{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T17:34:37Z","timestamp":1774028077038,"version":"3.50.1"},"reference-count":21,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T00:00:00Z","timestamp":1716508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AbbVie, Inc."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Nocturnal scratching substantially impairs the quality of life in individuals with skin conditions such as atopic dermatitis (AD). Current clinical measurements of scratch rely on patient-reported outcomes (PROs) on itch over the last 24 h. Such measurements lack objectivity and sensitivity. Digital health technologies (DHTs), such as wearable sensors, have been widely used to capture behaviors in clinical and real-world settings. In this work, we develop and validate a machine learning algorithm using wrist-wearing actigraphy that could objectively quantify nocturnal scratching events, therefore facilitating accurate assessment of disease progression, treatment effectiveness, and overall quality of life in AD patients. A total of seven subjects were enrolled in a study to generate data overnight in an inpatient setting. Several machine learning models were developed, and their performance was compared. Results demonstrated that the best-performing model achieved the F1 score of 0.45 on the test set, accompanied by a precision of 0.44 and a recall of 0.46. Upon satisfactory performance with an expanded subject pool, our automatic scratch detection algorithm holds the potential for objectively assessing sleep quality and disease state in AD patients. This advancement promises to inform and refine therapeutic strategies for individuals with AD.<\/jats:p>","DOI":"10.3390\/s24113364","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T05:36:06Z","timestamp":1716528966000},"page":"3364","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Quantifying Nocturnal Scratch in Atopic Dermatitis: A Machine Learning Approach Using Digital Wrist Actigraphy"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1366-8494","authenticated-orcid":false,"given":"Yunzhao","family":"Xing","sequence":"first","affiliation":[{"name":"Statistical Innovation Group, AbbVie, North Chicago, IL 60064, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bolin","family":"Song","sequence":"additional","affiliation":[{"name":"Digital Science, AbbVie, North Chicago, IL 60064, USA"},{"name":"Department of Biomedical Engineering, Emory University, Atlanta, GA 30322, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Crouthamel","sequence":"additional","affiliation":[{"name":"Digital Science, AbbVie, North Chicago, IL 60064, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaotian","family":"Chen","sequence":"additional","affiliation":[{"name":"Statistical Innovation Group, AbbVie, North Chicago, IL 60064, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9266-6592","authenticated-orcid":false,"given":"Sandra","family":"Goss","sequence":"additional","affiliation":[{"name":"Digital Science, AbbVie, North Chicago, IL 60064, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Wang","sequence":"additional","affiliation":[{"name":"Statistical Innovation Group, AbbVie, North Chicago, IL 60064, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2550-0066","authenticated-orcid":false,"given":"Jie","family":"Shen","sequence":"additional","affiliation":[{"name":"Digital Science, AbbVie, North Chicago, IL 60064, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1080\/09546634.2020.1713971","article-title":"The atopic dermatitis itch scale: Development of a new measure to assess pruritus in patients with atopic dermatitis","volume":"31","author":"Martin","year":"2020","journal-title":"J. Dermatol. Treat."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"513","DOI":"10.2340\/00015555-2560","article-title":"Nocturnal pruritus: Prevalence, characteristics, and impact on ItchyQoL in a chronic itch population","volume":"97","author":"Lavery","year":"2017","journal-title":"Acta Derm.-Venereol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s13223-018-0281-6","article-title":"Atopic Dermatitis","volume":"14","author":"Kapur","year":"2018","journal-title":"Allergy, Asthma Clin. Immunol.."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"18","DOI":"10.2340\/00015555-1002","article-title":"Are subjective accounts of itch to be relied on? The lack of relation between visual analogue itch scores and actigraphic measures of scratch","volume":"91","author":"Murray","year":"2011","journal-title":"Acta Derm.-Venereol."