Walking on common ground: a cross-disciplinary scoping review on the clinical utility of digital mobility outcomes.
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ABSTRACT:
SUBMITTER: Polhemus A
PROVIDER: S-EPMC8516969 | biostudies-literature | 2021 Oct
REPOSITORIES: biostudies-literature
Publications
Walking on common ground: a cross-disciplinary scoping review on the clinical utility of digital mobility outcomes.
Polhemus Ashley A Delgado-Ortiz Laura L Brittain Gavin G Chynkiamis Nikolaos N Salis Francesca F Gaßner Heiko H Gross Michaela M Kirk Cameron C Rossanigo Rachele R Taraldsen Kristin K Balta Diletta D Breuls Sofie S Buttery Sara S Cardenas Gabriela G Endress Christoph C Gugenhan Julia J Keogh Alison A Kluge Felix F Koch Sarah S Micó-Amigo M Encarna ME Nerz Corinna C Sieber Chloé C Williams Parris P Bergquist Ronny R Bosch de Basea Magda M Buckley Ellen E Hansen Clint C Mikolaizak A Stefanie AS Schwickert Lars L Scott Kirsty K Stallforth Sabine S van Uem Janet J Vereijken Beatrix B Cereatti Andrea A Demeyer Heleen H Hopkinson Nicholas N Maetzler Walter W Troosters Thierry T Vogiatzis Ioannis I Yarnall Alison A Becker Clemens C Garcia-Aymerich Judith J Leocani Letizia L Mazzà Claudia C Rochester Lynn L Sharrack Basil B Frei Anja A Puhan Milo M
NPJ digital medicine 20211014 1
Physical mobility is essential to health, and patients often rate it as a high-priority clinical outcome. Digital mobility outcomes (DMOs), such as real-world gait speed or step count, show promise as clinical measures in many medical conditions. However, current research is nascent and fragmented by discipline. This scoping review maps existing evidence on the clinical utility of DMOs, identifying commonalities across traditional disciplinary divides. In November 2019, 11 databases were searche ...[more]
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Project description:IntroductionAdvances in wearable sensor technology now enable frequent, objective monitoring of real-world walking. Walking-related digital mobility outcomes (DMOs), such as real-world walking speed, have the potential to be more sensitive to mobility changes than traditional clinical assessments. However, it is not yet clear which DMOs are most suitable for formal validation. In this review, we will explore the evidence on discriminant ability, construct validity, prognostic value and responsiveness of walking-related DMOs in four disease areas: Parkinson's disease, multiple sclerosis, chronic obstructive pulmonary disease and proximal femoral fracture.Methods and analysisArksey and O'Malley's methodological framework for scoping reviews will guide study conduct. We will search seven databases (Medline, CINAHL, Scopus, Web of Science, EMBASE, IEEE Digital Library and Cochrane Library) and grey literature for studies which (1) measure differences in DMOs between healthy and pathological walking, (2) assess relationships between DMOs and traditional clinical measures, (3) assess the prognostic value of DMOs and (4) use DMOs as endpoints in interventional clinical trials. Two reviewers will screen each abstract and full-text manuscript according to predefined eligibility criteria. We will then chart extracted data, map the literature, perform a narrative synthesis and identify gaps.Ethics and disseminationAs this review is limited to publicly available materials, it does not require ethical approval. This work is part of Mobilise-D, an Innovative Medicines Initiative Joint Undertaking which aims to deliver, validate and obtain regulatory approval for DMOs. Results will be shared with the scientific community and general public in cooperation with the Mobilise-D communication team.RegistrationStudy materials and updates will be made available through the Center for Open Science's OSFRegistry (https://osf.io/k7395).
