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NOCD

"NOCD offers live video-based OCD therapy and in-between session support, right in the NOCD platform." Evaluated: May 2020

The below evaluation is an example of the types of information you may find when using our Model to assess specific apps. This sample evaluation is not intended to enable you to make a decision about choosing these specific apps for actual use, as such a decision is a personal one that you will make based on your own unique preferences, needs, and evaluation. We strongly encourage you to download these apps for yourself and use our Model to conduct your own assessment.

This evaluation was completed May 2020, and is based on publicly available information found by our Panel at that time. In July 2020, APA's contacted the app developers and offered to them an opportunity to provide feedback on these assessments. Comments from developers who responded are included here. These comments do not necessarily reflect publicy available information at the time of the original assessment or presently.

 Access & Background

On which platforms/operating systems does the app work? Does it also work on desktop?

Android and Apple. Does not appear to have a desktop version. Review was completed on iOS.

Has the app been updated in the last 180 days?

Yes, updated to v2.1.0 on 9/24/2020.

Does the app identify ownership?

NOCD Inc., as listed on the website and in app store.

Does the app identify funding sources and conflicts of interest?

Reviewers were unable to find information about funding sources of conflicts of interest.

Does the app come from a trusted source?

NOCD Inc, which states "made by people with OCD, along with some of the world's top experts"

Does the app claim to be medical?

App is categorized Health and Fitness on website and app store.

Are there additional or hidden costs?

App identifies as free but does ask users for insurance information to assist in features that will enable work with a therapist. Appears cost and billing component related to this portion of the app feature. Without adding personal insurance information the user can only access message board, informational introductory video, and basic exercise plan.

Does the app work offline?

Yes, it appears so. Basic features of the app work in airplane mode.

Does the app work with accessibility features of the iPhone/Android? Is it accessible for those with impaired vision or other disabilities?

It does not appear to work with phone's accessibility features, such as zoom-in and voiceover capabilities.

 Privacy & Safety

Is there a transparent privacy policy that is clear and accessible before use?

Data pertaining privacy can be found under settings>FAQ section. On the website, user can access the privacy policy at: treatmyocd.com/privacy-policy/. These reviewers did not find the privacy power to be transparent. Reviewers were unable to find any information regarding how data is or is not de-identified.

Does the app collect, use, and/or transmit sensitive data? If yes, does it claim to do so securely?

Statement within the app: "No one can see any of your personal health information unless you choose to share your data." App also encourages users to share data with provider and family.

Does the app declare data use and purpose?

Yes. Collects info directly from user, passively and then also from thrid party sources.

Does the app describe use of PHI?

Reviewers were unable to find any information about use of PHI.

Can you opt out of data collection or delete data?

Reviewers were unable to determine this from statements pertaining to users ability to delete data from the app.

Is data maintained in the device or on the web?

In the app itself and sent to servers: "Yes all of the data is protected in an encrypted AWS server. NOCD LLC has a BAA with Amazon Web Services."

Does the app explain security systems used?

Yes: NOCD uses reasonable means to safeguard personal information under our control. When you access the Platform using modern web browsers, Secure Socket Layer (SSL) technology protects your information using both server authentication and data encryption. These technologies help ensure that your information is safe and secure. Unfortunately, no website, server or database is completely secure. NOCD cannot guarantee that your information will not be disclosed, misused or lost by accident or by the unauthorized acts of others. It is your responsibility to protect your username and password.

What third parties does the app share data with?

Per the developer: "We may also collect information about users over time and across different websites, apps and devices when you use the Platform. Third parties also collect personal information this way on our Platform." Reviewers were unable to identify these third parties based on information provided.

If appropriate, is the app equipped to respond to potential harms or safety concerns?

Offers an option in the app directed at "Harm OCD" in the SOS section, but reviewers could not find explicit links to emergency resources within the app.

 Clinical Foundation

Does the app appear to do what it claims to do?

According to these reviewers, yes, the app appears to support CBT treatment of OCD.

Does the app have a clinical/recovery foundation relevant to your intended use?

There are currently trials underway: https://www.treatmyocd.com/blog/nocd-is-partnering-with-biohaven-on-their-clinical-trial-for-ocd/.

Is the app content correct, well-written, and relevant?

Yes, according to these reviewers. The app references tehcniques commonly employed in OCD treatment.

What are the relevant sources or references supporting the app use cases?

https://www.sciencedirect.com/science/article/pii/S0005789420300666

Was there an attempt to validate app usability and feasibility?

Yes, see above link.

 Usability

Does the app seem easy to use?

These reviewers were unable to determine, in that the app seemed hard to navigate (beyond introductory/limited uses) without entering insurance information.

What are the main engagement styles of the app?

Engagement styles are customizable. User can explore treatment options for specific types of OCD. There are also exercises and SOS feature. Also offers means to track progress, engage with a therapist and community.

Do the app and its features align with your needs and priorities?

According to these reviewrs, the app aligns with current methods around CBT treatment for OCD.

Is it customizable?

Exercise tracking and anxiety ratings feature are customizable.

Does the app clearly define its functional scope?

Per the website: "NOCD Therapy includes video-based OCD therapy and in-between session support, right in the NOCD platform. It offers exposure and response prevention, or ERP, the most effective OCD treatment."

 Therapeutic Goal

Can data be easily shared and interpreted in a way that's consistent with the stated purpose of the app?

Unclear to these reviewers how you export data for use, although the app does claim that users can share with your provider.

Do you own your data?

Reviewers were unable to find any statement/information indicating data ownership.

Can the app share data with EMR and other data tools (Apple HealthKit, FitBit)?

Reviewers were unable to find a direct statement regarding this but does indicate on the website passive data collection can be done by" "enabling location-based features on our Platform," suggesting some communications with tools (but unclear which).

Is the app for individual use or to be used in collaboration with a provider? If intended to be used with a provider, does the app have the ability to export or transfer data?

The app's explicit purpose is to be used with a provider.

Does the app lead to any positive behavior change or skill acquisition?

It would appear to be, as it follows guidance around engaging in CBT treatment for OCD.

Does the app improve therapeutic alliance between patient and provider?

According to these reviewers, it would help to promote enagement in activities to address OCD behaviors in-between appointments.

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