},{"key":"ref_5","first-page":"618","article-title":"Frequency response of polymer sensor for measuring finger scratching motion","volume":"23","author":"Okuyama","year":"2015","journal-title":"J. Jpn. Soc. Appl. Electromagn. Mech."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1111\/1346-8138.12405","article-title":"Novel acoustic evaluation system for scratching behavior in itching dermatitis: Rapid and accurate analysis for nocturnal scratching of atopic dermatitis patients","volume":"41","author":"Noro","year":"2014","journal-title":"J. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e397","DOI":"10.1542\/peds.2014-0376","article-title":"Atopic dermatitis, melatonin, and sleep disturbance","volume":"134","author":"Chang","year":"2014","journal-title":"Pediatrics"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.jaad.2007.10.010","article-title":"Disease severity, scratching, and sleep quality in patients with atopic dermatitis","volume":"58","author":"Bender","year":"2008","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1111\/j.1365-2869.2009.00814.x","article-title":"Objective measurements of sleep for non-laboratory settings as alternatives to polysomnography\u2014A systematic review: A systematic review of objective sleep measures","volume":"20","author":"Holmes","year":"2011","journal-title":"J. Sleep Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1093\/sleep\/26.3.342","article-title":"The role of actigraphy in the study of sleep and circadian rhythms","volume":"26","author":"Cole","year":"2003","journal-title":"Sleep"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1093\/sleep\/15.5.461","article-title":"Automatic sleep\/wake identification from wrist activity","volume":"15","author":"Cole","year":"1992","journal-title":"Sleep"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.jdin.2021.06.005","article-title":"Use of technology for the objective evaluation of scratching behavior: A systematic review","volume":"5","author":"Yang","year":"2021","journal-title":"JAAD Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1038\/s41746-023-00821-y","article-title":"Assessing nocturnal scratch with actigraphy in atopic dermatitis patients","volume":"6","author":"Ji","year":"2023","journal-title":"NPJ Digit. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1109\/JBHI.2017.2710798","article-title":"Detection of nocturnal scratching movements in patients with atopic dermatitis using accelerometers and recurrent neural networks","volume":"22","author":"Moreau","year":"2017","journal-title":"IEEE J. Biomed. Health Inform."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1038\/s41746-021-00402-x","article-title":"Development of digital measures for nighttime scratch and sleep using wrist-worn wearable devices","volume":"4","author":"Mahadevan","year":"2021","journal-title":"NPJ Digit. Med."},{"key":"ref_16","unstructured":"(2024, May 20). Apple Watch Series 5\u2014Technical Specifications. Available online: https:\/\/support.apple.com\/en-lamr\/118453."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.neucom.2018.03.067","article-title":"Time series feature extraction on basis of scalable hypothesis tests (tsfresh\u2013a python package)","volume":"307","author":"Christ","year":"2018","journal-title":"Neurocomputing"},{"key":"ref_18","first-page":"2825","article-title":"Scikit-learn: Machine learning in Python","volume":"12","author":"Pedregosa","year":"2011","journal-title":"J. Mach. Learn. Res."},{"key":"ref_19","unstructured":"Polo, M. (2024, May 20). ECG Classification|CNN LSTM Attention Mechanism [Internet]. Available online: https:\/\/www.kaggle.com\/code\/polomarco\/ecg-classification-cnn-lstm-attention-mechanism#Models."},{"key":"ref_20","unstructured":"Ramachandran, P., Zoph, B., and Le, Q.V. (2017). Searching for Activation Functions [Internet]. arXiv, Available online: http:\/\/arxiv.org\/abs\/1710.05941."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Lin, T.Y., Goyal, P., Girshick, R., He, K., and Doll\u00e1r, P. (2017, January 22\u201329). Focal loss for dense object detection. Proceedings of the IEEE International Conference on Computer Vision, Venice, Italy. Available online: http:\/\/openaccess.thecvf.com\/content_iccv_2017\/html\/Lin_Focal_Loss_for_ICCV_2017_paper.html.","DOI":"10.1109\/ICCV.2017.324"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/11\/3364\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:47:49Z","timestamp":1760107669000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/11\/3364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,24]]},"references-count":21,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["s24113364"],"URL":"https:\/\/doi.org\/10.3390\/s24113364","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,24]]}}}