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Nawabi NLA, Emedom-Nnamdi P, Kilgallon JL, Gerstl JVE, Cote DJ, Jha R, Ellen JG, Maniar KM, Hong CS, Dawood HY, Onnela JP, Smith TR. Assessing Mobility in Patients With Glioblastoma Using Digital Phenotyping-Piloting the Digital Assessment in Neuro-Oncology. Neurosurgery 2024:00006123-990000000-01231. [PMID: 38912791 DOI: 10.1227/neu.0000000000003051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/26/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Digital phenotyping (DP) enables objective measurements of patient behavior and may be a useful tool in assessments of quality-of-life and functional status in neuro-oncology patients. We aimed to identify trends in mobility among patients with glioblastoma (GBM) using DP. METHODS A total of 15 patients with GBM enrolled in a DP study were included. The Beiwe application was used to passively collect patient smartphone global positioning system data during the study period. We estimated step count, time spent at home, total distance traveled, and number of places visited in the preoperative, immediate postoperative, and late postoperative periods. Mobility trends for patients with GBM after surgery were calculated by using local regression and were compared with preoperative values and with values derived from a nonoperative spine disease group. RESULTS One month postoperatively, median values for time spent at home and number of locations visited by patients with GBM decreased by 1.48 h and 2.79 locations, respectively. Two months postoperatively, these values further decreased by 0.38 h and 1.17 locations, respectively. Compared with the nonoperative spine group, values for time spent at home and the number of locations visited by patients with GBM 1 month postoperatively were less than control values by 0.71 h and 2.79 locations, respectively. Two months postoperatively, time spent at home for patients with GBM was higher by 1.21 h and locations visited were less than nonoperative spine group values by 1.17. Immediate postoperative values for distance traveled, maximum distance from home, and radius of gyration for patients with GBM increased by 0.346 km, 2.24 km, and 1.814 km, respectively, compared with preoperative values. CONCLUSIONS :Trends in patients with GBM mobility throughout treatment were quantified through the use of DP in this study. DP has the potential to quantify patient behavior and recovery objectively and with minimal patient burden.
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Affiliation(s)
- Noah L A Nawabi
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Patrick Emedom-Nnamdi
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - John L Kilgallon
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jakob V E Gerstl
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - David J Cote
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Rohan Jha
- Harvard Medical School, Boston, Massachusetts, USA
| | | | - Krish M Maniar
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Christopher S Hong
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Hassan Y Dawood
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Timothy R Smith
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Karas M, Olsen J, Straczkiewicz M, Johnson SA, Burke KM, Iwasaki S, Lahav A, Scheier ZA, Clark AP, Iyer AS, Huang E, Berry JD, Onnela J. Tracking amyotrophic lateral sclerosis disease progression using passively collected smartphone sensor data. Ann Clin Transl Neurol 2024; 11:1380-1392. [PMID: 38816946 PMCID: PMC11187949 DOI: 10.1002/acn3.52050] [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: 11/08/2023] [Revised: 02/03/2024] [Accepted: 03/05/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Passively collected smartphone sensor data provide an opportunity to study physical activity and mobility unobtrusively over long periods of time and may enable disease monitoring in people with amyotrophic lateral sclerosis (PALS). METHODS We enrolled 63 PALS who used Beiwe mobile application that collected their smartphone accelerometer and GPS data and administered the self-entry ALS Functional Rating Scale-Revised (ALSFRS-RSE) survey. We identified individual steps from accelerometer data and used the Activity Index to summarize activity at the minute level. Walking, Activity Index, and GPS outcomes were then aggregated into day-level measures. We used linear mixed effect models (LMMs) to estimate baseline and monthly change for ALSFRS-RSE scores (total score, subscores Q1-3, Q4-6, Q7-9, Q10-12) and smartphone sensor data measures, as well as the associations between them. FINDINGS The analytic sample (N = 45) was 64.4% male with a mean age of 60.1 years. The mean observation period was 292.3 days. The ALSFRS-RSE total score baseline mean was 35.8 and had a monthly rate of decline of -0.48 (p-value <0.001). We observed statistically significant change over time and association with ALSFRS-RSE total score for four smartphone sensor data-derived measures: walking cadence from top 1 min and log-transformed step count, step count from top 1 min, and Activity Index from top 1 min. INTERPRETATION Smartphone sensors can unobtrusively track physical changes in PALS, potentially aiding disease monitoring and future research.
