In a NIHR Newcastle Biomedical Research Centre funded project Professor Wan-Fai Ng and colleagues have collaborated with industry partners GSK to use wearable devices to explore the potential benefits of technology to assess fatigue symptoms in autoimmune conditions.

Fatigue is one of the most debilitating symptoms for patients living with many rheumatic and long-term conditions. As well having a major impact on quality of life it is often a key factor in people being unable to stay in gainful employment. As a result, fatigue as a symptom of disease represents a huge health and economic challenge to the NHS and society.

However at present the relationship between fatigue and disease activity is not clear. While some patients find their fatigue lessens when there is an improvement of their disease, for others it can persist despite clinical improvements in their condition.

Measuring fatigue symptoms

There is currently no validated objective measure of fatigue; clinicians rely on a patient’s self-assessment, something that can be difficult to reliably quantify due to the multiple factors involved for each individual. In addition, with the severity of fatigue also subject to fluctuation, capturing subjective fatigue measures is challenging.

If a validated objective measure of fatigue were available, it could complement patient assessments of fatigue symptoms and allow the changes in response to therapeutic interventions to be measured with greater accuracy, reliability and sensitivity.

In a project funded by the NIHR Newcastle Biomedical Research Centre as part of the Musculoskeletal Disease Research theme, Professor Wan Fai Ng leads a multidisciplinary team which will evaluate the benefits of new therapies for autoimmune rheumatic diseases and ageing syndromes.

Using digital devices worn by participants the study will capture physical and bio-behavioural activity with data having the potential to provide an indirect, objective assessment of fatigue, as well as an assessment of the “impact” of fatigue on the daily lives of study participants. It is also expected to allow an assessment of fatigue in patients’ own environment and capture the fluctuation levels of fatigue.

Industry collaboration

Collaborating with GSK, the study will generate pilot data that will be analysed using advanced data analytic and statistical modelling methods. The aim is to identify robust bio-behavioural markers of physical fatigue that correlate with neuropsychological tests to act as objective measures of mental fatigue.

Professor Ng comments: “We’re very excited about the valuable pilot data that this study will provide which can provide the basis for further studies that will expand the dataset and allow us to validate the use of such tools as objective measures of fatigue in clinical studies”.

Having more reliable data will bring huge advantages for the understanding of fatigue, for example:

• By frequent collecting easily accessible, audit-ready digital data from wearable devices the chance of errors compared to relying on study participants recollections will be reduced.
• By identifying key activity and physiological response patterns associated with fatigue, a deeper understanding of the symptoms will be possible.
• For mental fatigue, based on the symptoms described by patients, neuropsychological tests that measure parameters such as short-term memory, concentration and alertness, have the potential to provide objective, quantifiable measurements.
• By making reliable objective way to measure fatigue available, a key barrier to the pharmaceutical industry investing in new programmes to develop new treatments for fatigue will be removed.