Download PDF
Methods Inf Med 2016; 55(01): 65-69
DOI: 10.3414/ME14-01-0106
Focus Theme – Original Articles
Schattauer GmbH

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

Development and 3-month Feasibility Study
S. Nishiguchi
1   Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
2   Japan Society for the Promotion of Science, Tokyo, Japan
,
H. Ito
3   Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
,
M. Yamada
4   Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
,
H. Yoshitomi
5   Center for Innovation in Immunoregulative Technology and Therapeutics, Kyoto University Graduate School of Medicine, Kyoto, Japan
,
M. Furu
3   Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
,
M. Ito
6   NTT Service Evolution Laboratories, Kanagawa, Japan
,
A. Shinohara
6   NTT Service Evolution Laboratories, Kanagawa, Japan
,
T. Ura
6   NTT Service Evolution Laboratories, Kanagawa, Japan
,
K. Okamoto
7   Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan
,
T. Aoyama
1   Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
,
Tadao Tsuboyama
1   Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
› Author Affiliations
Further Information

Publication History

Received 28 October 2014

Accepted 07 September 2015

Publication Date:
08 January 2018 (online)

    Permissions and Reprints

Summary

Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on “Methodologies, Models and Algorithms for Patients Rehabilitation”. Background: Rheumatoid arthritis (RA) is a progressive inflammatory disease that causes damage to multiple joints, decline in functional status, and premature mortality. Thus, effective and frequent objective assessments are necessary. Then, we developed a self-assessment system for RA patients based on a smartphone application. Objective: The purpose of this study was to investigate the feasibility of a self-assessment system for RA patients using a smart-phone application. Methods: We measured daily disease activity in nine RA patients who used the smart-phone application for a period of three months. A disease activity score (DAS28) predictive model was used and feedback comments relating to disease activity were shown to patients via the smartphone application each day. To assess participants’ RA disease activity, the DAS28 based on the C-reactive protein level was measured by a rheumatologist during monthly clinical visits. Results: The disease activity measured by the application correlated well with the patients’ actual disease activity during the 3-month period, as assessed by clinical examination. Furthermore, most participants gave favourable responses to a questionnaire administered at the end of the 3-month period containing questions relating to the ease of use and usefulness of the system. Conclusions: 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.

Keywords

Rheumatoid arthritis - disease activity - smart-phone - self-assessment - feasibility study
 

