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Technology

Scientific research at Clue

How tracking your cycle advances female health

by Anna Druet, Former Science and Education Manager
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When you track in Clue, you contribute to an unprecedented data set that is forwarding the understanding of female health in a new frontier of health research. We work with top research institutions and clinicians to explore topics with real-world impact — to better understand our bodies and physical mechanisms, explore our cultural and demographic diversity, and to break harmful taboos.

We work with carefully chosen researchers within academic institutions to answer specific research questions of a non-commercial nature. We only share data that is directly relevant to the researcher’s question, and all data is always stripped of identifying factors such as email, names, and IP addresses.

With the help of our science and data teams, our academic collaborators are exploring questions like: what pain patterns are considered “normal” in which populations? What mood patterns do we see around ovulation? How might our menstrual and symptom patterns help us spot disease and illness risk earlier?

Here’s an overview of Clue’s current research collaborations.

Clue’s new research collaborations

The Max Planck Society: Psychological changes around ovulation

Ruben Arslan, PhD is post-doctoral researcher in adaptive rationality with The Max Planck Society. He has a PhD in Biological Personality Psychology, and has published on topics like paternal age and evolutionary fitness, and social network profiles and implicit cues to motivation. Ruben began his work with us in November of 2017, exploring mid-cycle psychological patterns. He described his work for us:

“With Clue, we plan to look for psychological changes around ovulation, especially in sexual desire. Our previous work has shown that not everyone experiences these changes to the same extent. Because Clue has so much data, this will also allow us to learn more about individual differences in these changes – some women experience large increases in sexual desire in the middle of their cycle, but others don't experience any. We know hormonal contraception inhibits these changes, but what are other reasons for differences?"

Follow Dr. Arslan on Twitter: @rubenarslan

Columbia University: Identifying population groups based on phenotype

Noemie Elhadad, PhD, is with the Biomedical Informatics Department at Columbia University, and has been working with us since early 2017. Her lab is approaching women’s health research with computational methods like mechanistic modeling. Noemie explained:

“We are health data scientists, who design novel machine learning algorithms to analyze and discover new insights about health and behavior. Together with Clue we will investigate two themes.

The first theme is: what do millions of women tell us about menstrual health, and how does it add to what research in women's health already knows? The Clue data is in essence the largest observational study about menstrual health, and we know it will shed new light on the menstrual cycle and its phenotypic variations.

The second theme is that while everyone is different, we hypothesize there are large groups of individuals that can be discovered who experience symptoms and other phenotypic variables of the menstrual cycle in a similar fashion. We plan to leverage data science methods to identify patterns in the data tracked by individuals and identify what symptoms of the menstrual cycle often go together and what it can mean for the women who experience them.”

In November of 2017, our paper “Towards Personalized Modeling of the Female Hormonal Cycle: Experiments with Mechanistic Models and Gaussian Processes” was presented at the Annual Conference on Neural Information Processing Systems (NIPS) 2017, at the Workshop on Machine Learning for Health.

The lab’s focus has also been on endometriosis. They have an ongoing research project called Citizen Endo to better understand the disease, and are currently looking for participants to share their experiences of endo.

Stanford University: Pain patterns and disease prediction

Laura Symul, PhD, is a research scientist in the field of computational biology. She started collaborating with Clue in late 2017, while at EPFL’s (école Polytechnique Fédérale de Lausanne, Switzerland) Digital Epidemiology Lab. In March 2018 Laura joined Stanford University, where she works with 8-Lab, focused on mhealth (mobile health—medicine and public health supported by mobile devices), and Dr. Paula Hillard, of Clue’s Medical Board. With Clue, Laura is researching patterns that may help identify disease risk groups. Laura explained:

“Many women have accepted physical pain and emotional suffering as part of their menstrual experience. While mild to moderate menstrual symptoms are common, severe pain or an inability to do normal activities may be due to medical conditions that deserve evaluation, diagnosis, and treatment. The diagnosis of conditions such as endometriosis may be delayed. Today, thanks to collaboration with Clue, we have a chance to better understand the diversity or menstrual pain patterns and through analysis of the data, to detect specific associations. Long-term goals include clinical validation of digital observations to provide an early warning to women and their clinicians.”

