Albert F Yang, Soham Patel, Keum San Chun, Dylan Richards, Jessica R Walter, Kazuaki Okamoto, Amy S Paller, Akihiko Ikoma, Shuai Xu
{"title":"Artificial Intelligence-Enabled Wearable Devices and Nocturnal Scratching in Mild Atopic Dermatitis.","authors":"Albert F Yang, Soham Patel, Keum San Chun, Dylan Richards, Jessica R Walter, Kazuaki Okamoto, Amy S Paller, Akihiko Ikoma, Shuai Xu","doi":"10.1001/jamadermatol.2024.5697","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>Although more than 1 in 10 people experience pruritus, there are limited medical technologies that can accurately and continuously quantify and simultaneously reduce scratching behaviors through nonpharmacological methods.</p><p><strong>Objective: </strong>To evaluate the accuracy and efficacy of an artificial intelligence-enabled wearable sensor with closed-loop haptic feedback to decrease nocturnal scratch in patients with mild atopic dermatitis who report a moderate to severe degree of scratching.</p><p><strong>Design, setting, and participants: </strong>This single-arm 2-stage cohort study with a within-participants design was conducted at a single center and carried out in an at-home environment. Adult patients with atopic dermatitis were recruited from the Northwestern University Department of Dermatology in Chicago, Illinois. Participants were fluent in English, 18 years old or older, had a diagnosis of atopic dermatitis, and self-reported moderate or severe scratching behaviors. Each participant's disease at time of recruitment was scored via the Validated Investigator Global Assessment for Atopic Dermatitis. Data were collected from April to July 2023.</p><p><strong>Exposures: </strong>Haptic feedback delivered by a wearable sensor mounted on the hand triggered whenever nocturnal scratch was detected by an artificial intelligence algorithm. Participants initially wore the sensor for sensing only for 7 nights to assess baseline nocturnal scratching and sleep parameters. This was followed by an additional 7 nights of wearing the sensor with haptic feedback activated.</p><p><strong>Main outcomes and measures: </strong>Retrospective analysis was performed for scratch events and scratch duration per night and per hour of sleep opportunity. Paired t tests were used to compare changes in patient scratching behaviors before and after use of the artificial intelligence-enabled haptic feedback devices.</p><p><strong>Results: </strong>Of 10 included patients, 6 were female, and the mean (SD) age was 36 (12) years. All patients had a Validated Investigator Global Assessment for Atopic Dermatitis score of 0 to 2 (clear to mild) who contributed a total of 104 sleep nights and 831 monitoring hours. No patients were lost to follow-up. There was a significant decrease in mean (SD) scratch events nightly (45.6 [24.0] vs 32.8 [13.0]; P = .03), a 28% difference, and mean (SD) scratch duration per hour of sleep opportunity (15.8 [10.7] seconds vs 7.9 [3.7] seconds; P = .01), a 50% difference, when haptic feedback was activated in the second week without a decrease in total sleep opportunity.</p><p><strong>Conclusions and relevance: </strong>This study found that haptic feedback may be used as a nonpharmacological intervention to reduce nocturnal scratching in patients with mild atopic dermatitis. Future randomized studies are needed to confirm.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5000,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800123/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAMA dermatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1001/jamadermatol.2024.5697","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Importance: Although more than 1 in 10 people experience pruritus, there are limited medical technologies that can accurately and continuously quantify and simultaneously reduce scratching behaviors through nonpharmacological methods.
Objective: To evaluate the accuracy and efficacy of an artificial intelligence-enabled wearable sensor with closed-loop haptic feedback to decrease nocturnal scratch in patients with mild atopic dermatitis who report a moderate to severe degree of scratching.
Design, setting, and participants: This single-arm 2-stage cohort study with a within-participants design was conducted at a single center and carried out in an at-home environment. Adult patients with atopic dermatitis were recruited from the Northwestern University Department of Dermatology in Chicago, Illinois. Participants were fluent in English, 18 years old or older, had a diagnosis of atopic dermatitis, and self-reported moderate or severe scratching behaviors. Each participant's disease at time of recruitment was scored via the Validated Investigator Global Assessment for Atopic Dermatitis. Data were collected from April to July 2023.
Exposures: Haptic feedback delivered by a wearable sensor mounted on the hand triggered whenever nocturnal scratch was detected by an artificial intelligence algorithm. Participants initially wore the sensor for sensing only for 7 nights to assess baseline nocturnal scratching and sleep parameters. This was followed by an additional 7 nights of wearing the sensor with haptic feedback activated.
Main outcomes and measures: Retrospective analysis was performed for scratch events and scratch duration per night and per hour of sleep opportunity. Paired t tests were used to compare changes in patient scratching behaviors before and after use of the artificial intelligence-enabled haptic feedback devices.
Results: Of 10 included patients, 6 were female, and the mean (SD) age was 36 (12) years. All patients had a Validated Investigator Global Assessment for Atopic Dermatitis score of 0 to 2 (clear to mild) who contributed a total of 104 sleep nights and 831 monitoring hours. No patients were lost to follow-up. There was a significant decrease in mean (SD) scratch events nightly (45.6 [24.0] vs 32.8 [13.0]; P = .03), a 28% difference, and mean (SD) scratch duration per hour of sleep opportunity (15.8 [10.7] seconds vs 7.9 [3.7] seconds; P = .01), a 50% difference, when haptic feedback was activated in the second week without a decrease in total sleep opportunity.
Conclusions and relevance: This study found that haptic feedback may be used as a nonpharmacological intervention to reduce nocturnal scratching in patients with mild atopic dermatitis. Future randomized studies are needed to confirm.
期刊介绍:
JAMA Dermatology is an international peer-reviewed journal that has been in continuous publication since 1882. It began publication by the American Medical Association in 1920 as Archives of Dermatology and Syphilology. The journal publishes material that helps in the development and testing of the effectiveness of diagnosis and treatment in medical and surgical dermatology, pediatric and geriatric dermatology, and oncologic and aesthetic dermatologic surgery.
JAMA Dermatology is a member of the JAMA Network, a consortium of peer-reviewed, general medical and specialty publications. It is published online weekly, every Wednesday, and in 12 print/online issues a year. The mission of the journal is to elevate the art and science of health and diseases of skin, hair, nails, and mucous membranes, and their treatment, with the aim of enabling dermatologists to deliver evidence-based, high-value medical and surgical dermatologic care.
The journal publishes a broad range of innovative studies and trials that shift research and clinical practice paradigms, expand the understanding of the burden of dermatologic diseases and key outcomes, improve the practice of dermatology, and ensure equitable care to all patients. It also features research and opinion examining ethical, moral, socioeconomic, educational, and political issues relevant to dermatologists, aiming to enable ongoing improvement to the workforce, scope of practice, and the training of future dermatologists.
JAMA Dermatology aims to be a leader in developing initiatives to improve diversity, equity, and inclusion within the specialty and within dermatology medical publishing.