Digital symptom tracker could enhance GORD management

A recently published prospective cohort study has unveiled a promising digital tool that could change how symptoms of gastro-oesophageal reflux disease (GORD) are monitored and managed. The research, titled ‘Establishment and optimisation of a patient-reported outcome-based electronic-diary for symptoms evaluation in patients with GORD’ describes the development and validation of a patient-friendly electronic diary designed to capture real-time symptom data directly from patients.

GORD affects millions worldwide and one in four people in Ireland. Accurate symptom assessment is essential for diagnosis, monitoring treatment response, and guiding clinical decisions. Traditionally, clinicians ask patients to recall symptoms over the previous week or month. However, recall bias and variability in symptom perception can limit the reliability of such reports, according to the study.

To address these challenges, researchers created a patient-reported outcome-based e-diary, enabling participants to log symptoms daily using a digital platform. The study followed a prospective cohort design, meaning patients were observed over time while using the tool. The primary aims were to evaluate feasibility, optimise the system’s design, and assess its reliability and validity in capturing GORD symptoms.

The e-diary evaluated eight daytime (acid regurgitation, cough, heartburn, sour taste in the mouth, hiccups, hoarseness, dysphagia, and chest pain) and two night-time symptoms (acid regurgitation and cough) for eight consecutive weeks.

Adherence – defined as the daily completion rate of e-diary – was analysed and optimised across three stages: 1. No reminder 2. Sending reminder SMS text messaging upon the detection of missing data (no reminders during the first three to five days after enrollment, and 3. Immediate installation of reminder system at enrollment.

Study findings suggest that the e-diary was both practical and well accepted by patients. Compliance rates for daily symptom reporting were high, indicating that participants were willing and able to use the system consistently. Many patients found the diary easy to navigate, suggesting that digital health tools – when well designed – can integrate smoothly into everyday life.

One of the most significant advantages of the e-diary was its ability to reduce recall bias. By recording symptoms in real time or at the end of each day, patients provided more accurate accounts of heartburn episodes, regurgitation, and related discomfort.

The system effectively captured key dimensions of GORD symptoms, including frequency, severity, and day to day variability. This data offers healthcare providers a clearer picture of disease patterns than periodic recall does, according to the investigators.

The study also examined the psychometric performance of the tool. Results demonstrated strong internal consistency and reliability, meaning the instrument produced stable and coherent measurements across repeated entries.

Importantly, the e-diary showed meaningful correlation with established GORD symptom scales, supporting its validity as a clinical assessment instrument. Furthermore, it proved sensitive to clinical changes over time, successfully detecting symptom improvement in patients undergoing treatment. This responsiveness suggests the diary could be valuable in evaluating therapeutic effectiveness in both clinical trials and routine practice.

An important component of the study was optimisation. Researchers used iterative refinement to improve question wording, symptom scoring systems, and user interface design. Feedback from participants informed adjustments that enhanced clarity and usability. The optimised version demonstrated improved performance without increasing patient burden – underscoring the importance of user-centred design in digital health development.

Clinicians may benefit as symptom tracking allows for more personalised treatment adjustments and timely identification of persistent or worsening symptoms. Instead of relying solely on infrequent clinic visits, care providers could review longitudinal symptom data to guide management decisions. The tool may also empower patients by increasing awareness of symptom triggers and patterns.

Reference

Chen YC, Wang Y, Hung J, et al. Establishment and optimisation of a patient-reported outcome-based electronic diary for symptoms evaluation in patients with gastroesophageal reflux disorder: Prospective cohort study. J Med Internet Res. 2026;28:e83680.  Available at: www.sciencedirect.com/org/science/article/pii/S1438887126000166.

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