Real time tracking of symptoms for research and clinical support

A need that comes up in both research and clinical practice is a way to track in as close to real-time as possible various self-reported measures. In the literature, this capability is usually referred to as ecological momentary assessment. For example, in drug/alcohol dependence treatment research, it’s useful to track measures such as craving levels. Correlations with other measures (e.g. stress level) or presence of specific triggers (e.g., proximity to a geographic location) can be made. Clinicians might be interested in tracking real-time measures of mood or side effects after starting or changing a medication.

Here’s a prototype for tracking ecological momentary assessment with smartphones using the Android platform. It allows you to rate yourself on a particular measure (0 – 100) scale and include comments. This information is stored in a remote database, allowing retrieval of that data either from the phone or from a web based interface. You can also trigger assessments remotely via the web – the patient’s phone will receive a notification indicating it’s time for another assessment.

If you have at least a device (or emulator) running Android 2.2 or later, browse back to this webpage using your device browser and click here to install the Track application (md5 hash: 4846fa76222671469bf4b01aa4e7a87f) on your device.

The assessment notification system is based on Google’s Cloud to Device Messaging (C2DM) service. If you want to trigger assessment notifications on your phone, you need a Google account associated with your phone (most likely you’ve already done this, but if not, set from the Settings->Accounts & Sync menu) and Google Market installed on your phone.

Try it:

  1. Start Track on your phone, then press ‘Menu’, press ‘Preferences, and enter some simple username and password (DO NOT use your Google Account/Gmail username and password – that info is not needed at all by the app….you just need a linked working Google account on your phone so that C2DM will work).
  2. Use the slider to assess your current need for speed, enter a comment if you want, and press ‘Store’. That measure ultimately ends up on a non-device (remote) database.
  3. Press ‘Menu’->’History’ to see a history of your particular assessments in a crude format.
  4. Next take a look at the web interface to the assessment database (and remote assessment trigger). It’s probably easiest to next use a regular computer web browser. Surf to the web interface and login there using the same username and password you used in Track on your phone. You should get the same assessment history view on the web, along with a history of external assessment triggers.

You can also generate assessment triggers to your own phone…either the default “need for speed” assessment, or you can generate something else you want to measure.

I’m currently implementing selectable input methods, graphical reports, and a little crontab function to allow scheduled assessments.

Additional references:

Stone, AA. Shiffman, S. Ecological momentary assessment (EMA) in behavorial medicine. Annals of Behavioral Medicine, Vol 16(3), 1994, 199-202.
Moskowitz, DS. Young SN. Ecological momentary assessment: what it is and why it is a method of the future in clinical psychopharmacology. J Psychiatry Neurosci. 2006 January; 31(1): 13–20.
Collins RL, Kashdan TB, Gollnisch G. The feasibility of using cellular phones to collect ecological momentary assessment data: application to alcohol consumption. Exp Clin Psychopharmacol. 2003;11(1):73–78.
Freedman MJ, Lester KM, McNamara C, Milby JB, Schumacher JE. Cell phones for ecological momentary assessment with cocaine-addicted homeless patients in treatment. J Subst Abuse Treat. 2006;30(2):105–111.

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