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Lee JB, Ben H, So SP, Alsaqri H, Lee HJ, Koh KH, Jeon IH. Osteoarthritis of Proximal Radioulnar Joint: Computed Tomography-Based Assessment and Associations with Clinical Findings. Orthop J Sports Med 2024; 12:23259671241255354. [PMID: 39328885 PMCID: PMC11425781 DOI: 10.1177/23259671241255354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/05/2023] [Indexed: 09/28/2024] Open
Abstract
Background Although many studies have focused on the degenerative changes of the ulnohumeral and radiohumeral joints in osteoarthritis (OA) of the elbow, the proximal radioulnar joint (PRUJ), which facilitates the pronation and supination motions of the forearm, has not been comprehensively evaluated. Purpose To assess the prevalence of PRUJ OA in patients diagnosed with OA of the elbow using computed tomography (CT) images and to establish an association between the CT findings and clinical manifestations. Study Design Cross-sectional study; Level of evidence, 3. Methods Between 2010 and 2022, a total of 85 consecutive patients who were scheduled to undergo osteocapsular arthroplasty for OA of the elbow and had undergone preoperative CT imaging were included in the study. As a control group, 85 patients who underwent CT scans of the elbow for reasons other than OA of the elbow were selected and matched to patients in the OA group. CT findings of OA in the PRUJ, including osteophytes, joint space narrowing, subchondral cysts, and loose bodies, were evaluated. Inter- and intraobserver agreement analyses for CT findings were performed. The relationship between the CT findings of OA in the PRUJ and OA of the elbow classification systems (Broberg-Morrey, Hasting-Rettig, and Kwak) as well as clinical manifestations (range of motion [ROM], Mayo Elbow Performance Score, and visual analog scale for pain) were evaluated. Results Patients in the OA group showed osteophytes in the radial notch (81.2%), osteophytes in the radial head (45.9%), joint space narrowing (54.1%), loose bodies (25.9%), and subchondral cysts (23.5%) involving the PRUJ. Both the interobserver (κ = 0.866) and intraobserver agreements (κ = 0.933) for CT findings of PRUJ OA were almost perfect. The CT findings of PRUJ OA were associated with the severity of OA of the elbow in Cochran-Armitage Trend analysis (with Brogberg-Morray, r = -2.624, P = .011; with Hasting-Rettig, r = -3.421, P = .002; with Kwak, r = -2.266, P = .032). The presence of radial notch osteophytes restricted ROM in the flexion-extension arc and pronation-supination arc (P = .009 and P < .001, respectively). Conclusion PRUJ OA could be identified using CT imaging and showed radial notch osteophytes, joint space narrowing, loose bodies within the joint space, and subchondral cysts. PRUJ OA was related to overall OA of the elbow and may contribute to reduced ROM in the elbow joint. Therefore, preoperative evaluation of PRUJ OA can aid in the surgical planning of osteocapsular arthroplasty for OA of the elbow.
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Affiliation(s)
- Jun-Bum Lee
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hui Ben
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Pil So
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hood Alsaqri
- Department of Orthopaedic Surgery, Rustaq Hospital, Rustaq, Sultanate of Oman
| | - Hyun June Lee
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyoung-Hwan Koh
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - In-Ho Jeon
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Neumeister S, Krefter C, Herren DB, Schindele S, Marks M. Are patients satisfied with online video consultations for assessing their hand disorder? HAND SURGERY & REHABILITATION 2024; 43:101606. [PMID: 37827447 DOI: 10.1016/j.hansur.2023.09.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/29/2023] [Accepted: 09/30/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVES The aim was to evaluate patient satisfaction with online video consultations in assessing hand disorder. MATERIAL AND METHODS This prospective study included patients who attended a video consultation, either as an initial meeting to assess the need for further evaluation or treatment or as an early postoperative follow-up consultation. After the consultation, they completed a satisfaction questionnaire. Regression models were used to reveal determinants of patient satisfaction. RESULTS We included 100 patients, with a mean age of 55 years (range 17-81 years). 95% were satisfied or very satisfied. The main reasons for choosing this form of consultation were shorter travel and wait times. Age, gender and educational level did not determine satisfaction. Significant factors for dissatisfaction were insufficient video and sound quality. CONCLUSION Online video consultation in hand surgery is a valuable alternative to in-clinic appointments for all age groups. However, it is crucial to ensure adequate video and audio quality.
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Affiliation(s)
- Sara Neumeister
- Department of Teaching, Research and Development, Schulthess Klinik, Zurich, Switzerland
| | - Caroline Krefter
- Department of Hand Surgery, Schulthess Klinik, Zurich, Switzerland
| | - Daniel B Herren
- Department of Hand Surgery, Schulthess Klinik, Zurich, Switzerland
| | | | - Miriam Marks
- Department of Teaching, Research and Development, Schulthess Klinik, Zurich, Switzerland.
