During October Chris Stone attended two days of the Manchester Digital Epidemiology School, hosted by the University of Manchester Centre for Epidemiology versus Arthritis. The focus for these two days was on the use of smartphones and wearables for health research, and included workshops on topics such as designing a mobile health study, using mobile devices to assess population health, capturing patient-generated data, designing micro-randomised trials using sensor data, and applications of wearable technology in digital healthcare. Also featured was a keynote address from Professor Claire Steves, lead scientist behind the development of the popular ZOE Covid app.

Digital patient-generated health data - electronic health-related data gathered by or from patients outside of a clinical environment - offers ease of participation, increased frequency of data collection, lower costs, higher reach, ecologically-valid real-time data, and access to a range of information from sensors in patients’ everyday environment. When harnessed appropriately, it can provide timely information about exposures, outcomes and mechanisms. This can bring many benefits, including the potential to support personalised medicine, but there are challenges to address, such as selection bias, digital exclusivity, ethics and information governance, attrition over time, and the complexities of multi-platform support and processing large quantities of raw data. Future directions and opportunities discussed during the school covered data capture from non-invasive biological sensors, the development of printed “conformal” devices (which have a tattoo-like connection to the skin), and closed-loop bioelectronic medicine - direct interfacing with the body’s electrical systems, opening new treatment targets with automated feedback and action based on sensed data.  There is clearly great scope for advance in this field but, for maximum effectiveness, developments need to be driven by “clinical pull” rather than “technology push”. Anchoring digital health in epidemiological practice will help achieve this.

Words by Chris Stone