Clinical wisdom in the age of computer apps: a systematic review of four functions that may complement clinical treatment

Mental health clinicians perform complex tasks with patients that potentially could be improved by the massive computing power available through mobile apps. This study aimed to analyze commercially available mobile and computer applications (apps) focused on treating psychiatric disorders. Apps were analyzed by two independent raters for whether they took advantage of computer power to process data in a fashion that augments four main elements of clinical treatment including 1) assessment/diagnosis, 2) treatment planning, 3) treatment fidelity monitoring, and 4) outcome tracking. The evidence base for each of these apps was also explored via PsychINFO, Research Gate, and Google Scholar. Searches of the Google Play Store, the Apple App Store, and the One Mind PsyberGuide found 722 apps labelled for mental health use, of which 163 apps were judged relevant to clinical work with patients with psychiatric disorders.   Fifty-nine of these were determined to contain a computer-driven function for at least one of the four main elements of clinical treatment. The most common element was assessment/diagnosis (55/59 apps), followed by outcome tracking (34/59 apps). Six apps updated treatment plans using user input. Only one app tracked treatment fidelity. None of the apps contained computer-driven functions for all four elements. Twelve apps were supported in randomized clinical trials to show greater efficacy compared to either wait list or other active treatments. Results showed that these four clinical elements can be meaningfully augmented, but the full potential of computer processing appears unreached in mental health-related apps.