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Theile H, Walsh S, Scougall P, Ryan D, Chopra S. Smartphone goniometer application for reliable and convenient measurement of finger range of motion: a comparative study. AUSTRALASIAN JOURNAL OF PLASTIC SURGERY 2022. [DOI: 10.34239/ajops.v5n2.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ObjectiveGoniometer measurements are commonly used in hand clinics to follow progress or as an outcome measure for acute and chronic conditions. The use of an Apple iPhone goniometer application (smartphone app) may provide a practical alternative for clinicians. This study sought to assess accuracy in range-of-motion measurements obtained by a smartphone app compared to a traditional universal goniometer (UG) in healthy and diseased hands.
MethodsPatients with various hand disease processes were recruited through a tertiary hospital hand clinic, as well as healthy volunteers. Middle and little fingers were assessed at the metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints for flexion and extension. Measurements were taken using a UG and a smartphone app by two independent evaluators using a standardised proforma.
ResultsTwenty patients were recruited (50% male, 50% female; 13 healthy volunteers and seven with hand pathology). There were no significant differences in measurements using the smartphone app. The only significant difference found using the UG was for little finger PIP joint flexion; however, the difference was only 2.5°. Comparison of the average measurements using a UG and smartphone app found significant differences for six joints, with none of these > 5° (largest 4.6°).
ConclusionThe smartphone app is as reliable as traditional UG and would be a practical tool for everyday use in hand clinics. Its uptake may provide broader utility for patient self-measurement and telemedicine.
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Huang T, Zhao Z, Wang L, Zhang C, Zhao R, Xiong C, Zhong W, Luo X. Rapid measurement of thoracolumbar kyphosis with the integrated inclinometer of a smartphone: a validity and reliability study. Sci Rep 2022; 12:8745. [PMID: 35610284 PMCID: PMC9130239 DOI: 10.1038/s41598-022-12690-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 04/26/2022] [Indexed: 11/23/2022] Open
Abstract
The objective of this study was to evaluate the accuracy, reliability, and time requirements of two methods for measuring thoracolumbar kyphosis: a conventional method using a picture archiving and communication system (PACS) and this new method using the integrated inclinometer of a smartphone. The thoracolumbar kyphotic angles of one hundred consecutive patients were measured by a PACS and this novel smartphone method. The measured angles were analysed by multiple statistical methods, and the two measurement tools were compared in terms of accuracy, reliability, and time requirements. The mean result of thoracolumbar kyphosis measured by the PACS was 21.43 ± 12.96°, and the mean value measured by the smartphone was 21.03 ± 13.01°. A Bland–Altman plot for these two methods showed a mean difference of 0.4°, with the limits of agreement being -2.4° and 3.2°. One-way ANOVA showed no significant difference (F = 0.080, P = 0.999) among measurements by different observers and different methods. The intraclass correlation coefficients (ICCs) of the mean values of four repeated measurements of thoracolumbar kyphosis between these two methods were 0.997 (0.995–0.998), revealing that the two methods were highly correlated. The ICC results showed that the concordance between these two methods was very good for all measurements of thoracolumbar kyphosis, and the inter- and intra-observer reliability of the novel smartphone method were very good. The PACS method (36.95 ± 0.98 s) took significantly longer than the smartphone method (17.68 ± 0.97 s) when compared by an independent-samples t test (P = 0.000). This new method using the integrated inclinometer of a smartphone has satisfactory validity and reliability compared to the PACS method. Additionally, the new method took significantly less time than the PACS method. Measuring with a smartphone is more convenient than using a PACS, which is always rooted in a full-sized computer. In summary, this new method using the integrated inclinometer of a smartphone is rapid, convenient, accurate and reliable when measuring thoracolumbar kyphosis in osteoporotic vertebral compression fracture (OVCF) patients.
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Affiliation(s)
- Tianji Huang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Zenghui Zhao
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Lin Wang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Chao Zhang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Runhan Zhao
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Chuang Xiong
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Weiyang Zhong
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.
| | - Xiaoji Luo
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.
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Comparison of the Wrist Range of Motion Measurement between Inertial Measurement Unit Glove, Smartphone Device and Standard Goniometer. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A goniometer is currently the gold standard for range of motion (ROM) measurements. However, trained staff are required for accurate measurements. The objective of this study is to assess an agreement between the proposed standalone inertial measurement unit glove, smartphone device, and a standard goniometer for the measurement of wrist range of motion. Twenty participants performed wrist flexion, wrist extension, pronation, supination, ulnar deviation, and radial deviation movements with three operators measuring the movements with three devices. Average measurements from the three approaches had within 1.5 degrees of difference from each other for all of the movements. Both the proposed IMU glove and smartphone showed a strong correlation to the goniometer in most of the movements, with an intraclass correlation coefficient (ICC) between 0.914 and 0.961, and between 0.929 and 0.951, respectively. Only wrist supination using the smartphone has an ICC of 0.828. In comparison with a standard goniometer, a smartphone device is a more convenient method and readily available. The proposed IMU glove requires additional hardware but is easier to use and is more suitable for measuring and monitoring dynamic motion than a smartphone or a goniometer. These patient-friendly approaches could be used by the patients at home and provide remote quantitative monitoring during the wrist rehabilitation process.
