Neu health: smartphone-based remote digital monitoring for Parkinson’s disease and dementia

<h3>Objective</h3> Develop an objective, multi-modal digital platform to remotely measure clinical changes and predict outcomes in patients with Parkinson’s disease (PD) and dementia using a smartphone application and interactive dashboard. <h3>Background</h3> PD and dementia are becoming increasingly prevalent with significant impact on morbidity and mortality. Challenges include medication management, limited clinical resources, and therapy access disparities. Innovative solutions to remotely measure disease progression, risk stratify, and optimise medication management are needed. <h3>Methods</h3> A software-based platform was developed that utilises sensors in patients own smartphones to quantify signs and symptoms remotely. Digital assessments included voice, balance, gait, finger tapping, reaction time, rest and postural tremor, and behavioural cognitive tests. Over 1000 healthy controls and patients with either idiopathic PD or Alzheimer’s disease completed the smartphone assessments. Clinical scores and risk of future disease outcomes were estimated using heuristic analysis, and machine learning models. Key metrics were displayed on a clinician dashboard. <h3>Results</h3> Digital motor features captured from the smartphone assessments showed significant correlations with clinical questionnaires and were sensitive to daily fluctuations in PD symptoms. Smartphone features could predict future clinical outcomes, including risk of falls, disease progression and cognitive decline, up to 18 months in advance. <h3>Conclusion</h3> Remote smartphone assessments can estimate clinical scores and risk outcomes. These outputs influenced clinical decision making. The Neu Health platform is now being used in the NHS to assess impact on clinical care.