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Petrasso C, Bayly J, Arculeo S, Bowers M, Costi S, Nottelmann L, Turola E, Vanzulli E, Maddocks M. Non-pharmacological interventions targeting mobility among people with advanced cancer: a systematic review. Support Care Cancer 2024; 32:569. [PMID: 39102127 DOI: 10.1007/s00520-024-08767-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 07/26/2024] [Indexed: 08/06/2024]
Abstract
PURPOSE To synthesise evidence evaluating non-pharmacological interventions targeting mobility among people with advanced cancer, considering the type, efficacy and contextual factors that may influence outcome. METHODS Systematic review of studies of non-pharmacological interventions in adults (≥ 18 years) with advanced (stage III-IV) cancer, and assessing mobility using clinical or patient-reported outcome measures. Searches were conducted across three electronic databases (MEDLINE, EMBASE and CINAHL) up to June 2024. Methodological quality was assessed using Joanna Briggs Institute tools and contextual factors were evaluated through the Context and Implementation of Complex Interventions framework. A narrative synthesis was conducted due to clinical heterogeneity of included studies. RESULTS 38 studies encompassing 2,464 participants were included. The most frequent mobility outcome measure was the 6-min walk test (26/38 studies). Exercise was the most common intervention, (33 studies: 27 aerobic and resistance, 5 aerobic, 1 resistance versus aerobic training) and improvements in mobility were found in 21/33 outcomes. Electrotherapy interventions led to significant improvements in mobility in 3/5 studies. Geographical factors (e.g. distance, transport, parking requirements) potentially limited participation in 18/38 studies. A lack of ethnic diversity among populations was evident and language proficiency was an inclusion criterion in 12 studies. CONCLUSION Exercise and neuromuscular electrical stimulation appear to improve mobility outcomes in advanced cancer. The evaluation of other non-pharmacological interventions targeting mobility should consider access and inclusivity, and be adaptable to the needs of this population.
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Affiliation(s)
- Carmine Petrasso
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation Bessemer Road, London, SE5 9PJ, UK.
| | - Joanne Bayly
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation Bessemer Road, London, SE5 9PJ, UK
| | - Simona Arculeo
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Megan Bowers
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation Bessemer Road, London, SE5 9PJ, UK
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Surgical, Medical and Dental Department of Morphological Sciences, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Lise Nottelmann
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
- The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Elena Turola
- Research and Statistics Infrastructure, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisa Vanzulli
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation Bessemer Road, London, SE5 9PJ, UK
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Mc Ardle R, Taylor L, Cavadino A, Rochester L, Del Din S, Kerse N. Characterizing Walking Behaviors in Aged Residential Care Using Accelerometry, With Comparison Across Care Levels, Cognitive Status, and Physical Function: Cross-Sectional Study. JMIR Aging 2024; 7:e53020. [PMID: 38842168 PMCID: PMC11185191 DOI: 10.2196/53020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 06/07/2024] Open
Abstract
Background Walking is important for maintaining physical and mental well-being in aged residential care (ARC). Walking behaviors are not well characterized in ARC due to inconsistencies in assessment methods and metrics as well as limited research regarding the impact of care environment, cognition, or physical function on these behaviors. It is recommended that walking behaviors in ARC are assessed using validated digital methods that can capture low volumes of walking activity. Objective This study aims to characterize and compare accelerometry-derived walking behaviors in ARC residents across different care levels, cognitive abilities, and physical capacities. Methods A total of 306 ARC residents were recruited from the Staying UpRight randomized controlled trial from 3 care levels: rest home (n=164), hospital (n=117), and dementia care (n=25). Participants' cognitive status was classified as mild (n=87), moderate (n=128), or severe impairment (n=61); physical function was classified as high-moderate (n=74) and low-very low (n=222) using the Montreal Cognitive Assessment and the Short Physical Performance Battery cutoff scores, respectively. To assess walking, participants wore an accelerometer (Axivity AX3; dimensions: 23×32.5×7.6 mm; weight: 11 g; sampling rate: 100 Hz; range: ±8 g; and memory: 512 MB) on their lower back for 7 days. Outcomes included volume (ie, daily