primary means by which consumers access digital health and wellness software, with delivery dominated by the 'Apple App Store' and the 'Google Play Store'. Through these virtual storefronts Apple and Google act as the distributor (and sometimes, importer) of many thousands of health and wellness apps into the EU, some of which have a medical purpose. As a result of changes to EU law which came into effect in May 2021, they must now ensure that apps are compliant with medical devices regulation and to inform authorities of serious incidents arising from their use. The extent to which these new rules are being complied with in practice is uneven, and in some areas unclear. In light of EU legislation related to competition, which came into effect in November 2022, it is also unclear how conflicts of interest can be managed between Apple and Google's roles as gateway duopoly importers and distributors whilst also developers of their own competitive health products. Finally, with the proposed European health data space regulation, wellness apps will be voluntarily registered and labelled in a fashion more like medical devices than consumer software. We explore the implications of these new regulations and propose future models that could resolve the apparent conflicts. All stakeholders would benefit from improved app store models to sustainably evolve safer, better, and fairer provision of digital health applications in the EU. As EU legislation comes into force it could serve as a template for other regions globally.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.