TY - JOUR
T1 - Mobile Health Daily Life Monitoring for Parkinson Disease
T2 - Development and Validation of Ecological Momentary Assessments
AU - Habets, Jeroen
AU - Heijmans, Margot
AU - Herff, Christian
AU - Simons, Claudia
AU - Leentjens, Albert Fg
AU - Temel, Yasin
AU - Kuijf, Mark
AU - Kubben, Pieter
N1 - Funding Information:
The authors would like to thank Mirella Waber for advice on the application and content of the eDiary among patients with Parkinson disease, the EMA expert group within the Department of Psychiatry and Neuropsychology at Maastricht University for constructive discussion on the EMA methodology, and Karel Borkelmans for the technical support of the PsyMate app. YT and PK received a grant from Stichting Weijerhorst.
Publisher Copyright:
© 2020 JMIR Publications. All rights reserved.
PY - 2020/5/11
Y1 - 2020/5/11
N2 - Background: Parkinson disease monitoring is currently transitioning from periodic clinical assessments to continuous daily life monitoring in free-living conditions. Traditional Parkinson disease monitoring methods lack intraday fluctuation detection. Electronic diaries (eDiaries) hold the potential to collect subjective experiences on the severity and burden of motor and nonmotor symptoms in free-living conditions. Objective: This study aimed to develop a Parkinson disease-specific eDiary based on ecological momentary assessments (EMAs) and to explore its validation. Methods: An observational cohort of 20 patients with Parkinson disease used the smartphone-based EMA eDiary for 14 consecutive days without adjusting free-living routines. The eDiary app presented an identical questionnaire consisting of questions regarding affect, context, motor and nonmotor symptoms, and motor performance 7 times daily at semirandomized moments. In addition, patients were asked to complete a morning and an evening questionnaire. Results: Mean affect correlated moderate-to-strong and moderate with motor performance (R=0.38 to 0.75; P<.001) and motor symptom (R=0.34 to 0.50; P<.001) items, respectively. The motor performance showed a weak-to-moderate negative correlation with motor symptoms (R=-0.31 to-0.48; P<.001). Mean group answers given for on-medication conditions vs wearing-off-medication conditions differed significantly (P<.05); however, not enough questionnaires were completed for the wearing-off-medication condition to reproduce these findings on individual levels. Conclusions: We presented a Parkinson disease-specific EMA eDiary. Correlations between given answers support the internal validity of the eDiary and underline EMA's potential in free-living Parkinson disease monitoring. Careful patient selection and EMA design adjustment to this targeted population and their fluctuations are necessary to generate robust proof of EMA validation in future work. Combining clinical Parkinson disease knowledge with practical EMA experience is inevitable to design and perform studies, which will lead to the successful integration of eDiaries in free-living Parkinson disease monitoring.
AB - Background: Parkinson disease monitoring is currently transitioning from periodic clinical assessments to continuous daily life monitoring in free-living conditions. Traditional Parkinson disease monitoring methods lack intraday fluctuation detection. Electronic diaries (eDiaries) hold the potential to collect subjective experiences on the severity and burden of motor and nonmotor symptoms in free-living conditions. Objective: This study aimed to develop a Parkinson disease-specific eDiary based on ecological momentary assessments (EMAs) and to explore its validation. Methods: An observational cohort of 20 patients with Parkinson disease used the smartphone-based EMA eDiary for 14 consecutive days without adjusting free-living routines. The eDiary app presented an identical questionnaire consisting of questions regarding affect, context, motor and nonmotor symptoms, and motor performance 7 times daily at semirandomized moments. In addition, patients were asked to complete a morning and an evening questionnaire. Results: Mean affect correlated moderate-to-strong and moderate with motor performance (R=0.38 to 0.75; P<.001) and motor symptom (R=0.34 to 0.50; P<.001) items, respectively. The motor performance showed a weak-to-moderate negative correlation with motor symptoms (R=-0.31 to-0.48; P<.001). Mean group answers given for on-medication conditions vs wearing-off-medication conditions differed significantly (P<.05); however, not enough questionnaires were completed for the wearing-off-medication condition to reproduce these findings on individual levels. Conclusions: We presented a Parkinson disease-specific EMA eDiary. Correlations between given answers support the internal validity of the eDiary and underline EMA's potential in free-living Parkinson disease monitoring. Careful patient selection and EMA design adjustment to this targeted population and their fluctuations are necessary to generate robust proof of EMA validation in future work. Combining clinical Parkinson disease knowledge with practical EMA experience is inevitable to design and perform studies, which will lead to the successful integration of eDiaries in free-living Parkinson disease monitoring.
KW - ecological momentary assessment
KW - experience sampling method
KW - electronic diary
KW - Parkinson's disease monitoring
KW - FLUCTUATIONS
U2 - 10.2196/15628
DO - 10.2196/15628
M3 - Article
C2 - 32339999
SN - 2291-5222
VL - 8
JO - JMIR mHealth and uHealth
JF - JMIR mHealth and uHealth
IS - 5
M1 - e15628
ER -