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Smart Data Collection for the Assessment of Treatment Effects in IBS 217 9 Figure 9.3 The Bristol Stool Chart questionnaire. Patients were requested to register each bowel movement by selecting the stool type most resembling theirs. In Dutch, ontlasting means defecation, kleine harde keutels, moeizame passage means small hard lumps, difficult to pass. Hoofdscherm means home screen, opslaan means save. All patients received extensive verbal and written instructions during the screenings visit on how to use the application and were encouraged to contact the researchers if the application crashed or otherwise did not function properly. A personalized username and password were provided for access to the application. Patients were instructed to enable automatic updates of the application to ensure the most recent version was used. If a patient did not own a smartphone or tablet, a device was provided. During the complete pre-treatment and treatment periods, an alert system in the planning tool notified the investigators when a patient had failed to submit three or more daily entries. In addition, the development (IT) team received automated notifications of application crashes. Web-based patient questionnaires At randomization, two, four, six, and eight weeks of treatment, and at three and six months of follow-up after treatment had ended, patients were requested to fill out web- based questionnaires. We chose not to implement these into the digital diary because of the large number of questions to be answered. Included were a questionnaire regarding demographics and lifestyle, and validated questionnaires regarding symptom severity (IBS Symptom Severity System), quality of life (IBS Quality of Life, EuroQoL EQ-5D-5L), comorbid symptoms of anxiety and depression (General Anxiety Disorder 7, Patient