There's an App for That

Last year, Apple unveiled a new platform that offers a streamlined way to create mobile applications linked to medical research. The technology, called ResearchKit, lets investigators more easily connect with the people whose diseases they're studying, allowing them to gather feedback on symptoms, as well as data on everything from a patient's weight to the air quality where they live. "When you can collect real-time information, you don't have issues with recall or bias," says Dr. Deborah Estrin, a professor of healthcare policy and research at Weill Cornell Medicine. "If you ask somebody how much pain they had over the last two weeks — as is typical in a doctor's appointment — they will answer the question differently than if you ask them how much pain they had today."

Five apps — focused on tracking such diseases as asthma, type 2 diabetes and breast cancer — launched soon after ResearchKit was released; today there are more than a dozen, each free for study participants to download and set up to securely transfer the collected data back to the medical institution running the study they're in. But as Dr. Estrin points out, ResearchKit has a major draw - back: less than 50 percent of smartphone users in the United States own an iPhone and could therefore participate in the studies. Plus, iPhone users aren't a representative sample of the population, tending to be wealthier, more educated and less racially diverse.

Wanting to address that disparity, Dr. Estrin developed a complementary version for Android, dubbed ResearchStack. Like ResearchKit, it will let programmers create apps connected to medical research, but specifically for Android devices, whose owners tend to come from a wider spectrum of socioeconomic and ethnic groups. "The idea is to take advantage of the great data-collection instruments many of us hold in our purses or pockets," says Dr. Estrin, also a professor of computer science at Cornell Tech, "and to promote and enable these large- scale research studies across a larger segment of the population."

After a beta test that began in February, ResearchStack 1.0 is set to be released this spring. The first app to be developed with it is Mole Mapper, which allows users to photograph their skin moles and track how they change and grow over time. It was created by a researcher now working at the National Cancer Institute in collaboration with Sage Bionetworks, a nonprofit that facilitates open science. The app - which already has an iPhone version — collects real-time data and sends it to melanoma researchers at the Oregon Health and Science University. The idea is to help users figure out when a mole has changed enough to require a medical evaluation, to foster early detection of malignancy, and to help researchers create better algorithms for melanoma diagnosis. Additional Android-compatible versions of all the ResearchKit projects are sure to come, Dr. Estrin says.

Dr. Estrin notes that the advent of ResearchStack is likely to make these study-facilitating apps more appealing to investigators studying all types of health conditions. Now that researchers are able to conceive apps that can be customized to work with both Apple and Android devices — thus allowing them to tap into much larger pools of participants — they will have stronger justification for seeking funds to develop them, which can be significant. "Increasingly, this will be the way that we conduct research," Dr. Estrin says. "With these apps, you're able to see how disease symptoms play out in the wild, and look at responsiveness to treatments outside of the clinical setting. You can ask patients to check in much more frequently than you'd ever be able to through in-person appointments — and during those check-ins, to not only share how they're feeling, but also provide useful information about their condition. That's the power of the smartphone."

— Anne Machalinski

This story first appeared in Weill Cornell Medicine, Vol. 15, No.2.