Fitbit devices could help predict the flare-ups of inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, according to a new study published in the Journal of Crohn’s and Colitis. The year-long study, which was recently presented at Digestive Disease Week, was conducted by the University of Chicago.
Impact of IBD Flare-Ups
Even when managed well, IBD can flare up or cause symptoms unexpectedly, which may be triggered by diet, stress, and physical activity (or lack thereof). People may not think about how certain events are connected to their symptoms, so studies like this one hope to help patients and doctors find new ways to predict, and potentially intervene to stop, potential flare-ups.
Proactive disease monitoring in inflammatory bowel disease (IBD) represents an opportunity to improve care. Certain biomarkers, including C-reactive protein (CRP) and faecal calprotectin (FC), are sensitive biomarkers for active inflammation in IBD. As part of an ongoing prospective study on the use of biosensors in IBD, University of Chicago researchers aimed to determine the feasibility of predicting a patient’s disease activity based on data collected by wearable devices.
Data Collection Approach
During the yearlong study, outpatients and inpatients with IBD were provided a Fitbit (San Francisco, CA) and a proprietary smartphone app (Litmus Health, Austin, TX) for data collection and completion of patient-reported outcomes. Daily steps, heart rate (HR), and sleep data were collected with the Fitbit device using their research API.
Baseline disease activity status was recorded using the Simple Clinical Colitis Activity Index or the Harvey–Bradshaw Index as well as baseline CRP and FC values. We also collected subsequent clinic visit data and when ordered, subsequent CRP/FC values. The predictive ability of Fitbit data for the subsequent CRP/FC values was determined by calculating the AUC for each metric. Groups were compared using the Student’s t-test for parametric data, and Wilcoxon rank sum for non-parametric data.
The study finds that out of 194 IBD patients included in our biosensor study, 39 patients (13 CD, 26 UC; median age 44 years (range 22–67); Fitbit duration median 296 d (range 23–365)) had subsequently obtained CRP or FC values and were eligible for this analysis. The median number of subsequent biomarkers per patient was 1 (range 1–7).
In addition, Patients reported lower daily steps (mean 6062 vs. 8541, p < 0.001) over the week before the elevated CRP or FC, but there was no difference in daily resting heart rate (mean 66.9 vs. 66.3, p = 0.42). Number of daily steps was predictive of having an elevated biomarker drawn within 7 days (AUC for steps = 0.70, 95% CI = 0.65–0.75)
The report concludes that those with lower physical activity levels and higher resting heart rates were more likely to experience a flare up of their IBD the following week. According to the researchers, this is the first study that uses passive wearable data to predict elevated biomarkers of inflammation in IBD.
Fitbit devices are also being used three year-long partnership between Takeda Pharmaceuticals, the University of Chicago School of Medicine and the Icahn School of Medicine to further the study of IBD, which will continue exploration wearables’ potential to help patients manage adverse symptoms.