Smartphone-based asthma study highlights potential for mobile health apps in clinical research

A first-of-its-kind study that involved collecting health data entirely via iPhone using Apple's ResearchKit framework and an app for asthma, developed at Mount Sinai Hospital in conjunction with other groups, yielded reliable results when compared to existing patient studies. Principal investigator Yvonne Chan said "we critically assessed the feasibility, strengths and limitations of a smartphone-based study and found that this methodology is particularly suitable for studies of short duration that require rapid enrollment across diverse geographical locations, frequent data collection, and real-time feedback to participants." She added that the study, whose results were published in Nature Biotechnology, "demonstrates the power of mobile health tools to scale and accelerate clinical research."

According to Mount Sinai, nearly 50 000 iPhone users in the US downloaded the Asthma Health app in the first six months of the Asthma Mobile Health Study, which was launched in 2015 when Apple introduced its ResearchKit platform. The study included regular surveys to understand how participants were affected by and treating their asthma over time. Overall, 7593 people enrolled in the study after filling out the electronic informed consent process, with 85 percent of them completing at least one survey. The researchers noted that a core group of 2317 users filled out multiple surveys over the course of the six-month study. Results were then compared to existing clinical studies on asthma and to external factors as a control for the reliability of patient-reported data.

The findings suggest "this approach was successful for large-scale participant enrollment across the country, secure bi-directional data exchange between study investigators and app users, and collection of other useful information, such as geolocation, air quality and device data," researchers said. They pointed out, for example, that there was there was increased reporting of asthma symptoms in regions affected by heat, pollen and wildfires, and that data for commonly used asthma metrics, such as peak flow, matched what has been observed in other trials. However, the authors cautioned that "potential challenges with this technology include selection bias, low retention rates, reporting bias and data security," adding that "these issues require attention to realise the full potential of mobile platforms in research and patient care."

Senior author Eric Schadt remarked "we now have the ability to capture rich research data from thousands of individuals to better characterise 'real world' patterns of disease, wellness and behaviour." He added that "this approach provides a more comprehensive and accurate view of our patients that was not feasible in the past due to logistical limitations and prohibitive costs."