Development and Validation of the Automated Evaluation of Gastrointestinal Symptoms (AEGIS) Platform

Through a four-year grant awarded to the University of California at Los Angeles in 2009,
Dr. Brennan Spiegel served as a principal investigator (PI) for a project to develop and
initially validate a bank of items to assess gastrointestinal (GI) symptoms for the National
Institutes of Health's (NIH's) Patient Reported Outcomes Measurement Information System
(PROMIS). By the end of the grant period in July 2013, the project team had successfully
developed and initially validated eight scales measuring the most common GI symptoms.

Afterwards, Dr. Spiegel's PROMIS team joined forces with the UCLA Computing Technology
Research Laboratory (CTRL) and the University of Michigan Center for Healthcare
Communication Research to develop the Automated Evaluation of Gastrointestinal Symptoms
(AEGIS) algorithm which is delivered via My GI Health, an open-‐source Internet based
patient-provider portal (P3) designed to enhance the delivery of GI health care
(www.MyGIHealth.org). Through My GI Health and AEGIS, patients are able to complete PROMIS
GI symptom measures and provide additional information about their GI symptoms and histories
from computers, tablets or smart phones without the constraints of physical locale. This
information is condensed into a GI PROMIS scores report and initial GI history that
patients' providers can review prior to or concurrent with seeing the patient. The report,
which can be incorporated into the electronic health record (EHR), helps busy clinicians to
quickly understand the patient's complaints, document their symptoms and GI history, and
leaves more time for conversation with the patient.

Beyond focusing their interaction, My GI Health also supports both the clinician and patient
with an individualized "educational prescription" which guides the patient through a library
of multi‐media educational materials on GI symptoms, conditions, and treatments also
contained within the website. The prescription is initially created by the website based on
each patient's unique GI PROMIS "fingerprint", and can be modified by the provider based on
their interaction with the patient. The clinician and patient can also access the
PROMIS-tailored education in the exam room to jointly review pertinent materials, including
animations of normal and abnormal GI functions, further reinforcing the patients'
educational experiences around the PROMIS symptoms.

The aim of this current study is to validate the use of GI PROMIS in clinical practice by
conducting a pragmatic clinical trial (PCT) comparing delivery of GI PROMIS on a novel
e--platform vs. usual care.