Apple's ResearchKit provides innovative medical research platform for various specialties

Apple Inc. recently announced ResearchKit, an open-source innovative software tool designed for researchers to gather and extrapolate patient data within the palms of their hands.

“With hundreds of millions of iPhones in use around the world, we saw an opportunity for Apple to have an even greater impact by empowering people to participate in and contribute to medical research,” Jeff Williams, Apple’s senior vice president of Operations, said in an Apple Inc. press release.

Initially, institutions including Mount Sinai, Dana-Farber Cancer Institute, UCLA’s Jonsson Comprehensive Cancer Center, Stanford Medicine, Massachusetts General Hospital and the University of Rochester developed five applications with clinical studies on asthma, breast cancer, heart disease, diabetes and Parkinson’s disease.

The format of the five apps allows users to decide if they want to participate in a specific study, as well as how their data will be shared. ResearchKit works cohesively with Apple’s HealthKit software, which enables iPhones to work with health and fitness apps that gather information on weight, blood pressure, glucose levels and asthma inhaler use, according to the release. Researchers are able to access data from the patient’s iPhone accelerometer, microphone, gyroscope and GPS sensors and obtain information on gait, motor impairment, fitness, speech and memory.

One of the many hopes of the creators for these apps is that research will include more diverse study populations — most often limited due to patient proximity to some of the larger academic medical institutions.

“What we are now looking at is different strategies to use this type of technology to monitor other patient populations,” Patricia Ganz, MD, professor at the UCLA Fielding School of Public Health and director of Cancer Prevention and Control Research at UCLA’s Jonsson Comprehensive Cancer Center, said during an interview with Healio.com. “Although others have created apps to be able to monitor patient populations or healthy individuals, the fame of Apple launching these apps really kind of gave it the boost that made the platform very special.”

Share the Journey study

Ganz is one of the creators behind the Share the Journey: Mind, Body, and Wellness After Breast Cancer app, a study that assesses the reasons why some breast cancer survivors experience quicker recovery time when compared with others, why symptoms vary and the different ways in which to improve these symptoms. The app was developed by UCLA’s Jonsson Comprehensive Cancer Center in collaboration with Dana-Farber Cancer Institute, Penn Medicine and Sage Bionetworks.

“For our specific project, we hope to obtain data long-term from both healthy women and female survivors of breast cancer, so that we can see how breast cancer may differentially impact women’s functioning and life,” she said.

With the app, users are asked to participate in surveys, do journaling activities and permit monitoring of their physical activity through sensors in the phone. They are also asked to respond to daily questions on the iPhone to assess fatigue, cognitive changes, mood, decreases in exercise and sleep disturbances.

“What attracted me to this project was the ability to obtain data from healthy women as well as women who were breast cancer survivors,” Ganz said. “So much of the research we conduct is dependent upon what are considered ‘published norms.’ I essentially gave the creators questionnaires that we used in conducting our own research to put into the format on the app. We also have a variety of questionnaires that collect data on a daily basis. This is a research study, but we hope that the participants will benefit from some of the self-monitoring that they are doing.”

Since the app became available on March 9, about 2,100 women became enrolled in the study. Of the 92% who have completed the demographic survey portion, 48% had a history of breast cancer. Seventy-percent of the women are white, 10% are Hispanic, 8% are Asian and 3% are black.

“We are continuing to work through the other demographics and survey responses and look forward to sharing those data soon,” Andrew Trister, MD, PhD, radiation oncologist in Seattle and senior physician at Sage Bionetworks, told Healio.com. “With the Share the Journey study, we are hoping to observe the impact that breast cancer treatment has had on women in regards to mood, cognition, fatigue and how sleep and exercise may modulate those symptoms.

“We encourage women without a history of breast cancer to join the study so we can mitigate the effects of aging,” Trister continued. “Ultimately, we hope that the study will provide a way to understand a single person's trajectory with their own symptoms in the context of their life, and find those moments when a change could lead to improvements in those symptoms. To achieve this audacious goal, we have built the apps to partner with participants and are working on ways to build communities of participants around specific symptoms and questions in an attempt to make the research as meaningful as possible.”

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MyHeart Counts

The cardiology app, MyHeart Counts, measures users’ activity levels and assesses risk factor and survey information to depict how activity and lifestyle factors affect cardiovascular health.

“The first cardiology app was launched and created by Stanford University researchers. I was really excited to see that within the first 24 hours, there were 11,000 patients that downloaded the app and … nearly 24,000 patients are enrolled and are participating in the study app,” Robert A. Harrington, MD, FACC, FAHA, FESC, of Stanford University, said during a session at the American College of Cardiology Scientific Sessions in San Diego. “This is the new way of doing research. Now, we need to find out how to conduct randomized trials on top of this; but, when more than 20,000 patients can be enrolled within a couple of days, this is a welcomed disruption.”

The hope for this app is that researchers will better understand the mechanisms in which to keep hearts healthier, according to the press release.

Diabetes, asthma and Parkinson’s disease apps

The other apps launched within the ResearchKit platform include:

GlucosSuccess: Developed by Massachusetts General Hospital, this app measures how diet, medications and physical activity affect glucose levels in patients with diabetes.
Asthma Health: Developed by Icahn School of Medicine at Mount Sinai and LifeMap Solutions, this app was designed to facilitate asthma education and self-monitoring, promote positive behavioral changes and reinforce adherence to treatment plans as recommended by guidelines.
Parkinson mPower: Developed by Sage Bionetworks and the University of Rochester, this app helps patients with Parkinson’s disease track symptoms with the use of sensors in the iPhone. Activities in the app include finger tapping, a memory game, speaking and walking. This study is considered to be the world’s largest of the disease, according to Apple.

“We see the projects that we have been leading in participant-centered research through study apps as providing new insights into the impact that disease and treatments have on the daily lives of people,” Trister said. “The use of smart phones is critical in this endeavor since these technologies have become ubiquitous, and there are a host of sensors and other technologies within the phone that can provide additional data points on a more frequent scale with only a minimal increase in burden to participants.”

Apple’s ResearchKit apps are only available for U.S. iPhone users and will eventually be available in other countries, according to the press release. – by Jennifer Southall

For more information:

Patricia A. Ganz, MD, can be reached at UCLA Jonsson Comprehensive Cancer Center, 650 Charles Young Drive South, Room A2 125 CHS, Los Angeles, CA 90095-6900; e-mail: pganz@mednet.ucla.edu.

Robert A. Harrington, MD, FACC, FAHA, FESC, can be reached at Cardiovascular Clinic, 300 Pasteur Dr., Room A200A, Stanford, CA 94305; email: rharring@stanford.edu.

Andrew D. Trister, MD, PhD, can be reached at Sage Bionetworks, 1100 Fairview Ave N, Mailstop M1-C108, Seattle, WA 98109; email: andrew.trister@sagebase.org.

Disclosures: Ganz, Harrington and Trister report no relevant financial disclosures.