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. 2017 Nov 28;5(11):e181.
doi: 10.2196/mhealth.7505.

Detecting Acute Otitis Media Symptom Episodes Using a Mobile App: Cohort Study

Annemarijn C Prins-van Ginkel  1 , Marieke LA de Hoog  1 , C Uiterwaal  1 , Henriette A Smit  1 , Patricia Cj Bruijning-Verhagen  1
Affiliations

Detecting Acute Otitis Media Symptom Episodes Using a Mobile App: Cohort Study

Annemarijn C Prins-van Ginkel et al. JMIR Mhealth Uhealth. .

Abstract

Background: Population cohort studies are useful to study infectious diseases episodes not attended by health care services, but conventional paper diaries and questionnaires to capture cases are prone to noncompliance and recall bias. Use of smart technology in this setting may improve case finding.

Objective: The objective of our study was to validate an interactive mobile app for monitoring occurrence of acute infectious diseases episodes in individuals, independent of health care seeking, using acute otitis media (AOM) symptom episodes in infants as a case study. We were interested in determining participant compliance and app performance in detecting and ascertaining (parent-reported) AOM symptom episodes with this novel tool compared with traditional methods used for monitoring study participants.

Methods: We tested the InfectieApp research app to detect AOM symptom episodes. In 2013, we followed 155 children aged 0 to 3 years for 4 months. Parents recorded the presence of AOM symptoms in a paper diary for 4 consecutive months and completed additional disease questionnaires when AOM symptoms were present. In 2015 in a similar cohort of 69 children, parents used an AOM diary and questionnaire app instead.

Results: During conventional and app-based recording, 93.13% (17,244/18,516) and 94.56% (7438/7866) of symptom diaries were returned, respectively, and at least one symptom was recorded for 32.50% (n=5606) and 43.99% (n=3272) of diary days (P<.01). The incidence of AOM symptom episodes was 605 and 835 per 1000 child-years, respectively. Disease questionnaires were completed for 59% (17/29) of episodes when participants were using conventional recording, compared with 100% (18/18) for app-based recording.

Conclusions: The use of the study's smart diary app improved AOM case finding and disease questionnaire completeness. For common infectious diseases that often remain undetected by health care services, use of this technology can substantially improve the accurateness of disease burden estimates.

Keywords: communicable diseases; infectious diseases, cohort studies, acute otitis media, underreporting, patient compliance; mobile app; mobile applications; otitis media; smartphone.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Paper diary sheet used in the 2013 study period. WHISTLER: Wheezing and Illnesses Study Leidsche Rijn.
Figure 2
Figure 2
Screenshots of the diary app (InfectieApp) used in the 2015 study period. (A) symptom diary; (B) home screen.
Figure 3
Figure 3
Flowcharts of the study population. WHISTLER: Wheezing and Illnesses Study Leidsche Rijn.
See this image and copyright information in PMC

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