Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 18, 2022
Date Accepted: Mar 25, 2023
Defining digital measurement of scratching during sleep, or “Nocturnal Scratch”: A review of the literature
ABSTRACT
Background:
Digital health technologies represent a convenient, objective, relatively inexpensive method that could be leveraged for assessing scratching during sleep (nocturnal scratch) in patients with inflammatory skin conditions. However, a lack of standardization of outcome measures for this symptom hampers the ability to compare different technologies for this purpose.
Objective:
To address this gap, we systematically reviewed the literature for definitions of 1) scratching in patients with skin inflammation, and 2) sleep in the period during which such scratching occurred.
Methods:
We performed two systematic literature reviews of English-language studies published between January 1996 and March 2022. The first search used the terms “scratch”, “itch” or “pruritus” in the titles of publications in the PubMed, IEEE, Scopus, and Web of Science databases, limiting the search to dermatitis-related studies in humans. We also searched the titles of publications in the PubMed and Google Scholar databases for the search terms “sleep opportunity” and “intended sleep”, to capture definitions of sleep in the context of when dermatitis-related scratching occurred.
Results:
In all, 29 studies contained a definition of scratch, itch, or pruritis related to inflammation, two of which also described sleep-related variables. Definitions for scratching differed widely according to the tool(s) used for assessment. From these studies, we developed an evidence-based and patient-centric definition of nocturnal scratch: An action of rhythmic and repetitive skin contact movement performed during a delimited time period of intended and actual sleep, that is not restricted to any specific time of the day or night. We also developed ontologies of relevant concepts and properties related to scratching and sleep.
Conclusions:
Investigators can use these ontologies and properties to develop detailed, objective, standardized measurements for use by clinical researchers, clinicians, technology developers, regulators, patients, and payers. Inclusion of more advanced properties remains to be decided by specific research groups or tool developers. Clinical Trial: n/a
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.