Laboratory Validation of Inertial Body Sensors to Detect Cigarette Smoking Arm Movements

Using a Novel Connected Device for the Collection of Puffing Topography Data for the Vuse Solo Electronic Nicotine Delivery System in a Real-World Setting: Prospective Ambulatory Clinical Study

BACKGROUND

Over the last decade, the use of electronic nicotine delivery systems (ENDSs) has risen, whereas studies that describe how consumers use these products have been limited. Most studies related to ENDS use have involved study designs focused on use in a central location environment or attempted to measure use outcomes through subjective self-reported end points. The development of accurate and reliable tools to collect data in a naturalistic real-world environment is necessary to capture the complexities of ENDS use. Using connected devices in a real-world setting provides a convenient and objective approach to collecting behavioral outcomes with ENDS.

OBJECTIVE

The Product Use and Behavior instrument was developed and used to capture the use of the Vuse Solo ENDS in an ambulatory setting to best replicate real-world use behavior. This study aims to determine overall mean values for topography outcomes while also providing a definition for an ENDS use session.

METHODS

A prospective ambulatory clinical study was performed with the Product Use and Behavior instrument. Participants (n=75) were aged between 21 and 60 years, considered in good health, and were required to be established regular users of ENDSs. To better understand use behavior within the population, the sample was sorted into percentiles with bins based on daily puff counts. To frame these data in the relevant context, they were binned into low-, moderate-, and high-use categories (10th to 40th, 40th to 70th, and 70th to 100th percentiles, respectively), with the low-use group representing the nonintense category, the high-use group representing the intense category, and the moderate-use group being reflective of the average consumer.

RESULTS

Participants with higher daily use took substantially more puffs per use session (6.71 vs 4.40) and puffed more frequently (interpuff interval: 32.78 s vs 61.66 s) than participants in the low-use group. Puff duration remained consistent across the low-, moderate‑, and high-use groups (2.10 s, 2.18 s, and 2.19 s, respectively). The moderate-use group had significantly shorter session lengths (P<.001) than the high- and low-use groups, which did not differ significantly from each other (P=.16).

CONCLUSIONS

Using connected devices allows for a convenient and robust approach to the collection of behavioral outcomes related to product use in an ambulatory setting. By using the variables captured with these tools, it becomes possible to move away from predefined periods of use to better understand topography outcomes and define use sessions. The data presented here offer a possible method to define these sessions. These data also begin to frame international standards used for the analytical assessments of ENDSs in the correct context and begin to shed light on the differences between standardized testing regimens and actual use behavior.

TRIAL REGISTRATION

Clinicaltrials.gov NCT04226404; https://clinicaltrials.gov/study/NCT04226404.

Machine learning applications in tobacco research: a scoping review

OBJECTIVE

Identify and review the body of tobacco research literature that self-identified as using machine learning (ML) in the analysis.

DATA SOURCES

MEDLINE, EMABSE, PubMed, CINAHL Plus, APA PsycINFO and IEEE Xplore databases were searched up to September 2020. Studies were restricted to peer-reviewed, English-language journal articles, dissertations and conference papers comprising an empirical analysis where ML was identified to be the method used to examine human experience of tobacco. Studies of genomics and diagnostic imaging were excluded.

STUDY SELECTION

Two reviewers independently screened the titles and abstracts. The reference list of articles was also searched. In an iterative process, eligible studies were classified into domains based on their objectives and types of data used in the analysis.

DATA EXTRACTION

Using data charting forms, two reviewers independently extracted data from all studies. A narrative synthesis method was used to describe findings from each domain such as study design, objective, ML classes/algorithms, knowledge users and the presence of a data sharing statement. Trends of publication were visually depicted.

DATA SYNTHESIS

74 studies were grouped into four domains: ML-powered technology to assist smoking cessation (n=22); content analysis of tobacco on social media (n=32); smoker status classification from narrative clinical texts (n=6) and tobacco-related outcome prediction using administrative, survey or clinical trial data (n=14). Implications of these studies and future directions for ML researchers in tobacco control were discussed.

CONCLUSIONS

ML represents a powerful tool that could advance the research and policy decision-making of tobacco control. Further opportunities should be explored.

