Apple's push into health is continuing apace with the announcement of three new health studies that users can get involved in through their Apple Watch and iPhone.
Apple has officially launched its Research app, which iPhone and Watch users can download from the App Store to take part in health studies. Once users have downloaded the app, and opted in to sharing their information with the studies, their hardware will collect data that will be used to inform the trio of studies.
The first of the three studies, conducted with the Harvard T.H. Chan School of Public Health and the NIH's National Institute of Environmental Health Sciences (NIEHS), is a long-term research effort that will track menstrual cycles and other related information, and could help develop an understanding of how women's menstrual cycles can affect conditions such as polycystic ovarian syndrome, which can cause infertility and diabetes, and osteoporosis, the age-related bone-thinning that cause bones to break more easily. In women, it's often brought on by the menopause, when levels of the bone-protecting hormone oestrogen drop.
The second study, alongside Brigham and Women's Hospital and the American Heart Association, will track how a person's activity – such as the level of regular exercise they do – and heart rate correlates with their heart health.
"The study will explore the correlation between a broad range of physical activities and a person's overall heart health to ultimately understand risks and interventions to improve health," a spokesperson for the American Heart Association says. "It will look specifically at how heart rate and mobility signals — like walking pace and flights of stairs climbed — relate to hospitalizations, falls, heart health and quality of life in order to promote healthy movement and improved cardiovascular health."
The study is aiming to uncover whether mobility changes, or changes in heart rate and rhythm, could be early warning signals for atrial fibrillation, a heart condition that can lead to stroke. It's a condition that Apple already enables users to monitor through the ECG app on its Watch.
The final piece of research, with the University of Michigan, will study how exposure to everyday noise can affect hearing, using sound data gathered from the iPhone and the Noise app on the Apple Watch.
Through the Research app, "the iPhone will now be able to evaluate people's exposures to music through their phone, and so this is something that really has just never been possible before", says Richard Neitzel, an exposure scientist and associate professor of environmental health science at the University of Michigan's School of Public Health.
Traditionally, hearing studies have tendered to focus on the noise a person is exposed to in their environment, while this study will allow data to be gathered on noise that comes through people's phones, including the music or media they listen to.
And, by using the app to monitor changes in user's hearing, it may be possible to draw out links between the noise levels someone encounters in their daily life, and whether they experience hearing loss.
"There have certainly been many studies that have looked at the association between exposure to sound and hearing loss. But virtually all of those studies have been done in the workplace, and as a result, we don't really have a very good idea about the association between things like music and impact on your hearing. There's always questions about, well, if people are seeing changes in their hearing, what's wrong? Do they have a noisy job? Do they have noisy hobbies? Do they listen to music? And historically, it's been kind of guesswork. And now, for the first time, we can actually have some data and make some more educated observations," Neitzel says.
The study will look at whether people who receive notifications through Apple's Health app will change their behaviour when they're alerted that they're being exposed to loud noise.
Apple had already announced the Research app in September, promising that it would be available in the App Store as a free download "later this fall".
It's not the first time that Apple has targeted the research community. In 2015, it launched ResearchKit, a software framework that allows scientists and medical researchers to build apps that use HealthKit to gather health data from iPhone users. CareKit followed in 2016, another framework that developers could use to build apps aimed at helping people manage their long-term health conditions.
ResearchKit led to the creation of Cupertino's first research study, the Apple Heart Study, where the company worked with Stanford to investigate whether the Watch could be used to detect irregular heart rhythms. While there has been debate about the real-world value of using Watch's ECG functionality to help detect arrhythmias, there's no doubt that Apple managed to bring an uncommon amount of users to a research study. According to Stanford, 400,000 people signed up to take part in the research – most medical studies can only dream of a few thousand participants at best.
"From my perspective as a researcher, partnering with Apple does absolutely give us unprecedented access to lots of potential participants, many more than we would typically have," Neitzel says.
The studies will all be several years long, according to Apple. Gathering data from a person over a longer period allows more connections to be made between risk factors and health conditions that develop.
Apple's launch of the Research app could potentially lay the groundwork for an overhaul of how medical studies are conducted. Traditionally, participants have been recruited to studies by healthcare providers locally and in a targeted way; Apple's Research app is a more scattergun approach where people, not their doctors, will suggest they get involved in a study. It could also mark a departure in how medical studies report their results: traditionally, scientists share their data and ask fellow researchers to review the data for errors or biases. The data in the Apple Heart Study wasn't shared in the same way.
Using Apple's platform as a way of conducting research has one notable advantage for research institutions and universities. "From the research side, it's all about getting access to large amounts of data, and consistent data as well. One of the reasons that Apple can do this, and you can't really do this sort of an initiative with Android, is because all of the hardware is different across Android devices," James Moar, lead analyst at Juniper Research, tells ZDNet.
The move into health has been something of an accidental one for the company. It reportedly only included the heart-rate monitor that would go on to form the basis of the Apple Heart Study as a way of getting the drop on rivals by offering a more accurate step counter. Nonetheless, Apple CEO Tim Cook said earlier this year that he expected that the company's "biggest contribution to mankind… will be about health".
Moar says the move fits with Apple's focus on promoting the Watch as more of a health, rather than fitness, device. "It opens up their market quite substantially… fitness is a nice to have, health is essential," he told ZDNet. And, thanks to a near-universal interest in improving or maintaining health, offering people a way to research into serious medical conditions offers another reason to choose the ecosystem – and another way for Apple to lock them into iOS.
A number of wearables manufacturers, Apple among them, have turned their focus towards health, not only as a way of appealing to more consumers, but also as a way of opening up new sources of revenue: devices with a health focus are more likely to be paid for or subsidised by insurance companies, potentially raising sales of the devices if insurers feel they could ultimately promote healthier behaviours and so reduce their costs to the companies.