Symptom Diary

What Is a symptom diary?

It is not always easy to reliably recall how you felt physically or emotionally at a particular point in time. Yet these are precisely the questions you are likely to face in a medical consultation:
When exactly did your symptoms start? Which came first, fever or sore throat? Have you ever had these symptoms before? Did you notice any changes in the weeks leading up to the acute illness?

In the context of an illness, well-documented answers to these questions can provide important clues to the underlying cause. They also make a real difference when it comes to selecting and fine-tuning the right therapy. For these reasons, symptom diaries are playing an increasingly important role in medicine. A diary makes it possible to record the exact state of health before, during and after an illness. It can also provide insights into the stage and severity of a disease.

Tracking symptoms digitally with an app

A lot has changed on the technical side as well. The days of scribbled notes and piles of paper, which are time-consuming, hard to read and difficult to share with doctors, are largely over. Keeping a symptom diary used to be a handwritten effort; today, many things are much easier in digital form.

With the right symptom diary app, all relevant questions can be answered reliably and without much effort. The information can then be easily shared with doctors or even researchers.

Symptom diary template: What should be documented?

A symptom diary is most helpful when you record certain information consistently and in a standardized structure. The following template can serve as a guide to which details are particularly valuable for you and your doctors:

• Date and time when the symptoms occurred
• Type of symptom
• Location in the body
• Intensity of the symptoms (for example on a scale from 0 to 10)
• Duration of the symptom and how it evolved over the day
• Accompanying symptoms
• Possible triggers or situations (for example specific foods, stress, physical exertion)
• Medicines taken or other measures (for example rest, cooling, exercise)
• Effect of these measures on the symptoms
• Impact on everyday life (for example work, sleep, social activities)

The more precisely and regularly these points are documented, the easier it becomes to identify patterns and, over time, to make well-founded decisions about diagnostics and treatment.

Benefits for users

A symptom diary also offers many practical benefits for users themselves. It makes the course of a disease visible and shows which symptoms recur. A symptom that seems rather unimportant on a single occasion can, in the overall picture of an illness, turn out to be an important clue. At the same time, people gain a better understanding of which situations, times of day or triggers worsen or relieve their symptoms. Many also find it a relief not to have to “carry symptoms around in their head” all the time, but to record them in a structured way instead.

From symptom diary to diagnosis

With questions like those above, doctors try to build as accurate a picture of the symptoms as possible. In addition to the patient’s own description, it is important in this medical history, or anamnesis, for doctors to ask about further symptoms and how they relate to each other over time.

This includes symptoms that those affected might not associate with the current illness at all. The more precise the information, the more likely it is that the correct diagnosis will be made [1].

Earlier studies estimated that, based on a good anamnesis alone, the correct diagnosis can be reached in up to 83 percent of cases [2]. While physical examination is losing some of its relative weight due to the rapid increase in technical diagnostic methods, anamnesis remains an important building block on the way to a diagnosis. It can also help determine whether further necessary tests are required or whether potentially harmful examinations can be avoided.

Benefits in chronic conditions

Many people are often unable to answer doctors’ questions, or can only do so in vague terms. Our memory frequently lets us down here. Remembering individual symptoms is particularly challenging for people who fall ill more often or who live with a chronic condition. This is precisely where a symptom diary can be very helpful [3].

Regular documentation of symptoms, and also of days without any symptoms, can assist doctors in making a diagnosis. Of course, a symptom diary can never replace a visit to the doctor, nor should it lead to delaying a necessary medical consultation.

Documenting headaches, migraine and more

These days, medical societies recommend that people with many different conditions keep a diary of their symptoms, the time they occur and any medication taken. Examples include headache diaries for people with migraine [4], blood glucose diaries for people with diabetes mellitus [5] or sleep diaries for people with sleep disorders [6].

The list of conditions for which a diary is useful could be extended further. Even for people without a chronic illness, however, a diary can help them prepare optimally for their next medical appointment.

Why should I document my symptoms every day?

The greatest challenge with any diary is keeping up the daily entries. While people are often highly motivated to maintain a symptom diary during an acute illness, the habit is quickly forgotten once the symptoms subside.

Yet, information from symptom diaries can even generate important insights for research. If this information is shared or “donated” anonymously to researchers, it can help to better estimate, for example, the spread of flu waves or the course of pandemics [7].

Why keep a digital symptom diary?

Using digital solutions offers a wide range of advantages in this context. For many people, a smartphone is a daily companion from breakfast to bedtime. An app for recording symptoms often requires much less effort and is easier to integrate into everyday life than writing notes in a paper diary or on loose slips of paper.

The documented symptoms can be shown to doctors or other trusted individuals, if desired. If an app offers mobile interfaces, it could even become possible to share the symptom diary directly with treating doctors.

In addition, these records could later help medical researchers link behavior patterns and lifestyles to the development of future diseases.

You can make best use of a symptom diary app by:

• establishing daily routines, such as using the diary after getting up or after dinner.
• allowing push notifications, so the app can send daily reminders.
• setting repeating reminders on your phone at the same time each day.
• placing reminder notes where you will see them.

Even small measures like these can create a stable routine that, after a while, no longer feels like extra effort.

By keeping a digital symptom diary, you help your doctors get a clear overview of the details that are important for anamnesis and diagnosis, and thus select the most appropriate therapy.

Thanks to automatic reminder functions, daily documentation becomes easier, and the information can be shared digitally with all healthcare professionals involved and with relatives. Your health will benefit from this.

Symptom diary for COVID-19 and Long COVID

Data4Life offers a symptom diary within the Data4Life app that helps you record your COVID-19 illness. You can find more information here.

Digital products can support the recording of symptoms, but does that automatically make them medical devices from a legal perspective?

A good example of a digital health solution as an alternative to a traditional health diary is a digital symptom diary. Perhaps you are already using such a diary or planning to do so. Here you can learn more about the background and how a symptom diary is classified from a legal point of view.