Wearable devices can identify and predict flare-ups in inflammatory bowel disease

Wearable devices can identify, differentiate, and predict flare-ups, or the worsening of symptoms and inflammation, in inflammatory bowel disease (IBD), Mount Sinai researchers have shown in a first-of-its-kind study.

The findings, published in the journal Gastroenterology on January 16, suggest that wearable technology can predict the subsequent development of flares in IBD, enabling continuous disease monitoring through widely available commercial devices.

"Current disease-monitoring methods rely on patients directly interacting with their doctors, either through office visits, blood or stool testing, or by undergoing a colonoscopy. These methods also only assess the disease at one point in time, and can often be invasive or inconvenient," said first author Robert Hirten, MD, Clinical Director of the Hasso Plattner Institute for Digital Health; and Associate Professor of Medicine (Gastroenterology), and Artificial Intelligence and Human Health, at the Icahn School of Medicine at Mount Sinai. "Our study shows that commonly used wearable devices such as Apple Watches, Fitbits, and Oura Rings can be effective tools in monitoring chronic inflammatory diseases like IBD. This creates an opportunity to monitor the disease remotely outside the health care setting, in a continuous manner, and potentially in real time."

IBD is a chronic condition that causes inflammation in the intestines and affects more than 2.4 million people in the United States. Mount Sinai researchers enrolled more than 300 participants with ulcerative colitis or Crohn's disease, the two major types of IBD, from 36 states. The participants wore devices, answered daily symptom surveys, and provided blood and stool assessments of inflammation.

The researchers found that circadian patterns of heart rate variability (a marker of nervous system function), along with heart rate, oxygenation, and daily activity, all measured by the wearable devices, were significantly altered when inflammation or symptoms were present. Moreover, these physiological markers could detect inflammation even in the absence of symptoms and distinguish whether symptoms were driven by active inflammation in the intestines. Importantly, the researchers found that these metrics measured by wearables changed up to seven weeks before flares developed.

The researchers are applying similar approaches to other chronic inflammatory diseases, such as rheumatoid arthritis, and leveraging artificial intelligence to develop algorithms using wearable device data to predict flares on an individualized basis.

These findings open the door to leveraging wearable technology for health monitoring and disease management in innovative ways we haven't previously considered. Our hope is that, in the future, this approach will significantly enhance the quality of life of our patients."

Robert Hirten, MD, Clinical Director of the Hasso Plattner Institute for Digital Health and Associate Professor of Medicine (Gastroenterology), and Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai