Digital health 數(shù)字健康

Psyber boom

Dramatic growth in mental-health apps has created a risky industry?

第一段：

When carolina escudero was severely depressed,?going to a therapist’s office became hard to face. So she joined BetterHelp, a popular therapy app.?She paid $65 each week but spent most of her time waiting for her assigned counsellor to respond. She?got two responses in a month.?“It was like texting an acquaintance who has no idea how to deal with mental illness,” she says.?BetterHelp says its service does not claim to operate?around the clock, all its therapists have advanced degrees and “thousands of hours of hands-on clinical work”, and users are able easily to switch them if scheduling is hard.

當(dāng)卡羅琳·埃斯庫(kù)德羅嚴(yán)重抑郁時(shí)，她很難去治療師的辦公室治療。所以她加入了BetterHelp，這是一個(gè)流行的治療應(yīng)用程序。她每周支付65美元，但大部分時(shí)間都在等待指定顧問(wèn)的答復(fù)。她在一個(gè)月內(nèi)收到了兩次回復(fù)。她說(shuō)：“這就像給一個(gè)不知道如何應(yīng)對(duì)精神疾病的熟人發(fā)短信?！盉etterHelp表示，它的服務(wù)并不是全天候的，它的所有治療師都有高學(xué)歷，并且有“數(shù)千小時(shí)的實(shí)踐臨床工作經(jīng)驗(yàn)”，如果某位治療師的時(shí)間沖突安排困難，用戶(hù)可以很容易地切換到另一位治療師。

第二段：

Helping people to deal with mental problems has rarely been more urgent.?The incidence of depression and anxiety has soared in the pandemic—by more than 25% globally in 2020, according to the Lancet, a medical journal.?That, combined with more people using online services, has led to a boom in mental-health apps. The American Psychological Association reckons 10,000-20,000 are available for download.?That, combined with more people using online services, has led to a boom in mental-health apps.?But evidence is mounting that privacy risks to users are being ignored. No one is checking if the apps work, either.

幫助人們解決心理問(wèn)題從來(lái)沒(méi)有像現(xiàn)在這樣緊迫。據(jù)醫(yī)學(xué)雜志《柳葉刀》報(bào)道，2020年，抑郁癥和焦慮癥的發(fā)病率在疫情期間飆升了25%以上。再加上越來(lái)越多的人使用在線服務(wù)，使心理健康app繁榮發(fā)展。美國(guó)心理協(xié)會(huì)估計(jì)有1萬(wàn)-2萬(wàn)個(gè)app可供下載。但越來(lái)越多的證據(jù)表明，用戶(hù)的隱私風(fēng)險(xiǎn)正被忽視。也沒(méi)有人檢查這些應(yīng)用程序是否有效。

第三段：

Mental-health-tech firms raised nearly $2bn in equity funding in 2020, according to CB Insights, a data firm. Their products tackle problems from general stress to serious?bipolar disorder.?Telehealth apps like BetterHelp or Talkspace connect users to licensed therapists.?Also common are subscription-based meditation apps like Headspace. In October Headspace bought Ginger, a therapy app, for $3bn.?Now that big companies are prioritising employees’ mental health, some apps are working with them to help entire workforces. Now that big companies are prioritising employees’ mental health, some apps are working with them to help entire workforces.?One such app, Lyra, supports 2.2m employee users globally and is valued at $4.6bn.

數(shù)據(jù)公司CBInsights的數(shù)據(jù)顯示，心理健康技術(shù)公司在2020年籌集了近20億美元的股權(quán)融資。他們的產(chǎn)品解決了從一般壓力到嚴(yán)重雙相情感障礙（也稱(chēng)躁郁癥，見(jiàn)文末補(bǔ)充資料）的問(wèn)題。遠(yuǎn)程健康app（如：BetterHelp或Talkspace）將用戶(hù)與持證的治療師聯(lián)系起來(lái)。同樣常見(jiàn)的還有基于訂閱的冥想應(yīng)用程序，如Headspace。10月，Headspace以30億美元收購(gòu)了治療應(yīng)用程序Ginger?，F(xiàn)在，大公司正在優(yōu)先考慮員工的心理健康，一些應(yīng)用程序正在與他們合作，幫助全體員工。其中一款應(yīng)用程序Lyra支持全球220萬(wàn)員工用戶(hù)，價(jià)值46億美元。

第四段：

Underneath, though, a?traumalurks?in some corners of the industry.?In October 2020 hackers who had?breached?Vastaamo, a popular Finnish startup, began blackmailing some of its users.?Vastaamo required therapists to back up patient notes online but reportedly did not anonymise or encrypt them.?Threatening to share details of extramarital affairs and, in some cases, thoughts about?paedophilia, on the dark web, the hackers reportedly demanded bitcoin ransoms from some 30,000 patients.?Vastaamo has filed for bankruptcy but left many Finns wary of telling doctors personal details, says Joni Siikavirta, a lawyer representing the company’s patients.