| S-EPMC7371223 | biostudies-literature
Project description:BackgroundSolutions to global health challenges depend on nations' capacity for cross-disciplinary research in global health. Despite longstanding demands for practical guidelines, published guidance and frameworks for evaluating cross-disciplinary research are scarce and scattered among disciplines. We aimed to bring together information on how cross-disciplinary research has been evaluated and collate the frameworks and tools that have been used to advance knowledge and practice about the design and evaluation of cross-disciplinary research in global health.MethodsWe conducted a systematic scoping review by searching five databases (MEDLINE, CINAHL COMPLETE, Global Health, PubMed, Web of Science) for publications relevant for our objectives. These were to understand the characteristics of frameworks used to evaluate cross-disciplinary research, to describe how they had been used in practice, and to identify underlying common underpinning criteria. Our inclusion criteria were that the publications (a) focus on frameworks for cross-disciplinary research and (b) include aspects of evaluation or monitoring. The last search was conducted in July 2023.ResultsThirty-one of 2718 screened publications met our inclusion criteria. The intended users of the frameworks were cross-disciplinary researchers (31; 97%), funders (15; 48%), evaluators/reviewers (15; 48%) and practitioners/stakeholders (10; 32%). Eight frameworks (26%) were bespoke for a particular project and used a 'context-process-outcome' approach to incorporate the whole research pathway. Four frameworks (13%) focused on evaluating outcome/impact. Nineteen (61%) focused on other specific aspects of cross-disciplinary research. Seventeen frameworks (55%) provided evaluation tools and 14 (45%) included guidance about their use in practice. Twenty-four (77%) provided examples of how their frameworks were used in practice, and 21 (68%) stated that their frameworks were generalizable in different contexts. The criteria used for the evaluations across the publications fell into four categories: appropriate cross-disciplinary research approaches for the project goal; shared learning and integration; meeting disciplinary standards; and effective synthesis.ConclusionsOur collation and description of the heterogenous published guidance and frameworks for evaluating cross-disciplinary research, and our practical lessons for how to improve the robustness of such evaluations, will help funders, researchers and evaluators to make evidence-informed choices when they commission, design and evaluate cross-disciplinary research programmes in global health.
| S-EPMC11800405 | biostudies-literature
Project description:BackgroundMaternal and child health (MCH) is a global health concern, especially impacting low- and middle-income countries (LMIC). Digital health technologies are creating opportunities to address the social determinants of MCH by facilitating access to information and providing other forms of support throughout the maternity journey. Previous reviews in different disciplines have synthesized digital health intervention outcomes in LMIC. However, contributions in this space are scattered across publications in different disciplines and lack coherence in what digital MCH means across fields.ObjectiveThis cross-disciplinary scoping review synthesized the existing published literature in 3 major disciplines on the use of digital health interventions for MCH in LMIC, with a particular focus on sub-Saharan Africa.MethodsWe conducted a scoping review using the 6-stage framework by Arksey and O'Malley across 3 disciplines, including public health, social sciences applied to health, and human-computer interaction research in health care. We searched the following databases: Scopus, PubMed, Google Scholar, ACM Digital Library, IEEE Xplore, Web of Science, and PLOS. A stakeholder consultation was undertaken to inform and validate the review.ResultsDuring the search, 284 peer-reviewed articles were identified. After removing 41 duplicates, 141 articles met our inclusion criteria: 34 from social sciences applied to health, 58 from public health, and 49 from human-computer interaction research in health care. These articles were then tagged (labeled) by 3 researchers using a custom data extraction framework to obtain the findings. First, the scope of digital MCH was found to target health education (eg, breastfeeding and child nutrition), care and follow-up of health service use (to support community health workers), maternal mental health, and nutritional and health outcomes. These interventions included mobile apps, SMS text messaging, voice messaging, web-based applications, social media, movies and videos, and wearable or sensor-based devices. Second, we highlight key challenges: little attention has been given to understanding the lived experiences of the communities; key role players (eg, fathers, grandparents, and other family members) are often excluded; and many studies are designed considering nuclear families that do not represent the family structures of the local cultures.ConclusionsDigital MCH has shown steady growth in Africa and other LMIC settings. Unfortunately, the role of the community was negligible, as these interventions often do not include communities early and inclusively enough in the design process. We highlight key opportunities and sociotechnical challenges for digital MCH in LMIC, such as more affordable mobile data; better access to smartphones and wearable technologies; and the rise of custom-developed, culturally appropriate apps that are more suited to low-literacy users. We also focus on barriers such as an overreliance on text-based communications and the difficulty of MCH research and design to inform and translate into policy.
