How to assess app credibility

Although an abundance of health care apps are available, the quality of the information that they provide varies dramatically. Anyone can create and promote a mobile app, and flashy technology can easily mask a lack of evidence-based information. For example, one study of iPhone apps for smoking cessation found that most of the apps available had low levels of adherence to proven evidenced-based protocol guidelines.20

As the popularity of these apps is increasing in the absence of an official certification or evaluation program, it is critical that clinicians empower themselves to determine the credibility of the mobile health tools that their patients are using. 

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This credibility issue is not unique to mobile apps but is a major issue with online health information in general.Studies have shown that the quality of health information on the internet is often lacking, with no universal standards for posting and rarely any oversight or editorial review.21 Both the health care and information science fields have tackled this problem by developing models and guidelines for evaluating online information.21-25

The literature identifies five criteria to be used in assessing the credibility of online information: currency, coverage or relevance, authority, accuracy, and objectivity or purpose.23,26 The checklist approach is the most common way librarians and educators train users to critically evaluate information, and checklists can be incorporated into clinical practice. 

The CRAAP Test (Table 1), developed at California State University Chico,27 is a checklist of questions based on the five criteria that can be adapted to evaluate the credibility of mobile apps. This easy-to-remember acronym can help clinicians determine the appropriateness of an app and guide their recommendations to patients.

Some of the information needed to answer these questions confidently may be found with a simple visual check of the app itself or the site from which it was downloaded; other questions may require more in-depth information verification and research. 

TABLE 1: CRAAP test for mobile apps27

  • Is the information up-to-date
  • When was the app developed or released?
  • How frequently is it updated?
  • How comprehensive is the app?
  • Does the app do what you would expect, based on its description?
  • Is the information provided at an appropriate level for the app’s target audience?
  • Who is the app’s developer, sponsor or creator?
  • What are the developer’s credentials or organizational affiliations
  • Is the information in the app free from errors?
  • Is the source of the information cited or otherwise indicated?
  • Can the information be independently verified?
  • Is the information in the app objective and without bias or conflict of interest?
  • Is the app selling something (products, additional features)?