time spent walking, steps, and bouts), pattern (ie, mean walking bout duration and alpha), and variability (of bout length) of walking. Analysis of covariance was used to assess differences in walking behaviors between groups categorized by level of care, cognition, or physical function while controlling for age and sex. Tukey honest significant difference tests for multiple comparisons were used to determine where significant differences occurred. The effect sizes of group differences were calculated using Hedges g (0.2-0.4: small, 0.5-0.7: medium, and 0.8: large). Results Dementia care residents showed greater volumes of walking (P<.001; Hedges g=1.0-2.0), with longer (P<.001; Hedges g=0.7-0.8), more variable (P=.008 vs hospital; P<.001 vs rest home; Hedges g=0.6-0.9) bouts compared to other care levels with a lower alpha score (vs hospital: P<.001; Hedges g=0.9, vs rest home: P=.004; Hedges g=0.8). Residents with severe cognitive impairment took longer (P<.001; Hedges g=0.5-0.6), more variable (P<.001; Hedges g=0.4-0.6) bouts, compared to those with mild and moderate cognitive impairment. Residents with low-very low physical function had lower walking volumes (total walk time and bouts per day: P<.001; steps per day: P=.005; Hedges g=0.4-0.5) and higher variability (P=.04; Hedges g=0.2) compared to those with high-moderate capacity. Conclusions ARC residents across different levels of care, cognition, and physical function demonstrate different walking behaviors. However, ARC residents often present with varying levels of both cognitive and physical abilities, reflecting their complex multimorbid nature, which should be considered in further work. This work has demonstrated the importance of considering a nuanced framework of digital outcomes relating to volume, pattern, and variability of walking behaviors among ARC residents.
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Affiliation(s)
- Ríona Mc Ardle
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
- National Institute for Health and Care Research Biomedical Research Centre, Newcastle University and the Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - Lynne Taylor
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Alana Cavadino
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Lynn Rochester
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
- National Institute for Health and Care Research Biomedical Research Centre, Newcastle University and the Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, Newcastle Upon Tyne, United Kingdom
- The Newcastle Upon Tyne Hospitals National Health Institute Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - Silvia Del Din
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
- National Institute for Health and Care Research Biomedical Research Centre, Newcastle University and the Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - Ngaire Kerse
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Aryal S, Blankenship JM, Bachman SL, Hwang S, Zhai Y, Richards JC, Clay I, Lyden K. Patient-centricity in digital measure development: co-evolution of best practice and regulatory guidance. NPJ Digit Med 2024; 7:128. [PMID: 38755349 PMCID: PMC11099175 DOI: 10.1038/s41746-024-01110-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Digital health technologies (DHTs) have the potential to modernize drug development and clinical trial operations by remotely, passively, and continuously collecting ecologically valid evidence that is meaningful to patients' lived experiences. Such evidence holds potential for all drug development stakeholders, including regulatory agencies, as it will help create a stronger evidentiary link between approval of new therapeutics and the ultimate aim of improving patient lives. However, only a very small number of novel digital measures have matured from exploratory usage into regulatory qualification or efficacy endpoints. This shows that despite the clear potential, actually gaining regulatory agreement that a new measure is both fit-for-purpose and delivers value remains a serious challenge. One of the key stumbling blocks for developers has been the requirement to demonstrate that a digital measure is meaningful to patients. This viewpoint aims to examine the co-evolution of regulatory guidance in the United States (U.S.) and best practice for integration of DHTs into the development of clinical outcome assessments. Contextualizing guidance on meaningfulness within the larger shift towards a patient-centric drug development approach, this paper reviews the U.S. Food and Drug Administration (FDA) guidance and existing literature surrounding the development of meaningful digital measures and patient engagement, including the recent examples of rejections by the FDA that further emphasize patient-centricity in digital measures. Finally, this paper highlights remaining hurdles and provides insights into the established frameworks for development and adoption of digital measures in clinical research.
