Tuesday, August 9, 2016

Is ResearchKit right for you?

Note: This is the second in a special series of posts jointly written by both Katie Donohue McMillan and me. Katie recently joined Duke as our Innovation Portfolio Manger and brings with her a wealth of experience and a unique perspective from outside the stodgy halls of academia.

In March of 2015, Apple announced ResearchKit, and open-source framework intended to accelerate medical research on mobile platforms. For those of us in healthcare, this made our ears perk up. One of the largest companies in the world is taking an interest in medical research? And providing tools to help us with it? For those of you unfamiliar with the details of ResearchKit, it is a software framework to facilitate the collection of  data from study participants via an iPhone app. The first apps announced at the event supported research around Parkinson’s , Diabetes, and Asthma (to name a few.) Later, apps were released for LGBTQ health and Autism Screening. The possibilities are seemingly endless.

But how do you know if ResearchKit is right for you?

Let’s say you have an idea to study people who have blue freckles. You want to know when people first noticed their blue freckles, how many they have, and if things like sunlight or moonlight increase the number of them. Maybe blueberries have something to do with it? No one really knows, because this blue freckle condition is rare and it’s hard to find more than 10 people in your area with them. You really just want to find more people with the condition and ask them a few questions at different intervals, over 12 months. In this case, Research Kit would be a good fit for you. It is great for surveys. Also, because the app can be downloaded from the Apple App Store, you can enroll patients all around the US and increase the sample size of your rare patient population to ensure that your evidence has statistical significance.

Here are some example screens of survey questions:

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In addition to surveys, ResearchKit has other standard capabilities, like a self-consent process  (a crucial part of any study), active tasks and data visualizations.

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Studies that require use of the hardware found in an iPhone would also be ideal candidates for ResearchKit. For example, the Parkinson’s app makes use of the accelerometer and gyroscope to assess the gait and balance of participants. It also employs the touch screen to assess fine motor control through repetitive tapping activities. The MyHeart Counts app uses the pedometer in a walk test that is used to calculate heart risk.

The Autism and Beyond app stretched beyond these standard capabilities to include facial recognition and recording video. If you have an idea that technology can support, ResearchKit’s open-source nature makes it amenable to exploration and experimentation.

So, when wouldn’t you want to use ResearchKit?

ResearchKit works best as an encapsulated study, meaning that everything the participant is required to do to participate occurs within the app. If you are interested in a study that includes both a survey and blood samples, a ResearchKit app could facilitate some of the data collection, but other aspects of the study would be more traditional, and study participants should be educated on the various aspects of their involvement.

Likewise, if your survey questions take an hour to fill out, this also might not be the best choice. People spend an average of 2.6 - 7.5 minutes in a mobile app. If you want them to continually submit data over time, it needs to be quick and easy. 

Are you interested in collecting data unbiased by socioeconomic factors inherent in supporting only a single platform? While ResearchKit is iOS-only, ResearchStack, a comparable toolkit, is available on Android. If you are interested in collecting data from people with either iPhone or Android devices, you’ll have to plan your budget accordingly to pay for the development of two apps. (Likely an additional 75% to 100% of the cost of the first app).

Would you like to track people for more than a year? You may want to also make use of more traditional study methods. Just as we didn’t know about ResearchKit a year ago, who knows what new technology will arrive on the scene in the next year? The possibilities in healthcare tech are endless and rapidly changing and you may not want to tie a long term study to a new mobile technology.

The tools ResearchKit provides to simplify research app creation have already demonstrated that there are ways to dramatically improve our ability to collect data at scale by tapping into the supercomputers that billions around the world have in their pockets. Research is no longer constrained to the ivory towers of academia. Understanding the strengths and limitations of the current version is important to ensure the success of your study. The beauty of ResearchKit and ResearchStack is that due to being open source, they will continue to evolve to meet the ever-growing needs of researchers around the world and improve our understanding of human health.

About Us: Ricky Bloomfield, MD, is the Director of Mobile Strategy and practicing pediatrician at Duke Health. In his spare time he likes to develop software and play with emerging technologies. Katie Donohue McMillan is the Innovation Portfolio Manager at Duke Health. Together, they’re attempting to accelerate the entrepreneurial spirit within Duke and amplify great solutions that improve healthcare.

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