iChooseKidney – End User License Agreement, Terms of Use, and Privacy Policy
This End User License Agreement, Terms of Use, and Privacy Policy (“Agreement”) is between Emory University, a Georgia nonprofit corporation with offices at 201 Dowman Drive, Atlanta, Georgia 30322 (“Emory”), and each person who downloads, installs, accesses, or uses the iChooseKidney mobile application (“You”). The application, its executable code, content, mobile front-end, backend server components, associated algorithms, Source Code (as defined below), prompt configurations, user interfaces, graphics, databases, documentation, and any copyrightable elements to which this Agreement is attached, together with any updates, enhancements, or derivative works thereof supplied by Emory to You and associated services are the “Software.” By selecting “Agree”, installing, or using the Software, You accept this Agreement. If You do not agree, do not install or use the Software.
1. Distribution and Relationship with Apple
The Software is distributed through Apple Inc.’s App Store. This Agreement is between You and Emory only, not Apple. Emory, not Apple, is solely responsible for the Software and its content, product claims, and any third-party intellectual-property claim, except to the extent otherwise required by applicable law. The Software is supplied to You as is, without any accompanying services, support, maintenance, or improvements from Emory. Apple has no obligation to furnish maintenance or support services. Apple and its subsidiaries are third-party beneficiaries of this Agreement and, upon Your acceptance, may enforce this Agreement against You as a third-party beneficiary.
Your use must comply with the Apple Media Services Terms and Conditions, App Store Usage Rules, and any applicable third-party agreement. Current Apple developer agreements and guidelines are available at https://developer.apple.com/support/terms/ and the App Review Guidelines are available at https://developer.apple.com/app-store/review/guidelines/.
2. Grant of License and Restrictions on Use
Subject to this Agreement, Emory grants You a limited, revocable, non-exclusive, non-transferable, non-sublicensable license to install and use one copy of the Software on Apple-branded products that You own or control, as permitted by the App Store Usage Rules, including permitted Family Sharing or volume-purchasing use. The Software is licensed, not sold.
Except to the extent a restriction is prohibited by applicable law or an identified open-source license expressly permits otherwise, You may not distribute, license, loan, rent, sell, transfer, copy, modify, adapt, translate, port, merge or create derivative works from, reverse engineer, decompile, decode, decrypt, disassemble, or attempt to derive Source Code (“Source Code” means the human-readable form of the Software, including front-end and backend source files, build scripts, configuration files, prompt templates, and any other files from which executable binaries or deployed application packages (including APK and iOS packages) are compiled or assembled), or any part of it from the Software; circumvent technical protections; or remove, alter, or obscure proprietary notices. You may not copy any ideas, features, functions, algorithms, user-interface designs, or graphics of the Software, nor use any portion of the Software to create a competing or substantially similar software or mobile application.
3. Ownership, Source Code, and Reservation of Rights
3.1 Emory retains all right, title, and interest in the Software, including copyright, trademark, patent, trade-secret, and other proprietary rights into the Software and any associated documentation, subject to third-party rights and the Federal Government rights described in Section 8, and You agree to preserve the same. Nothing in this Agreement grants You any ownership interest in the Software. You acknowledge that You are NOT granted any rights, by implication, estoppel, or otherwise, arising from any Emory-owned patents or patent applications that may cover the Software or any derivative works of the Software created by You or others. All rights not expressly granted to You under this License are reserved to Emory. Without limiting the foregoing, Emory retains all rights to use, reproduce, modify, improve, extend, publish, and further license the Software for any purpose not inconsistent with Emory’s ownership of the Software. No source-code access or source-code license is granted by this Agreement. The executable app does not include a right to obtain development files, models, coefficients, documentation, or Source Code.
3.2 Emory has not authorized public disclosure of the Source Code through GitHub or any other repository. If Emory later releases any Source Code, that release will be governed only by separate written license terms approved by Emory. Third-party and open-source components used in the development of the Software remain governed by their own respective licenses; nothing in this Agreement limits rights to those open-source components that their respective licenses independently grant.
3.3 Nothing in this License shall be construed to limit or restrict the Emory’s right to publish scholarly articles, abstracts, conference presentations, posters, theses, or other academic communications concerning the Software or the research underlying the Software, in accordance with Emory University policy and any applicable funding-agency requirements. The existence of this Agreement creates no obligation on the Emory’s part of the Inventors to You.