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Affiliation(s)
| | | | | | | | - Yaya Zhai
- VivoSense Inc, Newport Coast, CA, USA
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Delgado-Ortiz L, Ranciati S, Arbillaga-Etxarri A, Balcells E, Buekers J, Demeyer H, Frei A, Gimeno-Santos E, Hopkinson NS, de Jong C, Karlsson N, Louvaris Z, Palmerini L, Polkey MI, Puhan MA, Rabinovich RA, Rodríguez Chiaradia DA, Rodriguez-Roisin R, Toran-Montserrat P, Vogiatzis I, Watz H, Troosters T, Garcia-Aymerich J. Real-world walking cadence in people with COPD. ERJ Open Res 2024; 10:00673-2023. [PMID: 38444656 PMCID: PMC10910309 DOI: 10.1183/23120541.00673-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/05/2023] [Indexed: 03/07/2024] Open
Abstract
Introduction The clinical validity of real-world walking cadence in people with COPD is unsettled. Our objective was to assess the levels, variability and association with clinically relevant COPD characteristics and outcomes of real-world walking cadence. Methods We assessed walking cadence (steps per minute during walking bouts longer than 10 s) from 7 days' accelerometer data in 593 individuals with COPD from five European countries, and clinical and functional characteristics from validated questionnaires and standardised tests. Severe exacerbations during a 12-month follow-up were recorded from patient reports and medical registries. Results Participants were mostly male (80%) and had mean±sd age of 68±8 years, post-bronchodilator forced expiratory volume in 1 s (FEV1) of 57±19% predicted and walked 6880±3926 steps·day-1. Mean walking cadence was 88±9 steps·min-1, followed a normal distribution and was highly stable within-person (intraclass correlation coefficient 0.92, 95% CI 0.90-0.93). After adjusting for age, sex, height and number of walking bouts in fractional polynomial or linear regressions, walking cadence was positively associated with FEV1, 6-min walk distance, physical activity (steps·day-1, time in moderate-to-vigorous physical activity, vector magnitude units, walking time, intensity during locomotion), physical activity experience and health-related quality of life and negatively associated with breathlessness and depression (all p<0.05). These associations remained after further adjustment for daily steps. In negative binomial regression adjusted for multiple confounders, walking cadence related to lower number of severe exacerbations during follow-up (incidence rate ratio 0.94 per step·min-1, 95% CI 0.91-0.99, p=0.009). Conclusions Higher real-world walking cadence is associated with better COPD status and lower severe exacerbations risk, which makes it attractive as a future prognostic marker and clinical outcome.
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Affiliation(s)
- Laura Delgado-Ortiz
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Saverio Ranciati
- Department of Statistical Sciences, Università di Bologna, Bologna, Italy
| | - Ane Arbillaga-Etxarri
- Deusto Physical TherapIker, Physical Therapy Department, Faculty of Health Sciences, University of Deusto, San Sebastian, Spain
| | - Eva Balcells
- Universitat Pompeu Fabra, Barcelona, Spain
- Respiratory Medicine Department, Hospital del Mar, Barcelona, Spain
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Joren Buekers
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Heleen Demeyer
- Department of Rehabilitation Sciences, KULeuven, Leuven, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Elena Gimeno-Santos
- ISGlobal, Barcelona, Spain
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Barcelona, Spain
- Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Corina de Jong
- Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | | | - Luca Palmerini
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi”, Università di Bologna, Bologna, Italy
| | - Michael I. Polkey
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Milo A. Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Roberto A. Rabinovich
- Respiratory Medicine Department, Royal Infirmary of Edinburgh, Centre for Inflammation Research, QMRI, The University of Edinburgh, Scotland, UK
| | - Diego A. Rodríguez Chiaradia
- Respiratory Medicine Department, Hospital del Mar, Barcelona, Spain
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Robert Rodriguez-Roisin
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Barcelona, Spain
- Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Pere Toran-Montserrat
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Mataró, Spain
- Germans Trias i Pujol Research Institute, Badalona, Spain
| | - Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle upon Tyne, UK
| | - Henrik Watz
- Pulmonary Research Institute at Lungen Clinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany
| | | | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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Taraldsen K, Polhemus A, Engdal M, Jansen CP, Becker C, Brenner N, Blain H, Johnsen LG, Vereijken B. Evaluation of mobility recovery after hip fracture: a scoping review of randomized controlled studies. Osteoporos Int 2024; 35:203-215. [PMID: 37801082 PMCID: PMC10837269 DOI: 10.1007/s00198-023-06922-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023]
Abstract
