I know this is largely unknown but is there any major factor that goes into app rankings besides downloads and reviews? I ask because most of my apps are in the paid medical category, and they do okay, but there are some apps that do quite well and I can't understand why. Specifically there is an app called ASCCP mobile that has been in the top ten paid medical apps for about two months now. It's just guidelines on recommendations for colposcopy (what girls have done if they have an abnormal PAP smear). It's $10 although the guidelines can be found online for free. I find it extremely hard to believe that there are enough people who care about these guidelines and that are willing to pay the 10 bucks to keep it at that high of a ranking.

Josh -- the pricier apps are perceived as high-quality apps. The buyers are thinking "you get what you pay for" Especially in a special niche for a category that is largely price-insensitive. Think about it, when I want medical information, I am willing to pay a premium for (perceived) unique content. Does that help? -- Niraj

I agree with Niraj, so much of what I do follows the line of what do you think the end user will perceptive as a value item product vs a generic one. For me since everyone uses tools and frameworks that are available to developers in this space. Question is: is $10 worth something that will provide me with convenience and ongoing usability. So if that top 10 app is there, it could be that it outshines all the competitors in the same space. I just took a look at the app, ASCCP Mobile By American Society for Colposcopy and Cervical Pathology Inc here's my take, if this app was put together by an organization of authority like an American Society, then my money will go to the App that I feel would most likely have the most up to date and accurate content on the topic vs an App created by a solo developer. and that's just my opinion hope that helps. ~ Ed

I still think there's more to it than that. I actually have two apps right now ranked in the top 300 medical apps in the US. App #1 (ERres) has consistently had more downloads than app #2 (MAems) for the past week (and always), has one 5 star review, costs almost twice as much, and just had an update come out. App #2 has no reviews and hasn't been updated in almost a year. But which app has had a higher ranking for the past week? App #2. Makes no sense whatsoever.

Apple is a mystery... I find my apps moving up the chart without even selling 1 app... how can that be, right??