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Headache diaries are often used by headache sufferers to self-monitor headaches. With advances in mobile technology, mobile electronic diary apps are becoming increasingly common.
This review aims to identify and evaluate all commercially available mobile headache diary apps for the two most popular mobile phone platforms, iOS and Android.
The authors developed a priori a set of 7 criteria that define an ideal headache diary app intended to help headache sufferers better understand and manage their headaches, while providing relevant data to health professionals. The app criteria were intended as minimum requirements for an acceptable headache diary app that could be prescribed by health care professionals. Each app was evaluated and scored against each criterion.
Of the 38 apps identified, none of the apps met all 7 app criteria. The 3 highest scoring apps, meeting 5 of the app criteria, were iHeadache (developed by Better QOL), ecoHeadache (developed by ecoTouchMedia), and Headache Diary Pro (developed by Froggyware). Only 18% of the apps were created with scientific or clinical headache expertise and none of the apps reported on psychometric properties.
Despite the growing market and demand, there is a concerning lack of scientific expertise and evidence base associated with headache diary apps.
Headache disorders are highly prevalent, with 46% of adults and 51% of children and adolescents presenting with an active headache disorder worldwide [
Keeping a diary on a regular basis to track headache-related information such as occurrence, symptoms, triggers, and medication intake is often recommended by health care professionals [
The use of mobile e-diaries has several advantages over paper diaries. Mobile e-diaries allow users to conveniently take the diary with them at all times, they make it possible to incorporate branching questions which makes data entry more efficient, and they have the capability of automatically building reports from the data entered, which may help users to identify patterns and predict trends. E-diaries are also beneficial to health care professionals by allowing them to access patient data in real time, verify actual entry times, and ultimately user compliance rates. E-diaries have been shown to be more reliable than paper-based diaries, and they are associated with increased levels of compliance and satisfaction when compared to paper diaries in both adults and children [
E-diaries and other medical apps on mobile phones are rapidly expanding, especially outside the academic setting. The number of available mobile health apps across major mobile phone app stores increased from 17,000 in 2010 to 97,000 apps in 2013 [
Concerns are commonly raised around the quality of such mobile health apps, due to the low levels of involvement by health care professionals, and failure to use a scientific evidence base in app development [
The two most popular mobile phone platform app stores were used to identify all available headache diary apps. The Canadian Google Play (Android) and Apple iTunes App (iOS) stores were searched using the following search terms: headache, headache diary, headache tracker, migraine, migraine diary, and migraine tracker. The final app search was conducted on November 2, 2013 by 2 reviewers (ASH, Hayley Stinson, BA). ASH identified a total of 41 apps, while HS identified 42. Agreement between the reviewers was 96.4%. Any discrepancies were resolved by a discussion with a third reviewer (AH).
All of the apps identifying themselves in the Canadian Google Play or Apple iTunes App store description as headache logging or tracking tools were included. The apps were then downloaded and excluded from the review if they failed to log or track headaches, despite their associated description. When both a version requiring payment and a free version of an app was available, the version requiring payment was purchased and used, while the free version was excluded. This was done to ensure that the best available version of the app was considered. The apps not available in English were also excluded. Identical apps available in both the Google Play and Apple iTunes App stores were counted only once.
One reviewer (ASH) downloaded all of the apps meeting the criteria. The apps were installed on a Google LG Nexus 4 running Android 4.3 and an Apple iPod Touch ME178C/A (4th generation) running iOS 6.1.2. The reviewer extracted the following information for each app: date and version of last update, price, developer, technical requirements, language, assessment schemes (time contingent, signal contingent, or event contingent), presence of reports, reports linking multiple variables, type of reports (plain text, table, graphs/charts), presence of headache entry log (list of previous headache entries), ability to edit previous headache entries, ability to export data from app (eg, email, PDF), reminders, headache characteristics and related variables measured (eg, headache severity, triggers, headache quality), inclusion of customization and personalization features, ability to use the app without Internet connection, the need to create an account to use the app, and presence of advertisements in the app. Any associated components not directly part of the app, such as website components, were not evaluated, given that our main focus was to evaluate the diaries as stand-alone apps.
