Daily angina documentation versus subsequent recall: development of a symptom smartphone app
journal contributionposted on 2023-07-26, 15:54 authored by Alexandra N. Nowbar, James P. Howard, Matthew J. Shun-Shin, Christopher Rajkumar, Michael Foley, Arunima Basu, Akshit Goel, Sapna Patel, Ahmer Adnan, Catherine J. Beattie, Thomas R. Keeble, Afzal Sohaib, David Collier, Patrick McVeigh, Frank E. Harrell, Darrel P. Francis, Rasha K. Al-Lamee
Aims: The traditional approach to documenting angina outcomes in clinical trials is to ask the patient to recall their symptoms at the end of a month. With the ubiquitous availability of smartphones and tablets, daily contemporaneous documentation might be possible. Methods and results: The ORBITA-2 symptom smartphone app was developed with a user-centred iterative design and testing cycle involving a focus group of previous ORBITA participants. The feasibility and acceptability were assessed in an internal pilot of participants in the ongoing ORBITA-2 trial. Seven days of app entries by ORBITA-2 participants were compared with subsequent participant recall at the end of the 7-day period. The design focus group tested a prototype app. They reported that the final version captured their symptoms and was easy to use. In the completion assessment group, 141 of 142 (99%) completed the app in full and 47 of 141 (33%) without reminders. In the recall assessment group, 29 of 29 (100%) participants said they could recall the previous day’s symptoms, and 82% of them recalled correctly. For 2 days previously, 88% said they could recall and of those, 87% recalled correctly. The proportion saying they could recall their symptoms fell progressively thereafter: 89, 67, 61, 50%, and at 7 days, 55% (P < 0.001 for trend). The proportion of recalling correctly also fell progressively to 55% at 7 days (P = 0.04 for trend). Conclusion: Episode counts of angina are difficult to recall after a few days. For trials such as ORBITA-2 focusing on angina, daily symptom collection via a smartphone app will increase the validity of the results.
Publication titleEuropean Heart Journal - Digital Health
PublisherOxford University Press
- Published version