Exploring the Viability of a Speech-Based Diagnostic Tool in Parkinson's Disease in An Integrated Service

Background: Parkinson’s Disease (PD) is the second most prevalent neurodegenerative disease and the fastest-growing neurological condition globally (1). PD has several symptoms that impact quality of life, community participation and general health and wellbeing (2). Early identification of symptoms is essential when providing timely care within a multidisciplinary integrated care service to ensure optimal patient outcomes (3). There is no consistent pathway to report clinical information accurately and promptly on PD progression. The study explores the viability of a speech-based diagnostic tool by identifying essential requirements to report disease progression in Parkinson’s Disorder (PD). Early identification of PD is essential when providing timely care within a multidisciplinary integrated care service to ensure optimal patient outcomes (3). Speech-based diagnostic tools have the potential to diagnose, monitor, and predict PD progression objectively. Method: This project employed a mixed qualitative method data gathering and analysis. Participants are health and social care staff working in community-integrated care. The stakeholders’ current perspectives on the viability of a speech-based diagnostic tool for PD was explored through surveys, focus groups and interviews. This was then compared to a relevant public policy document to consolidate outcomes. Results: A ground theory approach generated multiple themes including reliability, ease of use, attitudes to technology, interoperability, training, privacy and costs. Although the accuracy of current speech-based devices is still being developed, training and awareness can be acquired to improve attitudes towards speech-based technology. Biases and internal motivations can affect the potential use of technologies that may benefit People with Parkinson’s Disease (PwPD). The study confirmed that interoperable systems and integrated pathways are crucial in successful digital health innovations to provide high-quality person-centred care. Health staff wants transparency on how the device analyses speech to ensure safe, and evidence-based practice. The preference of PwPD not to know further progression of the disease was consistently identified. Learning and next steps: The increasing global prevalence of PD as a debilitating disease necessitates maximising available resources to ensure accurate diagnosis, regular monitoring, and integrated intervention. A speech-based digital tool used in an integrated service model can improve clinical outcomes and contribute to a better quality of life for PwPD. However, issues are raised regarding the reliability, comfort, usability, and privacy of this technology. A co-design approach with PwPD, carers and staff is recommended in digital health innovation in an international context to ensure users’ preferences and lived experiences are included in the design, implementation and ongoing evaluations. More extensive, high-quality, varied speech sets from PwPD must be generated for speech-based diagnostics to mature. National Institute for Health and Care Excellence. Parkinson’s Disease: How common is it? [Internet]. 2023 [cited 2023 Aug 6]. Available from: https://cks.nice.org.uk/topics/parkinsons-disease/background-information/prevalence/#:~:text=The lifetime risk of being,some point in their lifetime. Parkinson’s U K. The incidence and prevalence of Parkinson’s in the UK [Internet]. Parkinson’s UK. 2017 [cited 2022 Oct 1]. p. 1–6. Available from: https://www.parkinsons.org.uk/sites/default/files/2018-01/CS2960 Incidence and prevalence report branding summary report Published 2017.pdf NICE. Parkinson’s NICE guidelines. 2017;97(5):1118–36. Available from: https://www.parkinsons.org.uk/sites/default/files/2018-10/Parkinson%27s NICE Guidelines 2017.pdf%0Ahttps://www.nice.org.uk/terms-and-%0Ahttps://www.nice.org.uk/guidance/ph27/resources/weight-management-before-during-and-after-pregnancy-pdf-1996242046405