Given that no standards exist for evaluating these apps, the authors consensually defined a set of criteria for an ideal headache diary app intended to help headache sufferers better understand and manage their headaches, while providing relevant data to health professionals. Based on the authors’ judgment, an ideal headache diary app should (1) be created with clinical and/or scientific headache expertise, (2) have undergone testing to ensure the diary is a feasible and reliable method of data collection, (3) measure clinically relevant headache variables, (4) be usable, (5) include customizable answer options and reports, (6) include reports linking multiple variables, and (7) have the ability to export headache data from the app. See below for how each of these criteria, intended as minimum requirements for an acceptable headache diary app, were evaluated.
An appropriate app does not necessarily need to be developed by headache experts themselves, but it is important that experts be involved at least in advising development. For this reason, we
To examine whether the feasibility—described in terms of adherence, acceptability, learnability, efficiency, or accuracy—and psychometric properties of the existing apps could have been formally tested, a search of the following databases was conducted: PubMed, Web of Knowledge, and PsychINFO (2000 to October 24, 2013). The search did not include publications prior to 2000; the oldest app versions included in this review were released in 2010. The search terms included “headache or migraine or cephalalgia” and “diary or diaries”. A total of 1442 abstracts were retrieved from our search strategy. Two reviewers (ASH, AH) independently screened all retrieved abstracts (n=723 after removing duplicates) for e-diaries or mobile phone diaries matching the names of the apps, their developers’ names, or descriptions of the content of the apps included in this review. The systematic review of the headache e-dairies developed and used in the academic setting was conducted recently by several members of this research team and was taken into account [
There is no consensus on a standard set of core variables that should be assessed in a headache diary. Consequently, the authors created and conducted an online survey among headache experts to define what the most clinically relevant headache variables for a headache diary app should be. Headache experts were required to (1) have an MD or PhD, (2) be affiliated with recognized universities, (3) be currently conducting research and/or practicing in the field of neurology or pain, and (4) be published in peer-reviewed journals on the topic of headaches. We identified and invited 35 headache experts to participate. Of the 35 experts contacted, 10 responded. Experts were independently asked to create a list including all variables they believed should be measured in a mobile headache diary. Responses were compiled and comparable responses grouped under the same variable (eg, headache severity, headache intensity, and pain level were grouped together). For a complete list of headache variables recommended by the experts, see
Headache variables recommended by headache experts (n=10).
Headache variablea | Number of experts recommending, n (%) |
Headache severity/intensity | 10 (100) |
Headache triggers | 9 (90) |
Medication/treatment taken for headache | 9 (90) |
Associated headache symptoms | 7 (70) |
Headache frequency (derived from headache occurrence) | 6 (60) |
Headache-related disability | 5 (50) |
Headache duration | 5 (50) |
Response to medication/treatment | 3 (30) |
Ongoing preventative medication | 2 (20) |
Time of headache onset | 2 (20) |
Date of headache | 2 (20) |
Presence of aura | 2 (20) |
Menses | 2 (20) |
Headache pain location | 2 (20) |
Headache pain quality | 2 (20) |
Side effects of treatment | 1 (10) |
Time of treatment | 1 (10) |
Nonpharmacological treatments | 1 (10) |
Life events (eg, travel, exercise) | 1 (10) |
Prodrome symptoms | 1 (10) |
Sought care from health professionals | 1 (10) |
Worry/anxiety/fear rating | 1 (10) |
Stress/mood rating | 1 (10) |
Sleep rating | 1 (10) |
aVariables recommended by 50% or more of the experts were considered clinically relevant.
An ideal app was expected to be usable. Usability is a qualitative attribute which assesses how easy user interfaces are to use and understand [
In the current review, each app user interface was systematically inspected, and its compliance with a common list of 10 well-established usability heuristics (see
Nielson usability heuristics [
Heuristic | Description |
Visibility of system status | The system should always keep users informed about what is going on, through appropriate feedback within reasonable time. |
Match between system and the real world | The system should speak the user’s language, with words, phrases and concepts familiar to the user, rather than system-oriented terms. The system should follow real-world conventions, making information appear in a natural and logical order. |
User control and freedom | Users often choose system functions by mistake and will need a clearly marked "emergency exit" to leave the unwanted state without having to go through an extended dialogue. The system should support undo and redo. |
Consistency and standards | Users should not have to wonder whether different words, situations, or actions mean the same thing. The system should follow platform conventions. |
Error prevention | Even better than good error messages is a careful design which prevents a problem from occurring in the first place. Either eliminate error-prone conditions or check for them and present users with a confirmation option before they commit to the action. |
Recognition rather than recall | Minimize the user's memory load by making objects, actions, and options visible. The user should not have to remember information from one part of the dialogue to another. Instructions for use of the system should be visible or easily retrievable whenever appropriate. |
Flexibility and efficiency of use | Accelerators—unseen by the novice user—may often speed up the interaction for the expert user such that the system can cater to both inexperienced and experienced users. The system should allow users to tailor frequent actions. |
Aesthetic and minimalist design | Dialogues should not contain information which is irrelevant or rarely needed. Every extra unit of information in a dialogue competes with the relevant units of information and diminishes their relative visibility. |
Help users recognize, diagnose, and recover from errors | Error messages should be expressed in plain language (no codes), precisely indicate the problem, and constructively suggest a solution. |
Help and documentation | Even though it is better if the system can be used without documentation, it may be necessary to provide help and documentation. Any such information should be easy to search, be focused on the user's task, list concrete steps to be carried out, and not be too large. |
Customizable answer options are important in making the apps relevant to each user. This feature allows users to create their own inputs when filling out a diary entry. For example, the possibility for the user to add a custom trigger (eg, chocolate, caffeine, or stress) in case the desired trigger does not appear in the default list. To meet this criterion, the apps were required to have at least one headache variable answer option input be customizable and to contain some level of customization in the reports. Customizable reports allow users to better understand their headaches by allowing them to examine the trends that are a concern to them. Examples of customizable reports include controlling the time span of a report or choosing the variables contained in a report. One reviewer (ASH) extracted the required information by reviewing the content of the apps.
Reports allow users to understand trends associated with their headaches. This criterion required that the apps include reports simultaneously linking multiple variables in tables or graphs. For example, a report displaying information about both time of day and headache occurrence was considered to be a report linking multiple variables (time of day and headache occurrence). One reviewer (ASH) extracted the required information by reviewing the content of the apps.
The final app criterion required that the apps include an export feature, allowing users to export logged headache data directly to email, PDF, etc, and allowing the data to be viewed and saved outside the app. This feature is important as it facilitates sharing users’ headache data with their health care professionals. One reviewer (ASH) extracted the required information by reviewing the content of the apps.
In total, 38 apps were identified as headache diaries. For a list of included apps and their characteristics see