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Boisvert-Plante V, Noutsios CD, Perez J, Ingelmo P. The Telemedicine-Based Pediatric Examination of the Neck and Upper Limbs: A Narrative Review. J Pain Res 2021; 14:3173-3192. [PMID: 34675645 PMCID: PMC8519790 DOI: 10.2147/jpr.s336168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/28/2021] [Indexed: 11/23/2022] Open
Abstract
With the COVID-19 pandemic hastening the adoption of telemedicine into clinical practice, it has also prompted an abundance of new literature highlighting its capabilities and limitations. The purpose of this review is to summarize the current state of the literature on telemedicine applied in the context of a musculoskeletal examination of the neck and upper limbs for children 3 to 18 years old. The PubMed and ScienceDirect databases were searched for relevant articles from January 2015 to August 2021 using a combination of keywords and nested searches. General examination components including inspection, guided self-palpation, range of motion, sensory and motor examination, as well as special testing are described. Although the literature is focused mainly on adult populations, we describe how each component of the exam can be reliably incorporated into a virtual appointment specific to pediatric patients. Caregivers are generally needed for most consultations, but certain maneuvers can be self-performed by older children and adolescents alone. There is general feasibility, validity, and substantial reliability in performing most examination components of the upper limbs remotely, except for the shoulder exam. Compared to those made in person, clinical diagnoses established virtually were found to be either the same or similar in most cases, and management decisions also had high agreement. Despite this, there is evidence that some pediatric providers may not be able to collect all the information needed from a telemedicine visit to make a complete clinical assessment. Lastly, currently available smartphone applications measuring joint range of motion were found to have high reliability and validity. This narrative review not only establishes a foundation for a structured pediatric musculoskeletal examination, but also aims to increase physicians' confidence in incorporating telemedicine into their standard of care.
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Affiliation(s)
| | | | - Jordi Perez
- Alan Edwards Pain Management Unit, Montreal General Hospital (McGill University Health Centre), Montreal, QC, Canada
- Alan Edwards Centre for Pain Research, McGill University, Montreal, QC, Canada
| | - Pablo Ingelmo
- Alan Edwards Centre for Pain Research, McGill University, Montreal, QC, Canada
- Edwards Family Interdisciplinary Complex Pain Centre, Montreal Children’s Hospital (McGill University Health Centre), Montreal, QC, Canada
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Ishii K, Oka H, Honda Y, Oguro D, Konno Y, Kumeta K, Nishihara S, Matsuyama H, Kaneko I, Takeuchi Y, Watanabe Y, Kawano H, Ogata N. Accuracy and reliability of a smartphone application for measuring the knee joint angle. J Phys Ther Sci 2021; 33:417-422. [PMID: 34083881 PMCID: PMC8165359 DOI: 10.1589/jpts.33.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/17/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Recently, a photo-based smartphone application for angle measurement—“Grid
line imaging application Professional”—was developed to evaluate joint disease treatments.
The aim of this study was to determine the accuracy and reliability of the application.
[Participants and Methods] We measured the knee joint of a mannequin using an application
and a universal goniometer. Twelve examiners measured eight knee joints of mannequins at
different arbitrary angles using the application and a universal goniometer. Correlations
between the application and universal goniometer measurements were examined using scatter
plots and correlation coefficients. Systematic errors of the application were visually
confirmed using the Bland-Altman method. Intra-class correlation coefficients were used to
evaluate the inter-examiner reliability of the application. [Results] The application and
universal goniometer measurements showed a good correlation (r=0.99) and
no systematic error. The intra-class correlation coefficient for inter-examiner
reliability was 0.999. Furthermore, to evaluate intra-examiner reliability, six examiners
measured six different knee joints twice using the application on a 2-day interval. The
intra-class correlation coefficient for intra-examiner reliability was 0.982. [Conclusion]
The accuracy of the application was equivalent to that of a universal goniometer, and both
the inter- and intra-examiner reliabilities of the application were almost perfect.
