RESUMEN
OBJECTIVE: Psoriatic disease remains underdiagnosed and undertreated. We developed and validated a suite of novel, sensor-based smartphone assessments (Psorcast app) that can be self-administered to measure cutaneous and musculoskeletal signs and symptoms of psoriatic disease. METHODS: Participants with psoriasis (PsO) or psoriatic arthritis (PsA) and healthy controls were recruited between June 5, 2019, and November 10, 2021, at 2 academic medical centers. Concordance and accuracy of digital measures and image-based machine learning models were compared to their analogous clinical measures from trained rheumatologists and dermatologists. RESULTS: Of 104 study participants, 51 (49%) were female and 53 (51%) were male, with a mean age of 42.3 years (SD 12.6). Seventy-nine (76%) participants had PsA, 16 (15.4%) had PsO, and 9 (8.7%) were healthy controls. Digital patient assessment of percent body surface area (BSA) affected with PsO demonstrated very strong concordance (Lin concordance correlation coefficient [CCC] 0.94 [95% CI 0.91-0.96]) with physician-assessed BSA. The in-clinic and remote target plaque physician global assessments showed fair-to-moderate concordance (CCCerythema 0.72 [0.59-0.85]; CCCinduration 0.72 [0.62-0.82]; CCCscaling 0.60 [0.48-0.72]). Machine learning models of hand photos taken by patients accurately identified clinically diagnosed nail PsO with an accuracy of 0.76. The Digital Jar Open assessment categorized physician-assessed upper extremity involvement, considering joint tenderness or enthesitis (AUROC 0.68 [0.47-0.85]). CONCLUSION: The Psorcast digital assessments achieved significant clinical validity, although they require further validation in larger cohorts before use in evidence-based medicine or clinical trial settings. The smartphone software and analysis pipelines from the Psorcast suite are open source and freely available.
Asunto(s)
Artritis Psoriásica , Aprendizaje Automático , Psoriasis , Teléfono Inteligente , Humanos , Artritis Psoriásica/diagnóstico , Femenino , Masculino , Psoriasis/diagnóstico , Adulto , Persona de Mediana Edad , Prueba de Estudio Conceptual , Aplicaciones Móviles , Reproducibilidad de los ResultadosRESUMEN
Inattentional blindness is a phenomenon wherein people fail to perceive obvious stimuli within their vision, sometimes leading to dramatic consequences. Research on the effects of fear chemosignals suggests that they facilitate receivers' sensory acquisition. We aimed to examine the interplay between these phenomena, investigating whether exposure to fear chemosignals (vs. rest body odors) can reduce the inattentional-blindness handicap. Utilizing a virtual-reality aquarium, we asked participants to count how many morsels a school of fish consumed while two unexpected stimuli swam by. We predicted that participants exposed to fear chemosignals (N = 131) would detect unexpected stimuli significantly more often than participants exposed to rest body odors (N = 125). All participants were adult Portuguese university students aged 18 to 40 years. The results confirmed our hypothesis, χ2(1) = 6.10, p = .014, revealing that exposure to fear chemosignals significantly increased the detection of unexpected stimuli by about 10%. The implications of our findings open a novel avenue for reducing the adverse consequences of inattentional blindness.