Objective: Objective: To evaluate the influence of composite scoring methodologies using digital measures of gait, tremor, and bradykinesia to monitor disease progression over one year in early-stage Parkinson’s disease (PD).

Background: Clinical measures of motor function in PD rely on assessments that capture major functional domains (e.g., gait, tremor, bradykinesia). However, measures collected using digital health technologies (DHTs) often provide information related to biomechanical features within each functional domain, for example decomposing gait into its component attributes (e.g., step length, cadence, stride time, etc.). This disconnect represents a challenge for mapping DHT-derived data to our clinical understanding of PD due to a mismatch in how clinical and biomechanical concepts are measured and described. To this end, we analyzed data from the WATCH-PD study in which PD patients were instrumented with inertial sensors during performance of the MDS-UPDRS Part III at routine clinic visits over one year. Individual biomechanical features of gait, tremor and bradykinesia were used to build composite motor scores that more closely link biomechanical concepts to clinical concepts. These composite motor scores were then compared for ability to detect changes in the cardinal motor signs of PD over one year.

Method: 82 early PD patients and 50 controls wore inertial sensors during the MDS-UPDRS Part 3 assessments at baseline, 1, 3, 6, 9, and 12 months. A set of standard features were derived for gait, tremor, and bradykinesia using fit-for-purpose signal processing algorithms. Signal features were then summarized into composite motor scores using multiple methodologies and evaluated based on their performance in distinguishing motor progression over time, as well as their relationships with specific items and sub-scores of the MDS-UPDRS.

Results: An overview and comparison of digital composite measures will be presented alongside the performance of these measures in capturing clinical constructs and progressive change over time.

Conclusion: Inertial sensors are able to provide an objective, composite assessment of gait, tremor, and bradykinesia that more closely captures clinically-relevant aspects of PD. Our results provide insight into the benefits and tradeoffs of multiple composite scoring methods to summarize digital measures of progression in early-stage PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/comparison-of-composite-method-calculations-for-monitoring-disease-progression-in-early-parkinsons-disease/