The Harvey-Bradshaw Index Adapted to a Mobile Application Compared with In-Clinic Assessment: The MediCrohn Study

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Autores de IDIVAL

Autores ajenos al IDIVAL

  • Echarri A
  • Vera I
  • Ollero V
  • Arajol C
  • Riestra S
  • Robledo P
  • Calvo M
  • Gallego F
  • Ceballos D
  • Aguas M
  • García-López S
  • Marín-Jiménez I
  • Chaparro M
  • Mesonero P
  • Guerra I
  • Guardiola J
  • Nos P
  • Muñiz J

Unidades

Abstract

Objectives: Mobile apps are useful tools in e-health and self-management strategies in disease monitoring. We evaluated the Harvey-Bradshaw index (HBI) mobile app self-administered by the patient to see if its results agreed with HBI in-clinic assessed by a physician. Methods: Patients were enrolled in a 4-month prospective study with clinical assessments at months 1 and 4. Patients completed mobile app HBI and within 48 h, HBI was performed by a physician (gold standard). HBI scores characterized Crohn's disease (CD) as remission <5 or active >= 5. We determined agreement per item and total HBI score and intraclass correlation coefficients (ICCs). Bland-Altman plot was performed. HBI changes in disease activity from month 1 to month 4 were determined. Results: A total of 219 patients were enrolled. All scheduled assessments (385 pairs of the HBI questionnaire) showed a high percentage of agreement for remission/activity (92.4%, kappa = 0.796), positive predictive value (PPV) for remission of 98.2%, and negative predictive value of 76.7%. High agreement was also found at month 1 (93.15%, kappa = 0.82) and month 4 (91.5%, kappa = 0.75). Bland-Altman plot was more uniform when the HBI mean values were <5 (remission). ICC values were 0.82, 0.897, and 0.879 in all scheduled assessments, 1 and 4 months, respectively. Conclusions: We found a high percentage of agreement between patients' self-administered mobile app HBI and in-clinic physician assessment to detect CD activity with a remarkably high PPV for remission. The mobile app HBI might allow a strict control of inflammation by remote monitoring and flexible follow-up of CD patients. Reduction of sanitary costs could be possible.

Datos de la publicación

ISSN/ISSNe:
1530-5627, 1556-3669

TELEMEDICINE AND E-HEALTH  Mary Ann Liebert Inc.

Tipo:
Article
Páginas:
80-88
PubMed:
30848700

Citas Recibidas en Web of Science: 19

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Keywords

  • behavioral health; e-health; home health monitoring; telehealth; telemedicine

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