Last Updated: May 29, 2026
One Cow Standing, LLC ("One Cow Standing," "we," "us," or "our"), in collaboration with Duke University and the University of Ruhuna, operates the RespiQuest AB mobile application (the "App"). This Privacy Policy describes how we collect, use, disclose, and safeguard your information when you use the App in connection with a clinical research study evaluating the management of lower respiratory tract infections (LRTI) in Sri Lanka.
By using the App, you consent to the collection and use of information in accordance with this Privacy Policy. If you do not agree with the terms of this Privacy Policy, please do not access or use the App.
RespiQuest AB is based on an algorithm designed in collaboration by Duke University and the University of Ruhuna, with the goal of improving the management of lower respiratory tract infections (LRTI) in Sri Lanka.
The App is designed for use in patients aged 14 years and older who meet a case definition for LRTI (one or more lower respiratory signs and one or more infectious signs). It applies to patients with syndromes such as bronchitis, infectious exacerbations of asthma and COPD, and pneumonia.
The algorithm integrates: (1) real-time influenza incidence data for Sri Lanka from the WHO FluNET, and (2) patient-level clinical variables predictive of bacterial, viral, or other illness based on a database of 521 patients with LRTI previously enrolled from National Hospital Galle. A machine learning algorithm assigns probability of five diagnoses: influenza, other viral infection (including SARS-CoV-2), bacterial, non-infectious, and indeterminate.
The App may recommend conducting a point-of-care (POC) test for influenza, SARS-CoV-2, Streptococcus pneumoniae, or procalcitonin if a positive test result would significantly change the most probable diagnosis. Clinicians may also conduct any POC test regardless of App recommendations. Post-test probabilities are displayed to aid clinical decision-making.
The App provides recommendations regarding treating with or withholding antibacterials and oseltamivir based on the most probable diagnosis. A positive POC test will override the probability-based treatment recommendation. The clinical team should always use their clinical judgment when deciding whether to follow the App recommendations.
The impact and safety of the App is being evaluated in a stepped-wedge cluster randomized trial at three public hospitals in Sri Lanka:
When you or a clinician enters information into the App as part of the clinical study, we may collect the following categories of information:
We will not share any of your personal information beyond our authorized study staff or those who monitor the study to ensure participant rights are protected, safety is maintained, and the study plan is followed.
When you use the App, we may automatically collect certain information, including but not limited to:
We may use the information we collect for the following purposes:
We rely on separate and overlapping lawful bases to collect and process your personal information, including:
We may share your anonymized information in the following circumstances:
With Duke University and the University of Ruhuna, as co-investigators in the clinical trial, in accordance with the approved study protocol and data sharing agreements. Future collaborators may also include but not be limited to publications future grant applications.
With third-party service providers who perform services on our behalf (e.g., cloud hosting, data analytics), subject to confidentiality obligations and data protection agreements.
With ethics review boards, institutional review boards (IRBs), data safety monitoring boards, and government regulatory authorities, as required for clinical trial oversight and compliance.
When required by law, regulation, or valid legal process (e.g., a court order or government request).
To protect the rights, property, or safety of the study, participants, or the public.
In connection with any merger, acquisition, or sale of assets, your Personal Data may be transferred, with prior notice provided to you.
We will not sell your personal information to third parties.
We are committed to protecting the security of your information. All personal and clinical data collected through the App is maintained on secure, encrypted servers via secure, password-protected access. Data transmitted from the App is securely encrypted in transit.
We employ commercially reasonable administrative, technical, and physical safeguards designed to protect against loss, unauthorized access, improper modification, or disclosure of your data. However, no method of transmission over the Internet or method of electronic storage is 100% secure, and we cannot guarantee absolute security.
RespiQuest AB uses Amazon Web Services (AWS), whose data centers and network architecture are designed for the highest levels of data privacy and security to meet the requirements of security-sensitive organizations. For more information about privacy and security at AWS, please visit: https://aws.amazon.com/privacy/
Your information may be transferred to, stored, and processed in a country other than the one in which it was collected, including the United States. When such transfers occur, we rely on appropriate safeguards to protect your information in accordance with applicable data protection laws, including standard contractual clauses, adequacy decisions, your consent, or binding agreements.
Your consent to this Privacy Policy, followed by your submission of information through the App, represents your agreement to such transfers.
We will retain your personal and clinical data only for as long as is necessary to fulfill the purposes described in this Privacy Policy, including the completion of the clinical trial and any required post-study retention periods. Usage data is generally retained for a shorter period unless needed for security, functionality improvement, or legal compliance.
Retention periods are determined by applicable laws, regulations governing clinical research data, and institutional policies of the collaborating universities.
Depending on your jurisdiction, you may have the following rights regarding your personal information:
Please note that in certain cases, we may have a lawful basis to continue processing your personal information after you have withdrawn consent, including when necessary to protect your health and safety or to comply with legal obligations related to the clinical trial.
To exercise any of these rights, please contact us using the information provided in the Contact Us section below.
If you are located in the EEA or UK, you have additional rights under the General Data Protection Regulation (GDPR), including the rights described above. You also have the right to lodge a complaint with your national data protection authority (supervisory authority).
The App is designed for use in patients aged 14 years and older. We do not knowingly collect personally identifiable information from children under the age of 13. If you are a parent or guardian and become aware that a minor has provided us with personal data, please contact us immediately. If we become aware that we have collected personal data from anyone under the age of 13 without proper consent, we will take steps to remove that information.
For participants aged 14 to 17, informed consent and/or assent is obtained in accordance with the clinical trial protocol and applicable local regulations.
The App may contain links to third-party websites or services not operated by us (e.g., WHO FluNET, clinical trial registries). We are not responsible for the privacy practices or content of such third-party sites. We encourage you to review the privacy policies of any third-party site you visit.
We may update this Privacy Policy from time to time. If any material changes are made, we will notify you by posting a notification within the App and updating the "Last Updated" date at the top of this policy. You are advised to review this Privacy Policy periodically for any changes. Changes are effective when posted.
If you have questions, comments, or requests regarding this Privacy Policy or our data practices, please contact us:
One Cow Standing, LLC
112 Broadway St, Suite B
Durham, NC 27701
Email: privacy@onecowstanding.com
Duke University Privacy Office
Email: privacy@duke.edu
Phone: 919-684-2144
Address: Duke Privacy, Office of Audit, Risk & Compliance, Box 90436, 705 Broad Street, Suite 210, Durham, NC 27708
To request deletion of your account and associated data, please contact privacy@onecowstanding.com with the subject line "Request for Deletion." Include your name and any identifying information used during enrollment. Your data will be deleted within 5 business days, subject to any legal or regulatory retention requirements applicable to clinical research data.