数字健康技术真的有益于我们的健康吗？

    10年来，无数创业者在世界各地建立了数字健康公司。目前，市面上的健康类App超过10万个，目的都是让我们变的更健康。然而，其中有多少家公司能拿出确凿证据来支持自己的保健方法呢？Omada Health公司联合创始人兼首席执行官肖恩·达菲认为这样的公司不多。Omada Health也是一家数字健康公司，它开发的软件针对可能患慢性病的人群。达菲说：“这样的公司仍很罕见。”

    实际上，由于涉及数字健康产品和服务的临床和经济证据是如此匮乏，以至于有人专门建立了一家初创型企业来解决这个问题。这就是Evidation Health。该公司CEO黛博拉·基尔帕特里克说，他们的工作就是分析数字健康公司的宣传广告，因为经科学检验的数字保健方法少之又少。

    基尔帕特里克表示：“我不会说这些公司无法为自己宣称的东西提供依据。它们只是还没有[予以证明]。这些公司能否做到这一点还有待观察。”

    她认为，数字健康行业缺乏依据的原因是在这方面几乎没有投入过时间和资金，也几乎没有相关的专业知识。她说：“公平地讲，数字健康这个行业还相当年轻。”

    基尔帕特里克说，目前许多数字健康公司仍在走向成熟，它们拿到了天使投资，或者正在进行A轮或B轮融资；这个行业也仍在探索提高保健效果意味着什么。建立这些公司的创业者往往来自消费品行业，而不是医疗保健行业。因此，他们知道证据很重要，但不知道怎样找到证据。

    临床试验是证明健康干预措施行之有效的标准途径，但其费用之昂贵令人望而却步。同时，这项工作通常需要一个资源丰富并且能接触到病人的合作伙伴，比如医院。但医疗保健机构往往不愿意跟没有证据支持的小公司合作，而找不到合作伙伴的小公司又无法拿出证据。此外，作为临床试验场所，医院习惯于就此收取费用；初创公司则希望医院在试用其解决方案时付钱，这也是一个障碍。

    基尔帕特里克指出，消费型科技的市场潜力在于得到消费者使用。但在医疗保健领域，推动产品或服务得到应用的经常是步调缓慢的医疗机构、保险公司和制药企业。她说：“这个应用过程要复杂得多，规模也大得多。”

    非营利医疗服务机构Ochsner Health System首席临床转化官理查德·米拉尼博士表示，医院对数字健康技术的采用受多个因素影响。医疗保健领域需要颠覆，但必须小心地颠覆。

    米拉尼博士说：“你得对自己采用的技术可靠而且精确这件事有把握。这确实是个问题。如果能拿出一些科学数据，或者经过同行检验的数据来予以证明，事情当然会变得容易一些。”

    在风险投资方GE风投和医疗机构Stanford Health Care的支持下，Evidation Health把数字健康公司和医疗系统联系在了一起。该公司基于医疗、行为和背景数据来设计并开展相关研究，以验证数字保健方法的效果，比如对社交媒体Buzzfeed推广的Fitbit计步器进行72小时的验证，或者长期观察一款按时服药App能否改善医院的临床治疗结果。

    基尔帕特里克说：“基于这些研究结论，我们就可以改变客户以及合作伙伴对其业务的看法。”

    一些数字健康公司已经在有威望的行业评估刊物上公布了相关数据，以证明自身数字保健方法的效果，达菲的Omada Health就是其中较引人注目的一家。在用人单位支持下，该公司针对可能患慢性病的人群推出了一个为期16周的在线数字健康项目，作用是改变他们的行为。CEO达菲指出，这个项目于2011年设立，就是为了解决数字健康行业越来越缺乏证据的问题。他说：“我们从第一天起就在互联网上公布数据。”Omada Health积累了一年的数据后才公布了第一个同行评审研究的结果。现在达菲表示，Omada Health是这个领域中唯一一家公布过某个数字健康项目两年数据的公司。

    达菲指出，毫无疑问，进行以证据为基础的研究从逻辑上看很复杂。入门级研究的成本就可能达到数十万美元，而更深入的研究会耗资数百万。但他认为这样做是对的。毕竟，如果没有证据支持，谁也不会让病人接受新的药物或手术。

    达菲说：“我觉得数字健康也不应例外。在我看来，数字健康行业需要朝着这个方向迈进，以便越来越多地赢得信任。”

    一些创业者已经向达菲提出请求，希望为自己的产品和服务找到证据。达菲表示，此类请求的数量表明，数字健康公司开始意识到将自身技术商业化的最佳途径就是证明它的效用。他说：“今后四、五年，能拿出确凿证据的公司将变得不那么少见。”（财富中文网）

    译者：Charlie

    校对：詹妮

    Countless entrepreneurs around the world have launched digital health companies in the last decade and more than 100,000 mobile apps are currently on the market—all with the goal of making us healthier. But how many of these companies have concrete evidence to support their health claims?

