Dramburg Stephanie, Perna Serena, Di Fraia Marco, Tripodi Salvatore, Arasi Stefania, Castelli Sveva, Villalta Danilo, Buzzulini Francesca, Sfika Ifigenia, Villella Valeria, Potapova Ekaterina, Brighetti Maria Antonia, Travaglini Alessandro, Verardo Pierluigi, Pelosi Simone, Matricardi Paolo Maria
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Pediatric Allergology Unit, Sandro Pertini Hospital, Rome, Italy.
JMIR Mhealth Uhealth. 2022 Jun 3;10(6):e31491. doi: 10.2196/31491.
Mobile health technologies enable allergists to monitor disease trends by collecting daily patient-reported outcomes of allergic rhinitis. To this end, patients with allergies are usually required to enter their symptoms and medication repetitively over long time periods, which may present a risk to data completeness and quality in the case of insufficient effort reporting. Completeness of patient's recording is easily measured. In contrast, the intrinsic quality and accuracy of the data entered by the patients are more elusive.
The aim of this study was to explore the association of adherence to digital symptom recording with a predefined set of parameters of the patient-generated symptom and medication scores and to identify parameters that may serve as proxy measure of the quality and reliability of the information recorded by the patient.
The @IT.2020 project investigates the diagnostic synergy of mobile health and molecular allergology in patients with seasonal allergic rhinitis. In its pilot phase, 101 children with seasonal allergic rhinitis were recruited in Rome and instructed to record their symptoms, medication intake, and general conditions daily via a mobile app (AllergyMonitor) during the relevant pollen season. We measured adherence to daily recording as the percentage of days with data recording in the observation period. We examined the patient's trajectories of 3 disease indices (Rhinoconjunctivitis Total Symptom Score [RTSS], Combined Symptom and Medication Score [CSMS], and Visual Analogue Scale [VAS]) as putative proxies of data quality with the following 4 parameters: (1) intravariation index, (2) percentage of zero values, (3) coefficient of variation, and (4) percentage of changes in trend. Lastly, we examined the relationship between adherence to recording and each of the 4 proxy measures.
Adherence to recording ranged from 20% (11/56) to 100% (56/56), with 64.4% (65/101) and 35.6% (36/101) of the patients' values above (highly adherent patients) or below (low adherent patients) the threshold of 80%, respectively. The percentage of zero values, the coefficient of variation, and the intravariation index did not significantly change with the adherence to recording. By contrast, the proportion of changes in trend was significantly higher among highly adherent patients, independently from the analyzed score (RTSS, CSMS, and VAS).
The percentage of changes in the trend of RTSS, CSMS, and VAS is a valuable candidate to validate the quality and accuracy of the data recorded by patients with allergic rhinitis during the pollen season. The performance of this parameter must be further investigated in real-life conditions before it can be recommended for routine use in apps and electronic diaries devoted to the management of patients with allergic rhinitis.
移动健康技术使过敏症专科医生能够通过收集患者每日报告的过敏性鼻炎结果来监测疾病趋势。为此，通常要求过敏患者在很长一段时间内反复输入其症状和用药情况，在报告力度不足的情况下，这可能会对数据的完整性和质量构成风险。患者记录的完整性很容易衡量。相比之下，患者输入数据的内在质量和准确性则更难捉摸。
本研究的目的是探讨数字症状记录的依从性与患者生成的症状和用药评分的一组预定义参数之间的关联，并确定可作为患者记录信息质量和可靠性替代指标的参数。
@IT.2020项目研究了移动健康与分子过敏学在季节性过敏性鼻炎患者中的诊断协同作用。在其试点阶段，在罗马招募了101名季节性过敏性鼻炎儿童，并指示他们在相关花粉季节期间通过移动应用程序（AllergyMonitor）每日记录其症状、药物摄入和一般状况。我们将每日记录的依从性衡量为观察期内有数据记录的天数百分比。我们检查了3种疾病指数（鼻结膜炎总症状评分[RTSS]、症状与用药综合评分[CSMS]和视觉模拟量表[VAS]）的患者轨迹，作为数据质量的假定替代指标，采用以下4个参数：（1）内部变异指数，（2）零值百分比，（3）变异系数，（4）趋势变化百分比。最后，我们检查了记录依从性与4种替代指标中每一种之间的关系。
记录依从性范围为20%（11/56）至100%（56/56），分别有64.4%（65/101）和35.6%（36/101）的患者值高于（高依从性患者）或低于（低依从性患者）80%的阈值。零值百分比、变异系数和内部变异指数并未随着记录依从性而显著变化。相比之下，则与分析的评分（RTSS、CSMS和VAS）无关，高依从性患者中趋势变化的比例显著更高。
RTSS、CSMS和VAS趋势变化的百分比是验证花粉季节过敏性鼻炎患者记录数据质量和准确性的一个有价值的候选指标。在推荐将该参数用于专门管理过敏性鼻炎患者的应用程序和电子日记的常规使用之前，必须在实际生活条件下对其性能进行进一步研究。