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Affiliation(s)
- Keisuke Ishii
- Trauma and Reconstruction Center, Teikyo University Hospital: 2-11-1 Kaga, Itabashi-Ku, Tokyo 173-8606, Japan
| | - Hiroyuki Oka
- 22nd Century Medical and Research Center, The University of Tokyo Hospital, Japan
| | - Yuji Honda
- Department of Rehabilitation Medicine, Teikyo University School of Medicine, Japan
| | - Daisuke Oguro
- Department of Rehabilitation Medicine, Teikyo University School of Medicine, Japan
| | | | | | | | | | - Ichiro Kaneko
- Department of Emergency Medicine, Teikyo University School of Medicine, Japan
| | - Yasuo Takeuchi
- Teikyo Simulation Education Research Center, Teikyo University School of Medicine, Japan
| | - Yoshinobu Watanabe
- Trauma and Reconstruction Center, Teikyo University Hospital: 2-11-1 Kaga, Itabashi-Ku, Tokyo 173-8606, Japan
| | - Hirotaka Kawano
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Japan
| | - Naoshi Ogata
- Department of Rehabilitation Medicine, Teikyo University School of Medicine, Japan
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Arman N, Oktay AB, Tarakci D, Tarakci E, Akgul YS. The validity of an objective measurement method using the Leap Motion Controller for fingers wrist, and forearm ranges of motion. HAND SURGERY & REHABILITATION 2021; 40:394-399. [PMID: 33781957 DOI: 10.1016/j.hansur.2021.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 10/21/2022]
Abstract
The present study aimed to validate the Leap Motion Controller (LMC)-based Fizyosoft® HandROM System developed by our team to evaluate range of motion (ROM) for fingers, wrist, and forearm in a new clinical setting. Thirty-five healthy individuals participated in the study (all right-handed, 20-30 years old). The LMC-based Fizyosoft® HandROM System is a licensed software ROM-measurement developed by our team. Pronation/supination, wrist flexion/extension, ulnar/radial deviation and metacarpophalangeal (MCP) flexion/extension of all fingers were measured with both the Fizyosoft® HandROM System and a universal goniometer. No significant differences were found between the two measurement methods for almost all mean ROMs except for ulnar and radial deviation (p > 0.05). Highly significant correlations were found between all ROMs of the forearm, wrist, and thumb (p < 0.01). MCP flexion showed significant correlation only in the index finger (r = 0.516, p = 0.003) and little finger (r = 0.517, p = 0.004). Besides, for both measures, the intraclass correlations were good to excellent on all ROMs of the forearm, wrist, and fingers except for MCP of the middle and ring fingers (0.68-0.88). The present study results indicated that the LMC-based Fizyosoft® HandROM System could sensitively track changes in the active motion of the thumb, wrist, and forearm. It is a viable alternative for assessing ROMs of the forearm, wrist, and thumb in patient follow-up.
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Affiliation(s)
- Nilay Arman
- Istanbul University-Cerrahpasa, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Büyükçekmece Yerleşkesi Alkent 2000 Mah., Yiğittürk Cad. No:5/9/1, Büyükçekmece/İstanbul, Turkey.
| | - Ayse Betul Oktay
- Istanbul Medeniyet University, Faculty of Engineering and Natural Sciences, Department of Computer Engineering, Kuzey Yerleşkesi H Blok, Ünalan Mah., Ünalan Sok, D100 Karayolu yanyol, 34700 Üsküdar/İstanbul, Turkey.
| | - Devrim Tarakci
- Istanbul Medipol University, Faculty of Health Sciences, Department of Ergotherapy, Kavacık Mah., Ekinciler Cad. No.19 Kavacık Kavşağı, 34810 Beykoz/İstanbul, Turkey.
| | - Ela Tarakci
- Istanbul University-Cerrahpasa, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Büyükçekmece Yerleşkesi Alkent 2000 Mah., Yiğittürk Cad. No:5/9/1, Büyükçekmece/İstanbul, Turkey.
| | - Yusuf Sinan Akgul
- Gebze Technical University, Department of Computer Engineering, 41400 Gebze/Kocaeli, Turkey.
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Ge M, Chen J, Zhu Z, Shi P, Yin L, Xia L. Wrist ROM measurements using smartphone photography: Reliability and validity. HAND SURGERY & REHABILITATION 2020; 39:261-264. [DOI: 10.1016/j.hansur.2020.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/19/2019] [Accepted: 02/25/2020] [Indexed: 10/24/2022]
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Jim HSL, Hoogland AI, Brownstein NC, Barata A, Dicker AP, Knoop H, Gonzalez BD, Perkins R, Rollison D, Gilbert SM, Nanda R, Berglund A, Mitchell R, Johnstone PAS. Innovations in research and clinical care using patient-generated health data. CA Cancer J Clin 2020; 70:182-199. [PMID: 32311776 PMCID: PMC7488179 DOI: 10.3322/caac.21608] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 02/24/2020] [Accepted: 02/24/2020] [Indexed: 12/17/2022] Open
Abstract
Patient-generated health data (PGHD), or health-related data gathered from patients to help address a health concern, are used increasingly in oncology to make regulatory decisions and evaluate quality of care. PGHD include self-reported health and treatment histories, patient-reported outcomes (PROs), and biometric sensor data. Advances in wireless technology, smartphones, and the Internet of Things have facilitated new ways to collect PGHD during clinic visits and in daily life. The goal of the current review was to provide an overview of the current clinical, regulatory, technological, and analytic landscape as it relates to PGHD in oncology research and care. The review begins with a rationale for PGHD as described by the US Food and Drug Administration, the Institute of Medicine, and other regulatory and scientific organizations. The evidence base for clinic-based and remote symptom monitoring using PGHD is described, with an emphasis on PROs. An overview is presented of current approaches to digital phenotyping or device-based, real-time assessment of biometric, behavioral, self-report, and performance data. Analytic opportunities regarding PGHD are envisioned in the context of big data and artificial intelligence in medicine. Finally, challenges and solutions for the integration of PGHD into clinical care are presented. The challenges include electronic medical record integration of PROs and biometric data, analysis of large and complex biometric data sets, and potential clinic workflow redesign. In addition, there is currently more limited evidence for the use of biometric data relative to PROs. Despite these challenges, the potential benefits of PGHD make them increasingly likely to be integrated into oncology research and clinical care.
