Background Functional gastroduodenal disorders include functional dyspepsia, chronic nausea and vomiting syndromes, and gastroparesis. These disorders are common, but their overlapping symptomatology poses challenges to diagnosis, research, and therapy. This study aimed to introduce and validate a standardized patient symptom‐logging system and App to aid in the accurate reporting of gastroduodenal symptoms for clinical and research applications. Methods The system was implemented in an iOS App including pictographic symptom illustrations, and two validation studies were conducted. To assess convergent and concurrent validity, a diverse cohort with chronic gastroduodenal symptoms undertook App‐based symptom logging for 4 h after a test meal. Individual and total post‐prandial symptom scores were averaged and correlated against two previously validated instruments: PAGI‐SYM (for convergent validity) and PAGI‐QOL (for concurrent validity). To assess face and content validity, semi‐structured qualitative interviews were conducted with patients. Key Results App‐based symptom reporting demonstrated robust convergent validity with PAGI‐SYM measures of nausea (rS =0.68), early satiation (rS =0.55), bloating (rS =0.48), heartburn (rS =0.47), upper gut pain (rS =0.40), and excessive fullness (rS =0.40); all p < 0.001 (n = 79). The total App‐reported Gastric Symptom Burden Score correlated positively with PAGI‐SYM (rS =0.56; convergent validity; p < 0.001), and negatively with PAGI‐QOL (rS = −0.34; concurrent validity; p = 0.002). Interviews demonstrated that the pictograms had adequate face and content validity. Conclusions and Inferences The continuous patient symptom‐logging App demonstrated robust convergent, concurrent, face, and content validity when used within a 4‐h post‐prandial test protocol. The App will enable standardized symptom reporting and is anticipated to provide utility in both research and clinical practice.

Background Body surface gastric mapping (BSGM) is a new clinical tool for gastric motility diagnostics, providing high‐resolution data on gastric myoelectrical activity. Artifact contamination was a key challenge to reliable test interpretation in traditional electrogastrography. This study aimed to introduce and validate an automated artifact detection and rejection system for clinical BSGM applications. Methods Ten patients with chronic gastric symptoms generated a variety of artifacts according to a standardized protocol (176 recordings) using a commercial BSGM system (Alimetry, New Zealand). An automated artifact detection and rejection algorithm was developed, and its performance was compared with a reference standard comprising consensus labeling by 3 analysis experts, followed by comparison with 6 clinicians (3 untrained and 3 trained in artifact detection). Inter‐rater reliability was calculated using Fleiss' kappa. Key Results Inter‐rater reliability was 0.84 (95% CI:0.77–0.90) among experts, 0.76 (95% CI:0.68–0.83) among untrained clinicians, and 0.71 (95% CI:0.62–0.79) among trained clinicians. The sensitivity and specificity of the algorithm against experts was 96% (95% CI:91%–100%) and 95% (95% CI:90%–99%), respectively, vs 77% (95% CI:68%–85%) and 99% (95% CI:96%–100%) against untrained clinicians, and 97% (95% CI:92%–100%) and 88% (95% CI:82%–94%) against trained clinicians. Conclusions & Inferences An automated artifact detection and rejection algorithm was developed showing >95% sensitivity and specificity vs expert markers. This algorithm overcomes an important challenge in the clinical translation of BSGM and is now being routinely implemented in patient test interpretations.

Embodied conversational agents (ECAs) are increasingly used in healthcare and other settings to improve self-management and provide companionship. Their ability to form close relationships with people is important for enhancing effectiveness and engagement. Several studies have looked at enhancing relationships with ECAs through design features focused on behaviours, appearance, or language. However, this evidence is yet to be systematically synthesized. This systematic review evaluates the effect of different design features on relationship quality with ECAs. A systematic search was conducted on electronic databases EMBASE, PsychInfo, PubMed, MEDLINE, Cochrane Library, SCOPUS, and Web of Science in January-February 2019. 43 studies were included for review that evaluated the effect of a design feature on relationship quality and social perceptions or behaviours towards an ECA. Results synthesize effective design features and lay a scientific framework for improving relationships with ECAs in healthcare and other applications. Risk of bias for included studies was generally low, however there were some limitations in the research quality pertaining to outcome measurement and the reporting of statistics. Further research is needed to understand how to make ECAs effective and engaging for all consumers.