Available headache diary apps (n=38) and their characteristics, ordered by number of app criteria met.
Name | Platform/ |
Price, Can$ | App criteria | Number of app |
||||||
Created with headache expertise | Published in scientific |
Headache variables measured / Clinically relevant |
Usability score (%) | Custom |
Reportsb / Reports linking multiple variables | Export data from app | ||||
iHeadache | iOS/1.45 | 4.99 | Yes | No | 8/7 | 90 | Few/Yes | Yes/No | Yes | 5 |
Headache Diary (ecoHeadache) | iOS/2.3 | 1.99 | No | No | 13/7 | 94 | Many/Yes | Yes/Yes | Yes | 5 |
Headache Diary Proc | Android/3.7 | 2.99 | No | No | 10/7 | 82 | Few/Yes | Yes/Yes | Yes | 5 |
Headache Diary Prod | iOS/1.5 | 3.99 | No | No | 12/7 | 94 | Many/No | Yes/Yes | Yes | 4 |
Migraine Diary | iOS/2.4.1 | 1.99 | No | No | 10/7 | 90 | Many/No | Yes/Yes | Yes | 4 |
PainCal | iOS/2.0 | 1.99 | No | No | 9/6 | 80 | Many/Yes | Yes/Yes | Yes | 4 |
A Migraine Diary for You | iOS&Android /1.1.3 & 1.1 | 4.99 / |
No | No | 13/7 | 62 | Many/Yes | Yes/Yes | Yes | 4 |
Migraine | iOS/1.1 | Free | Yes | No | 7/6 | 72 | Few/No | Yes/Yes | Yes | 3 |
Migralex | iOS/1.1 | Free | Yes | No | 10/5 | 84 | Few/No | Yes/No | Yes | 3 |
Oh, My head | iOS/1.0 | 1.99 | No | No | 5/2 | 76 | Few/Yes | Yes/Yes | No | 3 |
Migraine Free | iOS/1.1 | Free | Yes | No | 5/5 | 74 | None/No | Yes/Yes | Yes | 3 |
Cluster Headaches | Android |
Free | No | No | 4/3 | 80 | Few/No | Yes/Yes | Yes | 3 |
Headache Relief Log | Android/1.07 | 1.00 | No | No | 7/4 | 80 | Few/No | Yes/Yes | Yes | 3 |
Headache App | iOS&Android /1.4.5 & 1.5 | Free | No | No | 9/6 | 76 | Many/No | Yes/Yes | Yes | 3 |
Headache Notee | iOS&Android /1.2.1 & 1.0.3 | Free | No | No | 6/5 | 84 | Few/No | Yes/Yes | Yes | 3 |
Migraine Meter | iOS/2.6 | Free | Yes | No | 9/7 | 82 | Few/No | Yes/No | Yes | 3 |
PainTrek | iOS/1.1 | Free | Yes | No | 8/5 | 66 | None/Yes | Yes/Yes | No | 2 |
American |
iOS/1.0.1 | Free | Yes | No | 7/5 | 74 | No/No | No/No | Yes | 2 |
PainCalendar | iOS/1.0 | 5.99 | No | No | 9/6 | 86 | Few/No | Yes/Yes | No | 2 |
Headache & |
iOS/2.5.0 | 1.99 | No | No | 5/3 | 74 | No/Yes | Yes/Yes | Yes | 2 |
Migraine |
iOS/0.9.1 | Free | No | No | 4/4 | 86 | Few/No | No/No | Yes | 2 |
MigraineMate | iOS/2.198 | Free | No | No | 3/2 | 94 | No/No | Yes/Yes | No | 2 |
Migraine Diary | iOS/1.0 | Free | No | No | 8/6 | 86 | No/No | No/No | Yes | 2 |
Headachef | iOS/1.1.0 | 4.99 | No | No | 6/4 | 82 | Few/No | Yes/Yes | No | 2 |
Migraine Stop | iOS/1.0 | Free | No | No | 9/6 | 92 | No/No | Yes/No | Yes | 2 |
Migraine tracker! | iOS/4.0 | Free | No | No | 2/1 | 82 | No/No | No/No | No | 2 |
Headache diaryg | Android/1.3.0 | 1.34 | No | No | 7/6 | 72 | Few/No | Yes/Yes | Yes | 2 |
Migraine |
Android/4.0 | 1.96 | No | No | 10/6 | 86 | Few/No | Yes/No | Yes | 2 |
HeadacheDiary | Android/1.0 | 2.04 | No | No | 6/6 | 76 | No/Yes | Yes/Yes | No | 2 |
Headache Diaryh | Android/1.25 | Free | No | No | 7/4 | 74 | Few/No | Yes/Yes | Yes | 2 |
MyGraine | iOS/1.1 | Free | No | No | 9/5 | 70 | Few/No | Yes/Yes | Yes | 2 |
Migraine Institute | iOS/1.4 | 0.99 | Yes | No | 8/6 | 74 | No/No | No/No | Yes | 2 |
Ubiqi Health |
Android/2.1 | Free | No | No | 7/5 | 82 | Many/No | No/No | Noi | 1 |
Migraine Tracker | Android/0.9b | Free | No | No | 4/3 | 86 | No/No | No/No | No | 1 |
My Headache Diary | iOS/1.1 | Free | No | No | 7/5 | 72 | No/No | No/No | No | 0 |
migraineDiary | Android/0.1 | Free | No | No | 5/4 | 72 | No/No | No/No | No | 0 |
Headache Diaryj | Android/1.1 | 0.99 | No | No | 6/5 | 64 | No/No | No/No | No | 0 |
Headache & |
iOS/1.2 | 0.99 | No | No | 5/3 | 0k | Few/No | No/No | No | 0 |
aFew: 3 or less headache variables allow for custom answer options; Many: more than 3 headache variables allow for custom answer options.
bRefers to the app’s ability to create reports in general, not necessarily custom reports or reports linking multiple variables.
cDeveloped by Froggyware.
dDeveloped by appcellent GmbH.
eFull name: Headache Note – You can manage headache by recording the pain and the taken medicine (iOS name); Headache Note-be healthier- (Android name).
fFull name: Headache – migraine and headache journal/log/calendar.
gDeveloped by Marcel Shroder.
hDeveloped by Benjamin Gerfelder.
iAble to export data from website component associated with app.
jDeveloped by Tmoney.
kNot usable; unable to load headache entries.
The quality of the apps was determined by how many app criteria were met. The apps with the highest quality were iHeadache (developed by Better QOL), ecoHeadache (developed by ecoTouchMedia), and Headache Diary Pro (developed by Froggyware), each of which met 5 of the 7 app criteria. See
Number of apps meeting each app criterion (N=38).
