JMIR Publications

ABSTRACT

Background:

Traditional in-clinic methods of collecting self-reported information are costly, time-consuming, subjective, and often limited in the quality and quantity of observation. However, smartphone-based Ecological Momentary Assessments (EMA) provide complementary information to in-clinic visits by collecting real-time, frequent, and longitudinal data that are ecologically valid. While these methods are promising, they are often prone to various technical obstacles. Yet the availability and interoperability with different operating systems (OSs) need to be fully resolved in existing solutions. This shortness increases the selection bias, development and maintenance costs, and time. It also limits the configurability and adoption of existing solutions to new problems.

Objective:

The primary aim of this research was to develop a cross-platform EMA application that ensures a uniform user experience and core features across various OSs. Emphasis was placed on minimizing the resources and expenses associated with the development and maintenance and maximizing the integration and adaptability in various clinical trials, all while maintaining strict adherence to security and privacy protocols. JTrack EMA+ was designed and implemented in accordance with the FAIR principles (findable, accessible, interpretable, and reusable) in both its architecture and data management layers, thereby reducing the burden of integration for clinicians and researchers.

Methods:

"JTrack-EMA+" is built using the Flutter framework, enabling it to run seamlessly across different platforms. This platform comprises two main components. JDash is an online management tool created using Python with the Django framework. This online dashboard offers comprehensive study management tools, including assessment design, user administration, data quality control, and a reminder casting center. And JTrack-EMA+ application supports a wide range of question types, allowing flexibility in assessment design. It also has configurable assessment logic and the ability to include supplementary materials for a richer user experience. It strongly commits to security and privacy and complies with the General Data Protection Regulations (GDPR) to safeguard user data and ensure confidentiality.

Results:

We investigated our platform in a pilot study with 480 days of follow-up to assess participants' compliance. The six-month average compliance was 49.34%, significantly declining (P<0.05) from 66.75% in the first month to 42.0% in the sixth month. These results show the potential of using our newly introduced platform in remote and at-home-based EMA assessments.

Conclusions:

: JTrack EMA+ platform is a pioneer in prioritizing platform-independent architecture that provides an easy entry point for clinical researchers to deploy EMA in their respective clinical studies. Remote and home-based assessments of EMA using this platform can provide valuable insights into patients' daily lives, particularly in a population with limited mobility or inconsistent access to healthcare services.