Smoking Cessation System for Preemptive Smoking Detection

Smoking cessation is a significant challenge for many people addicted to cigarettes and tobacco. Mobile health-related research into smoking cessation is primarily focused on mobile phone data collection either using self-reporting or sensor monitoring techniques. In the past 5 years with the increased popularity of smartwatch devices, research has been conducted to predict smoking movements associated with smoking behaviors based on accelerometer data analyzed from the internal sensors in a user's smartwatch. Previous smoking detection methods focused on classifying current user smoking behavior. For many users who are trying to quit smoking, this form of detection may be insufficient as the user has already relapsed. In this paper, we present a smoking cessation system utilizing a smartwatch and finger sensor that is capable of detecting pre-smoking activities to discourage users from future smoking behavior. Pre-smoking activities include grabbing a pack of cigarettes or lighting a cigarette and these activities are often immediately succeeded by smoking. Therefore, through accurate detection of pre-smoking activities, we can alert the user before they have relapsed. Our smoking cessation system combines data from a smartwatch for gross accelerometer and gyroscope information and a wearable finger sensor for detailed finger bend-angle information. We compare the results of a smartwatch-only system with a combined smartwatch and finger sensor system to illustrate the accuracy of each system. The combined smartwatch and finger sensor system performed at an 80.6% accuracy for the classification of pre-smoking activities compared to 47.0% accuracy of the smartwatch-only system.

Real-time prediction of smoking activity using machine learning based multi-class classification model

Smoking cessation efforts can be greatly influenced by providing just-in-time intervention to individuals who are trying to quit smoking. Detecting smoking activity accurately among the confounding activities of daily living (ADLs) being monitored by the wearable device is a challenging and intriguing research problem. This study aims to develop a machine learning based modeling framework to identify the smoking activity among the confounding ADLs in real-time using the streaming data from the wrist-wearable IMU (6-axis inertial measurement unit) sensor. A low-cost wrist-wearable device has been designed and developed to collect raw sensor data from subjects for the activities. A sliding window mechanism has been used to process the streaming raw sensor data and extract several time-domain, frequency-domain, and descriptive features. Hyperparameter tuning and feature selection have been done to identify best hyperparameters and features respectively. Subsequently, multi-class classification models are developed and validated using in-sample and out-of-sample testing. The developed models obtained predictive accuracy (area under receiver operating curve) up to 98.7% for predicting the smoking activity. The findings of this study will lead to a novel application of wearable devices to accurately detect smoking activity in real-time. It will further help the healthcare professionals in monitoring their patients who are smokers by providing just-in-time intervention to help them quit smoking. The application of this framework can be extended to more preventive healthcare use-cases and detection of other activities of interest.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11042-022-12349-6.

CNN-Based Smoker Classification and Detection in Smart City Application

To better regulate smoking in no-smoking areas, we present a novel AI-based surveillance system for smart cities. In this paper, we intend to solve the issue of no-smoking area surveillance by introducing a framework for an AI-based smoker detection system for no-smoking areas in a smart city. Moreover, this research will provide a dataset for smoker detection problems in indoor and outdoor environments to help future research on this AI-based smoker detection system. The newly curated smoker detection image dataset consists of two classes, Smoking and NotSmoking. Further, to classify the Smoking and NotSmoking images, we have proposed a transfer learning-based solution using the pre-trained InceptionResNetV2 model. The performance of the proposed approach for predicting smokers and not-smokers was evaluated and compared with other CNN methods on different performance metrics. The proposed approach achieved an accuracy of 96.87% with 97.32% precision and 96.46% recall in predicting the Smoking and NotSmoking images on a challenging and diverse newly-created dataset. Although, we trained the proposed method on the image dataset, we believe the performance of the system will not be affected in real-time.

OpiTrack: A Wearable-based Clinical Opioid Use Tracker with Temporal Convolutional Attention Networks

Opioid use disorder is a medical condition with major social and economic consequences. While ubiquitous physiological sensing technologies have been widely adopted and extensively used to monitor day-to-day activities and deliver targeted interventions to improve human health, the use of these technologies to detect drug use in natural environments has been largely underexplored. The long-term goal of our work is to develop a mobile technology system that can identify high-risk opioid-related events (i.e., development of tolerance in the setting of prescription opioid use, return-to-use events in the setting of opioid use disorder) and deploy just-in-time interventions to mitigate the risk of overdose morbidity and mortality. In the current paper, we take an initial step by asking a crucial question: Can opioid use be detected using physiological signals obtained from a wrist-mounted sensor? Thirty-six individuals who were admitted to the hospital for an acute painful condition and received opioid analgesics as part of their clinical care were enrolled. Subjects wore a noninvasive wrist sensor during this time (1-14 days) that continuously measured physiological signals (heart rate, skin temperature, accelerometry, electrodermal activity, and interbeat interval). We collected a total of 2070 hours (≈ 86 days) of physiological data and observed a total of 339 opioid administrations. Our results are encouraging and show that using a Channel-Temporal Attention TCN (CTA-TCN) model, we can detect an opioid administration in a time-window with an F1-score of 0.80, a specificity of 0.77, sensitivity of 0.80, and an AUC of 0.77. We also predict the exact moment of administration in this time-window with a normalized mean absolute error of 8.6% and R ² coefficient of 0.85.