Criterion | Number of apps meeting the criterion, n (%) |
1. Created with headache expertise | 7 (18) |
2. Formal psychometric and feasibility testing | 0 (0) |
3. Clinically relevant headache variables measured | 7 (18) |
4. Usable | 24 (63) |
5. Customizable answer options and reports | 9 (24) |
6. Reports linking multiple variables | 22 (58) |
7. Export headache data from app | 25 (66) |
The home screen of iHeadache (left), ecoHeadache (middle), and Headache Diary Pro (right).
Only 7 apps (18%) were found to have been created with scientific or clinical expertise and met criterion #1. None of the apps in this review were found in the scientific literature search, and as a result none of the apps were considered to have undergone formal psychometric or feasibility testing (criterion #2).
Of the 38 apps, 7 of them (18%) measured all 7 clinically relevant headache variables as defined by app criterion #3. The average number of headache variables measured in each app was 7 out of 24. The average number of variables measured per app that were identified as clinically relevant by the experts was 5 out of 7. The most common variable measured was headache intensity (37/38, 97%), followed by medication usage (30/38, 79%), triggers (27/38, 71%), time of headache (27/38, 71%), notes/comments (26/38, 68%), other headache symptoms (25/38, 66%), headache duration (25/38, 66%), location of headache (21/38, 55%), headache disability (12/38, 32%), headache quality (11/38, 29%), and other coping strategies (11/38, 29%). Other variables less frequently measured were geographical location, weather, mood, and headache type. For a complete list of headache variables measured by those apps meeting 4 or more app criteria, see
Headache variables measured by all apps (n=7) meeting 4 or more app criteria.
Headache variables measured | App | ||||||
|
iHeadache | Headache Diary (ecoHeadache) | Headache Diary Proa | Headache Diary Prob | Migraine Diary | PainCal | A Migraine Diary for You |
Headache severity/intensity | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Headache triggers | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Medication/treatment taken for headache | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Associated headache symptoms | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Headache frequency | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Headache-related disability | ✓ | ✓ | ✓ | ✓ | ✓ |
|
✓ |
Headache duration | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Time of headache onset | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Headache pain location |
|
✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Headache pain quality |
|
✓ |
|
✓ |
|
✓ | ✓ |
Nonpharmacological treatment and coping strategies |
|
✓ |
|
✓ | ✓ |
|
✓ |
Type of day (eg, work, school) |
|
✓ |
|
|
|
|
|
Type of headache |
|
✓ | ✓ |
|
|
|
|
Weather when headache occurred |
|
|
|
|
|
|
✓ |
Activity when headache occurred |
|
|
|
|
|
|
✓ |
Geographical location when headache |
|
|
|
✓ |
|
|
|
aDeveloped by Froggyware.
bDeveloped by appcellent GmbH.
Of the 38 apps, 24 (63%) met this criterion, which consisted of scoring a total usability score of at least 75%. Usability scores ranged from 0% to 94% with a median score of 80%.
Most of the apps (27/38, 71%) contained reports on headache data, with 58% (22/38) of the apps containing reports linking multiple variables, while customizable reports were less common (9/38, 24%). The ability to modify existing lists of answer options for a headache variable (eg, adding a new trigger to the preexisting list) was seen in 63% (24/38) of the apps. Many of the apps (25/38, 66%) also allowed data entered into the diary to be exported, often via email or by creating PDF documents.
Clinicians often recommend that headache sufferers use a diary to record headache events, and e-diaries have been growing in popularity. Despite this, e-diaries created and tested by headache experts in academic settings are not available to the general population. As a result, consumers are restricted to what is available in the app stores. Despite the large volume of apps available commercially, none of the apps met all 7 app criteria. It is especially concerning that none of the apps identified in this review were found to have undergone formal feasibility or psychometric property testing. It is essential when developing mobile health apps to test feasibility and, later on, psychometric properties in order to offer consumers high-quality assessment tools. Additionally, only 2 apps included the ability to set reminders, despite research demonstrating that reminders can increase adherence in health interventions [
Of the 3 highest scoring apps (iHeadache, ecoHeadache, and Headache Diary Pro), iHeadache, developed by Better QOL for iOS, was the only app created with scientific or clinical headache expertise and is available for Can $4.99. The app records all clinically relevant variables without recording other nonessential information, making it easy to use with fast data input. However, it has not been formally tested for feasibility or psychometric properties and the in-app reports are in plain text format that can be difficult to interpret. The app developed by ecoTouchMedia for iOS, ecoHeadache, is available for Can $1.99. While it offers good levels of customization, it tracks significantly more information than what has been defined as essential. This app can track 13 headache variables and can generate 24 chart reports, in addition to customizable reports. Headache Diary Pro, developed for Android by Froggyware, costs Can $2.99 but was not rated as usable as were the 2 other apps mentioned above. However, it was the highest rated Android offering.