Few older adults regain their pre-fracture mobility after a hip fracture. Intervention studies evaluating effects on gait typically use short clinical tests or in-lab parameters that are often limited to gait speed only. Measurements of mobility in daily life settings exist and should be considered to a greater extent than today. Less than half of hip fracture patients regain their pre-fracture mobility. Mobility recovery is closely linked to health status and quality of life, but there is no comprehensive overview of how gait has been evaluated in intervention studies on hip fracture patients. The purpose was to identify what gait parameters have been used in randomized controlled trials to assess intervention effects on older people's mobility recovery after hip fracture. This scoping review is a secondary paper that identified relevant peer-reviewed and grey literature from 11 databases. After abstract and full-text screening, 24 papers from the original review and 8 from an updated search and manual screening were included. Records were eligible if they included gait parameters in RCTs on hip fracture patients. We included 32 papers from 29 trials (2754 unique participants). Gait parameters were primary endpoint in six studies only. Gait was predominantly evaluated as short walking, with gait speed being most frequently studied. Only five studies reported gait parameters from wearable sensors. Evidence on mobility improvement after interventions in hip fracture patients is largely limited to gait speed as assessed in a controlled setting. The transition from traditional clinical and in-lab to out-of-lab gait assessment is needed to assess effects of interventions on mobility recovery after hip fracture at higher granularity in all aspects of patients' lives, so that optimal care pathways can be defined.
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Affiliation(s)
- K Taraldsen
- Department of Rehabilitation Science and Health Technology, OsloMet, Oslo, Norway.
| | - A Polhemus
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - M Engdal
- Department of Neuromedicine and Movement Science, NTNU, Trondheim, Norway
| | - C-P Jansen
- Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Baden-Württemberg, Germany
| | - C Becker
- Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Baden-Württemberg, Germany
| | - N Brenner
- Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Baden-Württemberg, Germany
| | - H Blain
- Department of Geriatrics, Montpellier University Hospital and Montpellier University MUSE, Montpellier, France
| | - L G Johnsen
- Department of Neuromedicine and Movement Science, NTNU, Trondheim, Norway
- Department of Orthopaedic Surgery, St. Olav's Hospital HF, Trondheim, Norway
| | - B Vereijken
- Department of Neuromedicine and Movement Science, NTNU, Trondheim, Norway
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6
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Buttery SC, Williams PJ, Alghamdi SM, Philip KEJ, Perkins A, Kallis C, Quint JK, Polkey MI, Breuls S, Buekers J, Chynkiamis N, Delgado-Ortiz L, Demeyer H, Frei A, Garcia-Aymerich J, Gimeno-Santos E, Koch S, Megaritis D, Polhemus A, Troosters T, Vogiatzis I, Watz H, Hopkinson NS. Investigating the prognostic value of digital mobility outcomes in patients with chronic obstructive pulmonary disease: a systematic literature review and meta-analysis. Eur Respir Rev 2023; 32:230134. [PMID: 37993126 PMCID: PMC10663939 DOI: 10.1183/16000617.0134-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/05/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Reduced mobility is a central feature of COPD. Assessment of mobility outcomes that can be measured digitally (digital mobility outcomes (DMOs)) in daily life such as gait speed and steps per day is increasingly possible using devices such as pedometers and accelerometers, but the predictive value of these measures remains unclear in relation to key outcomes such as hospital admission and survival. METHODS We conducted a systematic review, nested within a larger scoping review by the MOBILISE-D consortium, addressing DMOs in a range of chronic conditions. Qualitative and quantitative analysis considering steps per day and gait speed and their association with clinical outcomes in COPD patients was performed. RESULTS 21 studies (6076 participants) were included. Nine studies evaluated steps per day and 11 evaluated a measure reflecting gait speed in daily life. Negative associations were demonstrated between mortality risk and steps per day (per 1000 steps) (hazard ratio (HR) 0.81, 95% CI 0.75-0.88, p<0.001), gait speed (<0.80 m·s-1) (HR 3.55, 95% CI 1.72-7.36, p<0.001) and gait speed (per 1.0 m·s-1) (HR 7.55, 95% CI 1.11-51.3, p=0.04). Fewer steps per day (per 1000) and slow gait speed (<0.80 m·s-1) were also associated with increased healthcare utilisation (HR 0.80, 95% CI 0.72-0.88, p<0.001; OR 3.36, 95% CI 1.42-7.94, p=0.01, respectively). Available evidence was of low-moderate quality with few studies eligible for meta-analysis. CONCLUSION Daily step count and gait speed are negatively associated with mortality risk and other important outcomes in people with COPD and therefore may have value as prognostic indicators in clinical trials, but the quantity and quality of evidence is limited. Larger studies with consistent methodologies are called for.
