Self-assessment of Rheumatoid Arthritis Disease Activity Using a Smartphone Application

Nishiguchi, Shu; Ito, Hiromu; Yamada, Minoru; Furu, Moritoshi; Ito, Tatsuaki; Shinohara, Akio; Ura, Tetsuya; Okamoto, Kazuya; Aoyama, Tomoki; Tsuboyama, Tadao

doi:10.3414/me14-01-0106

Cited by 27 publications

(12 citation statements)

References 25 publications

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“…The app has the potential for data collection at a higher frequency (eg, multiple points per day) than would be logistically possible in standard clinical studies; therefore, it can provide a more holistic view of disease exacerbation and remission. Furthermore, a previous study demonstrated that capture of Disease Activity Score in 28 joints data using a dedicated smartphone app correlated well with monthly clinical assessments of RA disease activity [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…For example, monitoring the impact of physical activity on cardiovascular health, by gathering objective data relating to patient mobility and activity levels through the use of the integral smartphone global positioning system, was shown to be successful [ 12 ]. An attempt to capture data relating to gait analysis in patients with RA has been reported, but this method awaits full validation [ 15 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Using a ResearchKit Smartphone App to Collect Rheumatoid Arthritis Symptoms From Real-World Participants: Feasibility Study

Crouthamel

Quattrocchi

Watts

et al. 2018

JMIR Mhealth Uhealth

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BackgroundUsing smartphones to enroll, obtain consent, and gather self-reported data from patients has the potential to enhance our understanding of disease burden and quantify physiological impact in the real world. It may also be possible to harness integral smartphone sensors to facilitate remote collection of clinically relevant data.ObjectiveWe conducted the Patient Rheumatoid Arthritis Data From the Real World (PARADE) observational study using a customized ResearchKit app with a bring-your-own-device approach. Our objective was to assess the feasibility of using an entirely digital approach (social media and smartphone app) to conduct a real-world observational study of patients with rheumatoid arthritis.MethodsWe conducted this observational study using a customized ResearchKit app with a bring-your-own-device approach. To recruit patients, the PARADE app, designed to guide patients through a series of tasks, was publicized via social media platforms and made available for patients in the United States to download from the Apple App Store. We collected patient-reported data, such as medical history, rheumatoid arthritis-related medications (past and present), and a range of patient-reported outcome measures. We included in the assessment a joint-pain map and a novel objective assessment of wrist range of movement, measured by the smartphone-embedded gyroscope and accelerometer.ResultsWithin 1 month of recruitment via social media campaigns, 399 participants self-enrolled, self-consented, and provided complete demographic data. Joint pain was the most frequently reported rheumatoid arthritis symptom to bother study participants (344/393, 87.5%). Severe patient-reported wrist pain appeared to be inversely linked with the range of wrist movement measured objectively by the app. At study entry, 292 of 399 participants (73.2%) indicated a preference for participating in a mobile app–based study. The number of participants in the study declined to 45 of 399 (11.3%) at week 12.ConclusionsDespite the declining number of participants over time, the combination of social media and smartphone app with sensor integration was a feasible and cost-effective approach for the collection of patient-reported data in rheumatoid arthritis. Integral sensors within smartphones can be harnessed to provide novel end points, and the novel wrist range of movement test warrants further clinical validation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Using a ResearchKit Smartphone App to Collect Rheumatoid Arthritis Symptoms From Real-World Participants: Feasibility Study

Crouthamel

Quattrocchi

Watts

et al. 2018

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

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“…Capitalizing on the popularity of smartphone-based entertainment in adolescents, health apps may represent an important means of increasing self-management through remote monitoring and access to information [ 33 - 36 ]. For example, health management behaviors can be integrated with daily activities, using technologies that can track information “on the go.” Apps used to monitor symptoms remotely also have considerable potential in helping HCPs deliver safe and timely health care, as it provides more accurate and frequent reports of health status compared with using paper diaries [ 37 - 39 ]. Reliable and secure electronic data collection of symptoms and emotions not only benefits clinical assessments, but it is also an established method for validly collecting daily data in research as well [ 40 - 43 ] and can help advance knowledge on factors influencing disease progression.…”

Section: Introductionmentioning

confidence: 99%

Developing and Evaluating JIApp: Acceptability and Usability of a Smartphone App System to Improve Self-Management in Young People With Juvenile Idiopathic Arthritis