A long-term strategy is needed to begin offering validated evidence-based medical apps to the general population. As a first step it is essential to disseminate the state of the current apps to headache sufferers and their health care professionals. Currently, this can be done through educating health care professionals on the existing app environment, allowing them to inform patients. In addition, findings can be distributed using social media to educate consumers on the quality of existing apps. Given the fast-growing number of medical apps available, it is not realistic to propose regulating the full marketplace. As well, systematic reviews such as this will become more complex as the number of apps increases, especially taking into account the rate at which apps are being developed and upgraded.
We recommend that headache experts and the research community partner with app developers to test high-quality, popular apps currently available to consumers. Another solution would be giving developers the opportunity to have their apps evaluated by an independent third party organization with mobile health expertise. There are current initiatives moving in this direction, for example, the National Health Service (NHS) in the United Kingdom has begun reviewing medical apps and currently offers a growing list of approved apps online [
We have evaluated the apps taking into account current knowledge. However, it is critical for apps to advance along with research, which will require continual updates to the apps to satisfy the newest developments and discoveries.
We intend to work toward filling the gaps identified in this review. We are currently developing the Wireless Headache Intervention (WHI) diary app called myWHI. The myWHI diary is designed to meet all 7 app criteria. It has been developed using a participatory design process involving both headache sufferers and headache experts [
Information on pain apps (including headache diaries) has been synthesized in a previous review by Rosser and Eccleston [
The scope of the review was limited to the English-language apps available in the Canadian app stores, and looked only at the 2 most popular platforms. Different apps may be available in other countries, and other apps may exist on less popular platforms. This review focused on mobile apps, and did not consider e-diaries available only as general websites. The authors focused on mobile diary apps because they are portable, which is key for a self-monitoring tool, allowing users to use them on the go. This in turn may facilitate increased adherence [
The app evaluation method had several limitations. First, the method for evaluating the quality of these apps was developed by the authors and the criteria have not been validated. Second, the app criteria were each given equal weight in evaluating the apps, despite the fact that some criteria might be more significant than others in terms of the effectiveness of the app. Third, we made the assumption that the more app criteria met, the higher the app quality, but this may not be the case. Fourth, when reaching a consensus on the most relevant clinical variables that should be collected by a headache diary, only scientific or clinical experts were used—headache sufferers were not consulted and may have suggested other relevant variables. Fifth, in determining if the app was created with headache expertise the authors were limited to the information made available to them in the app store description and developer websites, and these descriptions can be of poor quality. Finally, the literature search seeking to identify formal feasibility or psychometric testing of the apps could not confirm that this type of testing had not occurred, only that it has not been published.
The limitations to this review reflect limitations and concerns with the medical app market in general. It is an emerging field lacking quality standards with poor transparency in the app development process.
In summary, although a proliferation of headache diary apps exists, the majority do not meet reasonable quality standards. More emphasis on the quality of these tools is needed as they are easily accessed and used by the general population, often for self-managing health conditions. The demand remains for a high-quality, evidence-based headache diary app.
cognitive behavioral therapy
Food and Drug Administration
intraclass correlation
Wireless Headache Intervention
The authors thank Dr Deborah Tepper, Dr William Young, Dr John D Bartleson, Dr Gordon Robinson, Dr Jason Rosenberg, Dr Gretchen Tietjen, Dr Carl von Baeyer, Dr Jessica Ailani, Dr Todd Smitherman, and Dr Ronal Kaiser for their participation in the survey of headache experts. The authors would also like to thank Hayley Stinson for her assistance in searching the app stores. This research was undertaken, in part, thanks to funding from the Canada Research Chairs program.
The authors have received funding from the Canadian Institutes of Health Research (grant #97981) to develop an Internet-based CBT intervention for adolescents and young adults with headaches, called myWHI.