3.4 Emory’s Right to Use. Nothing in this Agreement restricts Emory from continuing to use, maintain, modify, improve, or further develop the Software for internal academic, research, and institutional purposes. This Agreement does not grant any general right of access to the Source Code to Emory personnel or others outside of Emory’s internal controls.
3.5 Separate Commercial Licensing. Emory expressly reserves the right to grant separate licenses to the Software on such terms as Emory may determine, including, without limitation, commercial licenses or options to license granted to a startup or any other commercial entity formed or joined by one or more of the Inventors. The grant of license under this Agreement to You shall not be construed as a waiver, exhaustion, or limitation of Emory’s right to grant such separate licenses, and You do not acquire any right of first refusal, most-favored-licensee status, or similar right by accepting this Agreement.
4. Development Tools, Artificial Intelligence, and Third-Party Components
The Software was developed using Xcode, Swift, and SwiftUI and incorporates BigUIPaging and the Montserrat font family. The integrated development environment (IDE) in Xcode is governed by the Xcode and Apple SDKs Agreement and other applicable Apple developer agreements. Your use of the Software is conditioned upon Your compliance with those agreements, Apple’s guidelines and terms for app development and distribution, the App Review Guidelines, and the separate licenses that govern any open-source components included within or used through Xcode. You can review the open-source licenses for components included in Xcode, in the electronic documentation provided with Xcode.
Gemini Code Assist and/or the Google Gemini chat interface were used only as development aids for troubleshooting software bugs and refining user-interface layouts. No Gemini API was used to develop, integrate, operate, or provide any feature of the Software. The released Software does not call a Gemini API, does not require a Gemini account, and does not transmit user inputs or results to Gemini. Gemini Code Assist and Gemini are not incorporated into or redistributed with the Software.
Use of Gemini Code Assist for development of the Software is subject to the terms of the Google’s Gemini Code Assist Plugin Software License Agreement, and the terms of the separate license agreements applicable to the third-party or open-source components used by the Google Gemini Code Assist Plugin software. To the limited extent a third-party license or open-source license expressly applies to a component of the Gemini Code Assist Plugin software, that license supersedes the Google’s Gemini Code Assist Plugin Software License Agreement and governs the use of that component. Your use of the Software is conditioned upon Your compliance with the applicable license terms. You agree to comply by the terms and conditions given in the companion THIRD-PARTY-NOTICES.docx that identifies the third-party and open-source components and tools that have been used in development of this Software by Emory and provides their respective license links, notices, and applicable conditions. You are solely responsible for ensuring that any data You submit through the Software is submitted in a manner consistent with the terms of those licenses and with applicable privacy and data-protection laws.
5. Privacy and Data Practices
5.1 Information entered into the calculator. To calculate an estimate, You may enter age at dialysis start, sex, dialysis type, time on dialysis, cardiovascular disease, hypertension, diabetes, and whether albumin is below 3.5 g/dL. The Software produces one-year and three-year mortality-risk or survival estimates. This information is processed on Your device and is not sent to Emory. Do not enter a name, medical-record number, contact information, or another direct identifier.
5.2 On-device processing and storage. Calculator inputs and results are processed entirely on Your device, and the calculator does not require an Internet connection. If You choose to save a result, the saved record may include the inputs listed above, calculated results, a date, and a user-entered note. Saved results and the record that You accepted this Agreement are stored only in the Software’s local container on Your device. They are not uploaded to Emory or synchronized by the Software to a remote server or cloud service.[SG1.1][MD1.2] Emory cannot access, retrieve, or restore these local records. Your operating-system backup settings may separately determine whether app data is included in a device backup controlled by You and the applicable platform provider.
5.3 No data collection, analytics, advertising, or tracking. As of the Effective Date, neither Emory nor the Software collects user data from the app. The Software does not create a user account or automatically transmit to Emory or any third party any calculator input, saved result, note, output estimate, direct identifier, device identifier, diagnostic information, or app-usage information. The Software contains no advertising, cross-app tracking, analytics, or telemetry functionality[SG2.1][MD2.2]. For purposes of this Section, information processed or stored only on Your device is not “collected”. Before introducing any off-device collection in a future release, Emory will update this policy and the applicable App Store privacy disclosures and will provide notice and obtain consent or device permission where required.
