by: Kevin Clauson, PharmD
The recently held mHealth Evidence Workshop was conceived from the desire to accelerate the often glacial pace of moving medical innovation from research to practice.
The workshop was launched by a Call for White Papers submitted by an institutional “Who’s Who”, including the likes of the Robert Wood Johnson Foundation, McKesson Foundation, National Institutes of Health, and the National Science Foundation. The workshop that resulted from the review of the white papers was an exciting full day of quick-fire, 5 minute panel presentations alternating with deep Q&A sessions.
Presenter bios and accepted white papers for all sessions can be found here. Those interested in conducting mHealth research or getting a preview of what will be the Next Big Thing™ could do worse than spend a few minutes perusing the thinking of some of the most progressive researchers working in the field.
Read below to see the major lessons from the workshop.
Chief among the offenders identified in slowing the down the rate of information diffusion was the venerable randomized, controlled trial (RCT). Outside of the white paper-driven conversation, one of the most echoed sentiments (albeit an unanticipated outcome) of the discussions was the entreaty to create opportunities in training, re-training, and career development specific to mHealth research.
The time constraints made for an interesting dynamic, as even those speakers comfortable with TED Talk lengths had to resort to the equivalent of steroid-infused elevator pitches. Fortunately, that pace ended up powering a very energizing day that was split into four major sessions: Study Design Innovations I and II, Reality Mining, Machine Learning, and Artificial Intelligence, and Infrastructure Innovations.
Among the notable papers from the first session was the use of remote recruitment, personalized micro-incentive strategies, and participatory sensing (using both smartphones and on-body sensors) to provide inputs for large scale behavioral studies by Dr. Deepak Ganesan’s group. Time-series methodology and tools like regression discontinuity were proposed to help make this type of study a reality. Presenter Dr. Richard Kravitz is well known for his work using n-of-1 trials to estimate individual treatment effects and subsequent aggregation to address heterogeneity of treatment effects. His mHealth paper forecast the use of a patient-initiated, physician-informed n-of-1 trial app that allowed for determination of therapeutic superiority. He further suggested that app data could be similarly aggregated to “optimize treatment for chronic conditions”.
A paper from Dr. Sara Browne crystallized the implementation of the Proteus System,which consists of an edible biosensor and external patch that communicates medication disposition and adherence information via wireless technology to patient and provider. Her group proposed a pooled time series approach to help manage this unprecedented level of personalized data.
With regards to the need for new pathways of mHealth research, the panelists and attendees responded with a variety of suggestions including the NIH Career Development(K Awards), including those specific to mentoring, career transition, biomedical informatics, clinical science, and patient-oriented research. Another great opportunity put forth was the mHealth Winter Institute , which is targeting ‘early career’ practitioners who received their doctoral degree in the last five years (or are within five years post-residency). There are also a growing number of conferences in this field to connect at including the mHealth Summit in DC (which featured two billionaire keynotes last year), Stanford mHealth, and the Medicine 2.0 Congress.
Overall, the workshop offered forward thinking about attacking problems in mHealth with less conventional and multi-modal approaches. There has never been a better time for clinicians who want to get involved in mHealth research.
Kevin Clauson, PharmD, is an Associate Professor at the College of Pharmacy at Nova Southeastern University. He has a long-standing interest in the role of health informatics, the potential of the discipline, as well as its pitfalls. He also blogs at Unnatural Language Processing.