MyMS

Problem

Multiple sclerosis is measured in a clinic, episodically. A neurologist sees a patient every few months, runs a walking test and a cognitive screen, reads an MRI, and infers a trajectory from a handful of widely spaced points. The disease does not move on that schedule, and the people living with it are spread across a country, not clustered around a research centre.

The USC Multiple Sclerosis Center wanted the opposite shape: many measurements from many people, gathered wherever they live. Dr. Daniel Pelletier, professor of neurology at the Keck School of Medicine of USC, framed the goal as collecting "a massive amount of data" in order to work toward individualised therapy. Doing that meant the study had to run on equipment participants already owned, with — in the study's own terms — no clinical visits involved.

Approach

Realm 8 built the native iOS and Android applications participants use, and the backend infrastructure the study runs on.

The apps turn the phone into the instrument. Validated walking, cognitive and visual tasks run locally, alongside quality-of-life questionnaires, and results are graphed over time in an interactive dashboard so a participant can see their own trend rather than a single reading. Participants can also upload their brain MRIs and view them at full resolution on the device, and — after three months of participation — link genetic data through 23andMe.

That combination is the hard part of the build: a research instrument has to capture task data under controlled conditions, accept large imaging files over consumer connections, and still feel like an app someone will open voluntarily for months. The backend has to keep all of it attributable and intact, because a research record that cannot be trusted is worse than no record.

Building on Apple ResearchKit was the decision that set the shape of the rest. It gives a research study the parts that are unwise to reinvent — informed consent flows, task scheduling, and standardised active-task modules — which meant the work could go into the parts that were specific to MS: the validated walking, cognitive and visual tasks, the MRI viewer, and the dashboard a participant actually sees.

Realm 8 built both halves of that: the participant-facing iOS application, and the infrastructure powering the clinician side. Those have opposite requirements. A participant app has to be forgiving — consumer network, consumer phone, opened voluntarily for months. The clinician side has to be exact, because it is the study record, and a research record that cannot be trusted is worse than none.

Outcome

The software carried the study through successfully, contributing to ongoing multiple sclerosis research. The study is registered as NCT03111394.