1. Disease Activity Patterns Recorded Using a Mobile Monitoring System Are Associated with Clinical Outcomes of Patients with Crohn's Disease.
- Author
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Kim, Eun Soo, Kim, Sung Kook, Jang, Byung Ik, Kim, Kyeong Ok, Kim, Eun Young, Lee, Yoo Jin, Lee, Hyun Seok, Kwak, Sang Gyu, the Crohn’s and Colitis Association in Daegu-Gyeongbuk (CCAiD), and Crohn’s and Colitis Association in Daegu-Gyeongbuk (CCAiD)
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CROHN'S disease , *MULTIVARIATE analysis , *GASTRIC acid , *INFLAMMATORY bowel diseases , *BREATH tests , *CROHN'S disease diagnosis , *ABDOMINAL pain , *CHI-squared test , *COMPARATIVE studies , *DEFECATION , *GASTROINTESTINAL motility , *HEALTH status indicators , *HOSPITAL admission & discharge , *RESEARCH methodology , *MEDICAL appointments , *MEDICAL cooperation , *PATIENTS , *PROGNOSIS , *RESEARCH , *TELEMEDICINE , *TIME , *LOGISTIC regression analysis , *EVALUATION research , *SPECIALTY hospitals , *SEVERITY of illness index , *DISEASE progression , *MOBILE apps , *ODDS ratio , *DISEASE complications , *THERAPEUTICS ,DIGESTIVE organ surgery - Abstract
Background: Usefulness of a mobile monitoring system for Crohn's disease (CD) has not been evaluated. We aimed to determine whether disease activity patterns depicted using a web-based symptom diary for CD could indicate disease clinical outcomes.Methods: Patients with CD from tertiary hospitals were prospectively invited to record their symptoms using a smartphone at least once a week. Disease activity patterns for at least 2 months were statistically classified into good and poor groups based on two factors in two consecutive time frames; the degree of score variation (maximum-minimum) in each frame and the trend (upward, stationary, or downward) of patterns indicated by the difference in the mean activity scores between two time frames.Results: Overall, 220 (82.7%) and 46 (17.3%) patients were included in good and poor groups, respectively. Poor group was significantly more associated with disease-related hospitalization (p = 0.004), unscheduled hospital visits (p = 0.005), and bowel surgery (p < 0.001) during the follow-up period than good group. In the multivariate analysis, poor patterns [odds ratio (OR) 2.62, p = 0.006], stricturing (OR 4.19, p < 0.001) or penetrating behavior (OR 2.27, p = 0.012), and young age at diagnosis (OR 1.06, p = 0.019) were independently associated with disease-related hospitalization. Poor patterns (OR 4.06, p = 0.006) and an ileal location (OR 5.79, p = 0.032) remained independent risk factors for unscheduled visits. Poor patterns (OR 15.2, p < 0.001) and stricturing behavior (OR 9.77, p = 0.004) were independent risk factors for bowel surgery.Conclusion: The disease activity patterns depicted using a web-based symptom diary were useful indicators of poor clinical outcomes in patients with CD. [ABSTRACT FROM AUTHOR]- Published
- 2018
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