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Affiliation(s)
- Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | - Aasha I Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | - Naomi C Brownstein
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida
| | - Anna Barata
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | - Adam P Dicker
- Department of Radiation Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | - Randa Perkins
- Department of Clinical Informatics and Clinical Systems, Moffitt Cancer Center, Tampa, Florida
| | - Dana Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Scott M Gilbert
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Ronica Nanda
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida
- BayCare Health Systems Inc, Morton Plant Hospital, Clearwater, Florida
| | - Anders Berglund
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida
| | - Ross Mitchell
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida
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Adding mobilisation with movement to exercise and advice hastens the improvement in range, pain and function after non-operative cast immobilisation for distal radius fracture: a multicentre, randomised trial. J Physiother 2020; 66:105-112. [PMID: 32291223 DOI: 10.1016/j.jphys.2020.03.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/04/2019] [Accepted: 03/19/2020] [Indexed: 11/21/2022] Open
Abstract
QUESTION Does adding mobilisation with movement (MWM) to usual care (ie, exercises plus advice) improve outcomes after immobilisation for a distal radius fracture? DESIGN A prospective, multicentre, randomised, clinical trial with concealed allocation, blinding and intention-to-treat analysis. PARTICIPANTS Sixty-seven adults (76% female, mean age 60 years) treated with casting after distal radius fracture. INTERVENTION The control group received exercises and advice. The experimental group received the same exercises and advice, plus supination and wrist extension MWM. OUTCOME MEASURES The primary outcome was forearm supination at 4 weeks (immediately post-intervention). Secondary outcomes included wrist extension, flexion, pronation, grip strength, QuickDASH (Disabilities of Arm, Shoulder and Hand), Patient-Rated Wrist Evaluation (PRWE) and global rating of change. Follow-up time points were 4 and 12 weeks, with patient-rated measures at 26 and 52 weeks. RESULTS Compared with the control group, supination was greater in the experimental group by 12 deg (95% CI 5 to 20) at 4 weeks and 8 deg (95% CI 1 to 15) at 12 weeks. Various secondary outcomes were better in the experimental group at 4 weeks: extension (14 deg, 95% CI 7 to 20), flexion (9 deg, 95% CI 4 to 15), QuickDASH (-11, 95% CI -18 to -3) and PRWE (-13, 95% CI -23 to -4). Benefits were still evident at 12 weeks for supination, extension, flexion and QuickDASH. The experimental group were more likely to rate their global change as 'improved' (risk difference 22%, 95% CI 5 to 39). There were no clear benefits in any of the participant-rated measures at 26 and 52 weeks, and no adverse effects. CONCLUSION Adding MWM to exercise and advice gives a faster and greater improvement in motion impairments for non-operative management of distal radius fracture. REGISTRATION ACTRN12615001330538.
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Modest J, Clair B, DeMasi R, Meulenaere S, Howley A, Aubin M, Jones M. Self-measured wrist range of motion by wrist-injured and wrist-healthy study participants using a built-in iPhone feature as compared with a universal goniometer. J Hand Ther 2020; 32:507-514. [PMID: 30017418 DOI: 10.1016/j.jht.2018.03.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 01/11/2018] [Accepted: 03/27/2018] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Cross-sectional cohort. INTRODUCTION Smartphone gyroscope and goniometer applications have been shown to be a reliable way to measure wrist ROM when used by researchers or trained staff. If wrist-injured patients could reliably measure their own ROM, rehabilitation efforts could be more effectively tailored. PURPOSE OF THE STUDY To assess agreement of self-measured ROM by wrist-injured and wrist-healthy study participants using a built-in iPhone 5 level feature as compared to researcher-measured ROM using a universal goniometer (UG). METHODS Thirty wrist-healthy and 30 wrist-injured subjects self-measured wrist flexion, extension, supination, and pronation ROM using the built-in preinstalled digital level feature on an iPhone 5. Simultaneously a researcher measured ROM with a UG. RESULTS Average absolute deviation between the self-measured iPhone 5 level feature and researcher-measured UG ROM was less than 2° for all 4 movements individually and combined was found to be 1.6° for both populations. Intraclass correlation coefficient showed high correlation with values over 0.94 and Bland-Altman plots showed very strong agreement. There was no statistical difference in the ability of wrist-injured and healthy patients to self-measure wrist ROM. DISCUSSION Both populations showed very high agreement between their self-measured ROM using the built-in level feature on an iPhone 5 and the researcher-measured ROM using the UG. Both populations were able to use the iPhone self-measurement equally well and the injury status of the subject did not affect the agreement results. CONCLUSION Wrist-healthy and wrist-injured subjects were able to reliably and independently measure ROM using a smartphone level feature.
