App developers have marketed their products to coaches and parents for sports-related uses. Their programs are said to diagnose concussions by evaluating changes in a person's balance, concentration, memory, speech, and vision.
However, the Food and Drug Administration (FDA) has never issued an approval for any such app. As such, the programs are actually illegal, not to mention potentially dangerous.
“I want to be clear, there are currently no devices to aid in assessing concussion that should be used by consumers on their own,” warns FDA official Dr. Jeffrey Shuren. “Using such devices can result in an incorrect diagnosis after a head injury that could lead a person with a serious injury to return to their normal activities instead of seeking critical medical care, putting them at greater danger.”
It is difficult to diagnose a concussion, even if a physician performs a thorough evaluation. There are no available diagnostic tests with sufficient consistency and reliability. (Related: Study suggests that activity, more than rest, speeds recovery after a brain injury.)
Patients with a concussion may lose consciousness for more than one minute or find it hard to stay awake. They may throw up and experience convulsions, double vision, severe headaches, pain in their neck, and seizures. Finally, patients may act differently than usual.
Healthcare professionals advise family members to keep a lookout for these symptoms. However, the symptoms might not show up immediately after the concussion.
Even first responders, primary care providers, and emergency personnel will find it hard to diagnose a concussion in a short amount of time. A smartphone app will not outperform the trained experts.
Furthermore, a concussion shares its symptoms with many other issues. A person may experience dizziness, headaches, and other issues without having a concussion.
During diagnosis, healthcare providers review the history and risk factors of a patient. They also investigate the process that caused the injury, as well as the apparent symptoms and timing. Finally, they conduct objective exams.
Even the most advanced app cannot perform all of these processes. It takes a trained healthcare provider with the right skills and experience to make anything close to an accurate judgment.
To make matters worse, parents and coaches who rely on apps for diagnosing concussions might fail to spot the brain injury. They run the risk of aggravating the existing issue.
They might even cause a second concussion that increases the injury of the brain. If this happens, the patient will suffer worse symptoms and take more time to recover from the brain injuries.
Michigan State University (MSU) researcher Sarah Clark observed that the parents of a child who experienced a head injury wanted confirmation of any possible concussion.
In a 2016 study conducted by Clark and her colleagues, 68 percent of participating parents expected an emergency department to tell them if their child had suffered a concussion. Around the same number relied on the hospital to advise them about the length of the recovery period.
However, while healthcare professionals do use concussion tests and devices in their diagnostic evaluation, those approaches operate on evidence and received FDA approval. They are not standalone tools.
“Concussions can be challenging to diagnose, even for very experienced clinicians,” warns Mount Sinai instructor Dr. Maria Kajankova.
She adds that it may be tempting to rely on technology to do this work, but current science has yet to support leaving this important job to an app.