Mount Sinai Launches New Precision Wellness ‘N1’ App
A medical science tool for individuals to compare the effectiveness of wellness-related treatments
Have you ever wondered whether your double latte really helps you function better in that early-morning meeting? Or if melatonin truly gives you better sleep at night? Now there’s a way to find out, thanks to a new mobile precision wellness iPhone app developed at the Icahn School of Medicine at Mount Sinai.
The app, known as N1, enables individuals to answer these kinds of questions in a statistically rigorous way. The app is also designed to address a pervasive problem in health and medicine—different treatments can work differently on different people. Some respond very well to acetaminophen, for example, while others feel no benefit. Trying to find the most effective treatment for yourself through trial and error can be challenging.
“We’ve taken the tools that power clinical research and for the first time made them available to the public,” says Noah Zimmerman, PhD, founding Director of the Health Data and Design Innovation Center at the Institute for Next Generation Healthcare (INGH). “Individuals can now use some of the statistical and methodological tools that scientists use.”
The app’s name is derived from what scientists call an “n-of-1” trial, in which individuals compare the effects of different treatments on themselves. The concept isn’t new, but n-of-1 trials haven’t been widely adopted because designing these kinds of studies from scratch can be expensive and require specialized expertise. The N1 app simplifies the process by defining the parameters of the experiment—outlining what treatments to try, when to take them, and what outcomes to measure. It then uses sophisticated statistics to analyze the data that users collect and generates individualized results summarizing the comparative effectiveness of the treatments.
“Through the use of technology, we are able to make these tools available to a much broader audience,” says Jason Bobe, MSc, Associate Professor of Genetics and Genomic Sciences at the Icahn School of Medicine at Mount Sinai, Director of Democratized Health Innovation at INGH, and Principal Investigator of the study. “The hope is the app will enable many more people to adopt the n-of-1 approach.”
Users must agree to share their data from the app—deidentified, in most cases—with Mount Sinai researchers, but can choose whether or not to share deidentified data with scientists outside Mount Sinai.
The app, now freely available in the Apple iOS store (but not yet available on Android), is launching with a specific experiment: the “coffee vs. tea challenge.” The goal of this study is to determine whether users get a better brain boost from caffeine or caffeine plus L-theanine, a naturally occurring compound found in green tea. Each morning, the app will instruct users to take caffeine or caffeine + L-theanine, from coffee, tea, or over-the-counter supplements. It will then deliver a series of brain teasers to assess creative thinking, processing speed, and visual attention.
“We are launching the app with a wellness-related experiment to give users a fun, interesting, and safe way to learn about the n-of-1 approach,” says Mr. Bobe.
Mr. Bobe and collaborators plan to roll out additional experiments designed to demonstrate how to use medical science to address common wellness-related issues, such as sleep problems or chronic pain. Some of these will take advantage of data from wearable devices and smartphone apps that many people already use for self-tracking. Eventually, the team hopes to adapt the platform so users will be able to design their own experiments. N-of-1 experiments may also provide individuals a way to assess the benefits of the myriad wellness products on the market, such as supplements or apps that claim to improve sleep or memory.
Though the N1 app will initially focus on wellness, these methods and tools may one day be more regularly used in clinical contexts. Some physicians already use n-of-1 experiments as an alternative to the trial-and-error approach often required to find the best treatment for their patients. For a patient suffering from chronic pain, for example, a physician might prescribe an n-of-1 experiment comparing acetaminophen (Tylenol) and ibuprofen (Advil). The N1 app could offer physicians an easier way to structure these comparisons.
“The N1 app gives users a tool to leverage data they may already collect to make informed decisions about real-world treatment dilemmas,” Dr. Zimmerman says. “We hope this will help people make data-supported choices about what really works for them.”
To learn more about the first n-of-1 trial, the Brain Boost Study, or to read the free guide to n-of-1 methods, visit the N1 app website: https://www.n1app.org/
About the Institute for Next Generation Healthcare
Mount Sinai’s Institute for Next Generation Healthcare (INGH) is a uniquely positioned research organization in the Icahn School of Medicine at Mount Sinai and the Mount Sinai Health System, founded and directed by Joel Dudley. INGH faculty, data scientists, clinicians, software developers, and students are committed to building a transformative model of healthcare through the unification of biomedical discovery, AI technology, digital health, and patient-driven platforms to make the future of medicine a reality today.
About the Mount Sinai Health System
The Mount Sinai Health System is New York City's largest integrated delivery system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai's vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The Health System includes approximately 7,480 primary and specialty care physicians; 11 joint-venture ambulatory surgery centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools", aligned with a U.S. News & World Report's "Honor Roll" Hospital, No. 12 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report's "Honor Roll" of top U.S. hospitals; it is one of the nation's top 20 hospitals in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Geriatrics, Gynecology, Nephrology, Neurology/Neurosurgery, and Orthopedics in the 2019-2020 "Best Hospitals" issue. Mount Sinai's Kravis Children's Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 12th nationally for Ophthalmology, Mount Sinai St. Lukes and Mount Sinai West are ranked 23rd nationally for Nephrology and 25th for Diabetes/Endocrinology, and Mount Sinai South Nassau is ranked 35th nationally for Urology. Mount Sinai Beth Israel, Mount Sinai St. Luke's, Mount Sinai West, and Mount Sinai South Nassau are ranked regionally.