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Affiliation(s)
- Jacob Modest
- Department of Orthopedic Surgery, University of Massachusetts, Worcester, MA, USA
| | - Brian Clair
- Department of Orthopedic Surgery, University of Massachusetts, Worcester, MA, USA
| | - Robin DeMasi
- Department of Orthopedic Surgery, University of Massachusetts, Worcester, MA, USA
| | - Stacy Meulenaere
- Department of Orthopedic Surgery, University of Massachusetts, Worcester, MA, USA
| | - Anthony Howley
- Department of Orthopedic Surgery, University of Massachusetts, Worcester, MA, USA
| | - Michelle Aubin
- Department of Orthopedic Surgery, University of Massachusetts, Worcester, MA, USA
| | - Marci Jones
- Department of Orthopedic Surgery, University of Massachusetts, Worcester, MA, USA.
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Clinical relevance commentary in response to "The validity and reliability of DrGoniometer, a smartphone application, for measuring forearm supination". J Hand Ther 2020; 32:118-120. [PMID: 30685194 DOI: 10.1016/j.jht.2018.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Wang KY, Hussaini SH, Teasdall RD, Gwam CU, Scott AT. Smartphone Applications for Assessing Ankle Range of Motion in Clinical Practice. FOOT & ANKLE ORTHOPAEDICS 2019; 4:2473011419874779. [PMID: 35097340 PMCID: PMC8696933 DOI: 10.1177/2473011419874779] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: Measuring ankle range of motion (ROM) following injury or intervention is necessary for monitoring recovery as well as for calculating permanent impairment ratings in workers’ compensation cases. In recent years, smartphone application developers have created applications (apps) that emulate ROM measurement tools like the universal goniometer. This study assessed the correlation between smartphone ROM measurements and universal goniometer measurements, as well as the reliability and usability of these apps in clinical practice. Methods: Three raters used the Goniometer app (Gonio), Clinometer app (Clino), DrGoniometer app (DrG), and a universal goniometer (UG) to assess the ankle ROM in plantarflexion and dorsiflexion of 24 patients with ankle pathology. Each patient completed a survey on the usability of the apps. Results: Lin’s concordance correlation coefficient test showed moderate correlation between the smartphone and UG measurements (Lin‘s correlation coefficient [rLC] = 0.931, 95% confidence interval [CI] = 0.911-0.946 for UG-Gonio; rLC = 0.908, 95% CI = 0.881-0.929 for UG-Clino; rLC = 0.935, 95% CI = 0.915-0.950 for UG-DrG). A 2-way mixed model showed good to excellent interrater reliability for each app for plantarflexion and dorsiflexion (ICCp = 0.836, ICCd = 0.912, P < .001 for Gonio; ICCp = 0.788, ICCd = 0.893, P < .001 for Clino; ICCp = 0.777, ICCd = 0.897, P < .001 for DrG). Most participants surveyed were very comfortable with having their ankle ROM measured by a smartphone. Conclusion: Smartphone apps may be a more convenient way to measure ankle ROM than UG. Physicians can use these apps to measure a patient’s ROM in clinic, a patient could send a picture of his or her dorsiflexed or plantarflexed ankle to the physician to remotely track ROM, or a patient could measure his or her own ROM at home using a personal smartphone. Level of Evidence: Level IV, case series.
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Affiliation(s)
- Kevin Y. Wang
- Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - S. Hanif Hussaini
- Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Robert D. Teasdall
- Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Chukwuweike U. Gwam
- Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Aaron T. Scott
- Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
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Smartphone Application with Virtual Reality Goggles for the Reliable and Valid Measurement of Active Craniocervical Range of Motion. Diagnostics (Basel) 2019; 9:diagnostics9030071. [PMID: 31295869 PMCID: PMC6787724 DOI: 10.3390/diagnostics9030071] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 06/28/2019] [Accepted: 07/09/2019] [Indexed: 11/23/2022] Open
Abstract
Objective: This study aimed to determine the intra-rater and inter-rater reliability and validity of a hybrid device, combining virtual reality goggles, a magnetometer and an inclinometer application for smartphones, to measure craniocervical range. Summary of Background Data: Accurate evaluation of craniocervical range of motion is important for early detection of certain diseased conditions and monitoring the progress of interventions. The universal goniometer is widely used for the measurement but it requires experienced practitioners. Whether a combination of virtual reality goggles and smartphone applications can provide the same or better performance compared with the goniometer is still unknown. Methods: Forty-one healthy adults from the department of physical medicine and rehabilitation were recruited for craniocervical range examination (flexion, extension, side-bending to the right or left and rotating to the right or left) by using the hybrid device and universal goniometer. Using the hybrid device, repeated measurements were performed twice by a primary rater and once by a second rater. The primary rater also conducted a measurement using the universal goniometer in the same cohort. The intra-rater and inter-rater reliability (intra-class correlation coefficient (ICC)) were calculated using the two-way random effect model, whereas the validity was examined by the Pearson correlation coefficient and Bland-and-Altman plot. The interval between the first and second sessions of the measurement for intra-rater reliability was set at 30 min. Results: Excellent intra-rater (ICC ≥ 0.925) and inter-rater (ICC ≥ 0.880) reliability was noted for the hybrid device. The minimal detectable changes from intra-observer and inter-observer comparisons ranged between 4.12° and 7.42° in all six directions. The Bland-and-Altman plot revealed small mean differences (≤1.68°) between the hybrid device and universal goniometer. Both instruments had highly correlated measurements of craniocervical motion (r values ≥ 0.918). Conclusion: For healthy participants, excellent intra-rater and inter-rater reliability was noted for the hybrid device, and the measurements were consistent with the universal goniometer measurements. Future studies are needed to examine whether the device can perform similarly for patients with neck disorders.