| S-EPMC10131761 | biostudies-literature
Project description:BackgroundDigital contact tracing apps have the potential to augment contact tracing systems and disrupt COVID-19 transmission by rapidly identifying secondary cases prior to the onset of infectiousness and linking them into a system of quarantine, testing, and health care worker case management. The international experience of digital contact tracing apps during the COVID-19 pandemic demonstrates how challenging their design and deployment are.ObjectiveThis study aims to derive and summarize best practice guidance for the design of the ideal digital contact tracing app.MethodsA collaborative cross-disciplinary approach was used to derive best practice guidance for designing the ideal digital contact tracing app. A search of the indexed and gray literature was conducted to identify articles describing or evaluating digital contact tracing apps. MEDLINE was searched using a combination of free-text terms and Medical Subject Headings search terms. Gray literature sources searched were the World Health Organization Institutional Repository for Information Sharing, the European Centre for Disease Prevention and Control publications library, and Google, including the websites of many health protection authorities. Articles that were acceptable for inclusion in this evidence synthesis were peer-reviewed publications, cohort studies, randomized trials, modeling studies, technical reports, white papers, and media reports related to digital contact tracing.ResultsEthical, user experience, privacy and data protection, technical, clinical and societal, and evaluation considerations were identified from the literature. The ideal digital contact tracing app should be voluntary and should be equitably available and accessible. User engagement could be enhanced by small financial incentives, enabling users to tailor aspects of the app to their particular needs and integrating digital contact tracing apps into the wider public health information campaign. Adherence to the principles of good data protection and privacy by design is important to convince target populations to download and use digital contact tracing apps. Bluetooth Low Energy is recommended for a digital contact tracing app's contact event detection, but combining it with ultrasound technology may improve a digital contact tracing app's accuracy. A decentralized privacy-preserving protocol should be followed to enable digital contact tracing app users to exchange and record temporary contact numbers during contact events. The ideal digital contact tracing app should define and risk-stratify contact events according to proximity, duration of contact, and the infectiousness of the case at the time of contact. Evaluating digital contact tracing apps requires data to quantify app downloads, use among COVID-19 cases, successful contact alert generation, contact alert receivers, contact alert receivers that adhere to quarantine and testing recommendations, and the number of contact alert receivers who subsequently are tested positive for COVID-19. The outcomes of digital contact tracing apps' evaluations should be openly reported to allow for the wider public to review the evaluation of the app.ConclusionsIn conclusion, key considerations and best practice guidance for the design of the ideal digital contact tracing app were derived from the literature.
| S-EPMC8189288 | biostudies-literature
Project description:BackgroundThe Andago is a rehabilitation robot that allows training walking over-ground while providing bodyweight unloading (BWU). We investigated the practicability, acceptability, and appropriateness of the device in children with gait impairments undergoing neurorehabilitation. Concerning appropriateness, we investigated whether (i) stride-to-stride variability of the stride time and inter-joint coordination was higher when walking over-ground in Andago versus treadmill walking, and (ii) activation of antigravity leg muscles decreased with higher levels of BWU.MethodsEighteen children and adolescents with gait impairments participated in three sessions. Practicability was assessed by determining the time needed to get a patient in and out of Andago, the accuracy of the BWU system, and other aspects. Acceptability was assessed by patients responding to questions, while six therapists filled out the System Usability Scale. To determine appropriateness, the participants were equipped with surface electromyography (sEMG) electrodes, electrogoniometers and accelerometers. Various parameters were compared between walking over-ground and on a treadmill, and between walking with three different levels of BWU (median: 20%, 35% and 50% of the bodyweight) over-ground.ResultsPracticability: the average time needed to get in and out of Andago amounted to 60 s and 16 s, respectively. The BWU system seemed accurate, especially at higher levels. We experienced no technical difficulties and Andago prevented 12 falls. However, participants had difficulties walking through a door without bumping into it. Acceptability: after the second session, nine participants felt safer walking in Andago compared to normal walking, 15 preferred walking in Andago compared to treadmill walking, and all wanted to train again with Andago. Therapists rated the usability of the Andago as excellent. Appropriateness: stride-to-stride variability of stride duration and inter-joint coordination was higher in Andago compared to treadmill walking. sEMG activity was not largely influenced by the levels of BWU investigated in this study, except for a reduced M. Gluteus Medius activity at the highest level of BWU tested.ConclusionsThe Andago is a practical and well-accepted device to train walking over-ground with BWU in children and adolescents with gait impairments safely. The system allows individual stride-to-stride variability of temporospatial gait parameters without affecting antigravity muscle activity strongly.Trial registrationClinicalTrials.gov Identifier: NCT03787199.