然而，繁榮的背后，在這個(gè)行業(yè)的某些角落里潛伏著一種創(chuàng)傷。2020年10月，黑客黑進(jìn)了芬蘭著名初創(chuàng)公司Vastaamo，黑客們開(kāi)始勒索其部分用戶(hù)。Vastaamo要求治療師在線備份患者記錄，但據(jù)報(bào)道沒(méi)有匿名或加密。據(jù)報(bào)道，這些黑客威脅要在暗網(wǎng)（見(jiàn)文末補(bǔ)充資料）上分享婚外情的細(xì)節(jié)，在某些情況下還想分享戀童癖的想法，他們要求約3萬(wàn)名患者支付比特幣贖金。代表公司病人的律師喬尼·西卡維塔說(shuō)，Vastaamo已經(jīng)申請(qǐng)破產(chǎn)，但這件事情讓許多芬蘭人不敢告訴醫(yī)生個(gè)人細(xì)節(jié)。

第五段：

Other cases may arise. No universal standards for storing “emotional data” exist.?John Torous of Harvard Medical School, who has reviewed 650 mental-health apps, describes their privacy policies as?abysmal. Some share information with advertisers.?“When I first joined BetterHelp, I started to see targeted ads with words that I had used on the app to describe my personal experiences,” reports one user.?BetterHelp says it shares with marketing partners only device identifiers associated with “generic event names”, only for measurement and optimisation, and only if users agree. No private information, such as dialogue with therapists, is shared, it says.

可能會(huì)出現(xiàn)其他情況。沒(méi)有存儲(chǔ)“情感數(shù)據(jù)”的通用標(biāo)準(zhǔn)。哈佛醫(yī)學(xué)院的約翰·托羅斯審查了650個(gè)心理健康應(yīng)用程序，他形容這些應(yīng)用程序的隱私政策糟糕透頂。有些人與廣告商分享用戶(hù)信息。據(jù)一位用戶(hù)說(shuō)：“當(dāng)我第一次加入BetterHelp時(shí)，我開(kāi)始看到的定向廣告，上面有我在應(yīng)用程序上用來(lái)描述我個(gè)人經(jīng)歷的詞語(yǔ)。”BetterHelp表示，它只與營(yíng)銷(xiāo)合作伙伴共享與“通用事件名稱(chēng)”相關(guān)的設(shè)備標(biāo)識(shí)符，僅用于測(cè)量和優(yōu)化，并且只有在用戶(hù)同意的情況下才會(huì)共享。該公司稱(chēng)，沒(méi)有共享私人信息，例如與治療師的對(duì)話。

第六段：

As for effectiveness, the apps’ methods are notoriously difficult to evaluate.?Woebot, for instance, is a?chatbot?which uses artificial intelligence to?reproduce?the experience of cognitive behavioural therapy.?The product is marketed as clinically validated based in part on a scientific study which concluded that humans can form meaningful bonds with bots.?But the study was written by people with financial links to Woebot.?Of its ten peer-reviewed reports to date, says Woebot, eight feature partnerships with a main investigator with no financial ties to it. Any co-authors with financial ties are disclosed, it says.

至于有效性，眾所周知，應(yīng)用程序的方法難以評(píng)估。例如，Woebot是一種聊天機(jī)器人，它利用人工智能生產(chǎn)認(rèn)知行為治療的經(jīng)驗(yàn)。該產(chǎn)品以臨床驗(yàn)證的形式上市，部分基于一項(xiàng)科學(xué)研究，該研究得出結(jié)論，人類(lèi)可以與機(jī)器人形成有意義的聯(lián)系。但這項(xiàng)研究是由與Woebot有利益關(guān)系的人撰寫(xiě)的。Woebot說(shuō)，在迄今為止的十份同行評(píng)議報(bào)告中，有八份是與一名主要調(diào)查人員的合作關(guān)系，而該調(diào)查人員與公司沒(méi)有任何財(cái)務(wù)利益關(guān)系。公司稱(chēng)，任何有財(cái)務(wù)利益關(guān)系的合著者都會(huì)被披露。

第七段：

Mental-health apps were designed to be used in addition to clinical care, not?in lieu of?them.?With that in mind, the European Commission is reviewing the field. It is getting ready to promote a new standard that will apply to all health apps.?A letter-based scale will rank safety, user friendliness and data security.?Liz Ashall-Payne, founder of ORCHA, a British startup that has reviewed thousands of apps, including for the National Health Service, says that 68% did not meet the firm’s quality criteria.?Time to head back to the couch?

設(shè)計(jì)心理健康應(yīng)用程序的目的是將他們用于輔助臨床治療，而不是代替臨床治療?？紤]到這一點(diǎn)，歐盟委員會(huì)正在審查這一領(lǐng)域。它正準(zhǔn)備推廣一項(xiàng)新標(biāo)準(zhǔn)，該標(biāo)準(zhǔn)將適用于所有健康應(yīng)用程序?；谧帜傅牧勘韺?duì)安全性、用戶(hù)友好性和數(shù)據(jù)安全性進(jìn)行排名。英國(guó)初創(chuàng)公司ORCHA的創(chuàng)始人莉茲·阿沙爾·佩恩說(shuō)，68%的應(yīng)用程序不符合公司的質(zhì)量標(biāo)準(zhǔn)。（ORCHA審查了數(shù)千個(gè)應(yīng)用程序，包括英國(guó)國(guó)家醫(yī)療服務(wù)。）是時(shí)候回到沙發(fā)上去了？（回到原點(diǎn)）