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Title: The Harvey-Bradshaw Index Adapted to a Mobile Application Compared with In-Clinic Assessment: The MediCrohn Study
Author: Echarri, Ana
Vera, Isabel
Ollero, Virginia
Arajol, Claudia
Riestra, Sabino
Robledo, Pilar
Calvo, Marta
Gallego, Francisco
Ceballos, Daniel
Castro, Beatriz
Aguas, Mariam
García López, Santiago
Marín Jiménez, Ignacio
Chaparro, María
Mesonero, Francisco
Guerra, Iván
Guardiola, Jordi
Nos, Pilar
Muñiz, Javier
MediCrohn study investigators
Keywords: Aplicacions mòbils
Telecomunicació en medicina
Malaltia de Crohn
Mobile apps
Telecommunication in medicine
Crohn's disease
Issue Date: 26-Jan-2020
Publisher: Mary Ann Liebert
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%, κ = 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%, κ = 0.82) and month 4 (91.5%, κ = 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.
Note: Reproducció del document publicat a:
It is part of: Telemedicine Journal and e-Health, 2020, vol. 26, num. 1, p. 78-86
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ISSN: 1530-5627
Appears in Collections:Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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