Electromyogram in Cigarette Smoking Activity Recognition

In this study, information from surface electromyogram (sEMG) signals was used to recognize cigarette smoking. The sEMG signals collected from lower arm were used in two different ways: (1) as an individual predictor of smoking activity and (2) as an additional sensor/modality along with the inertial measurement unit (IMU) to augment recognition performance. A convolutional and a recurrent neural network were utilized to recognize smoking-related hand gestures. The model was developed and evaluated with leave-one-subject-out (LOSO) cross-validation on a dataset from 16 subjects who performed ten activities of daily living including smoking. The results show that smoking detection using only sEMG signal achieved an F1-score of 75% in person-independent cross-validation. The combination of sEMG and IMU improved reached the F1-score of 84%, while IMU alone sensor modality was 81%. The study showed that using only sEMG signals would not provide superior cigarette smoking detection performance relative to IMU signals. However, sEMG improved smoking detection results when combined with IMU signals without using an additional device.

A CNN-LSTM neural network for recognition of puffing in smoking episodes using wearable sensors

A detailed assessment of smoking behavior under free-living conditions is a key challenge for health behavior research. A number of methods using wearable sensors and puff topography devices have been developed for smoking and individual puff detection. In this paper, we propose a novel algorithm for automatic detection of puffs in smoking episodes by using a combination of Respiratory Inductance Plethysmography and Inertial Measurement Unit sensors. The detection of puffs was performed by using a deep network containing convolutional and recurrent neural networks. Convolutional neural networks (CNN) were utilized to automate feature learning from raw sensor streams. Long Short Term Memory (LSTM) network layers were utilized to obtain the temporal dynamics of sensor signals and classify sequence of time segmented sensor streams. An evaluation was performed by using a large, challenging dataset containing 467 smoking events from 40 participants under free-living conditions. The proposed approach achieved an F1-score of 78% in leave-one-subject-out cross-validation. The results suggest that CNN-LSTM based neural network architecture sufficiently detect puffing episodes in free-living condition. The proposed model be used as a detection tool for smoking cessation programs and scientific research.

A CNN-LSTM neural network for recognition of puffing in smoking episodes using wearable sensors

A detailed assessment of smoking behavior under free-living conditions is a key challenge for health behavior research. A number of methods using wearable sensors and puff topography devices have been developed for smoking and individual puff detection. In this paper, we propose a novel algorithm for automatic detection of puffs in smoking episodes by using a combination of Respiratory Inductance Plethysmography and Inertial Measurement Unit sensors. The detection of puffs was performed by using a deep network containing convolutional and recurrent neural networks. Convolutional neural networks (CNN) were utilized to automate feature learning from raw sensor streams. Long Short Term Memory (LSTM) network layers were utilized to obtain the temporal dynamics of sensor signals and classify sequence of time segmented sensor streams. An evaluation was performed by using a large, challenging dataset containing 467 smoking events from 40 participants under free-living conditions. The proposed approach achieved an F1-score of 78% in leave-one-subject-out cross-validation. The results suggest that CNN-LSTM based neural network architecture sufficiently detect puffing episodes in free-living condition. The proposed model be used as a detection tool for smoking cessation programs and scientific research.

An electronic, smart lighter to measure cigarette smoking: A pilot study to assess feasibility and initial validity

