Are medical researchers passing the buck on porting ResearchKit to Android?

By Aditi Pai

C TrackerIt's been seven months since ResearchKit first launched and researchers from a number of research institutions have launched new studies on the platform -- at least 9 news apps have launched since the first five apps were announced. While Apple and its initial collaborators made the right move and made the framework open source, none of the studies so far have been made accessible to Android users.

When ResearchKit first launched, news sources highlighted some of the problems with running a study that is only available to iOS users. One factor is the lack of diversity among iPhone users. Another issue is that the number of people with Android smartphones is larger than the number of those with iPhones, especially outside the US.

MobiHealthNews reported in March, shortly after the ResearchKit launch, that creating a method to access ResearchKit on Android would require a lot of extra leg work and would depend, in the end, on how badly developers — and, by extension, medical researchers, want the integration.

"Right now it is open source but it is tailored to iOS, so it's really only working on iOS," Dr. Pascal Pfiffner, a research fellow at Boston Children's Hospital who is involved in a ResearchKit study, told MobiHealthNews recently. "Somebody will have to port it over to Android, and I don't know how translatable the process will be because with ResearchKit you still need to program the individual steps, for example, questionnaires, yourself. So you would also need to do that on Android, but you would need to do that on Android in Java, as opposed to Objective C or Swift on the iOS side."

Pfiffner, like a majority of the other researchers, is waiting for someone else to build a ResearchKit for Android.

"The first step will be somebody, I don't know who, has to pick up and create an Android version -- I think Duke has promised to do something," Pfiffner said.

In response to a question about Android, Dr. Ricky Bloomfield, director of mobile technology strategy and assistant professor in Internal Medicine & Pediatrics at Duke University, told MobiHealthNews in an interview that: "Our goal as scientists and researchers is to reach as many people as possible... but we have nothing to announce on [Android accessibility] now."

Yale School of Medicine researcher E. Kevin Hall, who developed the Yale Cardiomyopathy Index ResearchKit study, told MobiHealthNews that going into it, he was aware of the potential for bias and agreed that there is a need to move it to Android, but he isn't planning to create the translation.

"There’s only so many hours in my day and I think at the moment, for me personally, there's enough to know and learn about the iPhone side that it wouldn't be me that would do that," Hall said. "The library needs to be changed but really at the moment lot of the code for the app would need to be changed as well because it’s written in basically in Apple’s languages."

Hall also pointed out that it's important to remember that Apple took the initiative to develop this offering and helped bring more credibility to mobile-based studies.

"We unquestionably need to move it to Android to get as many people as possible and as wide and strong a representative cohort as we can, but my view of this is it’s a very bold move on Apple's part and I think their effort has added a lot of validity to this approach and gave us something to stand on when we went to our IRB and our legal team to say ‘Listen, this is an approach that has merit, it's been done five times before. Apple’s behind it,'" Hall said. "Because a lot of institutions are wary of such a big sea change in how we reach out to patients and what the legal ramifications of that might be. So it’s actually, while it’s not on Android now, it’s a very big step that Apple took in bridging the gap to give the validity that researchers to actually use this approach safely. It will come in time."

One of the lead researchers for Asthma Health, one of the earliest ResearchKit apps, Yu-Feng Yvonne Chan, who is the director of digital health and personalized medicine at the Icahn Institute at Mount Sinai, has seen diversity issues within her study population -- a predominance of white patients of higher socioeconomic status -- but also said this isn't a new phenomenon in research.

"One would also note that is a challenge of traditional clinical research methodologies in general," she said. "So it’s not unique to the ResearchKit platform. It’s a challenge for research period."

There is at least one developer who MobiHealthNews is aware of that is working on porting ResearchKit to Android: Nino Guba. Guba happens to be a web and mobile developer at UCLA Health, but he's been working on this project on his own time simply because he saw a need for it.

"If you do a search for Android and ResearchKit you'll see a lot of interest in this but no one is working on it. That's one of the reasons I got into it," Guba said. "ResearchKit is still very early stage, so that's probably why no one's worked on this yet."

Guba knows from his day job that his health system has a lot of Android users and he felt it would be unfair to deprive them of access to the studies using ResearchKit.

"It's going well, I'm not 100 percent where I want to be yet, but with what I have on hand, I probably should be done in a month or so," Guba said. "Hopefully then I'll set up a site to showcase what I've done."

Guba's actively looking for collaborators and intends to make it available for anyone to use.