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Gwak GT, Hwang UJ, Jung SH, Kim JH, Kim MH, Kwon OY. Comparison of maximal isometric forearm supination torque in two elbow positions between subjects with and without limited forearm supination range of motion. Physiother Theory Pract 2019; 37:99-105. [PMID: 31088319 DOI: 10.1080/09593985.2019.1616342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Study Design: Cross-sectional comparison. Introduction: Forearm supination range of motion is often limited by short or stiff pronators. Many studies have examined maximal isometric forearm supination torque (MIFST). However, there is little research comparing MIFST in two elbow positions between subjects with and without limited forearm supination range of motion (LSR). Purpose of the Study: The purpose of this study was to compare MIFST in two elbow positions (90º flexed elbow, extended elbow) between subjects with and without LSR. Methods: Thirteen right-handed subjects (seven men, six women) with LSR and 13 age- and gender-matched healthy controls participated in this study. The forearm supination range of motion and MIFST were measured using a Smart KEMA system. Two-way repeated-measures analysis of variance was used to compare MIFST in two elbow positions between subjects with and without LSR. Results: No significant difference between groups (p > .05) was found. However, there was an interaction effect between elbow position and group on MIFST (p < .05). Independent t-tests were used to confirm the simple effects. In the LSR group, the value of MIFST was significantly lower in the elbow-extended position than in the group without LSR (p < .05). Conclusions: These findings indicate that elbow position should be considered when assessing the strength or increasing the strength of the supinator muscle, especially in patients with LSR.
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Affiliation(s)
- Gyeong-Tae Gwak
- Department of Physical Therapy, Graduate School, Yonsei University , Wonju, Gangwon-do, Korea
| | - Ui-Jae Hwang
- Department of Physical Therapy, Graduate School, Yonsei University , Wonju, Gangwon-do, Korea
| | - Sung-Hoon Jung
- Department of Physical Therapy, Graduate School, Yonsei University , Wonju, Gangwon-do, Korea
| | - Jun-Hee Kim
- Department of Physical Therapy, Graduate School, Yonsei University , Wonju, Gangwon-do, Korea
| | - Moon-Hwan Kim
- Department of Rehabilitation Medicine, Wonju Christian Hospital, Wonju College of Medicine, Yonsei University , Wonju-si, Gangwon-do, Korea
| | - Oh-Yun Kwon
- Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis, Yonsei University , Wonju, Gangwon-do, Korea
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Keogh JWL, Cox A, Anderson S, Liew B, Olsen A, Schram B, Furness J. Reliability and validity of clinically accessible smartphone applications to measure joint range of motion: A systematic review. PLoS One 2019; 14:e0215806. [PMID: 31067247 PMCID: PMC6505893 DOI: 10.1371/journal.pone.0215806] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 04/09/2019] [Indexed: 12/01/2022] Open
Abstract
Measuring joint range of motion is an important skill for many allied health professionals. While the Universal Goniometer is the most commonly utilised clinical tool for measuring joint range of motion, the evolution of smartphone technology and applications (apps) provides the clinician with more measurement options. However, the reliability and validity of these smartphones and apps is still somewhat uncertain. The aim of this study was to systematically review the literature regarding the intra- and inter-rater reliability and validity of smartphones and apps to measure joint range of motion. Eligible studies were published in English peer-reviewed journals with full text available, involving the assessment of reliability and/or validity of a non-videographic smartphone app to measure joint range of motion in participants >18 years old. An electronic search using PubMed, Medline via Ovid, EMBASE, CINAHL, and SPORTSDiscus was performed. The risk of bias was assessed using a standardised appraisal tool. Twenty-three of the eligible 25 studies exceeded the minimum 60% score to be classified as a low risk of bias, although 3 of the 13 criteria were not achieved in >50% of the studies. Most of the studies demonstrated adequate intra-rater or inter-rater reliability and/or validity for >50% of the range of motion tests across all joints assessed. However, this level of evidence appeared weaker for absolute (e.g. mean difference ± limit of agreement, minimal detectable change) than relative (e.g. intraclass correlation, correlation) measures; and for spinal rotation than spinal extension, flexion and lateral flexion. Our results provide clinicians with sufficient evidence to support the use of smartphones and apps in place of goniometers to measure joint motion. Future research should address some methodological limitations of the literature, especially including the inclusion of absolute and not just relative reliability and validity statistics.
