Apple's ResearchKit holds promise as well as limitations
Outshined by the introduction of the Apple Watch, Apple’s ResearchKit, a new iOS software framework was also introduced at the Apple event this week, allowing physicians and scientists collect and monitor clinical data from iPhone users who volunteer to join medical research studies. Based on the premise that medical research tends to be challenged by small sample sizes and inconsistent data collection, ResearchKit will first and foremost facilitate access to potential subjects, as recruiting for research can be challenging in and of itself. Small sample sizes can generate inaccuracies, and may not be able to be extrapolated to a general population. Apple can help alleviate that problem by giving physicians and scientists access to its iPhone users, which amount to more than 42% of smart phone users in the US according to an article in CNN Money.
ResearchKit will use iPhone’s technology to let people take tests, like using the microphone to record sounds such as “ahhh” to detect vocal variations, or use the iPhone’s sensors to record gait data and compare it to a healthy person’s gait to detect inconsistencies that may signal a particular disease or health problem.
To design the operating system, Apple’s Jeff Williams explained that Apple worked with 12 research institutions to build the app. Given the sensitive nature of health information, a number of permissions for how data is used are also built into the app. Information obtained by users of the app can decide how to share their data, and Apple won’t see it. The operating system, Apple says, will be open source, and available next month with the first five tests built in. The built in tests are designed to help people participate in tests related to Parkinson’s, diabetes, cardiovascular disease, asthma, and breast cancer.
In his presentation about ResearchKit, Williams stressed the benefit to users, that they will be able to learn more about their health, even before the study concludes, and can speak to their doctor about any health concerns at any time.
Solid medical research, however, is based on the quality of the data. Using a mobile device for remote data input also takes a key variable out of the equation—control. Despite the large numbers of potential patients who can access the studies, questions will remain regarding the reliability of the data. In addition, the data may be skewed toward a certain population of patients, namely those people who can afford an iPhone. According to an article in CNN Money, rich white males tend to buy more iPhones, particularly in the first weeks that they go on sale. In the first month of sales, nearly 80% of iPhone 6 and iPhone 6 Plus buyers in the United States were male, and more than 60% made over $75,000 a year, according to Slice, a company that tracks consumer purchases. That data certainly speaks to the limitations of broad result generalization across a global population.
There are obvious benefits as well as limitations, but the true test here is adoption. How many researchers will get onboard with ResearchKit? It certainly has potential for far reaching sample sizes, but it also takes time to develop traditional lab studies into an app and there are some studies which may always require personal observation. Time will tell, but the potential for mass medical research has arrived.