Category: Technology
Objective: To develop telehealth digital data collection methods for evaluation of multi-modal function in people with Parkinson’s Disease (PwPD) and develop biomedical informatics tools for collation, storage and future data exploration.
Background: Gait and balance problems make travel cumbersome in PwPD, and cognitive impairments limit driving, making PwPD reliant on others for transportation. This limits both access to care and research participation. About 75% of the population seen at the UAMS Movement Disorders Clinic reside in designated medically underserved areas.
Method: In-home telemedicine research visits were performed in PwPD using the Doxy.me platform. To quantify motor and non-motor features of PwPD, 12 digital instruments created in the Research Electronic Data Capture (REDCap) platform were administered. Digital data from REDCap, electronic medical records and imaging archives were integrated, pseudonymized, and securely stored in the Arkansas Research Image Enterprise System (ARIES). ARIES, an informatics platform developed by our team, will facilitate future data mining from stored data sets using semantic representations that leverage axiomatically rich ontologies.
Results: Over 4 months 19 PwPD with a mean age of 67.5±6.9 years, disease duration of 8.9±6.2 years, modified motor Unified Parkinson’s Disease Rating Scale (UPDRS) score of 12.2±6.2, total UPDRS score of 22.8±10.6 and Hoehn & Yahr staging of 2.1±0.3 participated. Mean Montreal Cognitive Assessment scores were 26.4±3.0, Parkinson’s Disease Questionnaire (PDQ-39) scores were 22.8±17.9 and REM sleep behavior disorder screening scores were 4.5±2.7. Mean timed-up-and-go times were 11.7±3.3s. Voice and handwritings samples were also collected. On an after visit survey, ability to participate in research (89%) and perform visits at home (79%) were top features with 50% reporting greater likelihood of future telemedicine over in-person research participation. For clinic visits, 50% reported travel >30 miles and 25% costs >$35. Only 16% of participants required us to spend >5 minutes on set-up, with >5 minutes of additional time to help understand, locate or complete assessments in 32%. We rated great audio-video quality in 63% of visits.
Conclusion: In-home visits in PwPD are feasible, and could help improve access to care and research participation in rural and underserved regions.
To cite this abstract in AMA style:
T. Virmani, L. Pillai, A. Glover, A. Kemp, J. Utecht, H. Spencer, T. Nolan, M. Rutherford, P. Farmer, S. Syed, H. Eswaran, M. Lotia, J. Bona, L. Larson-Prior, F. Prior. Development of quantitative tools for in-home clinical assessment of people with Parkinson’s disease [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/development-of-quantitative-tools-for-in-home-clinical-assessment-of-people-with-parkinsons-disease/. Accessed November 22, 2024.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/development-of-quantitative-tools-for-in-home-clinical-assessment-of-people-with-parkinsons-disease/