Understanding variability in smoking patterns may inform smoking cessation interventions. Retrospective reports of cigarettes smoked per day may be biased and typically do not provide temporal precision regarding when cigarettes are smoked. However, real-time, user-initiated tracking, such as logging each time a cigarette is smoked, can be burdensome over long time frames. In this study, adult, non-treatment seeking daily smokers (N = 22) used an electronic, smart lighter to light and timestamp cigarettes for 14 days. Participants reported number of cigarettes smoked per day (CPD) via a mobile device (daily diary) and retrospectively reported CPD at the end of the study using the Timeline Followback (TLFB). Self-reported lighter satisfaction and adherence varied with 68% of participants reporting that they liked using the lighter and participants reporting using the lighter for 92% of cigarettes smoked, on average. Lighter-estimated CPD did not differ from daily diary-estimated CPD, but was significantly lower than TLFB estimates. The lighter resulted in greater day-to-day variability relative to other methods and fewer rounded cigarette counts (digit bias) relative to the TLFB. The lighter appears to be feasible for capturing data on smoking patterns in daily smokers. Though false positive cigarettes are likely low, additional technologies that augment data captured from the lighter may be necessary to reduce false negatives (missed cigarettes) and alternative lighter designs may appeal more to certain smokers.

Wearable Sensors for Monitoring of Cigarette Smoking in Free-Living: A Systematic Review

Globally, cigarette smoking is widespread among all ages, and smokers struggle to quit. The design of effective cessation interventions requires an accurate and objective assessment of smoking frequency and smoke exposure metrics. Recently, wearable devices have emerged as a means of assessing cigarette use. However, wearable technologies have inherent limitations, and their sensor responses are often influenced by wearers' behavior, motion and environmental factors. This paper presents a systematic review of current and forthcoming wearable technologies, with a focus on sensing elements, body placement, detection accuracy, underlying algorithms and applications. Full-texts of 86 scientific articles were reviewed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines to address three research questions oriented to cigarette smoking, in order to: (1) Investigate the behavioral and physiological manifestations of cigarette smoking targeted by wearable sensors for smoking detection; (2) explore sensor modalities employed for detecting these manifestations; (3) evaluate underlying signal processing and pattern recognition methodologies and key performance metrics. The review identified five specific smoking manifestations targeted by sensors. The results suggested that no system reached 100% accuracy in the detection or evaluation of smoking-related features. Also, the testing of these sensors was mostly limited to laboratory settings. For a realistic evaluation of accuracy metrics, wearable devices require thorough testing under free-living conditions.

Smoking detection based on regularity analysis of hand to mouth gestures

A number of studies have been introduced for the detection of smoking via a variety of features extracted from the wrist IMU data. However, none of the previous studies investigated gesture regularity as a way to detect smoking events. This study describes a novel method to detect smoking events by monitoring the regularity of hand gestures. Here, the regularity of hand gestures was estimated from a one axis accelerometer worn on the wrist of the dominant hand. To quantify the regularity score, this paper applied a novel approach of unbiased autocorrelation to process the temporal sequence of hand gestures. The comparison of regularity score of smoking events with other activities substantiated that hand-to-mouth gestures are highly regular during smoking events and have the potential to detect smoking from among a plethora of daily activities. This hypothesis was validated on a dataset of 140 cigarette smoking events generated by 35 regular smokers in a controlled setting. The regularity of gestures detected smoking events with an F1-score of 0.81. However, the accuracy dropped to 0.49 in the free-living study of same 35 smokers smoking 295 cigarettes. Nevertheless, regularity of gestures may be useful as a supportive tool for other detection methods. To validate that proposition, this paper further incorporated the regularity of gestures in an instrumented lighter based smoking detection algorithm and achieved an improvement in F1-score from 0.89 (lighter only) to 0.91 (lighter and regularity of hand gestures).

Cigarette Smoking Detection with An Inertial Sensor and A Smart Lighter

In recent years, a number of wearable approaches have been introduced for objective monitoring of cigarette smoking based on monitoring of hand gestures, breathing or cigarette lighting events. However, non-reactive, objective and accurate measurement of everyday cigarette consumption in the wild remains a challenge. This study utilizes a wearable sensor system (Personal Automatic Cigarette Tracker 2.0, PACT2.0) and proposes a method that integrates information from an instrumented lighter and a 6-axis Inertial Measurement Unit (IMU) on the wrist for accurate detection of smoking events. The PACT2.0 was utilized in a study of 35 moderate to heavy smokers in both controlled (1.5–2 h) and unconstrained free-living conditions (~24 h). The collected dataset contained approximately 871 h of IMU data, 463 lighting events, and 443 cigarettes. The proposed method identified smoking events from the cigarette lighter data and estimated puff counts by detecting hand-to-mouth gestures (HMG) in the IMU data by a Support Vector Machine (SVM) classifier. The leave-one-subject-out (LOSO) cross-validation on the data from the controlled portion of the study achieved high accuracy and F1-score of smoking event detection and estimation of puff counts (97%/98% and 93%/86%, respectively). The results of validation in free-living demonstrate 84.9% agreement with self-reported cigarettes. These results suggest that an IMU and instrumented lighter may potentially be used in studies of smoking behavior under natural conditions.

