Clinical researchers are slow to utilize digital health to help with studies
According to an in-depth review of medical literature, many investigators who design and implement clinical trials have been slow to adopt internet based tools in their processes. However, there have been several early adopters who use technology to improve results. Cochran Collaboration review found that using text message reminders significantly improved the rate of attendance at appointments. Carmen Rosa, from the National Institutes of Health and her colleagues explained that the reason for the slow adoption is the lack of regulatory guidance.
Iltifat Husain MD reviewed this article.

Many research scientists are not keeping up with the latest developments in mobile technology, according to a recent in-depth review of the medical literature. The review found that investigators who design and implement clinical trials have been slow to adopt mobile devices and the Internet–digital tools that have the potential to improve the research process.

Traditionally, trial recruitment has relied on newspaper and radio advertisements, follow-up assessments have been conducted through mail and phone calls, and data has been collected using pencil and paper. As Carmen Rosa from the National Institutes of Health and her colleagues explain in the review, there is so much more that can be done if researchers would take advantage of the same digital resources that patients and commercial enterprises have been using for many years.

Rosa et al point to several early adopters who have been leading the way, including medical researchers who are now using social media, including Facebook and Twitter, as well as text messaging and blogs to recruit study participants and improve patient attendance at appointments. A Cochrane Collaboration review, for instance, found that: “Text message reminders improved the rate of attendance at healthcare appointments compared with no reminders … and postal reminders.” Other investigators have been using web sites, smartphones and tablets to collect data, including patient-reported outcomes. Wagner and associates, for example, recruited patients for a cognitive behavioral therapy study using a university-based depression web site, along with more traditional newspaper ads and compared therapist-supported Internet-based treatment to face-to-face treatment. Both therapy approaches were equally effective. Some investigators are even incorporating global positioning systems and wearable devices into their research projects.

Among the most recent technological advances that may be worth considering, according to the literature review, are the ResearchKit software introduced by Apple in March 2015, as well as several iPhone apps developed with clinical trials in mind, including those intended for use in asthma, breast cancer, diabetes, Parkinson’s disease, and cardiovascular disease research.

Data collection is another area in which e-technologies can play a larger role. Rosa and her associates describe the work on Hossain et al, for instance, in which the researchers “developed a model to detect drug (cocaine) use events from physiological measurements using a wearable electrocardiogram (ECG) sensor and accelerometers. Over 11,000 hours of data from 13 participants was collected and used to develop a model using physiological measures to track an individual’s health status.”

Along with the potential benefits of mobile technology and the Internet are some potential obstacles to overcome as well. Among the most significant are regulatory issues and patient privacy. Institutional review boards are struggling to keep up with advancing technology and its use in medical research. As Rosa et al point out: “Despite the ubiquity of social media and technology use in the general population, and increasing efforts to integrate technology into research practices, little regulatory guidance exists on using technology in clinical research.”