Background Functional gastroduodenal disorders include functional dyspepsia, chronic nausea and vomiting syndromes, and gastroparesis. These disorders are common, but their overlapping symptomatology poses challenges to diagnosis, research, and therapy. This study aimed to introduce and validate a standardized patient symptom-logging system and App to aid in the accurate reporting of gastroduodenal symptoms for clinical and research applications. Methods The system was implemented in an iOS App including pictographic symptom illustrations, and two validation studies were conducted. To assess convergent and concurrent validity, a diverse cohort with chronic gastroduodenal symptoms undertook App-based symptom logging for 4-hours after a test meal. Individual and total post-prandial symptom scores were averaged and correlated against two previously validated instruments: PAGI-SYM (for convergent validity) and PAGI-QOL (for concurrent validity). To assess face and content validity, semi-structured qualitative interviews were conducted with patients. Key Results App-based symptom reporting demonstrated robust convergent validity with PAGI-SYM measures of nausea (rS=0.68), early satiation (rS=0.55), bloating (rS=0.48), heartburn (rS=0.47), upper gut pain (rS=0.40) and excessive fullness (rS=0.40); all p<0.001 (n=79). The total App-reported Gastric Symptom Burden Score correlated positively with PAGI-SYM (rS=0.56; convergent validity; p<0.001), and negatively with PAGI-QOL (rS=-0.34; concurrent validity; p=0.002). Interviews demonstrated that the pictograms had adequate face and content validity. Conclusions and Inferences The continuous patient symptom-logging App demonstrated robust convergent, concurrent, face, and content validity when used within a 4-hour post-prandial test protocol. The App will enable standardized symptom reporting and is anticipated to provide utility in both research and clinical practice.

Background: Psychological comorbidities are common in patients with disorders of gut-brain interaction (DGBIs) and are often linked with poorer patient outcomes. Likewise, extensive research has shown a bidirectional association between psychological factors and gastrointestinal symptoms, termed the gut-brain axis. Consequently, assessing and managing mental wellbeing, in an integrated care pathway, may lead to improvements in symptoms and quality of life for some patients. This study aimed to explore patients' and gastroenterology clinicians' opinions on integrating psychometrics into routine DGBI testing. Methods: Semi-structured interviews were conducted with 16 patients with a gastroduodenal DGBI and 19 clinicians who see and treat these patients. Interviews were transcribed verbatim and analysed using inductive, reflexive thematic analysis. Results: Three key clinician themes were developed: (1) psychology as part of holistic care, emphasising the importance of a multidisciplinary approach; (2) the value of psychometrics in clinical practice, highlighting their potential for screening and expanding management plans; and (3) navigating barriers to utilising psychometrics, addressing the need for standardisation and external handling to maintain the therapeutic relationship. Four key patient themes were also developed: (1) the utility of psychometrics in clinical care, reflecting the perceived benefits; (2) openness to psychological management, indicating patients' willingness to explore psychological treatment options; (3) concerns with psychological integration, addressing potential stigma and fear of labelling; and (4) the significance of clinician factors, emphasising the importance of clinician bedside manner, knowledge, and collaboration. Conclusions: The themes generated from the interviews indicated that patients and clinicians see value in integrating psychometrics into routine DGBI testing. Despite potential barriers, psychometrics would advance the understanding of a patient's condition and facilitate holistic and multidisciplinary management. Recommendations for navigating challenges were provided, and considering these, patients and clinicians supported the use of psychometrics as mental health screening tools for patients with gastroduodenal DGBIs.