Much More Than the Malady: The Promise of a Web-Based Digital Platform Incorporating Self-Report for Research and Clinical Care in Mild Cognitive Impairment

Traditional clinical trials in neurodegenerative disorders have utilized combinations of examination-based outcomes, global assessments by investigators and participants, and scales aimed at function, some of which are patient-reported outcomes. It is debatable whether these tools optimally convey t...

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Main Authors: Andrew McGarry, MD, Oliver Roesler, PhD, Jackson Liscombe, PhD, Michael Neumann, PhD, Hardik Kothare, PhD, Abhishek Hosamath, MBM, Lakshmi Arbatti, MS, Anusha Badathala, MD, Stephen Ruhmel, BS, MPH, Bryan J. Hansen, PhD, Madeline Quall, BA, Sandrine Istas, MBio, Arthur Wallace, MD, PhD, David Suendermann-Oeft, PhD, Vikram Ramanarayanan, PhD, Ira Shoulson, MD
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Mayo Clinic Proceedings: Digital Health
Online Access:http://www.sciencedirect.com/science/article/pii/S2949761225000318
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author Andrew McGarry, MD
Oliver Roesler, PhD
Jackson Liscombe, PhD
Michael Neumann, PhD
Hardik Kothare, PhD
Abhishek Hosamath, MBM
Lakshmi Arbatti, MS
Anusha Badathala, MD
Stephen Ruhmel, BS, MPH
Bryan J. Hansen, PhD
Madeline Quall, BA
Sandrine Istas, MBio
Arthur Wallace, MD, PhD
David Suendermann-Oeft, PhD
Vikram Ramanarayanan, PhD
Ira Shoulson, MD
author_facet Andrew McGarry, MD
Oliver Roesler, PhD
Jackson Liscombe, PhD
Michael Neumann, PhD
Hardik Kothare, PhD
Abhishek Hosamath, MBM
Lakshmi Arbatti, MS
Anusha Badathala, MD
Stephen Ruhmel, BS, MPH
Bryan J. Hansen, PhD
Madeline Quall, BA
Sandrine Istas, MBio
Arthur Wallace, MD, PhD
David Suendermann-Oeft, PhD
Vikram Ramanarayanan, PhD
Ira Shoulson, MD
author_sort Andrew McGarry, MD
collection DOAJ
description Traditional clinical trials in neurodegenerative disorders have utilized combinations of examination-based outcomes, global assessments by investigators and participants, and scales aimed at function, some of which are patient-reported outcomes. It is debatable whether these tools optimally convey therapeutic efficacy. A complementary approach using digital biomarkers to surpass exam-based limitations for detecting physical change coupled with a direct report from participants on what their sources of suffering are could be a useful advance in reporting beneficial effects of interventions, particularly if changes track together. We sought to determine the feasibility of remotely assessing speech, facial features, and cognition in an mild cognitive impairment (MCI) population, whether those extracted features could distinguish MCI from controls, and to explore what self-reported problems could reveal about the MCI experience. Our web-based platform was easy to use and revealed facial features in particular as capable of discriminating MCI from controls. Using the features that showed a statistically significant difference between cohorts (P<.01) produced an area under the receiver operating curve of 0.75. Self-reported problems with cognition, gait, sleep, and behavior were more common in the MCI group. The MCI was associated with 6 times more difficulty with falls (n=6 vs 1). These data support the feasibility and discriminative utility of using remote monitoring technology in combination with participant self-report in an MCI population. Future work will investigate the extent to which multimodal biomarkers combined with self-report can characterize MCI longitudinally and for potential research applications as a measure of therapeutic effect.
