{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T18:17:04Z","timestamp":1771957024404,"version":"3.50.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T00:00:00Z","timestamp":1682467200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T00:00:00Z","timestamp":1682467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["npj Digit. Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Nocturnal scratch is one major factor leading to impaired quality of life in atopic dermatitis (AD) patients. Therefore, objectively quantifying nocturnal scratch events aids in assessing the disease state, treatment effect, and AD patients\u2019 quality of life. In this paper, we describe the use of actigraphy, highly predictive topological features, and a model-ensembling approach to develop an assessment of nocturnal scratch events by measuring scratch duration and intensity. Our assessment is tested in a clinical setting against the ground truth obtained from video recordings. The new approach addresses unmet challenges in existing studies, such as the lack of generalizability to real-world applications, the failure to capture finger scratches, and the limitations in the evaluation due to imbalanced data in the current literature. Furthermore, the performance evaluation shows agreement between derived digital endpoints and the video annotation ground truth, as well as patient-reported outcomes, which demonstrated the validity of the new assessment of nocturnal scratch.<\/jats:p>","DOI":"10.1038\/s41746-023-00821-y","type":"journal-article","created":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T09:02:33Z","timestamp":1682499753000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Assessing nocturnal scratch with actigraphy in atopic dermatitis patients"],"prefix":"10.1038","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7281-1636","authenticated-orcid":false,"given":"Ju","family":"Ji","sequence":"first","affiliation":[]},{"given":"Jordan","family":"Venderley","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3037-3604","authenticated-orcid":false,"given":"Hui","family":"Zhang","sequence":"additional","affiliation":[]},{"given":"Mengjue","family":"Lei","sequence":"additional","affiliation":[]},{"given":"Guangchen","family":"Ruan","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0101-2321","authenticated-orcid":false,"given":"Neel","family":"Patel","sequence":"additional","affiliation":[]},{"given":"Yu-Min","family":"Chung","sequence":"additional","affiliation":[]},{"given":"Regan","family":"Giesting","sequence":"additional","affiliation":[]},{"given":"Leah","family":"Miller","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2023,4,26]]},"reference":[{"key":"821_CR1","doi-asserted-by":"publisher","first-page":"513","DOI":"10.2340\/00015555-2560","volume":"97","author":"MJ Lavery","year":"2017","unstructured":"Lavery, M. J. et al. Nocturnal pruritus: prevalence, characteristics, and impact on itchyqol in a chronic itch population. Acta Derm. Venereol. 97, 513\u2013515 (2017).","journal-title":"Acta Derm. Venereol."},{"key":"821_CR2","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1080\/09546634.2020.1713971","volume":"31","author":"SA Martin","year":"2020","unstructured":"Martin, S. A. et al. The atopic dermatitis itch scale: development of a new measure to assess pruritus in patients with atopic dermatitis. J. Dermatol. Treat. 31, 484\u2013490 (2020).","journal-title":"J. Dermatol. Treat."},{"key":"821_CR3","doi-asserted-by":"publisher","first-page":"425","DOI":"10.3390\/ijms17030425","volume":"17","author":"MJ Lavery","year":"2016","unstructured":"Lavery, M. J., Stull, C., Kinney, M. O. & Yosipovitch, G. Nocturnal pruritus: the battle for a peaceful night\u2019s sleep. Int. J. Mol. Sci. 17, 425 (2016).","journal-title":"Int. J. Mol. Sci."},{"key":"821_CR4","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1016\/j.ijwd.2021.02.010","volume":"7","author":"I Podder","year":"2021","unstructured":"Podder, I., Mondal, H. & Kroumpouzos, G. Nocturnal pruritus and sleep disturbance associated with dermatologic disorders in adult patients. Int. J. Womens Dermatol. 7, 403\u2013410 (2021).","journal-title":"Int. J. Womens Dermatol."},{"key":"821_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1109\/TSMCC.2009.2032660","volume":"40","author":"A Pantelopoulos","year":"2009","unstructured":"Pantelopoulos, A. & Bourbakis, N. G. A survey on wearable sensor-based systems for health monitoring and prognosis. IEEE Trans. Syst. Man Cybern. C Appl. Rev. 40, 1\u201312 (2009).","journal-title":"IEEE Trans. Syst. Man Cybern. C Appl. Rev."