OBJECTIVES: The study objective is to examine linguistic and cultural considerations when implementing Bring Your Own Device (BYOD) studies globally in order to increase consistency and reduce bias across sites. BYOD studies allow patients in clinical studies to use personal devices to complete electronic Clinical Outcome Assessments (eCOAs) using a single cross-platform application. Consistency across countries within trials is key to obtaining unbiased data. Complexities of utilizing BYOD globally stem from the interplay of cultural and socioeconomic factors: culturally mediated differences in relationships to touchscreen technology, and average technological literacy. Further problems arise from the different non-Latin writing systems worldwide.

METHODS: Global eCOA projects completed between 2015 and 2017 were reviewed by two researchers and qualitatively analyzed using an impact analysis perspective to isolate linguistic and cultural themes that affect the implementation of eCOAs across device platforms. The impact of interface and formatting issues across languages on BYOD timelines, and consistency between translations, were also considered.

RESULTS: Analysis of completed eCOA projects indicated several important linguistic and cultural considerations for BYOD studies. These included tailoring technology to support global language requirements, the necessity of consistent translations and formatting across devices, and the need for rigorous proofreading across languages and device platforms. Cultural considerations included patients’ access to technology, and the success of integrating their writing system with the application interface. These considerations are largely determined by the study’s specific countries, indicating that translation requirements should be determined early to avoid negative impacts to timelines, study implementation, or bias across languages.

CONCLUSIONS: BYOD studies require application consistency across devices and methodological rigor due to numerous cultural and linguistic factors that can result in bias across cultures, languages, or devices. Global BYOD application development requires expertise in foreign languages and cultures, and the ability to customize methodologies so that consistency is maximized.