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P411 Using wearable devices to assess pain in inflammatory bowel disease

O. V. Yvellez*1, P. H. Sossenheimer1, M. Andersen Jr1, K. El Jurdi1, A. Mayampurath2, D. T. Rubin1

1Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, USA, 2Litmus Health, Inc., Austin, TX, USA


We previously reported that increased pain is associated with decreased health-related quality of life (HRQoL) in inflammatory bowel disease (IBD) patients (AIBD 2017). However, there have been few studies to predict or to manage pain in IBD patients, and no technologies validated to monitor pain, HRQoL, or disease activity. We combined passive biosensor data with patient-reported outcomes (PROs) in IBD patients to develop a predictive model of pain.


As part of a year-long prospective study on the use of biosensors in IBD, outpatients and inpatients with IBD were provided a Fitbit (Charge or Alta HR, San Francisco, CA) and a proprietary smartphone app (Litmus Health, Austin, TX) for data collection and completion of PROs. Daily steps, heart rate (HR), and sleep data were collected with the Fitbit device. Patients input daily information using the Wong-Baker (WB) FACES™ Pain Rating Scale, and visual analogue scale questions about their sleep quality and overall well being. Every 2 weeks they complete the previously validated questionnaires, the SIBDQ and the Pittsburgh Sleep Quality Index. WB scores range between 0 (no pain) to 5 (worst pain), with scores >2 categorised as "increased pain". Baseline disease activity status was recorded using the Harvey–Bradshaw Index or the Simple Clinical Colitis Activity Index (this is routinely performed in our clinic template). We performed logistic regression analysis to determine the association between WB score on a given day and the steps, median HR variability, resting HR, or number of night time awakenings that had occurred the prior day. The model was controlled for disease status, age, BMI, sex, days since study enrolment, and the previous days’ WB score.


91 patients were enrolled (66 Crohn's disease, 25 ulcerative colitis). Median age was 39 years (range = 18–74), median length of disease was 12.5 years (range 0.25–37), median BMI was 25.8 (range = 18.0–51.5). Twenty patients had active disease upon enrolment. There was no association between median HR variability, steps, or number of awakenings and WB score the subsequent day (OR 9.7, p = 0.685; OR 0.89, p = 0.51; OR 1.05, p-value = 0.84 respectively). However, resting HR was significantly associated with reported pain the subsequent day (OR 1.05, p = <0.001). Each 1 bpm increase in daily resting HR increased the odds of experiencing pain on the subsequent day by 5%.


We demonstrate the feasibility of combined biosensor and PRO data in IBD patients and have identified a predictive association between increasing resting HR and subsequently reported pain. This is the first study to demonstrate the utility of wearable devices for IBD management and informs our ongoing work in this area.