Spline Function Simulation Data Generation for Walking Motion Using Foot-Mounted Inertial Sensors

This paper investigates the generation of simulation data for motion estimation using inertial sensors. The smoothing algorithm with waypoint-based map matching is proposed using foot-mounted inertial sensors to estimate position and attitude. The simulation data are generated using spline functions, where the estimated position and attitude are used as control points. The attitude is represented using B-spline quaternion and the position is represented by eighth-order algebraic splines. The simulation data can be generated using inertial sensors (accelerometer and gyroscope) without using any additional sensors. Through indoor experiments, two scenarios were examined include 2D walking path (rectangular) and 3D walking path (corridor and stairs) for simulation data generation. The proposed simulation data is used to evaluate the estimation performance with different parameters such as different noise levels and sampling periods.

Combining ecological momentary assessment with objective, ambulatory measures of behavior and physiology in substance-use research

Whereas substance-use researchers have long combined self-report with objective measures of behavior and physiology inside the laboratory, developments in mobile/wearable electronic technology are increasingly allowing for the collection of both subjective and objective information in participants' daily lives. For self-report, ecological momentary assessment (EMA), as implemented on contemporary smartphones or personal digital assistants, can provide researchers with near-real-time information on participants' behavior and mood in their natural environments. Data from portable/wearable electronic sensors measuring participants' internal and external environments can be combined with EMA (e.g., by timestamps recorded on questionnaires) to provide objective information useful in determining the momentary context of behavior and mood and/or validating participants' self-reports. Here, we review three objective ambulatory monitoring techniques that have been combined with EMA, with a focus on detecting drug use and/or measuring the behavioral or physiological correlates of mental events (i.e., emotions, cognitions): (1) collection and processing of biological samples in the field to measure drug use or participants' physiological activity (e.g., hypothalamic-pituitary-adrenal axis activity); (2) global positioning system (GPS) location information to link environmental characteristics (disorder/disadvantage, retail drug outlets) to drug use and affect; (3) ambulatory electronic physiological monitoring (e.g., electrocardiography) to detect drug use and mental events, as advances in machine learning algorithms make it possible to distinguish target changes from confounds (e.g., physical activity). Finally, we consider several other mobile/wearable technologies that hold promise to be combined with EMA, as well as potential challenges faced by researchers working with multiple mobile/wearable technologies simultaneously in the field.

Recognizing cigarette smoke inhalations using hidden Markov models

Previous studies with the Personal Automatic Cigarette Tracker (PACT) wearable system have found that smoking presents a distinct temporal breathing pattern, which might be well-suited for recognition by hidden Markov models (HMMs). In this work, we explored the feasibility of using HMMs to characterize the temporal information of smoking inhalations contained in the respiratory signals such as tidal volume, airflow, and the signal from the hand-to-mouth proximity sensor. Left-to-right HMMs were built to classify smoking and non-smoking inhalations using either only the respiratory signals, or both respiratory and hand proximity signals. Using a data set of 20 subjects, a leave-one-out cross-validation was performed on each HMM. In the recognition of smoke inhalations, the highest average recall, precision and F-score perceived by the HMMs was 42.39%, 88.19% and 56.38%, respectively, providing a 7.3% improvement in recall against a previously reported Support Vector Machines.

Development of a Multisensory Wearable System for Monitoring Cigarette Smoking Behavior in Free-Living Conditions

