AI-Enabled, Wearable Sensor Useful for Reducing Scratching in Atopic Dermatitis

A wearable artificial intelligence-enabled haptic feedback sensor may be helpful as a non-pharmacological intervention for patients to reduce their nocturnal scratching due to mild atopic dermatitis, new findings suggest.1

These data represent the conclusion of new research by a team of investigators led by Albert F. Yang, MD, from the department of dermatology at the University of Michigan, Ann Arbor. Yang and colleagues noted that prior research had been published regarding the utilization of haptic feedback for temporary sleep disturbance due to post-traumatic stress-related nightmares.2

“With integration of a haptic motor, this closed-loop wearable was tested in patients with mild [atopic dermatitis] who reported moderate or severe scratching to evaluate its ability to reduce nocturnal scratching,” Yang et al. wrote.1

Haptic Feedback Sensor Analysis and Findings

Prior research explored the development of a scratch detection algorithm and the integration of a haptic motor into a wearable device, in addition to the selection of an optimal vibratory feedback profile. In this analysis, the investigative team evaluated the efficacy of real-time scratch detection and haptic feedback under a set of controlled conditions.

A total of 10 healthy adult participants were evaluated by the researchers. Each individual involved in the study was provided with a sensor that they placed on the dorsal side of their hand. They were asked by the team to scratch 5 common atopic dermatitis regions, including the cheek, dorsal hand, inner elbow, neck, and posterior knee, for a total of 5 seconds.

This action was then done 10 times with 5-second intervals of rest, followed by 5 non-scratching activities such as texting and waving. Following each of these actions, the trial participants were asked whether they perceived a haptic response.

After this initial validation phase of the analysis, the research team involved 10 adults diagnosed with atopic dermatitis in a 2-week study, with participants being required to be aged 18 years at least, to have noted moderate to severe scratching behavior on a 3-point survey, and to have no irritation on their hands’ dorsal sides.

Through the use of the Validated Investigator Global Assessment for Atopic Dermatitis (vIGA), the investigators determined the subjects’ atopic dermatitis severity level at the point of baseline. They attached the wearable sensor to participants’ dominant dorsal hands and, within the initial week, disabled the haptic feedback feature to determine baseline measurements of nocturnal scratching.

Such data as the number of scratch events, participants’ total and hourly duration of scratching, and the duration of each scratch event were all evaluated by the team once the haptic feedback function was enabled in the next week. A retrospective analysis examined changes in scratching behaviors and the research team implemented paired t-tests to assess statistical differences between the 2 phases.

There were 6 female subjects in the 10 included in the investigators’ final analysis, with a mean age of 36 years. A vIGA score ranging from 0 - 2 (suggesting clear to mild atopic dermatitis) was observed among all of the participants.

No participants were lost in the study to follow-up. Following the research team’s analysis, it was revealed that there was a significant reduction in nightly scratch events among these subjects. The team highlighted that the mean of such events dipped from 45.6 (24.0) to 32.8 (13.0) (P = .03), indicating a 28% scratching event reduction.

Additionally, the investigative team found that the mean scratch duration per hour of sleep opportunity had been significantly lower after haptic feedback was enabled, with a notable dip from 15.8 (10.7) seconds to 7.9 (3.7) seconds (P = .01). This represented a 50% reduction.

Importantly, such reductions were shown to have taken place without any observed decrease in participants' total sleep opportunity. This was suggested by the research team to have shown that the haptic feedback effectively reduced their scratching behavior without disrupting sleep.

“This study describes the application of a wearable sensor with the ability to notify users of scratching behavior via biofeedback,” they wrote. “This technology may serve as a standalone or, more likely, a supportive therapeutic device for decreasing scratching behavior in patients with mild [atopic dermatitis] who may not meet the criteria for systemic therapy or prefer to not use topical corticosteroids yet still report a high degree of scratching.”1

References

1. Yang A, Patel S, Xu S, et al. Artificial Intelligence–Enabled Wearable Devices and Nocturnal Scratching in Mild Atopic Dermatitis. JAMA Dermatol. doi:10.1001/jamadermatol.2024.5697. Published online February 5, 2025.
2. Davenport ND, Werner JK. A randomized sham-controlled clinical trial of a novel wearable intervention for trauma-related nightmares in military veterans. J Clin Sleep Med. 2023;19(2): 361-369. doi:10.5664/jcsm.10338.