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spelling doaj-art-d33e10863da843638d08f9bcf6f8f6da2025-08-20T02:33:42ZengElsevierMayo Clinic Proceedings: Digital Health2949-76122025-06-013210022410.1016/j.mcpdig.2025.100224Much More Than the Malady: The Promise of a Web-Based Digital Platform Incorporating Self-Report for Research and Clinical Care in Mild Cognitive ImpairmentAndrew McGarry, MD0Oliver Roesler, PhD1Jackson Liscombe, PhD2Michael Neumann, PhD3Hardik Kothare, PhD4Abhishek Hosamath, MBM5Lakshmi Arbatti, MS6Anusha Badathala, MD7Stephen Ruhmel, BS, MPH8Bryan J. Hansen, PhD9Madeline Quall, BA10Sandrine Istas, MBio11Arthur Wallace, MD, PhD12David Suendermann-Oeft, PhD13Vikram Ramanarayanan, PhD14Ira Shoulson, MD15Department of Neurology, Cooper University Healthcare at Rowan University, Camden, NJModality.AI, Inc, San Francisco, CAModality.AI, Inc, San Francisco, CAModality.AI, Inc, San Francisco, CAModality.AI, Inc, San Francisco, CAModality.AI, Inc, San Francisco, CAModality.AI, Inc, San Francisco, CASan Francisco Veterans Affairs Health Care System, San Francisco, CAJanssen Research &amp; Development, LLC, a Johnson &amp; Johnson Company, New Brunswick, NJJanssen Research &amp; Development, LLC, a Johnson &amp; Johnson Company, New Brunswick, NJJanssen Research &amp; Development, LLC, a Johnson &amp; Johnson Company, New Brunswick, NJICON Strategic Solutions, ICON plc., BelgiumSan Francisco Veterans Affairs Health Care System, San Francisco, CA; Department of Anesthesia and Perioperative Care, University of California, San Francisco, CAModality.AI, Inc, San Francisco, CAModality.AI, Inc, San Francisco, CA; Correspondence: Address to Vikram Ramanarayanan, PhD, Chief Scientific Officer, Modality.AI, Inc, San Francisco, CA.Modality.AI, Inc, San Francisco, CATraditional clinical trials in neurodegenerative disorders have utilized combinations of examination-based outcomes, global assessments by investigators and participants, and scales aimed at function, some of which are patient-reported outcomes. It is debatable whether these tools optimally convey therapeutic efficacy. A complementary approach using digital biomarkers to surpass exam-based limitations for detecting physical change coupled with a direct report from participants on what their sources of suffering are could be a useful advance in reporting beneficial effects of interventions, particularly if changes track together. We sought to determine the feasibility of remotely assessing speech, facial features, and cognition in an mild cognitive impairment (MCI) population, whether those extracted features could distinguish MCI from controls, and to explore what self-reported problems could reveal about the MCI experience. Our web-based platform was easy to use and revealed facial features in particular as capable of discriminating MCI from controls. Using the features that showed a statistically significant difference between cohorts (P<.01) produced an area under the receiver operating curve of 0.75. Self-reported problems with cognition, gait, sleep, and behavior were more common in the MCI group. The MCI was associated with 6 times more difficulty with falls (n=6 vs 1). These data support the feasibility and discriminative utility of using remote monitoring technology in combination with participant self-report in an MCI population. Future work will investigate the extent to which multimodal biomarkers combined with self-report can characterize MCI longitudinally and for potential research applications as a measure of therapeutic effect.http://www.sciencedirect.com/science/article/pii/S2949761225000318
spellingShingle Andrew McGarry, MD
Oliver Roesler, PhD
Jackson Liscombe, PhD
Michael Neumann, PhD
Hardik Kothare, PhD
Abhishek Hosamath, MBM
Lakshmi Arbatti, MS
Anusha Badathala, MD
Stephen Ruhmel, BS, MPH
Bryan J. Hansen, PhD
Madeline Quall, BA
Sandrine Istas, MBio
Arthur Wallace, MD, PhD
David Suendermann-Oeft, PhD
Vikram Ramanarayanan, PhD
Ira Shoulson, MD
Much More Than the Malady: The Promise of a Web-Based Digital Platform Incorporating Self-Report for Research and Clinical Care in Mild Cognitive Impairment
Mayo Clinic Proceedings: Digital Health
title Much More Than the Malady: The Promise of a Web-Based Digital Platform Incorporating Self-Report for Research and Clinical Care in Mild Cognitive Impairment
title_full Much More Than the Malady: The Promise of a Web-Based Digital Platform Incorporating Self-Report for Research and Clinical Care in Mild Cognitive Impairment
title_fullStr Much More Than the Malady: The Promise of a Web-Based Digital Platform Incorporating Self-Report for Research and Clinical Care in Mild Cognitive Impairment
title_full_unstemmed Much More Than the Malady: The Promise of a Web-Based Digital Platform Incorporating Self-Report for Research and Clinical Care in Mild Cognitive Impairment
title_short Much More Than the Malady: The Promise of a Web-Based Digital Platform Incorporating Self-Report for Research and Clinical Care in Mild Cognitive Impairment
title_sort much more than the malady the promise of a web based digital platform incorporating self report for research and clinical care in mild cognitive impairment
url http://www.sciencedirect.com/science/article/pii/S2949761225000318
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