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Affiliation(s)
- Sara C Buttery
- National Heart and Lung Institute, Imperial College London, London, UK
- Department of Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Parris J Williams
- National Heart and Lung Institute, Imperial College London, London, UK
- Department of Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Saeed M Alghamdi
- Clinical Technology Department, Respiratory Care Program, Faculty of Applied Medical Science, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Keir E J Philip
- National Heart and Lung Institute, Imperial College London, London, UK
- Department of Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Alexis Perkins
- National Heart and Lung Institute, Imperial College London, London, UK
- Department of Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | | | - Jennifer K Quint
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Michael I Polkey
- National Heart and Lung Institute, Imperial College London, London, UK
- Department of Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Sofie Breuls
- KU Leuven, Department of Rehabilitation Sciences and Pulmonary Rehabilitation, Respiratory Division, University Hospital Gasthuisberg, Leuven, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Joren Buekers
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Nikolaos Chynkiamis
- Department of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle upon Tyne, UK
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Laura Delgado-Ortiz
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Heleen Demeyer
- KU Leuven, Department of Rehabilitation Sciences and Pulmonary Rehabilitation, Respiratory Division, University Hospital Gasthuisberg, Leuven, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Anja Frei
- Thorax Research Foundation and First Dept. of Respiratory Medicine, National and Kapodistrian University of Athens, Sotiria General Chest Hospital, Athens, Greece
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Elena Gimeno-Santos
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Sarah Koch
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Dimitrios Megaritis
- Department of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle upon Tyne, UK
| | - Ashley Polhemus
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Thierry Troosters
- KU Leuven, Department of Rehabilitation Sciences and Pulmonary Rehabilitation, Respiratory Division, University Hospital Gasthuisberg, Leuven, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Ioannis Vogiatzis
- Thorax Research Foundation and First Dept. of Respiratory Medicine, National and Kapodistrian University of Athens, Sotiria General Chest Hospital, Athens, Greece
- Department of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle upon Tyne, UK
| | - Henrik Watz
- Pulmonary Research Institute at Lungen Clinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - Nicholas S Hopkinson
- National Heart and Lung Institute, Imperial College London, London, UK
- Department of Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
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7
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Keogh A, Mc Ardle R, Diaconu MG, Ammour N, Arnera V, Balzani F, Brittain G, Buckley E, Buttery S, Cantu A, Corriol-Rohou S, Delgado-Ortiz L, Duysens J, Forman-Hardy T, Gur-Arieh T, Hamerlijnck D, Linnell J, Leocani L, McQuillan T, Neatrour I, Polhemus A, Remmele W, Saraiva I, Scott K, Sutton N, van den Brande K, Vereijken B, Wohlrab M, Rochester L. Mobilizing Patient and Public Involvement in the Development of Real-World Digital Technology Solutions: Tutorial. J Med Internet Res 2023; 25:e44206. [PMID: 37889531 PMCID: PMC10638632 DOI: 10.2196/44206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 08/09/2023] [Accepted: 08/31/2023] [Indexed: 10/28/2023] Open
Abstract
Although the value of patient and public involvement and engagement (PPIE) activities in the development of new interventions and tools is well known, little guidance exists on how to perform these activities in a meaningful way. This is particularly true within large research consortia that target multiple objectives, include multiple patient groups, and work across many countries. Without clear guidance, there is a risk that PPIE may not capture patient opinions and needs correctly, thereby reducing the usefulness and effectiveness of new tools. Mobilise-D is an example of a large research consortium that aims to develop new digital outcome measures for real-world walking in 4 patient cohorts. Mobility is an important indicator of physical health. As such, there is potential clinical value in being able to accurately measure a person's mobility in their daily life environment to help researchers and clinicians better track changes and patterns in a person's daily life and activities. To achieve this, there is a need to create new ways of measuring walking. Recent advancements in digital technology help researchers meet this need. However, before any new measure can be used, researchers, health care professionals, and regulators need to know that the digital method is accurate and both accepted by and produces meaningful outcomes for patients and clinicians. Therefore, this paper outlines how PPIE structures were developed in the Mobilise-D consortium, providing details about the steps taken to implement PPIE, the experiences PPIE contributors had within this process, the lessons learned from the experiences, and recommendations for others who may want to do similar work in the future. The work outlined in this paper provided the Mobilise-D consortium with a foundation from which future PPIE tasks can be created and managed with clearly defined collaboration between researchers and patient representatives across Europe. This paper provides guidance on the work required to set up PPIE structures within a large consortium to promote and support the creation of meaningful and efficient PPIE related to the development of digital mobility outcomes.
