While mobile health technologies and companies offer great promise is reaching patients and consumers, perhaps the greatest challenge is quantifying actual success versus hype and simply touting the next app.
Partners Healthcare in a blog post notes that the success of mHealth platforms is increasingly difficult to gauge or is taken from a tiny sample size. Part of the issue, however, is the fast-moving world of mobile technology contrasted with the lumbering healthcare system that is often averse to change.
“mHealth represents the collision of two interesting worlds — mobile, which changes on what seems to be a daily basis, and health care, which changes infrequently, only after significant deliberation and usually much empirical analysis.”
The seeming breakneck speed of mobile technologies, and the entrepreneurs who tout them, make sense from a pure consumer point of view – get the minimally viable product out to market ASAP and see how often it’s downloaded. But that’s no so readily applicable with healthcare clinicians, at least not at the moment.
“But does this work in health care? I’m not so sure. As clinicians, we’re trained to turn our noses up at this sort of measure of success. But maybe we’re the ones who are wrong.”
More specifically, the author notes that a recent mobile health company touted the success of its program, which wasn’t named, using a 10-patient sample size over three months. That exposes obvious issues like selection bias, regression to the mean, sample size bias and, lastly, a novelty effect.
The author posits that the reason for such a seeming disconnect between mHealth advocates and the staid clinical standpoint is not hard to figure out – lives can literally be at stake when it comes to healthcare.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
“It is cliché to say it, but lives are at stake. So we’re more careful and more demanding of evidence. Is this holding us up from the changes that need to occur in our broken health care non-system? Possibly.”
So how does one design a scientifically sound trial that can keep pace with the technology?
“One thing we’ve done at CCH is design studies that use a large matched data set from our electronic record as a comparator. This speeds things up a bit, eliminating the need to enroll, randomize and follow a control group. Results are acceptable to all but the most extreme purists.”
