SALVE: Scleroderma App for Lesion VErification (Study 1)

  • Research type

    Research Study

  • Full title

    Development of a measuring app for finger lesions as an outcome measure for systemic sclerosis-related digital ulceration (SALVE: Scleroderma App for Lesion VErification) (Study 1)

  • IRAS ID

    275971

  • Contact name

    Ariane Herrick

  • Contact email

    ariane.herrick@manchester.ac.uk

  • Sponsor organisation

    University of Manchester

  • Clinicaltrials.gov Identifier

    N/A, N/A

  • Duration of Study in the UK

    0 years, 6 months, 1 days

  • Research summary

    Summary of Research
    Digital lesions (finger or toe ulcers) are common in the multisystem connective tissue disease, systemic sclerosis, occurring in about 50% of patients, and are problematic because they are painful and disabling. Current treatments are not as effective as we would like and new therapies are urgently needed. However, clinical trials of new drugs are currently being hampered by inadequate ‘outcome measures’ – indicators of how well a drug performs in clinical trials.

    To overcome this problem we wish to develop a smartphone app to monitor digital lesions over time and provide a tool for assessing digital lesion healing rates. If successful, this could be used in future clinical trials to provide accurate outcome measures and ultimately aid in the discovery of effective new treatments for digital lesions. This will involve three key stages:

    1 Develop an imaging protocol for patients to photograph or video their digital lesions.

    2. Develop a smartphone app that guides patients through the image capture process.

    3. Develop automated methods of analysis to monitor digital lesion healing rates.

    This study will be limited to the development and testing of the imaging protocol. A second study will cover the development and testing of the smartphone app (and will have it's own separate ethics application)

    To develop and test the imaging protocol, 30 patients with systemic sclerosis related digital lesions will be recruited. At their first study visit they will be consented and have the imaging protocol explained. They will then image their digital lesion(s) daily for about 30 days before returning for a second study visit. They will be asked to provide imaging protocol feedback. The images recorded and feedback received will help refine the imaging protocol and inform future smartphone app development.

    Recruitment and study visits will take place at Salford Royal Hospital and funding is being provided by Versus Arthritis

    Summary of Results
    Objective:
    Studies of digital ulcers (finger sores) in people with systemic sclerosis (SSc) have struggled because there isn’t a good way to measure healing. This study looked at whether patients could take good-quality photos of their sores using a smartphone, as a first step toward creating a phone-based way to track healing.
    Methods:
    Patients took daily photos of one or more finger sores for 30 days using their smartphones and uploaded them to a secure folder. The quality of the photos was checked based on six factors: focus, shadows, lighting, position and angle of a reference dot, and whether the sore was centred. Patients also gave feedback through a questionnaire.
    Results:
    Twelve patients submitted 332 photos of 18 sores. On average, each patient sent about 30 photos. After removing duplicates, most photos were clear and centred, but many had shadows and uneven lighting. About 6 out of 10 patients said they would be willing to take daily photos in future studies, and 9 out of 10 would take photos at least a few times per week.
    Conclusion:
    Most patients were able to take usable smartphone photos of their sores. These results suggest that using smartphones to monitor sores is practical and could be developed further into an app that tracks photos and symptoms.

  • REC name

    London - Chelsea Research Ethics Committee

  • REC reference

    20/LO/0674

  • Date of REC Opinion

    12 May 2020

  • REC opinion

    Further Information Favourable Opinion