Agile research to complement agile development: a proposal for an mHealth research lifecycle

Abstract

Mobile health (mHealth) technology is increasingly being used, but academic evaluations supporting its use are not keeping pace. This is partly due to the disconnect between the traditional pharmaceutical approach to product evaluation, with its incremental approach, and the flexible way in which mHealth products are developed. An important step to addressing these problems lies in establishing agile research methods that complement the agile development methodologies used to create modern digital health applications. We describe an mHealth research model that mirrors traditional clinical research methods in its attention to safety and efficacy, while also accommodating the rapid and iterative development and evaluation required to produce effective, evidence-based, and sustainable digital products. This approach consists of a project identification stage followed by four phases of clinical evaluation: Phase 1: User Experience Design, Development, & Alpha Testing; Phase 2: Beta testing; Phase 3: Clinical Trial Evaluation; and Phase 4: Post-Market Surveillance. These phases include sample gating questions and are adapted to accommodate the unique nature of digital product development.

Keywords: Medical research; Public health.

Fig. 1

The traditional four-phase pharmaceutical evaluation framework. (Adapted from K. Sagitova, 2009. Watching clinical trials liability. Risk Futures.)

Fig. 2

The Agile System Development Lifecycle, courtesy of Ambler 2008 (ref)

Fig. 3

mHealth Agile Development & Evaluation Lifecycle