Rheumatoid arthritis (RA) fluctuates through painful, disabling flares, but rheumatology appointments may be 6–12 months apart. The University of Manchester’s REMORA programme has shown the value of daily smartphone symptom tracking linked to clinical records, while also identifying reporting fatigue and reluctance to be repeatedly reminded of illness. REMORA SensoRA proposes investigating whether data from everyday devices can indicate disease severity without additional daily questionnaires. Passive measurements may be particularly useful for people who find daily symptom prompts tiring or intrusive.

Objectives

This retrospective observational study will link historical smartphone and wearable records to existing REMORA daily symptom reports. Researchers will test associations between steps, activity, sleep and heart rate and the Rheumatoid Arthritis Impact of Disease (RAID) score; examine variation between people and device types; and develop preliminary severity-estimation models. Patients, rheumatology professionals, regulators and digital biomarker specialists will advise on interpretation and future use.

Challenge

Consumer health signals are not yet validated measures of RA activity. Meaningful comparison requires aligned longitudinal symptom and sensor data without increasing reporting burden. Historical data permissions, manufacturer differences, gaps, inconsistent readings, individual behaviours, device use, and digital confidence all affect feasibility and generalisability. Historical device records may also be incomplete and not equally available across all platforms or participants.

RADAR-base solution

RADAR-base and Onsentia’s HealthRADAR enrolment infrastructure will support remote registration, electronic consent and authorisation to access existing device data. Previous REMORA participants will enrol through a dedicated website. Planned sources include Fitbit, Garmin, Oura and Apple, with an extension to Google Health Connect; Apple users can contribute through an iPhone study app. Data will pass through a secure AWS-hosted RADAR-base backend into restricted University of Manchester research storage for linkage to earlier REMORA symptom records.

Impact

The study could establish the feasibility of scalable, less burdensome passive monitoring, informing digital biomarkers, longitudinal trials and more complete clinical understanding between visits. This approach could eventually help patients understand flare patterns and clinicians assess symptoms between appointments.

Publication

van der Veer et al. (2024), ‘Remote monitoring of rheumatoid arthritis (REMORA): Study protocol for a stepped wedge cluster randomised trial and process evaluation of an integrated symptom tracking intervention.’