Comparing Raynaud's phenomenon attack measurement tools: paper or smartphone application?

Objective: To compare two methods of recording Raynaud's Phenomenon (RP) attack frequency, duration and severity: the traditional Raynaud Condition Score (RCS) paper diary and a new smartphone application. 

Methods: We conducted a multicenter study of patients with stable SSc-RP. Participants were randomized to document their RP attacks in the RCS paper diary or smartphone application for one week, at which point they were again randomized to either continue the original recording method or cross over to the other recording method for an additional week. Participants who crossed over completed a questionnaire about their experience with each method. We compared patient preference, and RP documentation by recording method. 

Results: Fifty-five patients with stable SSc-RP were included. The 24 participants who used both modalities were significantly more likely to report “liking” the smartphone application than the paper diary (92% vs. 58%, p=0.04). There was also a non-significant difference in real-time documentation with the smartphone than the paper diary (71% vs. 38%, p=0.06). Participants reported significantly more attacks with the paper diary than with the smartphone application, however, the severity and average attack length were not significantly different. 

Conclusion: This study supports the use of a smartphone application to document RP attack frequency, duration and severity. Not only did patients prefer the smartphone application to the paper diary, but they were also more likely to record RP attacks in real-time with the smartphone application, reducing the risk of recall bias. Future clinical trials should consider using a smartphone-based application to capture RP attacks.