Technology-enabled assessments to enhance multiple sclerosis clinical care and research

• Published in: Neurology. Clinical practice 2020-06, Vol.10 (3), p.222-231
• Main Authors: Macaron, Gabrielle, Moss, Brandon P., Li, Hong, Baldassari, Laura E., Rao, Stephen M., Schindler, David, Alberts, Jay L., Weber, Malory, Ayers, Malissa, Bethoux, François, Boissy, Adrienne, Chizmadia, Desiree, Conway, Devon S., Fink, Charlene, Fox, Robert J., Gales, Shauna, Green, Bethany, Hara-Cleaver, Claire, Jordan, Neal, Mahajan, Kedar R., McGinley, Marisa P., Miller, Deborah M., Namey, Marie, Rae-Grant, Alexander, Rensel, Mary, Young, Hilary, Willis, Mary A., Ontaneda, Daniel, Cohen, Jeffrey A., Bermel, Robert A.
• Format: Article
• Language: English
• ISSN: 2163-0402; 2163-0933
• DOI: 10.1212/CPJ.0000000000000710

Comprehensive and efficient assessments are necessary for clinical care and research in chronic diseases. Our objective was to assess the implementation of a technology-enabled tool in MS practice. We analyzed prospectively collected longitudinal data from routine multiple sclerosis (MS) visits between September 2015 and May 2018. The MS Performance Test, comprising patient-reported outcome measures (PROMs) and neuroperformance tests (NPTs) self-administered using a tablet, was integrated into routine care. Descriptive statistics, Spearman correlations, and linear mixed-effect models were used to examine the implementation process and relationship between patient characteristics and completion of assessments. A total of 8022 follow-up visits from 4199 patients (median age 49.9 [40.2-58.8] years, 32.1% progressive course, and median disease duration 13.6 [5.9-22.3] years) were analyzed. By the end of integration, the tablet version of the Timed 25-Foot Walk was obtained in 89.0% of patients and the 9-Hole Peg Test in 94.8% compared with 74.2% and 64.3%, respectively before implementation. The greatest increase in data capture occurred in processing speed and low-contrast acuity assessments (0% prior vs 78.4% and 36.7%, respectively, following implementation). Four PROMs were administered in 41%-98% of patients compared with a single depression questionnaire with a previous capture rate of 70.6%. Completion rates and time required to complete each NPT improved with subsequent visits. Younger age and lower disability scores were associated with shorter completion time and higher completion rates. Integration of technology-enabled data capture in routine clinical practice allows acquisition of comprehensive standardized data for use in patient care and clinical research.