Using the AllerSearch Smartphone App to Assess the Association Between Dry Eye and Hay Fever: mHealth-Based Cross-Sectional Study

BackgroundDry eye (DE) and hay fever (HF) show synergistic exacerbation of each other’s pathology through inflammatory pathways. ObjectiveThis study aimed to investigate the association between DE and HF comorbidity and the related risk factors. Method...

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Main Authors: Takenori Inomata, Jaemyoung Sung, Masahiro Nakamura, Masao Iwagami, Yasutsugu Akasaki, Kenta Fujio, Nobuyuki Ebihara, Takuma Ide, Masashi Nagao, Yuichi Okumura, Ken Nagino, Keiichi Fujimoto, Atsuko Eguchi, Kunihiko Hirosawa, Akie Midorikawa-Inomata, Kaori Muto, Kumiko Fujisawa, Yota Kikuchi, Shuko Nojiri, Akira Murakami
Format: Article
Language:English
Published: JMIR Publications 2023-09-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2023/1/e38481
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author Takenori Inomata
Jaemyoung Sung
Masahiro Nakamura
Masao Iwagami
Yasutsugu Akasaki
Kenta Fujio
Masahiro Nakamura
Nobuyuki Ebihara
Takuma Ide
Masashi Nagao
Yuichi Okumura
Ken Nagino
Keiichi Fujimoto
Atsuko Eguchi
Kunihiko Hirosawa
Akie Midorikawa-Inomata
Kaori Muto
Kumiko Fujisawa
Yota Kikuchi
Shuko Nojiri
Akira Murakami
author_facet Takenori Inomata
Jaemyoung Sung
Masahiro Nakamura
Masao Iwagami
Yasutsugu Akasaki
Kenta Fujio
Masahiro Nakamura
Nobuyuki Ebihara
Takuma Ide
Masashi Nagao
Yuichi Okumura
Ken Nagino
Keiichi Fujimoto
Atsuko Eguchi
Kunihiko Hirosawa
Akie Midorikawa-Inomata
Kaori Muto
Kumiko Fujisawa
Yota Kikuchi
Shuko Nojiri
Akira Murakami
author_sort Takenori Inomata
collection DOAJ
description BackgroundDry eye (DE) and hay fever (HF) show synergistic exacerbation of each other’s pathology through inflammatory pathways. ObjectiveThis study aimed to investigate the association between DE and HF comorbidity and the related risk factors. MethodsA cross-sectional observational study was conducted using crowdsourced multidimensional data from individuals who downloaded the AllerSearch smartphone app in Japan between February 2018 and May 2020. AllerSearch collected the demographics, medical history, lifestyle and residential information, HF status, DE symptoms, and HF-related quality of life. HF symptoms were evaluated using the nasal symptom score (0-15 points) and nonnasal symptom score (0-12 points). HF was defined by the participants’ responses to the questionnaire as HF, non-HF, or unknown. Symptomatic DE was defined as an Ocular Surface Disease Index total score (0-100 points), with a threshold score of 13 points. HF-related quality of life was assessed using the Japanese Allergic Conjunctival Disease Standard Quality of Life Questionnaire (0-68 points). We conducted a multivariable linear regression analysis to examine the association between the severity of DE and HF symptoms. We subsequently conducted a multivariable logistic regression analysis to identify the factors associated with symptomatic DE (vs nonsymptomatic DE) among individuals with HF. Dimension reduction via Uniform Manifold Approximation and Projection stratified the comorbid DE and HF symptoms. The symptom profiles in each cluster were identified using hierarchical heat maps. ResultsThis study included 11,284 participants, classified into experiencing HF (9041 participants), non-HF (720 participants), and unknown (1523 participants) groups. The prevalence of symptomatic DE among individuals with HF was 49.99% (4429/9041). Severe DE symptoms were significantly associated with severe HF symptoms: coefficient 1.33 (95% CI 1.10-1.57; P<.001) for mild DE, coefficient 2.16 (95% CI 1.84-2.48; P<.001) for moderate DE, and coefficient 3.80 (95% CI 3.50-4.11; P<.001) for severe DE. The risk factors for comorbid symptomatic DE among individuals with HF were identified as female sex; lower BMI; medicated hypertension; history of hematologic, collagen, heart, liver, respiratory, or atopic disease; tomato allergy; current and previous mental illness; pet ownership; living room and bedrooms furnished with materials other than hardwood, carpet, tatami, and vinyl; discontinuation of contact lens use during the HF season; current contact lens use; smoking habits; and sleep duration of <6 hours per day. Uniform Manifold Approximation and Projection stratified the heterogeneous comorbid DE and HF symptoms into 14 clusters. In the hierarchical heat map, cluster 9 was comorbid with the most severe HF and DE symptoms, and cluster 1 showed severe HF symptoms with minimal DE-related symptoms. ConclusionsThis crowdsourced study suggested a significant association between severe DE and HF symptoms. Detecting DE among individuals with HF could allow effective prevention and interventions through concurrent treatment for ocular surface management along with HF treatment.