5.4 User-directed disclosure and platform services. The current release does not read Your Contacts, Camera, Microphone, Location, Health data, or Photos library from Your device. If You affirmatively select email, a system share option, or printing, the result information You choose may be transferred to the recipient, destination app or service, or printer You select. The Software does not initiate that transfer automatically, and Emory does not receive the information unless You deliberately select Emory as a recipient. Any resulting copy is governed by the privacy and security practices of the selected recipient, platform, app, service, or printer. Apple may independently process App Store, device, diagnostic, or usage information under Apple’s terms, privacy policy, and Your device settings; that independent Apple processing is not collection by Emory through the Software.
5.5 Security, retention, and deletion. Locally stored information remains on Your device until You delete the applicable saved result or remove the Software, subject to Your device and backup settings. It is protected by the security controls of Your device and operating system, but no storage method is completely secure. Use a device passcode, install operating-system updates, and delete saved results when no longer needed. Removing the Software generally removes its local container from the device, but it does not delete copies that You previously sent, shared, printed, or backed up. Those copies must be deleted through the applicable destination, recipient, service, or backup controls.
5.6 HIPAA. Because information entered into or stored by the Software remains on Your device and is not received or maintained by Emory through this consumer app, that on-device activity does not by itself create a record maintained by Emory as Protected Health Information. The Software is not represented as providing HIPAA-regulated storage or transmission safeguards and should not be used as a substitute for an authorized clinical record system. Emory’s HIPAA status and obligations in any separate clinical-care or research context are determined by that context and are not altered by this Agreement.
5.7 Research participation. Use of the Software alone does not transmit research data to Emory. If You use the Software as part of any research study involving human subjects, patient data, or protected health information, any separate study procedure that collects information must be described in the study’s informed-consent document and, where applicable, HIPAA authorization. You must first obtain approval from a duly constituted Institutional Review Board (IRB) and comply with all applicable regulatory requirements, including 45 CFR Part 46 (Common Rule), HIPAA (including the Privacy Rule and Security Rule, 45 CFR Parts 160 and 164), and any applicable policies. You are solely responsible for obtaining and maintaining all such approvals. Those documents govern the separate research collection, use, disclosure, and protection of information to the extent they supplement or conflict with this Agreement.
5.8 Academic Attribution. You agree to acknowledge the Software and its creators in a manner consistent with academic practice in any peer reviewed papers, abstracts, presentations, posters, or similar publications that report results derived in whole or in part from use of the Software. A suggested citation is available from Emory upon request.
6. Medical Uses and Important Limitations
The Software is an informational clinical decision aid and has not been evaluated or cleared by the U.S. Food and Drug Administration. It is not intended to diagnose, cure, mitigate, treat, or prevent disease and is not a substitute for professional medical judgment. Patients should discuss results with a qualified healthcare professional. Healthcare professionals must independently assess all relevant clinical information and must not rely primarily on the Software for diagnosis or treatment decisions.
7. Research Data Used to Develop the Model
The statistical coefficients and calculation logic were derived from aggregated analyses of United States Renal Data System data used under applicable data-use agreements and research approvals. The underlying research dataset is not included in the Software, and the Software does not identify or provide access to any person in that dataset.
8. Funding Acknowledgment and Federal Government Rights
Development of the original iChooseKidney application was supported by National Institutes of Health grant awards. Development of this updated version of Software was supported by a grant from the American Society of Transplantation Research Network.
To the extent the Software or another copyrightable work was developed or acquired under a Federal award, the Federal government retains the rights provided by the award terms and Federal law, including a royalty-free, nonexclusive, and irrevocable right to reproduce, publish, or otherwise use the Software or the federally supported work for Federal purposes and to authorize others to do so for Federal purposes. See 2 C.F.R. section 200.315(b). Nothing in this Agreement restricts those Federal Government rights.9. Links and Third-Party Services
The Software may provide user-directed access to third-party websites, apps, services, printers, or resources. The Software does not automatically disclose calculator or usage data to them. If You choose to open, share with, email, or print through a third party, that third party’s terms and privacy practices apply. Emory does not control and is not responsible for their content, availability, security, or privacy practices. Providing access for Your convenience does not constitute endorsement.
10. Intellectual-Property Claims
To the best of Emory’s knowledge, Emory has the rights necessary to grant the license in Section 2, subject to the separately licensed third-party components identified in THIRD-PARTY-NOTICES.docx. If a third-party claims that the Software or Your possession or use infringes its intellectual-property rights, Emory, not Apple, is responsible for investigation, defense, settlement, and discharge of that claim, and may resolve it by terminating this license or discontinuing the Software.