},{"key":"821_CR6","doi-asserted-by":"publisher","first-page":"17472","DOI":"10.3390\/s131217472","volume":"13","author":"H Banaee","year":"2013","unstructured":"Banaee, H., Ahmed, M. U. & Loutfi, A. Data mining for wearable sensors in health monitoring systems: a review of recent trends and challenges. Sensors 13, 17472\u201317500 (2013).","journal-title":"Sensors"},{"key":"821_CR7","doi-asserted-by":"publisher","first-page":"130","DOI":"10.3390\/s17010130","volume":"17","author":"S Majumder","year":"2017","unstructured":"Majumder, S., Mondal, T. & Deen, M. J. Wearable sensors for remote health monitoring. Sensors 17, 130 (2017).","journal-title":"Sensors"},{"key":"821_CR8","doi-asserted-by":"publisher","first-page":"3119","DOI":"10.1109\/JSEN.2014.2357257","volume":"15","author":"MM Rodgers","year":"2014","unstructured":"Rodgers, M. M., Pai, V. M. & Conroy, R. S. Recent advances in wearable sensors for health monitoring. IEEE Sens. J. 15, 3119\u20133126 (2014).","journal-title":"IEEE Sens. J."},{"key":"821_CR9","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.jdin.2021.06.005","volume":"5","author":"AF Yang","year":"2021","unstructured":"Yang, A. F. et al. Use of technology for the objective evaluation of scratching behavior: a systematic review. JAAD Int. 5, 19\u201332 (2021).","journal-title":"JAAD Int."},{"key":"821_CR10","doi-asserted-by":"crossref","unstructured":"Feuerstein, J., Austin, D., Sack, R. & Hayes, T. L. Wrist actigraphy for scratch detection in the presence of confounding activities. In 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 3652\u20133655 (IEEE, 2011).","DOI":"10.1109\/IEMBS.2011.6090615"},{"key":"821_CR11","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1109\/TITB.2012.2204761","volume":"17","author":"J Petersen","year":"2013","unstructured":"Petersen, J., Austin, D., Sack, R. & Hayes, T. L. Actigraphy-based scratch detection using logistic regression. IEEE J. Biomed. Health Inform. 17, 277\u2013283 (2013).","journal-title":"IEEE J. Biomed. Health Inform."},{"key":"821_CR12","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1109\/JBHI.2017.2710798","volume":"22","author":"A Moreau","year":"2017","unstructured":"Moreau, A. et al. Detection of nocturnal scratching movements in patients with atopic dermatitis using accelerometers and recurrent neural networks. IEEE J. Biomed. Health Inform. 22, 1011\u20131018 (2017).","journal-title":"IEEE J. Biomed. Health Inform."},{"key":"821_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41746-021-00402-x","volume":"4","author":"N Mahadevan","year":"2021","unstructured":"Mahadevan, N. et al. Development of digital measures for nighttime scratch and sleep using wrist-worn wearable devices. NPJ Digit. Med. 4, 1\u201310 (2021).","journal-title":"NPJ Digit. Med."},{"key":"821_CR14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-018-31266-z","volume":"8","author":"VT van Hees","year":"2018","unstructured":"van Hees, V. T. et al. Estimating sleep parameters using an accelerometer without sleep diary. Sci. Rep. 8, 1\u201311 (2018).","journal-title":"Sci. Rep."},{"key":"821_CR15","doi-asserted-by":"crossref","unstructured":"Lefebvre, G., Berlemont, S., Mamalet, F. & Garcia, C. Inertial gesture recognition with blstm-rnn. In Artificial Neural Networks, 393\u2013410 (Springer, 2015).","DOI":"10.1007\/978-3-319-09903-3_19"},{"key":"821_CR16","doi-asserted-by":"crossref","unstructured":"Lee, J. et al. Itchtector: a wearable-based mobile system for managing itching conditions. In Proceedings of the 2017 CHI Conference on Human Factors in Computing Systems, 893\u2013905 (2017).","DOI":"10.1145\/3025453.3025569"},{"key":"821_CR17","doi-asserted-by":"publisher","first-page":"2345","DOI":"10.1007\/s00006-017-0793-z","volume":"27","author":"M Boyle","year":"2017","unstructured":"Boyle, M. The integration of angular velocity. Adv. Appl. Clifford Algebras 27, 2345\u20132374 (2017).","journal-title":"Adv. Appl. Clifford Algebras"},{"key":"821_CR18","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1090\/S0273-0979-09-01249-X","volume":"46","author":"G Carlsson","year":"2009","unstructured":"Carlsson, G. Topology and data. Bull. Am. Math. Soc. 46, 255\u2013308 (2009).","journal-title":"Bull. Am. Math. Soc."