Measuring symptom improvement in Nerva

Psychological symptoms are assessed using the Patient Health Questionnaire-4 (PHQ4), a validated subset of the PHQ-9 which is used to assess symptoms of depression, and the GAD-7, which is used to assess symptoms of anxiety.

These questions are asked at baseline, and again upon program completion.

Weekly throughout program

During the Nerva program, patients are asked to complete a short version of the baseline questions each week.

Patients are asked to report on overall GI symptoms at each weekly checkpoint using a visual analog scale. Patients are also asked to complete a PHQ-4 questionnaire.

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Some results

The IBS-VAS scale is a 100mm scale, and a clinically significant change on the VAS scale is a 20mm change. Looking at the aggregate patient data from the VAS question on “overall gastrointestinal symptoms,” this is what we see:

The caveat to this way of looking at the data is that it relies on selection bias, only people who complete the program have recorded their symptoms. This introduces a selection bias to this data as only users committed enough to complete the program report symptoms. More comprehensive studies on symptom improvement are underway.

Despite this, we can report that 85% of users see physical symptom improvement above a 20-point improvement on the VAS-IBS scale. This result is in line with previous studies on hypnotherapy and noteworthy in the comparison with patient outcomes with the FODMAP diet.

Improvement in gastrointestinal symptoms

Nerva users, on average, achieve a greater than 20mm improvement across four of the five observed categories on the VAS-IBS scale, including overall GI symptoms, satisfaction with stool consistency, bloating, and abdominal pain.

Improvements in psychological symptoms

Eighty-two per cent of Nerva users see an improvement on the PHQ-4 scale. This is noteworthy because it differs from other IBS management modalities, including the low FODMAP diet, which does not address psychological state as well as GI symptoms.

Conclusion

These are just some of the exciting results we have seen in the Nerva data and they do not begin to scratch the surface of the complexity of IBS management or each patient's unique experience.

These results are exciting but reaffirm how much work still needs to be done. There are peer-reviewed studies underway to dive deeper into symptom improvement data.

Additional reporting: Rafael Mello

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