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SignalBox

.. toctree::
    :maxdepth: 1

    install
    custom
    roles
    studies
    questionnaires
    memberships
    replies
    managing_data
    trial-admins
    reference



    glossary






Overview

SignalBox is a web application application designed to make it easy to run clinical and other studies. Signalbox makes it easy to recruit, take consent from, and follow-up large numbers of participants, using a customisable assessment schedule.

Participants can provide self-report data via email, telephone, or SMS message. Study coordinators can login to a secure administration website to manage studies and check participation. The admin interface integrates online and offline elements of a study; researchers can enter addtional datapoints collected offline or in the lab, and there is full support for double entry and reconciling of paper-based data, and also for audit trails of changes to participant data.

Signalbox was designed to replace the numerous, ad-hoc systems which have been developed by research groups, providing a flexible, secure, and well-tested system. The software has been independently audited, and used in many numerous studies, including a large, MRC-funded clinical trial (http://www.reframed.org.uk).

Functional anatomy

Below is a description of the data model used by the system. In essence, all capitalised words are tables in the database; the text below helps describe their structural and functional interrelations.

Core components

A :class:`~signalbox.models.Study` is lined to a number of :class:`~signalbox.models.StudyCondition`s which can each use a number of :class:`~signalbox.models.Script`s. A :class:`~signalbox.models.Script` links to an :class:`~ask.models.Asker` (a questionnaire) which includes a number of :class:`~ask.models.Page`s that contain :class:`~ask.models.Question`s. :class:`~ask.models.Question`s can use a :class:`~ask.models.ChoiceSet` which represents a set of :class:`~ask.models.Choice`s which define the range of allowed :class:`~signalbox.models.Answer`s (e.g. as part of a Likert type scale). Alternatively, Scripts may define an external url at which participants will enter data (e.g. a bespoke experimental task, or via a third party service like SurveyMonkey).

When a :class:`~django.contrib.auth.models.User` joins a :class:`~signalbox.models.Study` then a :class:`~signalbox.models.Membership` is created, which stores the randomisation times etc. When a :class:`~signalbox.models.Membership` is randomised to a :class:`~signalbox.models.StudyCondition` then the :class:`~signalbox.models.Script` is used to create :class:`~signalbox.models.Observation`s (scripts use a special syntax to describe the offset at which each :class:`~signalbox.models.Observation` will be created, by default counting from when the user is randomised).

When :class:`~signalbox.models.Observation`s are due then they are executed by a background task, causing an email, SMS to be sent, or a phone call to be made. In responding, users create a :class:`~signalbox.models.Reply` to the :class:`~signalbox.models.Observation`: A :class:`~signalbox.models.Reply` consists of multiple :class:`~signalbox.models.Answer`s, which represent responses to individual questions. Because a :class:`~signalbox.models.Reply` might be interrupted or left incomplete, multiple replies can be made to each :class:`~signalbox.models.Observation` (which the administrator needs to remember when the data are exported; they can chose a particular :class:`~signalbox.models.Reply` to use by marking it as canonical).

The diagram below represents the core constructs within Signalbox (but is not complete... see below).

/images/studystructure.pdf

Questionnaires and collecting data

As noted above, :class:`~ask.models.Asker`s contain :class:`~ask.models.Page`s which in turn contain :class:`~ask.models.Question`s. Some questions may also refer to :class:`~ask.models.Instrument`s, which represent a bundle of :class:`~ask.models.Question`s which are commonly shown together (e.g. a psychometric scale). When a questionnaire is displayed, 'instrument' questions automatically include this group of questions on a single page. See the diagram below:

/images/questionnairestructure.pdf

Additional components which may not always be used

:class:`~signalbox.models.Script``s` generate :class:`~signalbox.models.Observation`s, but can also generate :class:`~signalbox.models.Reminder`s for those :class:`~signalbox.models.Observation`s, and these send an additional messages to users at intervals after the :class:`~signalbox.models.Observation` falls due.

:class:`~signalbox.models.Script`s can also have :class:`~signalbox.models.ScoreSheet`s attached to them, which are sets of rules which describe how a set of :class:`~ask.models.Answer`s in response to the Script's Asker can be reduced to a single number (e.g. the mean or total for a set of Questions). ScoreSheets create scores which can be viewed for a particular User (e.g. to check whether a user meets a criteria for study entry from a screening questionnaire). ShowIfs are rules which evaluate to a boolean (yes/no) based on Replies Users have previously made (or Replies that are in progress). ShowIfs can be used to determine whether a particular Question should be shown based on previous responses. They can also be used to create new Observations based on a Reply, using an ObservationCreator. For example, if a User completes a depression questionnaire (Asker) and a ScoreSheet computes they have scored above a certain threshold, then an additional Observation could be created and a followup email sent.

Users are linked to a UserProfile which can contain additional fields like a telephone number, address etc. A Study can specify the subset of these fields which are required when a user signs up. ContactRecords are made when the administration interface is used to send a User a message. In some studies, its necessary to collect data from some Users (e.g. therapists) about other Users (e.g. clients); where this is the case a Membership can store an additional field indicating which User the data is about, as well as who it has been collected from

StudySites represent different locations in a multi-site trial, can can be used to filter Memberships when viewing date.

Database schema

In addition to the simplified diagrams above, the database schema for the Signalbox and Ask apps may also help clarify the structure of the application:

:download:`Download Signalbox app schema .pdf </images/signalboxgraph.pdf>`

/images/signalboxgraph.pdf

:download:`Download Ask app schema .pdf </images/askgraph.pdf>`

/images/askgraph.pdf

Note

Required fields in the database are displayed in bold

Technical overview

Signalbox is based on a number of excellent open source software projects. It was written using the Django web framework (i.e. in Python), and uses either an sqlite or a postgresql database (postgresql is strongly recommended). Configuration is provided to quickly host an instance using Heroku (a cloud-based application host, see http://en.wikipedia.org/wiki/Heroku), although self hosting is also possible.

Indices and tables