| S-EPMC7871598 | biostudies-literature
Project description:Electronic health records (EHRs) allow for meaningful usage of healthcare data. Their adoption provides clinicians with a central location to access and share data, write notes, order labs and prescriptions, and bill for patient visits. However, as non-clinical requirements have increased, time spent using EHRs eclipsed time spent on direct patient care. Several solutions have been proposed to minimize the time spent using EHRs, though each have limitations. Digital scribe technology uses voice-to-text software to convert ambient listening to meaningful medical notes and may eliminate the physical task of documentation, allowing physicians to spend less time on EHR engagement and more time with patients. However, adoption of digital scribe technology poses many barriers for physicians. In this study, we perform a scoping review of the literature to identify barriers to digital scribe implementation and provide solutions to address these barriers. We performed a literature review of digital scribe technology and voice-to-text conversion and information extraction as a scope for future research. Fifteen articles met inclusion criteria. Of the articles included, four were comparative studies, three were reviews, three were original investigations, two were perspective pieces, one was a cost-effectiveness study, one was a keynote address, and one was an observational study. The published articles on digital scribe technology and voice-to-text conversion highlight digital scribe technology as a solution to the inefficient interaction with EHRs. Benefits of digital scribe technologies included enhancing clinician ability to navigate charts, write notes, use decision support tools, and improve the quality of time spent with patients. Digital scribe technologies can improve clinic efficiency and increase patient access to care while simultaneously reducing physician burnout. Implementation barriers include upfront costs, integration with existing technology, and time-intensive training. Technological barriers include adaptability to linguistic differences, compatibility across different clinical encounters, and integration of medical jargon into the note. Broader risks include automation bias and risks to data privacy. Overcoming significant barriers to implementation will facilitate more widespread adoption.Supplementary informationThe online version contains supplementary material available at 10.1007/s12553-021-00568-0.
| S-EPMC8169416 | biostudies-literature
Project description:ObjectivesWe aimed to derive observational research evidence on treatment patterns through a scoping review of common data model (CDM)-based publications.MethodsWe searched the medical literature databases PubMed and EMBASE, as well as the Observational Health Data Sciences and Informatics (OHDSI) website, for papers published between January 1, 2010 and August 21, 2023 to identify research papers relevant to our topic.ResultsEighteen articles satisfied the inclusion criteria for this scoping review. We summarized study characteristics such as phenotypes, patient numbers, data periods, countries, Observational Medical Outcomes Partnership (OMOP) CDM databases, and definitions of index date and target cohort. Type 2 diabetes mellitus emerged as the most frequently studied disease, covered in five articles, followed by hypertension and depression, each addressed in four articles. Biguanides, with metformin as the primary drug, were the most commonly prescribed first-line treatments for type 2 diabetes mellitus. Most studies utilized sunburst plots to visualize treatment patterns, whereas two studies used Sankey plots. Various software tools were employed for treatment pattern analysis, including JavaScript, the open-source ATLAS by OHDSI, R code, and the R package "TreatmentPatterns."ConclusionsThis study provides a comprehensive overview of research on treatment patterns using the CDM, highlighting the growing importance of OMOP CDM in enabling multinational observational network studies and advancing collaborative research in this field.
| S-EPMC11854637 | biostudies-literature
Project description:BackgroundAssociation between human mobility and disease transmission has been established for COVID-19, but quantifying the levels of mobility over large geographical areas is difficult. Google has released Community Mobility Reports (CMRs) containing data about the movement of people, collated from mobile devices.ObjectiveThe aim of this study is to explore the use of CMRs to assess the role of mobility in spreading COVID-19 infection in India.MethodsIn this ecological study, we analyzed CMRs to determine human mobility between March and October 2020. The data were compared for the phases before the lockdown (between March 14 and 25, 2020), during lockdown (March 25-June 7, 2020), and after the lockdown (June 8-October 15, 2020) with the reference periods (ie, January 3-February 6, 2020). Another data set depicting the burden of COVID-19 as per various disease severity indicators was derived from a crowdsourced API. The relationship between the two data sets was investigated using the Kendall tau correlation to depict the correlation between mobility and disease severity.ResultsAt the national level, mobility decreased from -38% to -77% for all areas but residential (which showed an increase of 24.6%) during the lockdown compared to the reference period. At the beginning of the unlock phase, the state of Sikkim (minimum cases: 7) with a -60% reduction in mobility depicted more mobility compared to -82% in Maharashtra (maximum cases: 1.59 million). Residential mobility was negatively correlated (-0.05 to -0.91) with all other measures of mobility. The magnitude of the correlations for intramobility indicators was comparatively low for the lockdown phase (correlation ≥0.5 for 12 indicators) compared to the other phases (correlation ≥0.5 for 45 and 18 indicators in the prelockdown and unlock phases, respectively). A high correlation coefficient between epidemiological and mobility indicators was observed for the lockdown and unlock phases compared to the prelockdown phase.ConclusionsMobile-based open-source mobility data can be used to assess the effectiveness of social distancing in mitigating disease spread. CMR data depicted an association between mobility and disease severity, and we suggest using this technique to supplement future COVID-19 surveillance.
