Using Mobile Applications to Improve Chronic Disease Outcomes: A Case Study

We first ask you to fill out a brief survey about you and your experience of Crohn's disease. Then, depending on which part of the study you are randomly assigned to, we may ask you to track your food consumption, activities, and symptoms using one of several methods daily for two months; some of these methods may provide you feedback on how your consumption and activities appear to relate to your symptoms, which you may use or not as you see fit. At the end of each month, we will ask you to fill out a survey on your experience of Crohn's disease and of tracking your health.

Description of treatment or intervention (mechanism of action): 

After filling out an initial intake study, participants are randomly assigned to one of three mobile health applications. Participants are asked to use these apps at least daily to track their symptoms, food consumption, sleep, and other health behaviors over two months. Depending on which application a participant receives, the app may provide them with customized feedback based upon what they enter. Researchers will also ask participants to fill out a Crohn's specific symptom survey at the end of each month.

Patient Participation Requirements:

That participants regularly use the assigned mobile application as indicated, and fill out the intake, midpoint, and final health surveys. 

Possible risks and side effects: 

First, there is the risk that subjects may not want their personal medical information shared, and this study has a confidentiality breach that results in said sharing. Researchers will take every effort to anonymize subject data that they collect at the end of data collection to delink participant identity and their personal medical information.

Second, there is the risk that subjects learn something through tracking their health that is medically accurate but personally disquieting to them. Given this particular illness, it is not clear what that would be, but this is a risk from using tools that allow participants to see relationships between foods or behaviors and disease symptoms. 

Third, there is risk that the subjects receiving feedback from an application fail to seek additional medical treatment because they overestimate the value of the application. Researchers emphasize that these applications are not meant to replace medical care, but are meant to help subjects engage in better self-care, which includes having better and more accurate information to share with their health care providers.

Beyond these, the goal of mobile health applications is to reduce, rather than increase, discomfort and illness due to chronic conditions. As these are neither a drug nor a procedure, but rather a method for noticing links between one’s activities/foods and one’s symptoms, it cannot directly harm subjects. It can only lead subjects to take actions based on the information shared.