My Arthritis is an app developed by Ampersand drawing on the expertise of patients and clinicians from King’s College Hospital. It helps people manage their Arthritis day-to-day, bringing together a personal health record, daily tracking and easy-to-access help and support from NRAS. Hospitals that sign up can use the app to manage their patients remotely, improving care quality and reducing unnecessary hospital visits.

Inflammatory autoimmune conditions – including Rheumatoid Arthritis, Crohn’s Disease and Ulcerative Colitis – are characterised by periods of relapse and remission or low disease and impact people of any age, including the young. In addition to the physical symptoms of pain, fatigue, swollen joints, anxiety, depression and other factors impact emotional wellbeing and can severely affect quality of life. At times of relapse, when help with flare-management is needed, rapid access to specialist advice can lead to better outcomes (and reduce hospital admission costs).  Many people with RA experience anxiety and depression as this disease impacts on quality of life in a major way. People need access to tools and resources which can help them manage their disease better. People who are able to self-manage better reduce the burden and cost to the healthcare system.

Nader Alaghband, Founder of Ampersand Health said, “we know that the patient’s journey is often long and lonely and a model of care based on infrequent outpatient appointments (which rarely coincide with a clinical need) can be significantly improved, through better communication and increased patient engagement. We’re delighted to be working with NRAS to support patients with RA on that journey.”

“There is a growing body of evidence that self-management works for patients with Rheumatoid Arthritis”, said James Galloway, consultant rheumatologist at Kings College Hospital. “Equally, the burden that long term conditions such as RA place on the NHS is unsustainable and the time is right to develop and advocate for new, digitally-enabled models of care that could drive savings and quality improvement.”

Clare Jacklin, CEO of NRAS said, “RA can impact on every aspect of an individual’s life so being more engaged in one’s own care and treatment and learning good self-management techniques is essential for improving quality of life. We believe that apps such as ‘My Arthritis’ will provide timely access to quality information on managing flares, thus improving adherence to treatment. Improving the health of the RA population in this way will also result in more efficient use of stretched NHS services. NRAS is pleased to be working with Ampersand on the development of such an innovation for today’s contemporary RA patients”

The app – which is free for patients – is currently being used by many people living with RA and several hospitals are either using or about to start using the platform to manage their patients remotely when appropriate.

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The rapid, non-invasive technique could help clinicians diagnose the disease earlier, and assess how effectively the selected treatment is controlling the progression of the disease.

Rheumatoid arthritis (RA) is an autoimmune disease, in which the body’s immune system attacks the lining of joints, causing painful inflammation and swelling. It affects around 500,000 people in the UK and current diagnosis relies on a combination of physical examinations by a consultant rheumatologist, blood tests, and scanning by x-ray or ultrasound. Analysing these can be time-consuming, but also subjective, requiring highly-trained staff.

The new technique, developed by a team in the University of Birmingham’s School of Computer Science in partnership with Health Technologies Institute and Rheumatologists in the NIHR Birmingham Biomedical Research Centre, combines 3D digital imaging with infrared spectroscopy to create a 3D image of blood content inside a patients’ hand that can be used to produce an objective, quantifiable assessment.

The patient places a hand inside the scanner, which first creates a 3D model of the hand, measuring its size and contours. In the next step, an infrared beam is directed through each finger in turn and the amount of light coming out through the finger is measured. Because oxygenated and deoxygenated blood absorb light differently, it’s possible to use the infrared imaging to calculate warning signs of RA such as hypoxia – lowered levels of blood oxygen – and increased levels of blood content, an indication of inflammation.

“We know that diagnosing patients with RA early is really important, because early treatment leads to better long-term outcomes,” explains Professor Hamid Dehghani, who led the study. “The system we have developed offers a low-cost, objective way of detecting the disease and potentially grading how advanced it is. We hope, in time it will enable clinicians to diagnose the disease earlier and offer personalised treatment plans for patients.”

In a pilot study, the team examined 144 joints from 21 rheumatology patients and were able to detect accurately inflamed joints, with results closely matching diagnoses made using ultrasound and clinical examination. The results are published in the Journal of Biomedical Optics.

The research was funded by the Engineering and Physical Sciences Research Council, through SciPhy4Health CDT and is part of the Research into Inflammatory Arthritis Centre Versus Arthritis (RACE). The next step for the team is to investigate ways to miniaturise the scanner and further improve its accuracy.

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