How the weather affects the pain of
citizen scientists using a smartphone
app
William G Dixon; Anna L. Beukenhorst; Belay Birlie Yimer et al.
2019
Structured summary
Snapshot
A study analyzing daily data from 2658 patients over 15 months
found significant yet modest relationships between pain and relative
humidity, pressure, and wind speed, highlighting the potential of
citizen-science experiments to collect large datasets on real-world
populations to address long-standing health questions.
Key findings
The study found significant associations between pain and relative humidity, pressure,
and wind speed, with relative humidity having the strongest association with pain.
The study found significant relationships between relative humidity, pressure, wind
speed, and pain, with correlations remaining even when accounting for mood and
physical activity.
The study estimates the odds ratio for a pain event in response to changes in weather
variables, including temperature, wind speed, relative humidity, and pressure.
The odds of a pain event was 12% higher per one standard deviation increase in relative
humidity (9 percentage points) (OR 1.119 (1.084–1.154), compared to 4% lower for
pressure (OR 0.958 (0.930–0.989) and 4% higher for wind speed (OR 1.041 (1.010–
1.073) (11 mbar and 2 m s−1, respectively)
The analysis has demonstrated significant relationships between relative humidity,
pressure, wind speed and pain, with correlations remaining even when accounting for
mood and physical activity
Objectives
The study aimed to investigate the relationship between weather and pain, overcoming
limitations of prior weather–pain studies such as small populations, short follow-up, and
assumptions about participant location and weather exposure.
Methods
The study used a smartphone app to collect daily data from participants, including pain
symptoms, mood, physical activity, and weather data from nearby weather stations. The
data was analyzed using a case-crossover design, comparing the weather on pain-event
days to weather on control days within a risk set of a calendar month.
The study used a case-crossover design, where participants served as their own control,
eliminating confounding by time-invariant factors. Participants were asked to collect daily
symptoms for six months, and weather data were obtained by linking hourly smartphone
GPS data to the nearest UK Met Office weather stations.
The study uses a conditional logistic regression model to estimate the odds ratio for a pain
event in response to changes in weather variables. The model includes the preceding day’s
pain score, mood, physical activity, and time spent outside as covariates.
Results
The study found significant associations between pain and relative humidity, pressure, and
wind speed, with relative humidity having the strongest association with pain. The odds of a
pain event were higher than other variables.
The study retained 65% of participants for the first seven days and 44% for the first month,
with over 2600 participants contributing to the analysis. The results showed significant
relationships between weather variables and pain, with correlations remaining even when
accounting for mood and physical activity.
The results of the study are presented as odds ratios for a pain event in response to changes
in weather variables.
Conclusions
The study validated the perception of those who believe that their pain is associated with
the weather, and understanding the relationship between weather and pain could allow
pain forecasts and better understanding of pain mechanisms.
The study provides insights into the relationship between weather variables and pain
events in patients with chronic pain.
Analysis
Limitations
The study had several limitations, including potential biases due to participant selection,
information bias, and subjective pain reporting. Additionally, the study's findings may not
be generalizable to different climates, and the analysis assumed that all participants had the
same weather–pain relationship.
The study has limitations, including the potential for bias and confounding variables.
Future work
Future studies could explore the relationship between weather and pain in different
climates, and investigate the mechanisms underlying the weather–pain relationship.
Future studies can build on the findings of this study to further examine the relationship
between weather variables and pain events in patients with chronic pain.
Practical applications
The study's findings could be used to develop pain forecasts, allowing patients to plan
activities and take greater control of their lives.
The study has practical applications for the management of chronic pain, including the
potential for weather-based forecasting of pain events.
Statistics and tests
questionnaire
After downloading the study app, participants completed an electronic consent form and a
baseline questionnaire including demographic information (sex, year of birth, first half of
postcode), anatomical site(s) of pain, underlying pain condition(s), baseline medication use,
and beliefs about the extent to which weather influenced their pain on a scale of 0–10,
including which weather condition(s) were thought to be most associated with pain
case-crossover design
The data were analysed using a case-crossover design where, for each participant, exposure
during days with a pain event (“hazard periods”) were compared to “control periods”
without a pain event in the same month.23
questionnaire
The blue line represents the cumulative number of participants with a completed baseline
questionnaire and at least one pain score submitted
odds ratios
Of the four weather variables, relative humidity had the strongest association with pain, and
temperature the least, evidenced by the estimated relative importance of the variables and
their standardized odds ratios (Table 1, Supplementary Table 4)
Markov model
A first-order hidden Markov model was used to estimate the levels of engagement of
participants by assuming three latent engagement states: high, low, and disengaged
Study compliance
Ethics
Ethical approval was obtained from the University of Manchester Research Ethics
Committee (ref: ethics/15522) and from the NHS IRAS (ref: 23/NW/0716). Participants
were required to provide electronic consent for study inclusion. Further details are
available elsewhere.[13,14] Weather dataWeather data were obtained by linking hourly
smartphone GPS data to the nearest of 154 possible United Kingdom Met Office weather
stations. Where GPS data were missing, we used significant location imputation. (For
details, see supplement). Local hourly weather data were obtained from the Integrated
Surface Database (ISD) of NOAA (http://www.ncdc.noaa.gov/isd), which includes hourly
observations from UK Met Office weather stations.
W.G.D. has received consultancy fees from Bayer Pharmaceuticals and Google, unrelated to
this study. B.J. and B.H. are co-founders of uMotif. All other authors declare no competing
interests.
The study was funded by Versus Arthritis (new name for Arthritis Research UK) (grant
reference 21225), with additional support from the Centre for Epidemiology (grants 21755
and 20380)
A.G. and A.M.V.C. are the recipients of Medical Research Council U.K. grants
(MR/M022625/1 and MR/R013349/1)
H.L.P. is the recipient of the Ken Muirden Overseas Training Fellowship from the Arthritis
Australia, an educational research grant funded by the Australian Rheumatology
Association
A.B. is supported by a Medical Research Council doctoral training partnership (grant
MR/N013751/1)
T.H. is supported by the Alan Turing Institute and the Royal Society (grant INF/R2/180067)
D.M.S. is partially supported by the Natural Environment Research Council U.K. (grants
NE/I005234/1, NE/I026545/1, and NE/N003918/1)
R.S. is partially supported by the Alan Turing Institute (grant EP/N510129/1)
Abstract
Abstract Patients with chronic pain commonly believe their pain is related to the weather.
Scientific evidence to support their beliefs is inconclusive, in part due to difficulties in
getting a large dataset of patients frequently recording their pain symptoms during a
variety of weather conditions. Smartphones allow the opportunity to collect data to
overcome these difficulties. Our study Cloudy with a Chance of Pain analysed daily data
from 2658 patients collected over a 15-month period. The analysis demonstrated significant
yet modest relationships between pain and relative humidity, pressure and wind speed,
with correlations remaining even when accounting for mood and physical activity. This
research highlights how citizen-science experiments can collect large datasets on real-world
populations to address long-standing health questions. These results will act as a starting
point for a future system for patients to better manage their health through pain forecasts.
Bibliography
1. Dixon, W. G., Beukenhorst, A. L., Yimer, B. B., Cook, L. M., Gasparrini, A., El‐Hay, T., …
McBeth, J.. (2019). How the weather affects the pain of citizen scientists using a
smartphone app. https://doi.org/10.1038/s41746-019-0180-3
