Can biometric data collected from people self-measuring at home be used to predict urgent care?

Primary outcome measures are collected once daily for 12 weeks (unless otherwise stated) by participants self-measuring using devices selected for them by a qualified doctor using professional judgment following review of the participant's primary care record. Participants are asked to self-monitor daily but adherence to the requested frequency of measurements will vary between participants. These primary measures are:
1. Blood pressure – reported as systolic pressure in mmHg, diastolic pressure in mmHg, pulse in beats per minute, and measured using a CE-certified commercially available blood pressure monitor, data transcribed into the Reassure app running on iOS or Android smartphone or tablet and transferred via the internet to the L2S2 database.
2. Temperature – reported as degrees Centigrade and measured using a CE-certified commercially available forehead thermometer, data transcribed into the Reassure app running on iOS or Android smartphone or tablet and transferred via the internet to the L2S2 database.
3. Blood oxygen saturation – reported as a percentage of the maximum concentration of oxygen in blood and pulse in beats per minute and measured using a CE-certified commercially available pulse oximeter, data transcribed into the Reassure app running on iOS or Android smartphone or tablet and transferred via the internet to the L2S2 database.
4. Respiration rate – reported as breaths per minute and measured using the Reassure app (CE-certified medical device) and transferred via the internet to the L2S2 database
5. Urine protein – measured using Siemens Uristix, reported as negative, trace, 0.3, 1, 3, or ≥20 g of protein/litre urine. Reported by participant by assessing colour change visually and entering result into the Reassure app running on iOS or Android smartphone or tablet. The result is transferred via the internet to the L2S2 database
6. Urine ketones - measured using Siemens Ketostix, reported as negative, trace, 0.05, 0.15, 0.4, 0.8, or 1.6 g ketone/litre urine. Reported by the participant by assessing colour change visually and entering result into the Reassure app running on an iOS or Android smartphone or tablet. The result is transferred via the internet to the L2S2 database
7. Weight – measured in kg using participant’s own scales, entered by the participant into the Reassure app running on an iOS or Android smartphone or tablet and transferred via the internet to the L2S2 database. Only those participants who already self-monitor for weight under the instruction of their GP will be asked to report this parameter. Measurement frequency will be that requested by the GP (generally several times per week) and data will be collected for 12 weeks.
8. ECG - measured using CE-certified commercially available electrocardiogram, reported as normal or arrhythmia, data transcribed into the Reassure app running on an iOS or Android smartphone or tablet and transferred via the internet to the L2S2 database.
9. Peak flow – reported as litres per minute breathed out and measured using a CE-certified commercially available peak flow meter, data transcribed into the Reassure app running on an iOS or Android smartphone or tablet and transferred via the internet to the L2S2 database.
10. Participant self-assessment of state – reported through answering the question, “How are you feeling today” and assessed by the participant selecting one of five faces showing very sad/miserable, unhappy, neither happy nor sad, fairly happy, very happy in the Reassure app running on an iOS or Android smartphone or tablet and transferred via the internet to the L2S2 database
11. Blood glucose – reported as mmol/l and measured using a CE-certified commercially available glucometer, data transcribed into the Reassure App running on an iOS or Android smartphone or tablet and transferred via the internet to the L2S2 database. Only those participants who already self-monitor for blood glucose under the instruction of their GP will be asked to report this parameter. Measurement frequency will be that requested by the GP (generally several times per week) and data will be collected for 12 weeks.
12. Participant complication group – participants are categorised by primary and any secondary complication group they fall into. The complication groups are:
12.1. Circulation/blood
12.2. Respiratory
12.3. Gastrointestinal
12.4. Endocrine / Rheumatology
12.5. Renal/urology
12.6. Neurology
12.7. Psychiatry/psychology
12.8. Developmental
12.9. Sensory/age-related
12.10. Social/drug/ alcohol
This outcome measure is researched by inspection of the participant primary care record. This record is obtained with participant consent from their General Practice. This outcome measure is ascertained once before self-monitoring commences. If a participant falls into multiple Complication Groups then they will be categorized by the Complication Group into which their most serious condition falls.

1. Dropout percentage defined as the ratio of the number of days on which readings were taken by participants divided by the number of days the person participates in the study (84 being 12 weeks). This measure is determined after 12 weeks of self-measurement by the participant.
2. Frailty score is as extracted from the participant’s medical record as the NHS electronic Frailty Index. The NHS Frailty Index is a risk stratification tool and frailty is confirmed using a validated tool such as the Gait Speed Test, PRISMA-7 or Timed Up and Go test. This measure is determined after 12 weeks of self-measurement by the participant.
3. Technical support calls, reported as the number of technical support calls made by trained Research Assistants to participants categorised by primary Complication Group. Technical support calls will be logged as they are made in the Reassure participant management system. Technical support calls will be categorised as:
3.1. Training the participant in the use of devices
3.2. Provision of additional training in the use of devices
3.3. Troubleshooting issues in the use of devices
This measure is determined after 12 weeks of self-measurement by the participant.
4. Identification of participants feelings about being involved in the trial, including feedback on different aspects of the study. Aspects will include:
4.1. Participant Information Leaflet
4.2. Recruitment procedure
4.3. Equipment set up procedure
4.4. Use of devices
4.5. Provision of technical support by Research Assistant
Feedback will be obtained by interviewing participants using qualitative and categorical questions to ascertain and categorise their feedback on the above aspects. This measure is determined after 12 weeks of self-measurement by the participant.
5. Identification of participants’ perception of positive or negative effects resulting from participation in the study. Participants will be asked to provide feedback through structured interviews on their perception of the positive and negative effects of participation. This will be determined twice, once at around week 8 and once after 12 weeks of self-measurement. Categorical feedback will be requested to assess whether participants perceive benefit or disbenefit in the following attributes:
5.1. Anxiety about health
5.2. Behavioural changes to healthiness of lifestyle
Categories will be:
5.3. Large benefit
5.4. Small benefit
5.5. No change
5.6. Small disbenefit
5.7. Large disbenefit
Qualitative questioning will also be used to collect data on other attributes where participants perceive either benefit or disbenefit. These will be reported as a list and the number of times each one is reported. Qualitative questioning will also be used to collect other anecdotal observations from participants. These will be reported as a list and the number of times each one is reported.