This paper presents the development and validation of a novel multi-sensory wearable system (Personal Automatic Cigarette Tracker v2 or PACT2.0) for monitoring of cigarette smoking in free-living conditions. The contributions of the PACT2.0 system are: (1) the implementation of a complete sensor suite for monitoring of all major behavioral manifestations of cigarette smoking (lighting events, hand-to-mouth gestures, and smoke inhalations); (2) a miniaturization of the sensor hardware to enable its applicability in naturalistic settings; and (3) an introduction of new sensor modalities that may provide additional insight into smoking behavior e.g., Global Positioning System (GPS), pedometer and Electrocardiogram(ECG) or provide an easy-to-use alternative (e.g., bio-impedance respiration sensor) to traditional sensors. PACT2.0 consists of three custom-built devices: an instrumented lighter, a hand module, and a chest module. The instrumented lighter is capable of recording the time and duration of all lighting events. The hand module integrates Inertial Measurement Unit (IMU) and a Radio Frequency (RF) transmitter to track the hand-to-mouth gestures. The module also operates as a pedometer. The chest module monitors the breathing (smoke inhalation) patterns (inductive and bio-impedance respiratory sensors), cardiac activity (ECG sensor), chest movement (three-axis accelerometer), hand-to-mouth proximity (RF receiver), and captures the geo-position of the subject (GPS receiver). The accuracy of PACT2.0 sensors was evaluated in bench tests and laboratory experiments. Use of PACT2.0 for data collection in the community was validated in a 24 h study on 40 smokers. Of 943 h of recorded data, 98.6% of the data was found usable for computer analysis. The recorded information included 549 lighting events, 522/504 consumed cigarettes (from lighter data/self-registered data, respectively), 20,158/22,207 hand-to-mouth gestures (from hand IMU/proximity sensor, respectively) and 114,217/112,175 breaths (from the respiratory inductive plethysmograph (RIP)/bio-impedance sensor, respectively). The proposed system scored 8.3 ± 0.31 out of 10 on a post-study acceptability survey. The results suggest that PACT2.0 presents a reliable platform for studying of smoking behavior at the community level.

Monitoring smoking behaviour using a wearable acoustic sensor

Smoking is a cause of multiple health problems resulting in diseases which can also be fatal. It is well known that smoking has long-term impact on the health of an individual as well. While a number of studies have looked at the impact of smoking on health and its economic impacts, most of these rely on input from smokers in the form of questionnaires and surveys. Long-term monitoring of smoking habits and behaviour is thus not possible because of the lack of means to do so. This paper proposes the use of a wearable device to monitor breathing signals of subjects. It is shown that the acoustic properties of a smoking breath are different from a non-smoking breath. To encapsulate these differences, several features from a breath segment are extracted and used with a simple classifier to automatically identify smoking breaths. The proposed algorithm detected smoking and non-smoking breaths with average accuracy of 66% and 99% respectively.

Attitudes and interest in technology-based treatment and the remote monitoring of smoking among adolescents and emerging adults

INTRODUCTION

Despite the public health relevance of smoking in adolescents and emerging adults, this group remains understudied and underserved. High technology utilization among this group may be harnessed as a tool for better understanding of smoking, yet little is known regarding the acceptability of mobile health (mHealth) integration.

METHODS

Participants (ages 14-21) enrolled in a smoking cessation clinical trial provided feedback on their technology utilization, perceptions, and attitudes; and interest in remote monitoring for smoking. Characteristics that predicted greater technology acceptability for smoking treatment were also explored.

RESULTS

Participants (N=87) averaged 19 years old and were mostly male (67%). Technology utilization was high for smart phone ownership (93%), Internet use (98%), and social media use (94%). Despite this, only one-third of participants had ever searched the Internet for cessation tips or counseling (33%). Participants showed interest in mHealth-enabled treatment (48%) and felt that it could be somewhat helpful (83%). Heavier smokers had more favorable attitudes toward technology-based treatment, as did those with smartphones and unlimited data.

CONCLUSIONS

Our results demonstrate high technology utilization, favorable attitudes towards technology, and minimal concerns. Technology integration among this population should be pursued, though in a tailored fashion, to accomplish the goal of providing maximally effective, just-in-time interventions.

Mobile devices for the remote acquisition of physiological and behavioral biomarkers in psychiatric clinical research

Psychiatric disorders are linked to a variety of biological, psychological, and contextual causes and consequences. Laboratory studies have elucidated the importance of several key physiological and behavioral biomarkers in the study of psychiatric disorders, but much less is known about the role of these biomarkers in naturalistic settings. These gaps are largely driven by methodological barriers to assessing biomarker data rapidly, reliably, and frequently outside the clinic or laboratory. Mobile health (mHealth) tools offer new opportunities to study relevant biomarkers in concert with other types of data (e.g., self-reports, global positioning system data). This review provides an overview on the state of this emerging field and describes examples from the literature where mHealth tools have been used to measure a wide array of biomarkers in the context of psychiatric functioning (e.g., psychological stress, anxiety, autism, substance use). We also outline advantages and special considerations for incorporating mHealth tools for remote biomarker measurement into studies of psychiatric illness and treatment and identify several specific opportunities for expanding this promising methodology. Integrating mHealth tools into this area may dramatically improve psychiatric science and facilitate highly personalized clinical care of psychiatric disorders.