Symptom Monitoring Algorithm

The first three consecutive days of app responses are averaged to establish each participant’s baseline score. A score increase of at least 3 points from baseline triggers orange or red alerts depending on persistence duration. Pulmonologists make all clinical decisions after alerts, while trained medical students collect initial triage data under supervision. ANIMA’s questionnaire scores cough, sputum volume, sputum color, haemoptysis, dyspnoea, systemic symptoms, and fever using symptom-specific rules. Haemoptysis triggers an immediate alert in the ANIMA algorithm. The alert thresholds were informed by the European consensus definition of bronchiectasis exacerbation by Hill and colleagues.