| S-EPMC8407437 | biostudies-literature
Project description:BackgroundThe main focus of rehabilitation following hip fracture is to regain mobility.ObjectivesTo estimate the progression of real-world mobility the first year after hip fracture using digital mobility outcomes.DesignAn exploratory, prospective cohort study with pooled data from four previously conducted clinical trials.Setting and subjectsWe combined data from the Trondheim Hip Fracture Trial and Eva-Hip Trial in Trondheim, Norway, and the PROFinD 1 and PROFinD 2 trials in Stuttgart and Heidelberg, Germany, resulting in a sample of 717 hip fracture patients aged ≥65 years.MethodsEach of the trials assessed mobility using body-fixed sensors (activPAL) at three time points, collectively providing observations across the entire first year post-surgery. The following 24-h DMOs were calculated: total walking duration (minutes), maximum number of steps within a walking bout, and number of sit-to-stand-to-walk transfers. Continuous 1-year progression of the median, the 25th percentile, and the 75th percentile were estimated using quantile regression models with splines.ResultsThe dataset contained 5909 observation days. The median daily total walking duration increased until 36 weeks post-surgery reaching 40 min; daily maximum number of steps within a walking bout increased during the first eight weeks and then stabilized at less than 100 steps; daily sit-to-stand-to-walk transfers reached a plateau after 6 weeks with less than 40 transfers.ConclusionsThe three DMOs progressed differently and attained plateau levels at varying times during the first year after hip fracture, indicating that these Digital Mobility Outcomes provide complementary information about different aspects of mobility recovery.
| S-EPMC11518866 | biostudies-literature
Project description:IntroductionFalls pose significant health risks to older adults, impacting their quality of life. Preventive strategies are crucial, as research shows that fall prevention interventions can effectively reduce fall risks. However, these interventions often suffer from low adherence and uptake. Digital, interactive interventions, incorporating experience-, and game-related aspects, offer a promising solution, making this topic inherently cross-disciplinary.ObjectiveThis review aims to assess the current landscape of digital interactive experience and game-based fall interventions for community-dwelling, healthy older adults. It focuses on integrating Human Movement Science and User Experience & Game Design perspectives, emphasizing the cross-disciplinary nature of this research.MethodsWe employed a cross-disciplinary literature search framework, searching the databases ACM-DL, IEEE-Xplore, ScienceDirect, PubMed, Scopus, and Web of Science. The review focused on healthy community-dwelling older adults (50+), including those at risk of falling. Excluded were studies involving chronic diseases, non-age-related impairments, other age groups, or individuals receiving care. Only digital, interactive fall prevention interventions without commercial software were considered. Studies published between 2000-2024 were included. A qualitative thematic synthesis was conducted, focusing on four categories: Objectives (O), Design and Development (D), Types of Intervention (T), and Evaluation Methods (E).ResultsThe search yielded 2,747 results, with 59 articles included in the final synthesis. Objectives were mainly driven by a combination of HMS and UXG rather than a single aspect. In Design and Development it was observed that concept-based design was scarce, with most being procedure-based. Descriptions of interventions frequently lacked specificity, particularly in-depth experience-related terminology and exercise descriptions. Evaluation methods were found to be more frequently informed by both HMS and UXG, although only four studies used a mixed-method approach to explore their interplay. Among included articles, most aspects incorporated both HMS and UXG across all four categories: O(n = 37), D(n = 37), T(n = 54), and E(n = 21).ConclusionThe review underscores the importance of digital interactive experience- and game-based fall prevention interventions. It highlights the need for enhanced cross-disciplinary collaboration between HMS and UXG to address gaps, such as the lack of a shared thesaurus and standardized guidelines, which are vital for improving transparency, reproducibility, and the refinement of these interventions.
| S-EPMC11799000 | biostudies-literature