    Not many, says Sean Duffy, co-founder and CEO ofOmada Health, a digital health company that develops programs for people at risk for chronic disease. “It’s still rare,” he adds.

    In fact, there’s such a lack of clinical and economic evidence on the effectiveness of digital health products and services that a new startup was created just to focus on the problem. Evidation Health works to parse the marketing claims of digital health companies, which are rarely proven using scientific evidence, says CEO Deborah Kilpatrick.

    “I wouldn’t couch it in the context of, ‘these companies are making claims they can’t back up,’” she says. “They just haven’t [proven them]. Whether or not they can remains to be seen.”

    Kilpatrick blames little time, knowledge and money spent on evidence in the digital health world for the lack of proof. “In all fairness,” she says, “digital health as a sector is still fairly young.”

    Many digital health companies are just now reaching maturity—they’re angel funded or in Series A or B rounds—and the sector is still figuring out what it means to prove effectiveness, Kilpatrick says. The entrepreneurs building these companies frequently come from the consumer sector, rather than healthcare, she says, so while they understand the importance of evidence, they don’t know how to generate it.

    Clinical trials—the standard in proving the effectiveness of health interventions—can be prohibitively expensive. And these tests usually require a partner with ample resources and access to patients, such as a hospital. Healthcare systems are often reluctant to partner with small companies that don’t have evidence, and these companies can’t get the evidence without a partner. Another hitch: hospitals are accustomed to being paid to host clinical trials, but startups want hospitals to pay them to pilot their solutions.

    Market potential in the consumer tech world is based on customer adoption, Kilpatrick says. But in healthcare, often slow-moving hospital systems, insurance payers, and pharmaceutical companies drive adoption. “It’s a much more complex and larger process of adoption,” she says.

    Several factors play a role in a hospital’s adoption of digital health technology, says Dr. Richard Milani, chief clinical transformation officer at Ochsner Health System. Healthcare needs disruption, he says, but it must be done carefully.

    “You want to be comfortable that the technology you’re utilizing is reliable and accurate,” Milani says. “That’s a genuine concern. If you have some scientific data or peer-reviewed data to back it up, that certainly makes it a little easier.”

    Evidation Health, which is backed by GE Ventures and Stanford Health Care, brings together digital health companies and healthcare systems. Evidation designs and executes outcome studies based on medical, behavioral and contextual data. The studies range from a 72-hour investigation into Fitbit claims made by Buzzfeed to a long-term look into whether a medication adherence app can improve a hospital’s clinical outcomes.

    “This allows us to redefine for clients and partners the way they think about their business on the basis of these outcomes,” Kilpatrick says.

    Duffy’s Omada Health is one notable example of a digital health company that has published its outcomes data in respected peer-reviewed journals. Omada offers an employer-sponsored 16-week online digital health program to promote behavioral change in people at risk for chronic disease. It was founded in 2011 in response to the growing lack of evidence in the digital health sector, Duffy says. “We had the intent to publish from day one,” he says. Omada’s first peer-reviewed study wasn’t released until the company had a year’s worth of data. Now, Duffy claims Omada is the only company in its space to publish two-year data from a digital program.

    There’s no doubt, Duffy says, that producing evidence-based studies is logistically complex. The cost of an entry-level study is likely to reach into the hundreds of thousands, though more robust research can tip into the millions. But, he says, it’s the right thing to do. After all, we wouldn’t subject patients to a new pharmaceutical or surgery without the evidence to back it up.

    “I don’t know why digital should be the exception,” Duffy says. “That’s the direction I think digital health needs to take to gain increasing trust.”

    Based on the number of queries he gets from entrepreneurs who want to generate evidence to back up their products and services, Duffy says digital health companies are beginning to realize that the best way to commercialize their tech is to prove it works. “In the next four or five years,” he says, “it will become less rare.”