Decreased Memory Bias via a Mobile Application: A Symptom Tracker to Monitor Children’s Periodic Fever

Abstract

Memory bias, the tendency to rely on certain events over others, can become an issue in chronic illnesses, especially when symptoms are reported retrospectively. This paper examines a case where continuous symptom registration can be facilitated, memory supported, and memory bias reduced by introducing a mobile application. The aim of the paper is to report on the design of an app for collecting subjective data over an extended period to continuously follow children with periodic fever. The research approach is qualitative, building on interview data. The design method is co-design, a collaborative and participatory approach involving researchers, physicians and other key stakeholders, with focus on the views of the parents. We argue that collecting data continuously through an app moves the discussion from memory to the specific data points, which is illustrated through trends shown in the visualizations of the data. Moreover, we highlight the importance of systematically collecting data over an extended period through a data-driven approach to both forward clinical practice and research on complex, often chronic topics such as periodic fever, which is genuinely under-researched to date.

Evaluating User Compliance in Mobile Health Apps: Insights from a 90-Day Study Using a Digital Sleep Diary

“…To our knowledge, this is the first study that investigates participant compliance with a sleep diary app in an intensive longitudinal setting. The results highlight the potential of digital health solutions in improving longitudinal sleep assessment and indicate that a digital sleep diary can foster compliance and, thus, overcome the limitations and drawbacks associated with the traditional pen-and-paper format [ 6 , 21 , 22 , 23 ]. The study emphasizes that the integration of longitudinal subjective measurements in digital health solutions opens up new possibilities for capturing comprehensive sleep information and contributing to meaningful changes in daily habits, mood, and overall well-being [ 8 , 10 , 11 , 16 ].…”

“…Each of these items is rated on a 5-point Likert scale (e.g., 0 = no problem; 4 = very severe problem), with a total score ranging from 0 to 28. The interpretation for the total score is as follows: absence of insomnia (0-7); sub-threshold insomnia (8)(9)(10)(11)(12)(13)(14); moderate insomnia (15)(16)(17)(18)(19)(20)(21); and severe insomnia (22)(23)(24)(25)(26)(27)(28). In this study, a cut-off of ≥15 was used to indicate a significant risk of insomnia.…”

“…Sleep diaries are traditionally delivered on paper and have shown a high correlation with actigraphy measures on sleep onset and offset times, making them an essential support tool for diagnosing and treating sleep hygiene and insomnia [ 19 , 20 ]. However, although sleep diaries in pen-and-paper format are the conventional method for self-report sleep assessment, they are increasingly considered outdated and are prone to memory bias and difficulties in monitoring compliance [ 6 , 21 , 22 , 23 ]. Despite the rapid increase in digitization across different sectors, the consumer adoption of mobile apps and wearables, and their feasibility for delivering digital health solutions, there remain significant challenges in the design and development of digital health solutions for sleep, in particular in digital sleep diaries [ 16 , 24 ].…”