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spelling doaj.art-0b8616da172d41729610aeff34dd4eea2023-09-12T14:16:28ZengJMIR PublicationsJournal of Medical Internet Research1438-88712023-09-0125e3848110.2196/38481Using the AllerSearch Smartphone App to Assess the Association Between Dry Eye and Hay Fever: mHealth-Based Cross-Sectional StudyTakenori Inomatahttps://orcid.org/0000-0003-3435-1055Jaemyoung Sunghttps://orcid.org/0000-0002-9441-3687Masahiro Nakamurahttps://orcid.org/0000-0002-4363-069XMasao Iwagamihttps://orcid.org/0000-0001-7079-0640Yasutsugu Akasakihttps://orcid.org/0000-0001-9527-0115Kenta Fujiohttps://orcid.org/0000-0002-8472-0800Masahiro Nakamurahttps://orcid.org/0000-0001-5710-4458Nobuyuki Ebiharahttps://orcid.org/0000-0002-6772-6549Takuma Idehttps://orcid.org/0000-0001-8204-5808Masashi Nagaohttps://orcid.org/0000-0002-8909-4650Yuichi Okumurahttps://orcid.org/0000-0002-5521-5469Ken Naginohttps://orcid.org/0000-0002-0317-6074Keiichi Fujimotohttps://orcid.org/0000-0003-0420-0782Atsuko Eguchihttps://orcid.org/0000-0002-5540-055XKunihiko Hirosawahttps://orcid.org/0000-0001-6775-3697Akie Midorikawa-Inomatahttps://orcid.org/0000-0002-6054-5710Kaori Mutohttps://orcid.org/0000-0001-5286-4706Kumiko Fujisawahttps://orcid.org/0009-0006-8335-0453Yota Kikuchihttps://orcid.org/0009-0005-0421-6532Shuko Nojirihttps://orcid.org/0000-0003-0422-8152Akira Murakamihttps://orcid.org/0000-0002-0022-2514 BackgroundDry eye (DE) and hay fever (HF) show synergistic exacerbation of each other’s pathology through inflammatory pathways. ObjectiveThis study aimed to investigate the association between DE and HF comorbidity and the related risk factors. MethodsA cross-sectional observational study was conducted using crowdsourced multidimensional data from individuals who downloaded the AllerSearch smartphone app in Japan between February 2018 and May 2020. AllerSearch collected the demographics, medical history, lifestyle and residential information, HF status, DE symptoms, and HF-related quality of life. HF symptoms were evaluated using the nasal symptom score (0-15 points) and nonnasal symptom score (0-12 points). HF was defined by the participants’ responses to the questionnaire as HF, non-HF, or unknown. Symptomatic DE was defined as an Ocular Surface Disease Index total score (0-100 points), with a threshold score of 13 points. HF-related quality of life was assessed using the Japanese Allergic Conjunctival Disease Standard Quality of Life Questionnaire (0-68 points). We conducted a multivariable linear regression analysis to examine the association between the severity of DE and HF symptoms. We subsequently conducted a multivariable logistic regression analysis to identify the factors associated with symptomatic DE (vs nonsymptomatic DE) among individuals with HF. Dimension reduction via Uniform Manifold Approximation and Projection stratified the comorbid DE and HF symptoms. The symptom profiles in each cluster were identified using hierarchical heat maps. ResultsThis study included 11,284 participants, classified into experiencing HF (9041 participants), non-HF (720 participants), and unknown (1523 participants) groups. The prevalence of symptomatic DE among individuals with HF was 49.99% (4429/9041). Severe DE symptoms were significantly associated with severe HF symptoms: coefficient 1.33 (95% CI 1.10-1.57; P<.001) for mild DE, coefficient 2.16 (95% CI 1.84-2.48; P<.001) for moderate DE, and coefficient 3.80 (95% CI 3.50-4.11; P<.001) for severe DE. The risk factors for comorbid symptomatic DE among individuals with HF were identified as female sex; lower BMI; medicated hypertension; history of hematologic, collagen, heart, liver, respiratory, or atopic disease; tomato allergy; current and previous mental illness; pet ownership; living room and bedrooms furnished with materials other than hardwood, carpet, tatami, and vinyl; discontinuation of contact lens use during the HF season; current contact lens use; smoking habits; and sleep duration of <6 hours per day. Uniform Manifold Approximation and Projection stratified the heterogeneous comorbid DE and HF symptoms into 14 clusters. In the hierarchical heat map, cluster 9 was comorbid with the most severe HF and DE symptoms, and cluster 1 showed severe HF symptoms with minimal DE-related symptoms. ConclusionsThis crowdsourced study suggested a significant association between severe DE and HF symptoms. Detecting DE among individuals with HF could allow effective prevention and interventions through concurrent treatment for ocular surface management along with HF treatment.https://www.jmir.org/2023/1/e38481
spellingShingle Takenori Inomata
Jaemyoung Sung
Masahiro Nakamura
Masao Iwagami
Yasutsugu Akasaki
Kenta Fujio
Masahiro Nakamura
Nobuyuki Ebihara
Takuma Ide
Masashi Nagao
Yuichi Okumura
Ken Nagino
Keiichi Fujimoto
Atsuko Eguchi
Kunihiko Hirosawa
Akie Midorikawa-Inomata
Kaori Muto
Kumiko Fujisawa
Yota Kikuchi
Shuko Nojiri
Akira Murakami
Using the AllerSearch Smartphone App to Assess the Association Between Dry Eye and Hay Fever: mHealth-Based Cross-Sectional Study
Journal of Medical Internet Research
title Using the AllerSearch Smartphone App to Assess the Association Between Dry Eye and Hay Fever: mHealth-Based Cross-Sectional Study
title_full Using the AllerSearch Smartphone App to Assess the Association Between Dry Eye and Hay Fever: mHealth-Based Cross-Sectional Study
title_fullStr Using the AllerSearch Smartphone App to Assess the Association Between Dry Eye and Hay Fever: mHealth-Based Cross-Sectional Study
title_full_unstemmed Using the AllerSearch Smartphone App to Assess the Association Between Dry Eye and Hay Fever: mHealth-Based Cross-Sectional Study
title_short Using the AllerSearch Smartphone App to Assess the Association Between Dry Eye and Hay Fever: mHealth-Based Cross-Sectional Study
title_sort using the allersearch smartphone app to assess the association between dry eye and hay fever mhealth based cross sectional study
url https://www.jmir.org/2023/1/e38481
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