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Affiliation(s)
- Justin W. L. Keogh
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Sports Performance Research Institute New Zealand (SPRINZ), AUT University, Auckland, New Zealand
- Cluster for Health improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
- * E-mail:
| | - Alistair Cox
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Sarah Anderson
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Bernard Liew
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Alicia Olsen
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Ben Schram
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
- Water Based Research Unit, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD, Australia
| | - James Furness
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
- Water Based Research Unit, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD, Australia
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Abstract
Mobile health apps are growing constantly in number and popularity. Some mobile apps are used for clinical assessment, and consequently need to be verified and validated appropriately, along with the mobile platform, to ensure their safe and effective operation. We review the current literature on available smartphone goniometric apps validated for joint angle measurement and their main psychometric characteristics. A literature search of Medline and Scopus databases was performed to select papers on smartphone commercial apps validated for joint angle measurement and relevant to Physical Medicine and Rehabilitation. A platform search verified whether the selected apps were still available for download. The literature search identified 126 papers in Medline and 113 in Scopus, 49 of which were selected. They dealt with the validation of 23 apps, eight of which were no longer available and therefore excluded from the review. Psychometric characteristics of the selected apps were robust, but heterogeneity of the studies did not enable comparisons between apps to identify the most valid one. The increase in the number of apps and validation studies highlights the growing interest in this new approach for measuring body angles. Given the precarious commercial availability of some apps, when research is the goal, it is advisable to select apps with the longest durability. A need continues to exist for validation studies on available apps focused on goniometric measurement in gait or during performance of therapeutic exercises in neurological and orthopedic disorders.
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Crouthamel M, Quattrocchi E, Watts S, Wang S, Berry P, Garcia-Gancedo L, Hamy V, Williams RE. Using a ResearchKit Smartphone App to Collect Rheumatoid Arthritis Symptoms From Real-World Participants: Feasibility Study. JMIR Mhealth Uhealth 2018; 6:e177. [PMID: 30213779 PMCID: PMC6231853 DOI: 10.2196/mhealth.9656] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 05/09/2018] [Accepted: 07/10/2018] [Indexed: 01/09/2023] Open
Abstract
Background Using smartphones to enroll, obtain consent, and gather self-reported data from patients has the potential to enhance our understanding of disease burden and quantify physiological impact in the real world. It may also be possible to harness integral smartphone sensors to facilitate remote collection of clinically relevant data. Objective We conducted the Patient Rheumatoid Arthritis Data From the Real World (PARADE) observational study using a customized ResearchKit app with a bring-your-own-device approach. Our objective was to assess the feasibility of using an entirely digital approach (social media and smartphone app) to conduct a real-world observational study of patients with rheumatoid arthritis. Methods We conducted this observational study using a customized ResearchKit app with a bring-your-own-device approach. To recruit patients, the PARADE app, designed to guide patients through a series of tasks, was publicized via social media platforms and made available for patients in the United States to download from the Apple App Store. We collected patient-reported data, such as medical history, rheumatoid arthritis-related medications (past and present), and a range of patient-reported outcome measures. We included in the assessment a joint-pain map and a novel objective assessment of wrist range of movement, measured by the smartphone-embedded gyroscope and accelerometer. Results Within 1 month of recruitment via social media campaigns, 399 participants self-enrolled, self-consented, and provided complete demographic data. Joint pain was the most frequently reported rheumatoid arthritis symptom to bother study participants (344/393, 87.5%). Severe patient-reported wrist pain appeared to be inversely linked with the range of wrist movement measured objectively by the app. At study entry, 292 of 399 participants (73.2%) indicated a preference for participating in a mobile app–based study. The number of participants in the study declined to 45 of 399 (11.3%) at week 12. Conclusions Despite the declining number of participants over time, the combination of social media and smartphone app with sensor integration was a feasible and cost-effective approach for the collection of patient-reported data in rheumatoid arthritis. Integral sensors within smartphones can be harnessed to provide novel end points, and the novel wrist range of movement test warrants further clinical validation.
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Affiliation(s)
| | | | | | - Sherry Wang
- GlaxoSmithKline, Collegeville, PA, United States
| | - Pamela Berry
- GlaxoSmithKline, Collegeville, PA, United States
| | | | - Valentin Hamy
- GlaxoSmithKline, Stockley Park, Uxbridge, United Kingdom
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