Cai¹,

Beste²,

Chaplin³

et al. 2017

JMIR Mhealth Uhealth

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BackgroundFlare-ups in juvenile idiopathic arthritis (JIA) are characterized by joint pain and swelling and often accompanied with fatigue, negative emotions, and reduced participation in activities. To minimize the impact of JIA on the physical and psychosocial development and well-being of young people (YP), it is essential to regularly monitor disease activity and side effects, as well as to support self-management such as adherence to treatment plans and engagement in general health-promoting behaviors. Smartphone technology has the potential to engage YP with their health care through convenient self-monitoring and easy access to information. In addition, having a more accurate summary of self-reported fluctuations in symptoms, behaviors, and psychosocial problems can help both YP and health care professionals (HCPs) better understand the patient’s condition, identify barriers to self-management, and assess treatment effectiveness and additional health care needs. No comprehensive smartphone app has yet been developed in collaboration with YP with JIA, their parents, and HCPs involved in their care.ObjectivesThe objective of this study was to design, develop, and evaluate the acceptability and usability of JIApp, a self-management smartphone app system for YP with JIA and HCPs.MethodsWe used a qualitative, user-centered design approach involving YP, parents, and HCPs from the rheumatology team. The study was conducted in three phases: (1) phase I focused on developing consensus on the features, content, and design of the app; (2) phase II was used for further refining and evaluating the app prototype; and (3) phase III focused on usability testing of the app. The interview transcripts were analyzed using qualitative content analysis.ResultsA total of 29 YP (aged 10-23, median age 17) with JIA, 7 parents, and 21 HCPs were interviewed. Major themes identified as the ones that helped inform app development in phase I were: (1) remote monitoring of symptoms, well-being, and activities; (2) treatment adherence; and (3) education and support. During phase II, three more themes emerged that informed further refinement of the app prototype. These included (4) adapting a reward system to motivate end users for using the app; (5) design of the app interface; and (6) clinical practice integration. The usability testing during phase III demonstrated high rates of overall satisfaction and further affirmed the content validity of the app.ConclusionsWe present the development and evaluation of a smartphone app to encourage self-management and engagement with health care for YP with JIA. The app was found to have high levels of acceptability and usability among YP and HCPs and has the potential to improve health care and outcomes for this age group. Future feasibility testing in a prospective study will firmly establish the reliability, efficacy, and cost-effectiveness of such an app intervention for patients with arthritis.

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“…Similarly, a feasibility study of a smartphone application for sleep apnea patients [27] demonstrated good feasibility with > 60% of participants completing the daily questionnaire, > 65% of the study time, and with a 94% satisfaction rates. Another small 3-month feasibility study in rheumatoid arthritis [28] measured the self-assessment of daily disease activity using a smartphone application. The vast majority of these participants (~ 88%) had no issues reporting their daily symptoms, and all were confident sharing their information.…”

Section: Discussionmentioning

confidence: 99%

Comparison of an interactive voice response system and smartphone application in the identification of gout flares

et al. 2019

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Objective To examine the feasibility, preference, and satisfaction of an interactive voice response (IVR) system versus a customized smartphone application (StudyBuddy) to capture gout flares Methods In this 24-week prospective, randomized, crossover, open-label pilot study, 44 gout patients were randomized to IVR vs. StudyBuddy and were crossed over to the other technology after 12 weeks. Flares were reported via weekly (and later daily) scheduled StudyBuddy or IVR queries. Feasibility was ascertained via response rate to scheduled queries. At 12 and 24 weeks, participants completed preference/satisfaction surveys. Preference and satisfaction were assessed using dichotomous or ordinal questions. Sensitivity was assessed by the frequency of flare reporting with each approach. Results Thirty-eight of 44 participants completed the study. Among completers, feasibility was similar for IVR (81%) and StudyBuddy (80%). Conversely, most (74%) preferred StudyBuddy. Measures of satisfaction (ease of use, preference over in-person clinic visits, and willingness for future use) were similar between the IVR and StudyBuddy; however, more participants deemed the StudyBuddy as convenient (95% vs. 73%, P = 0.01) and less disruptive (97% vs. 82%, P = 0.03). Although the per patient number of weeks in flare was not significantly different (mean 3.4 vs. 2.6 weeks/patient, P = 0.15), the StudyBuddy captured more of the total flare weeks (35%) than IVR (27%, P = 0.02). Conclusion A smartphone application and IVR demonstrated similar feasibility but overall sensitivity to capture gout flares and participant preference were greater for the smartphone application. Participant preference for the smartphone application appeared to relate to perceptions of greater convenience and lower disruption. Trial registration NCT, NCT02855437 . Registered 4 August 2016

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Self-assessment of Rheumatoid Arthritis Disease Activity Using a Smartphone Application

Abstract: The results of this feasibility study indicated that the DAS28 predictive model can longitudinally predict DAS28 and may be an acceptable and useful tool for assessment of RA disease activity for both patients and healthcare providers.

Cited by 27 publications

References 25 publications

Using a ResearchKit Smartphone App to Collect Rheumatoid Arthritis Symptoms From Real-World Participants: Feasibility Study

Using a ResearchKit Smartphone App to Collect Rheumatoid Arthritis Symptoms From Real-World Participants: Feasibility Study

Developing and Evaluating JIApp: Acceptability and Usability of a Smartphone App System to Improve Self-Management in Young People With Juvenile Idiopathic Arthritis

Comparison of an interactive voice response system and smartphone application in the identification of gout flares

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