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Affiliation(s)
- Alison Keogh
- Insight Centre Data Analytics, University College Dublin, Dublin4, Ireland
- School of Medicine, Trinity College Dublin, Dublin2, Ireland
| | - Ríona Mc Ardle
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Mara Gabriela Diaconu
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Nadir Ammour
- Clinical Science and Operations, Global Development, Sanofi Research & Development, Chilly-Mazarin, France
| | - Valdo Arnera
- Clario, Clario Holdings Inc, Geneva, Switzerland
| | - Federica Balzani
- Mobilise-D Patient and Public Advisory Group, Newcastle, United Kingdom
| | - Gavin Brittain
- Department of Clinical Neurology, Sheffield Teaching Hospitals National Health Service, Foundation Trust, Sheffield, United Kingdom
- Sheffield Institute for Translational Neuroscience, The University of Sheffield, Sheffield, United Kingdom
| | - Ellen Buckley
- Department of Mechanical Engineering, University of Sheffield, Sheffield, United Kingdom
- Insigneo Institute for in Silico Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Sara Buttery
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Alma Cantu
- School of Computer Science, Newcastle University, Newcastle, United Kingdom
| | | | - Laura Delgado-Ortiz
- Non-Communicable Diseases and Environment Programme, ISGlobal, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Centro de Investigación Biomedical en Red Epidemiologia y Salud Publica, Barcelona, Spain
| | - Jacques Duysens
- Mobilise-D Patient and Public Advisory Group, Newcastle, United Kingdom
| | - Tom Forman-Hardy
- Mobilise-D Patient and Public Advisory Group, Newcastle, United Kingdom
| | - Tova Gur-Arieh
- Mobilise-D Patient and Public Advisory Group, Newcastle, United Kingdom
| | | | - John Linnell
- Mobilise-D Patient and Public Advisory Group, Newcastle, United Kingdom
| | - Letizia Leocani
- Department of Neurology, San Raffele University, Milan, Italy
| | - Tom McQuillan
- Mobilise-D Patient and Public Advisory Group, Newcastle, United Kingdom
| | - Isabel Neatrour
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Ashley Polhemus
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Werner Remmele
- Mobilise-D Patient and Public Advisory Group, Newcastle, United Kingdom
| | - Isabel Saraiva
- Mobilise-D Patient and Public Advisory Group, Newcastle, United Kingdom
| | - Kirsty Scott
- Department of Mechanical Engineering, University of Sheffield, Sheffield, United Kingdom
- Insigneo Institute for in Silico Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Norman Sutton
- Mobilise-D Patient and Public Advisory Group, Newcastle, United Kingdom
| | | | - Beatrix Vereijken
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Martin Wohlrab
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tuebingen, Tuebingen, Germany
| | - Lynn Rochester
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
- Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, Newcastle, United Kingdom
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8
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Bogen B, Tangen GG, Mc Ardle R. Editorial: Mobility in older adults with cognitive impairment. Front Aging Neurosci 2023; 15:1257605. [PMID: 37559679 PMCID: PMC10407946 DOI: 10.3389/fnagi.2023.1257605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 08/11/2023] Open
Affiliation(s)
- Bård Bogen
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
- Department of Rehabilitation Services, Haraldsplass Deaconal Hospital (HDS), Bergen, Norway
| | - Gro Gujord Tangen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Riona Mc Ardle
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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9
