Table 1.

Ethical recommendations for the use of mobile phones in the clinic and laboratory.

Ethical issue	Recommendation
Anonymity and de-identification	In many cases, deidentification is not possible. Developers must communicate this to users when obtaining consent.
Third-party use of data	Individuals should be informed about the risk of third parties accessing data collected on mobile phones, either via hacking, legal interception (eg, subpoena), incidental discovery by someone accessing the phone, or by telecommunication companies (eg, ISP provider, Google) that may claim ownership of the data recorded by or transmitted through their networks.
Storage and transmission of data	The risk of privacy violations can be minimized by thoughtful consideration of how the data are stored locally on the phone or transmitted to the research or clinical team. Apps can be placed in secure vaults on mobile phones to minimize incidental discovery. Developers should also record and transmit the minimal amount of data necessary for the purpose of the app.
Obtaining informed consent	Participants need to be informed about the risks and benefits of using mHealth technologies and must have the capacity to understand these risks and make a free and uncoerced decision about whether to participate. Researchers and clinicians should employ visual aids that communicate the complex nature of the risks posed by mHealth. Developers should maximize opportunities for users to control what data are shared with the clinical/research team, such as through the use of pop-up messages asking whether they consent to specific information being shared.
Communication of clinically relevant results	Feedback of clinically relevant information should be provided by a qualified health care professional and when there is strong empirical evidence to support the findings. Users should be informed at the point of consent what information may be uncovered by mobile phones and whether they will be informed about these findings. Patients should also be assisted with accessing necessary clinical services as a result of the findings.
Access to mHealth technologies	Efforts should be undertaken to prevent individuals benefiting from advances in mHealth as a result of their socioeconomic status or physical or mental impairments.
Active engagement with patients	Developers should use reference groups (eg, consumer, family, industry, health care professional) throughout the development process to ensure that the technology meets participants’ needs.
Regulation of mHealth products	mHealth technologies should be rigorously evaluated to demonstrate their safety and effectiveness before the widespread rolling out of mHealth apps and associated products.