Department of Emergency Medicine, Division of Medical Toxicology, University of Massachusetts Medical School, Worcester, MA, United States.
Department of Electrical Engineering, University of Texas at Tyler, Tyler, TX, United States.
Drug Alcohol Depend. 2020 Apr 1;209:107929. doi: 10.1016/j.drugalcdep.2020.107929. Epub 2020 Mar 3.
To determine the accuracy of a wearable sensor to detect and differentiate episodes of self-reported craving and stress in individuals with substance use disorders, and to assess acceptability, barriers, and facilitators to sensor-based monitoring in this population.
This was an observational mixed methods pilot study. Adults enrolled in an outpatient treatment program for a substance use disorder wore a non-invasive wrist-mounted sensor for four days and self-reported episodes of stress and craving. Continuous physiologic data (accelerometry, skin conductance, skin temperature, and heart rate) were extracted from the sensors and analyzed via various machine learning algorithms. Semi-structured interviews were conducted upon study completion, and thematic analysis was conducted on qualitative data from semi-structured interviews.
Thirty individuals completed the protocol, and 43 % (N = 13) were female. A total of 41 craving and 104 stress events were analyzed. The differentiation accuracies of the top performing models were as follows: stress vs. non-stress states 74.5 % (AUC 0.82), craving vs. no-craving 75.7 % (AUC 0.82), and craving vs. stress 76.8 % (AUC 0.8). Overall participant perception was positive, and acceptability was high. Emergent themes from the exit interviews included a perception of connectedness and increased mindfulness related to wearing the sensor, both of which were reported as helpful to recovery. Barriers to engagement included interference with other daily wear items, and perceived stigma.
Wearable sensors can be used to objectively differentiate episodes of craving and stress, and individuals in recovery from substance use disorder are accepting of continuous monitoring with these devices.
确定可穿戴传感器在检测和区分物质使用障碍患者自我报告的渴望和压力发作方面的准确性，并评估该人群中基于传感器监测的可接受性、障碍和促进因素。
这是一项观察性混合方法试点研究。参加物质使用障碍门诊治疗计划的成年人佩戴非侵入式腕戴式传感器四天，并自我报告压力和渴望发作情况。从传感器中提取连续的生理数据（加速度计、皮肤电导率、皮肤温度和心率），并通过各种机器学习算法进行分析。研究完成后进行半结构化访谈，并对半结构化访谈中的定性数据进行主题分析。
30 名参与者完成了方案，其中 43%（N=13）为女性。共分析了 41 次渴望和 104 次压力事件。表现最佳模型的区分准确性如下：压力与非压力状态 74.5%（AUC 0.82），渴望与无渴望 75.7%（AUC 0.82），以及渴望与压力 76.8%（AUC 0.8）。总体参与者的看法是积极的，接受度很高。从退出访谈中出现的主题包括佩戴传感器与增强的联系感和正念感，两者都被报告为有助于康复。参与的障碍包括与其他日常穿戴物品的干扰以及感知的耻辱感。
可穿戴传感器可用于客观地区分渴望和压力发作，且物质使用障碍康复中的个体接受使用这些设备进行连续监测。