},{"key":"821_CR19","doi-asserted-by":"publisher","first-page":"667963","DOI":"10.3389\/frai.2021.667963","volume":"4","author":"F Chazal","year":"2021","unstructured":"Chazal, F. & Michel, B. An introduction to topological data analysis: fundamental and practical aspects for data scientists. Front. Artif. Intell. 4, 667963 (2021).","journal-title":"Front. Artif. Intell."},{"key":"821_CR20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1090\/psapm\/070\/587","volume":"70","author":"A Zomorodian","year":"2012","unstructured":"Zomorodian, A. Topological data analysis. Adv. Appl. Comput. Topol. 70, 1\u201339 (2012).","journal-title":"Adv. Appl. Comput. Topol."},{"key":"821_CR21","doi-asserted-by":"crossref","unstructured":"Carlsson, G. & Vejdemo-Johansson, M. Topological Data Analysis with Applications (Cambridge University Press, 2021).","DOI":"10.1017\/9781108975704"},{"key":"821_CR22","doi-asserted-by":"publisher","first-page":"202","DOI":"10.3389\/fphys.2021.637684","volume":"12","author":"Y-M Chung","year":"2021","unstructured":"Chung, Y.-M., Hu, C.-S., Lo, Y.-L. & Wu, H.-T. A persistent homology approach to heart rate variability analysis with an application to sleep-wake classification. Front. Physiol. 12, 202 (2021).","journal-title":"Front. Physiol."},{"key":"821_CR23","doi-asserted-by":"publisher","first-page":"115326","DOI":"10.1016\/j.eswa.2021.115326","volume":"183","author":"A Karan","year":"2021","unstructured":"Karan, A. & Kaygun, A. Time series classification via topological data analysis. Expert Syst. Appl. 183, 115326 (2021).","journal-title":"Expert Syst. Appl."},{"key":"821_CR24","doi-asserted-by":"crossref","unstructured":"Lawson, A., Chung, Y.-M. & Cruse, W. A hybrid metric based on persistent homology and its application to signal classification. In 2020 25th International Conference on Pattern Recognition (ICPR), 9944\u20139950 (IEEE, 2021).","DOI":"10.1109\/ICPR48806.2021.9412768"},{"key":"821_CR25","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1007\/s10208-014-9206-z","volume":"15","author":"JA Perea","year":"2015","unstructured":"Perea, J. A. & Harer, J. Sliding windows and persistence: an application of topological methods to signal analysis. Found. Comput. Math. 15, 799\u2013838 (2015).","journal-title":"Found. Comput. Math."},{"key":"821_CR26","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1152\/japplphysiol.00421.2014","volume":"117","author":"VT Van Hees","year":"2014","unstructured":"Van Hees, V. T. et al. Autocalibration of accelerometer data for free-living physical activity assessment using local gravity and temperature: an evaluation on four continents. J. Appl. Physiol. 117, 738\u2013744 (2014).","journal-title":"J. Appl. Physiol."},{"key":"821_CR27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1140\/epjds\/s13688-017-0104-x","volume":"6","author":"A Patania","year":"2017","unstructured":"Patania, A., Vaccarino, F. & Petri, G. Topological analysis of data. EPJ Data Sci. 6, 1\u20136 (2017).","journal-title":"EPJ Data Sci."},{"key":"821_CR28","doi-asserted-by":"crossref","unstructured":"Chung, Y.-M., Nikooienejad, A. & Zhang, B. Automatic eating behavior detection from wrist motion sensor using Bayesian, gradient boosting, and topological persistence methods. In IEEE Big Data 2022 (IEEE, 2022).","DOI":"10.1109\/BigData55660.2022.10021031"},{"key":"821_CR29","unstructured":"Chung, Y.-M., Hull, M., Lawson, A. & Pritchard, N. Gaussian persistence curves. Preprint at arXiv:2205.11353 (2022)."},{"key":"821_CR30","unstructured":"The GUDHI Project. GUDHI User and Reference Manual, 3.4.1 edn (GUDHI Editorial Board). https:\/\/gudhi.inria.fr\/doc\/3.4.1\/ (2021)."}],"container-title":["npj Digital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41746-023-00821-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-023-00821-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-023-00821-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T09:04:16Z","timestamp":1682499856000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41746-023-00821-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,26]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["821"],"URL":"https:\/\/doi.org\/10.1038\/s41746-023-00821-y","relation":{},"ISSN":["2398-6352"],"issn-type":[{"value":"2398-6352","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,26]]},"assertion":[{"value":"9 December 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 April 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 April 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"72"}}