Performance, acceptability, and validation of a phone application bowel diary.

Area of Science:

• Urogynecology
• Digital Health
• Patient-Reported Outcomes

Background:

• Accidental bowel leakage (ABL) significantly impacts quality of life for many women.
• Accurate tracking of bowel movements (BM) and fecal incontinence episodes (FIE) is crucial for effective management.
• Traditional paper diaries can be burdensome and prone to recall bias.

Purpose of the Study:

• To evaluate the performance, acceptability, external validity, and reliability of the PFDN Bowel eDiary, a smartphone application for tracking bowel symptoms.
• To compare the eDiary with traditional paper diaries in women with refractory ABL.

Main Methods:

• A randomized, crossover trial was conducted with women experiencing refractory ABL.
• Participants used both paper and eDiary formats to record BM and FIE, including urgency and stool consistency.
• Data were compared using Pearson correlation, and eDiary usability was assessed with the System Usability Scale (SUS). Test-retest reliability was determined using intraclass correlations (ICCs).

Main Results:

• The PFDN Bowel eDiary demonstrated moderate to strong correlations with paper diaries for BM and FIE frequency (r values ranging from .61 to .72).
• Test-retest reliability was good, with ICCs ranging from .62 to .81.
• The eDiary achieved a high mean SUS score (82.3), with 91.4% finding it easy to use and 75.9% preferring it over paper.

Conclusions:

• The PFDN Bowel eDiary is a valid, reliable, and user-friendly tool for documenting bowel symptoms in women with ABL.
• Its high acceptability and preference over paper diaries suggest potential for improved patient adherence and data accuracy.
• The eDiary's real-time data capture obviates the need for manual staff data entry, streamlining clinical workflows.