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Clay I, Peerenboom N, Connors DE, Bourke S, Keogh A, Wac K, Gur-Arie T, Baker J, Bull C, Cereatti A, Cormack F, Eggenspieler D, Foschini L, Ganea R, Groenen PM, Gusset N, Izmailova E, Kanzler CM, Leyens L, Lyden K, Mueller A, Nam J, Ng WF, Nobbs D, Orfaniotou F, Perumal TM, Piwko W, Ries A, Scotland A, Taptiklis N, Torous J, Vereijken B, Xu S, Baltzer L, Vetter T, Goldhahn J, Hoffmann SC. Reverse Engineering of Digital Measures: Inviting Patients to the Conversation. Digit Biomark 2023; 7:28-44. [PMID: 37206894 PMCID: PMC10189241 DOI: 10.1159/000530413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/07/2023] [Indexed: 05/21/2023] Open
Abstract
Background Digital measures offer an unparalleled opportunity to create a more holistic picture of how people who are patients behave in their real-world environments, thereby establishing a better connection between patients, caregivers, and the clinical evidence used to drive drug development and disease management. Reaching this vision will require achieving a new level of co-creation between the stakeholders who design, develop, use, and make decisions using evidence from digital measures. Summary In September 2022, the second in a series of meetings hosted by the Swiss Federal Institute of Technology in Zürich, the Foundation for the National Institutes of Health Biomarkers Consortium, and sponsored by Wellcome Trust, entitled "Reverse Engineering of Digital Measures," was held in Zurich, Switzerland, with a broad range of stakeholders sharing their experience across four case studies to examine how patient centricity is essential in shaping development and validation of digital evidence generation tools. Key Messages In this paper, we discuss progress and the remaining barriers to widespread use of digital measures for evidence generation in clinical development and care delivery. We also present key discussion points and takeaways in order to continue discourse and provide a basis for dissemination and outreach to the wider community and other stakeholders. The work presented here shows us a blueprint for how and why the patient voice can be thoughtfully integrated into digital measure development and that continued multistakeholder engagement is critical for further progress.
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Affiliation(s)
| | | | | | | | - Alison Keogh
- Insight Centre for Data Analytics, UC Dublin, Dublin, Ireland
- Mobilise-D, Newcastle University, Newcastle upon Tyne, UK
| | - Katarzyna Wac
- Quality of Life Lab, University of Geneva, Geneva, Switzerland
| | - Tova Gur-Arie
- Mobilise-D, Newcastle University, Newcastle upon Tyne, UK
| | | | - Christopher Bull
- Newcastle University, Newcastle, UK
- IDEA-FAST, Newcastle University, Newcastle upon Tyne, UK
| | - Andrea Cereatti
- Mobilise-D, Newcastle University, Newcastle upon Tyne, UK
- Polytechnic University of Torino, Torino, Italy
| | - Francesca Cormack
- IDEA-FAST, Newcastle University, Newcastle upon Tyne, UK
- Cambridge Cognition Ltd, Cambridge, UK
| | | | | | | | | | | | | | | | | | | | - Arne Mueller
- Mobilise-D, Newcastle University, Newcastle upon Tyne, UK
- Novartis, Basel, Switzerland
| | - Julian Nam
- F. Hoffmann-La Roche, Basel, Switzerland
| | - Wan-Fai Ng
- Newcastle University, Newcastle, UK
- IDEA-FAST, Newcastle University, Newcastle upon Tyne, UK
| | - David Nobbs
- IDEA-FAST, Newcastle University, Newcastle upon Tyne, UK
- F. Hoffmann-La Roche, Basel, Switzerland
| | | | | | - Wojciech Piwko
- Takeda Pharmaceuticals International, Zurich, Switzerland
| | - Anja Ries
- F. Hoffmann-La Roche, Basel, Switzerland
| | - Alf Scotland
- Biogen Digital Health International GmbH, Baar, Switzerland
| | - Nick Taptiklis
- IDEA-FAST, Newcastle University, Newcastle upon Tyne, UK
- Cambridge Cognition Ltd, Cambridge, UK
| | | | - Beatrix Vereijken
- Mobilise-D, Newcastle University, Newcastle upon Tyne, UK
- Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | | | - Jörg Goldhahn
- Swiss Federal Institute of Technology, Zurich, Switzerland
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