11. Disclaimer of Warranties
TO THE MAXIMUM EXTENT PERMITTED BY LAW, THE SOFTWARE IS PROVIDED “AS IS” AND “AS AVAILABLE,” WITH ALL FAULTS. EMORY DISCLAIMS ALL EXPRESS, IMPLIED, AND STATUTORY WARRANTIES, INCLUDING, BUT NOT LIMITED TO, THE WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, NON-INFRINGEMENT, ACCURACY, SECURITY, CONFIDENTIALITY, AVAILABILITY, AND ERROR-FREE OPERATION. EMORY DOES NOT WARRANT THAT OUTPUTS WILL BE ACCURATE OR APPROPRIATE FOR ANY INDIVIDUAL OR THAT LOCALLY STORED OR SHARED INFORMATION WILL BE FREE FROM LOSS, CORRUPTION, OR UNAUTHORIZED ACCESS.
If the Software fails to conform to an applicable warranty that cannot lawfully be disclaimed, You may notify Apple and Apple may refund any purchase price paid. To the maximum extent permitted by law, Apple has no other warranty obligation regarding the Software.
12. Limitation of Liability
TO THE MAXIMUM EXTENT PERMITTED BY LAW, EMORY WILL NOT BE LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, EXEMPLARY, OR PUNITIVE DAMAGES, (INCLUDING, BUT NOT LIMITED TO, FOR LOSS OF DATA, OR PROFITS; OR BUSINESS INTERRUPTION) ARISING IN ANY WAY OUT OF THE USE OF THIS or FORM THIS SOFTWARE, EVEN IF ADVISED OF THE POSSIBILITY OF SUCH DAMAGE. NOTHING IN THIS AGREEMENT EXCLUDES LIABILITY THAT CANNOT BE EXCLUDED UNDER APPLICABLE LAW.
13. Indemnification
You agree to indemnify, hold harmless, and defend Emory, its trustees, officers, employees, students, and agents against any and all claims, losses, damages, liabilities, costs, and expenses (including reasonable attorneys’ fees) of any kind arising out of or related to Your exercise of any rights granted under this Agreement or Your breach of this Agreement.
14. Compliance with Law and Export Restrictions
You must use the Software in compliance with applicable laws, policies and regulations and applicable third-party terms, including but not limited to laws concerning data privacy, export control, informed consent, and patient confidentiality. The Software is subject to U.S. export jurisdiction. You represent that You are not located in a country subject to a U.S. Government embargo or designated by the U.S. Government as supporting terrorism and are not listed on a U.S. Government prohibited- or restricted-party list.
15. Termination
This Agreement is effective until terminated. Your rights under this Agreement will terminate automatically and without notice from Emory if You fail to comply with any term of this Agreement. You may terminate this Agreement by deleting the Software and all copies under Your control. Emory may discontinue the Software at any time, subject to Emory’s obligations to Apple and applicable law. Upon termination, Your licensed rights cease and You must promptly cease all use of the Software thereof, uninstall and delete all copies of the Software in Your possession or control. Sections concerning ownership, third-party licenses, Federal Government rights, disclaimers, liability, and accrued obligations survive.
16. No Endorsement
You agree that neither the name of Emory University, any of its trademarks or service marks, the names of any of its employees, nor the names of any contributors to the Software may be used to endorse or promote products or services derived from or using the Software without specific prior written permission from Emory.
17. Contact
Questions, complaints, or claims regarding the Software should be directed to: Emory University, 201 Dowman Drive, Atlanta, Georgia 30322; app-support email/URL: rapatzer@regenstrief.org. Apple is not responsible for addressing user or third-party claims regarding the Software.
18. Entire Agreement; Severability; Order of Precedence
This Agreement is the entire agreement between You and Emory concerning Your installation and use of the Software, except for a research consent or authorization described in Section 5.7 and third-party licenses that expressly govern their components. If a provision is invalid or unenforceable, the remaining provisions remain effective. If this Agreement conflicts with mandatory App Store Usage Rules or an applicable open-source license, those terms control only to the extent of the conflict.
19. Changes to this Agreement or Privacy Practices
Emory may update this Agreement. For a material change, Emory will provide notice through the Software, the App Store listing, or another reasonable method before the change takes effect where required. If a future version begins collecting data off the device, Emory will revise this Privacy Policy and the App Store privacy disclosures before that collection begins and will obtain any required consent or permission. Continued use after the effective date of an updated Agreement constitutes acceptance to the extent permitted by law. If You do not accept an update, stop using and delete the Software.