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Affiliation(s)
- Marta Karas
- Department of Biostatistics, Harvard T.H. Chan School of Public HealthHarvard University677 Huntington Ave.BostonMassachusetts02115USA
| | - Julia Olsen
- Department of Biostatistics, Harvard T.H. Chan School of Public HealthHarvard University677 Huntington Ave.BostonMassachusetts02115USA
| | - Marcin Straczkiewicz
- Department of Biostatistics, Harvard T.H. Chan School of Public HealthHarvard University677 Huntington Ave.BostonMassachusetts02115USA
| | - Stephen A. Johnson
- Department of NeurologyMayo Clinic13400 E. Shea Blvd.ScottsdaleArizona85259USA
| | - Katherine M. Burke
- Neurological Clinical Research Institute and Sean M. Healey & AMG Center for ALS, Massachusetts General Hospital15 Parkman St #835BostonMassachusetts02114USA
| | - Satoshi Iwasaki
- Mitsubishi Tanabe Pharma Holdings America, Inc.525 Washington Blvd.Jersey CityNew Jersey07310USA
| | - Amir Lahav
- Mitsubishi Tanabe Pharma Holdings America, Inc.525 Washington Blvd.Jersey CityNew Jersey07310USA
| | - Zoe A. Scheier
- Neurological Clinical Research Institute and Sean M. Healey & AMG Center for ALS, Massachusetts General Hospital15 Parkman St #835BostonMassachusetts02114USA
| | - Alison P. Clark
- Neurological Clinical Research Institute and Sean M. Healey & AMG Center for ALS, Massachusetts General Hospital15 Parkman St #835BostonMassachusetts02114USA
| | - Amrita S. Iyer
- Neurological Clinical Research Institute and Sean M. Healey & AMG Center for ALS, Massachusetts General Hospital15 Parkman St #835BostonMassachusetts02114USA
| | - Emily Huang
- Department of Statistical SciencesWake Forest UniversityWinston‐SalemNorth Carolina27106USA
| | - James D. Berry
- Neurological Clinical Research Institute and Sean M. Healey & AMG Center for ALS, Massachusetts General Hospital15 Parkman St #835BostonMassachusetts02114USA
| | - Jukka‐Pekka Onnela
- Department of Biostatistics, Harvard T.H. Chan School of Public HealthHarvard University677 Huntington Ave.BostonMassachusetts02115USA
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Jurek M, Calder CA, Zigler C. Statistical inference for complete and incomplete mobility trajectories under the flight-pause model. J R Stat Soc Ser C Appl Stat 2024; 73:162-192. [PMID: 38222067 PMCID: PMC10782461 DOI: 10.1093/jrsssc/qlad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 07/05/2023] [Accepted: 09/07/2023] [Indexed: 01/16/2024]
Abstract
We formulate a statistical flight-pause model (FPM) for human mobility, represented by a collection of random objects, called motions, appropriate for mobile phone tracking (MPT) data. We develop the statistical machinery for parameter inference and trajectory imputation under various forms of missing data. We show that common assumptions about the missing data mechanism for MPT are not valid for the mechanism governing the random motions underlying the FPM, representing an understudied missing data phenomenon. We demonstrate the consequences of missing data and our proposed adjustments in both simulations and real data, outlining implications for MPT data collection and design.
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Affiliation(s)
- Marcin Jurek
- Department of Statistics and Data Sciences, University of Texas at Austin, Austin, TX, USA
| | - Catherine A Calder
- Department of Statistics and Data Sciences, University of Texas at Austin, Austin, TX, USA
| | - Corwin Zigler
- Department of Statistics and Data Sciences, University of Texas at Austin, Austin, TX, USA
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Galatzer-Levy IR, Onnela JP. Machine Learning and the Digital Measurement of Psychological Health. Annu Rev Clin Psychol 2023; 19:133-154. [PMID: 37159287 DOI: 10.1146/annurev-clinpsy-080921-073212] [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: 05/10/2023]
Abstract
Since its inception, the discipline of psychology has utilized empirical epistemology and mathematical methodologies to infer psychological functioning from direct observation. As new challenges and technological opportunities emerge, scientists are once again challenged to define measurement paradigms for psychological health and illness that solve novel problems and capitalize on new technological opportunities. In this review, we discuss the theoretical foundations of and scientific advances in remote sensor technology and machine learning models as they are applied to quantify psychological functioning, draw clinical inferences, and chart new directions in treatment.
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Affiliation(s)
- Isaac R Galatzer-Levy
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA;
- Current affiliation: Google LLC, Mountain View, California, USA
| | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Kiang MV, Chen JT, Krieger N, Buckee CO, Alexander MJ, Baker JT, Buckner RL, Coombs G, Rich-Edwards JW, Carlson KW, Onnela JP. Sociodemographic characteristics of missing data in digital phenotyping. Sci Rep 2021; 11:15408. [PMID: 34326370 PMCID: PMC8322366 DOI: 10.1038/s41598-021-94516-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/12/2021] [Indexed: 11/09/2022] Open
Abstract
The ubiquity of smartphones, with their increasingly sophisticated array of sensors, presents an unprecedented opportunity for researchers to collect longitudinal, diverse, temporally-dense data about human behavior while minimizing participant burden. Researchers increasingly make use of smartphones for "digital phenotyping," the collection and analysis of raw phone sensor and log data to study the lived experiences of subjects in their natural environments using their own devices. While digital phenotyping has shown promise in fields such as psychiatry and neuroscience, there are fundamental gaps in our knowledge about data collection and non-collection (i.e., missing data) in smartphone-based digital phenotyping. In this meta-study using individual-level data from six different studies, we examined accelerometer and GPS sensor data of 211 participants, amounting to 29,500 person-days of observation, using Bayesian hierarchical negative binomial regression with study- and user-level random intercepts. Sensitivity analyses including alternative model specification and stratified models were conducted. We found that iOS users had lower GPS non-collection than Android users. For GPS data, rates of non-collection did not differ by race/ethnicity, education, age, or gender. For accelerometer data, Black participants had higher rates of non-collection, but rates did not differ by sex, education, or age. For both sensors, non-collection increased by 0.5% to 0.9% per week. These results demonstrate the feasibility of using smartphone-based digital phenotyping across diverse populations, for extended periods of time, and within diverse cohorts. As smartphones become increasingly embedded in everyday life, the insights of this study will help guide the design, planning, and analysis of digital phenotyping studies.
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Affiliation(s)
- Mathew V Kiang
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Caroline O Buckee
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Monica J Alexander
- Department of Sociology, University of Toronto, Toronto, ON, Canada
- Department of Statistical Sciences, University of Toronto, Toronto, ON, Canada
| | - Justin T Baker
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Randy L Buckner
- Department of Psychology, Harvard University, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Garth Coombs
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Janet W Rich-Edwards
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical, Boston, MA, USA
| | - Kenzie W Carlson
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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