  • References

  • 1 Murphy D. Lycra working splint for the rheumatoid arthritic hand with mcp ulnar deviation. Aust J Rural Health 1996; 4: 217-220.
    CrossrefPubMedSearch in Google Scholar
  • 2 Plant MJ, Williams AL, O’Sullivan MM, Lewis PA, Coles EC, Jessop JD. Relationship between time-integrated c-reactive protein levels and radiologic progression in patients with rheumatoid arthritis. Arthritis Rheum 2000; 43: 1473-1477.
    CrossrefPubMedSearch in Google Scholar
  • 3 Luqmani R, Hennell S, Estrach C, Birrell F, Bos-worth A, Davenport G, Fokke C, Goodson N, Jeffreson P, Lamb E, Mohammed R, Oliver S, Stable-ford Z, Walsh D, Washbrook C, Webb F. Rheumatology BSf, British Health Professionals in Rheumatology Standards GiaAWG.. British society for rheumatology and british health professionals in rheumatology guideline for the management of rheumatoid arthritis (the first two years). Rheumatology (Oxford) 2006; 45: 1167-1169.
    CrossrefPubMedSearch in Google Scholar
  • 4 Azevedo AR, de Sousa HM, Monteiro JA, Lima AR. Future perspectives of smartphone applications for rheumatic diseases self-management. Rheumatol Int 2015; 35: 419-431.
    CrossrefPubMedSearch in Google Scholar
  • 5 Azevedo R, Bernardes M, Fonseca J, Lima A. Smartphone application for rheumatoid arthritis self-management: Cross-sectional study revealed the usefulness, willingness to use and patients’ needs. Rheumatol Int 2015
    PubMedSearch in Google Scholar
  • 6 Shinohara A, Ito T, Ura T, Nishiguchi S, Ito H, Yamada M, Yoshitomi H, Furu M, Okamoto K, Aoyama T. Development of lifelog sharing system for rheumatoid arthritis patients using smart-phone. Conf Proc IEEE Eng Med Biol Soc 2013; 2013 pp 7266-7269.
    PubMedSearch in Google Scholar
  • 7 Nishiguchi S, Yamada M, Nagai K, Mori S, Kajiwara Y, Sonoda T, Yoshimura K, Yoshitomi H, Ito H, Okamoto K, Ito T, Muto S, Ishihara T, Aoyama T. Reliability and validity of gait analysis by android-based smartphone. Telemed J E Health 2012; 18: 292-296.
    CrossrefPubMedSearch in Google Scholar
  • 8 Yamada M, Aoyama T, Mori S, Nishiguchi S, Okamoto K, Ito T, Muto S, Ishihara T, Yoshitomi H, Ito H. Objective assessment of abnormal gait in patients with rheumatoid arthritis using a smart-phone. Rheumatol Int 2012; 32: 3869-3874.
    CrossrefPubMedSearch in Google Scholar
  • 9 Nishiguchi S, Ito H, Yamada M, Yoshitomi H, Furu M, Ito T, Shinohara A, Ura T, Okamoto K, Aoyama T. Self-assessment tool of disease activity of rheumatoid arthritis by using a smartphone application. Telemed J E Health 2014; 20: 235-240.
    CrossrefPubMedSearch in Google Scholar
  • 10 Pincus T, Summey JA, Soraci SA, Wallston KA, Hummon NP. Assessment of patient satisfaction in activities of daily living using a modified Stanford health assessment questionnaire. Arthritis Rheum 1983; 26: 1346-1353.
    CrossrefPubMedSearch in Google Scholar
  • 11 Moe-Nilssen R, Helbostad JL. Trunk accelerometry as a measure of balance control during quiet standing. Gait Posture 2002; 16: 60-68.
    CrossrefPubMedSearch in Google Scholar
  • 12 Auvinet B, Berrut G, Touzard C, Moutel L, Collet N, Chaleil D, Barrey E. Reference data for normal subjects obtained with an accelerometric device. Gait Posture 2002; 16: 124-134.
    CrossrefPubMedSearch in Google Scholar
  • 13 Kimura T, Tezuka H, Kanda Y. Development of an information-interoperable environment based on open technologies for lean production systems. Lean Business Systems and Beyond 2008; 257: 121-128.
    PubMedSearch in Google Scholar
  • 14 Tezuka H, Katafuchi N, Nakamura Y, Machino T, Nanjo Y, Iwaki S, Shimokura K. Robot platform architecture for information sharing and collaboration among multiple networked robots. Journal of Robotics and Mechatronics 2006; 18: 325-332.
    CrossrefPubMedSearch in Google Scholar
  • 15 Muto S, Iwamoto H, Ito T, Uchida N, Urata M, Takenaka H, Nakagawa J, Satou T. The concept of cooperative sidewalk supporting system that manages sensory information from mobile terminals and personal mobility. 2013 Ieee/Sice International Symposium on System Integration (Sii). 2013 pp 364-369.
    PubMedSearch in Google Scholar
  • 16 van Gestel AM, Prevoo ML, van’t Hof MA, van Rijswijk MH, van de Putte LB, van Riel PL. Development and validation of the european league against rheumatism response criteria for rheumatoid arthritis. Comparison with the preliminary american college of rheumatology and the world health organization/international league against rheumatism criteria. Arthritis Rheum 1996; 39: 34-40.
    CrossrefPubMedSearch in Google Scholar
  • 17 Prevoo ML, van’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 1995; 38: 44-48.
    CrossrefPubMedSearch in Google Scholar
  • 18 van der Heijde DM, van’t Hof M, van Riel PL, van de Putte LB. Validity of single variables and indices to measure disease activity in rheumatoid arthritis. J Rheumatol 1993; 20: 538-541.
    PubMedSearch in Google Scholar
  • 19 Uhlig T, Kvien TK, Pincus T. Test-retest reliability of disease activity core set measures and indices in rheumatoid arthritis. Ann Rheum Dis 2009; 68: 972-975.
    CrossrefPubMedSearch in Google Scholar
  • 20 Fransen J, Hauselmann H, Michel BA, Caravatti M, Stucki G. Responsiveness of the self-assessed rheumatoid arthritis disease activity index to a flare of disease activity. Arthritis Rheum 2001; 44: 53-60.
    PubMedSearch in Google Scholar
  • 21 Hewlett S, Ambler N, Almeida C, Cliss A, Hammond A, Kitchen K, Knops B, Pope D, Spears M, Swinkels A, Pollock J. Self-management of fatigue in rheumatoid arthritis: A randomised controlled trial of group cognitive-behavioural therapy. Ann Rheum Dis 2011; 70: 1060-1067.
    CrossrefPubMedSearch in Google Scholar
  • 22 Barlow J, Turner A, Swaby L, Gilchrist M, Wright C, Doherty M. An 8-yr follow-up of arthritis self-management programme participants. Rheumatology (Oxford) 2009; 48: 128-133.
    CrossrefPubMedSearch in Google Scholar
  • 23 Smarr KL, Musser DR, Shigaki CL, Johnson R, Hanson KD, Siva C. Online self-management in rheumatoid arthritis: A patient-centered model application. Telemed J E Health 2011; 17: 104-110.
    CrossrefPubMedSearch in Google Scholar
  • 24 Newman ED, Lerch V, Jones JB, Stewart W. Touch-screen questionnaire patient data collection in rheumatology practice: Development of a highly successful system using process redesign. Arthritis Care Res 2012; 64: 589-596.
    CrossrefPubMedSearch in Google Scholar
  • 25 Nes AA, van Dulmen S, Eide E, Finset A, Kristjansdottir OB, Steen IS, Eide H. The development and feasibility of a web-based intervention with diaries and situational feedback via smartphone to support self-management in patients with diabetes type 2. Diabetes Res Clin Pract. 2012
    PubMedSearch in Google Scholar