Stanford University: Modeling cycles in computational health

In mid 2017, computer scientists in Jure Leskovec’s Stanford University lab started working with Clue to study cyclic patterns in mood and behavior, and develop new methods for detecting and modeling cycles. They have substantial prior experience analyzing large human health data sets collected via apps. Their first paper was accepted for publication at WWW 2018. Emma Pierson from the lab described their work:

“Many types of cycles are fundamental to human health and behavior (examples include the menstrual cycle, annual mood cycles, and circadian cycles) and Clue data gives researchers an excellent way to test cycle modeling methods. We are very excited to have the chance to study menstrual cycle data.”


Clue’s ongoing collaborations

We’ve worked for several years with the following researchers:

University of Oxford: Evolution, menstruation, and “PMS”

Dr. Alexandra Alvergne of the University of Oxford works ongoing with Clue and has written the review paper “Is Female Health Cyclical? Evolutionary Perspectives on Menstruation” in partnership with Clue’s previous head of science, Vedrana H?gqvist Tabor. Dr. Alvergne explains:

“Women aren’t in control of their reproductive lives. Without enough understanding of what’s “normal”, any deviation is categorized as biological malfunctioning that requires medical attention, leaving women with anxiety, feelings of guilt and unnecessary treatment.

The project aims to bring anthropology to women and show that variation is “normal” — and to research how a more refined understanding of the premenstrual experience can be harnessed to improve women’s health.

In 2017, more than 30,000 Clue users filled out a survey to participate in a study with Dr. Alvergne, called “Putting Big Data into Action: Combining a Digital Period Tracker with Anthropological Insight to Empower Women to Take Control over their Reproductive Health.”

“The project aims to exchange knowledge in order to bring valuable—personal—insights to women, that is, develop user-led research on female reproductive health. The focus is on PMS, a biomedical category describing a number of symptoms that occur before the menses and that is currently tracked and predicted by the app.

Ultimately, this project is a stepping stone for us to be leaders in transforming research practice on female reproductive health.”

Follow Dr. Alvergne on Twitter: @AlexAlvergne

Stanford University: The menstrual cycle as a vital sign

Clue medical board member Dr. Paula Hillard is currently working with Clue on a research paper exploring the menstrual cycle as a vital sign, and what a large menstrual data set can add to our basic understanding of the cycle. The study aims to understand the natural variability in the length of the menstrual cycle and period across the reproductive lifespan. An abstract of the paper, “Data From a Menstrual Cycle Tracking App Informs Our Knowledge of the Menstrual Cycle in Adolescents and Young Adults,” was accepted and presented at the meeting of North American Society for Pediatric and Adolescent Gynecology in 2017, and publication is set for 2018.

Columbia University: Menarche, menstruation, and breast cancer

Another partnership with Columbia University explores associations between menstrual patterns and chronic disease risk in women from adolescence to mid-adulthood. Jasmine McDonald, Lauren Houghton, and Mary Beth Terry of the Mailman School of Public Health at Columbia are spearheading these efforts. Jasmine and Lauren explained their work:

"Our team is examining associations between detailed characteristics of adolescents' and women’s periods and chronic disease, primarily breast cancer. When gathering information from women on their menstrual cycle characteristics, traditional research methods often rely on participant recall or the participant diligently annotating one’s calendar. Adolescent periods have been historically difficult to track because they are irregular by definition. In replace of possible biased and antiquated tools, Clue enables us to collect real-time detailed information on a daily basis.”

Kinsey Institute, Indiana University: Sex and technology and female perspectives on condom use

In 2017, we collaborated with researchers at the Kinsey Institute to conduct two groundbreaking surveys on topics relevant to our users’ lives and to public health. With social scientist Dr. Amanda Gesselman we explored sex, technology, and how smartphones are changing how we date and relate. Findings from this survey are enroute to being peer reviewed for publishing.

Kinsey’s trailblazing Condom Use Research Team (CURT) worked with us to conduct the largest-ever study of women’s attitudes and behaviours around condom use. With over 90,000 responses, the survey findings will contribute to both interest and understanding with real-world impact potential. Preliminary results will be released in April 2018, and CURT will be applying to publish more findings after further analyses.

These are the biggest surveys of their kind ever done, and provide great insight into under-researched fields. Stephanie A. Sanders, Senior Scientist at The Kinsey Institute comments:

“This is the largest and most internationally diverse study examining the effect of menstruation on current sexual practices, and the use of condoms.”

In the coming months, we’ll be releasing a call for submissions for new research collaborations across various fields. Sign up for our newsletter (in the box on the right, on a desktop) and follow us on Twitter to know when that happens.

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