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Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Advanced Parkinson\u2019s disease (PD) is characterized by motor fluctuations including unpredictable oscillations remarkably impairing quality of life. Effective management and development of novel therapies for these response fluctuations largely depend on clinical rating instruments such as the widely-used PD home diary, which are associated with biases and errors. Recent advancements in digital health technologies provide user-friendly wearables that can be tailored for continuous monitoring of motor fluctuations. Their criterion validity under real-world conditions using clinical examination as the gold standard remains to be determined. We prospectively examined this validity of a wearable <jats:underline>a<\/jats:underline>ccelerometer-based <jats:underline>d<\/jats:underline>igital <jats:underline>P<\/jats:underline>arkinson\u2019s <jats:underline>M<\/jats:underline>otor <jats:underline>D<\/jats:underline>iary (adPMD) using the Parkinson\u2019s Kinetigraph (PKG<jats:sup>\u00ae<\/jats:sup>) in an alternative application by converting its continuous data into one of the three motor categories of the PD home diary (Off, On and Dyskinetic state). Sixty-three out of 91 eligible participants with fluctuating PD (46% men, average age 66) had predefined sufficient adPMD datasets (&gt;70% of half-hour periods) from 2 consecutive days. 92% of per-protocol assessments were completed. adPMD monitoring of daily times in motor states showed moderate validity for Off and Dyskinetic state (ICC\u2009=\u20090.43\u20130.51), while inter-rating methods agreements on half-hour-level can be characterized as poor (median Cohen\u2019s <jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.13\u20130.21). Individualization of adPMD thresholds for transferring accelerometer data into diary categories improved temporal agreements up to moderate level for Dyskinetic state detection (median Cohen\u2019s <jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.25\u20130.41). Here we report that adPMD real-world-monitoring captures daily times in Off and Dyskinetic state in advanced PD with moderate validities, while temporal agreement of adPMD and clinical observer diary data is limited.<\/jats:p>","DOI":"10.1038\/s41746-023-00937-1","type":"journal-article","created":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T19:02:21Z","timestamp":1697569341000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Application of single wrist-wearable accelerometry for objective motor diary assessment in fluctuating Parkinson\u2019s disease"],"prefix":"10.1038","volume":"6","author":[{"given":"Matthias","family":"L\u00f6hle","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2577-8607","authenticated-orcid":false,"given":"Jonathan","family":"Timpka","sequence":"additional","affiliation":[]},{"given":"Alexander","family":"Bremer","sequence":"additional","affiliation":[]},{"given":"Hamid","family":"Khodakarami","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2874-9817","authenticated-orcid":false,"given":"Florin","family":"Gandor","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9427-2100","authenticated-orcid":false,"given":"Malcom","family":"Horne","sequence":"additional","affiliation":[]},{"given":"Georg","family":"Ebersbach","sequence":"additional","affiliation":[]},{"given":"Per","family":"Odin","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1133-9216","authenticated-orcid":false,"given":"Alexander","family":"Storch","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2023,10,17]]},"reference":[{"key":"937_CR1","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.parkreldis.2015.11.007","volume":"22","author":"A Bjornestad","year":"2016","unstructured":"Bjornestad, A. et al. 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Jonathan Timpka has received funding from the Swedish National Government and County Councils through the ALF agreement, the Elsa Schmitz Foundation, and the Swedish Parkinson Foundation. He has received compensation for consultancies from TransPerfect and the Swedish National Board of Health and Welfare, as well as royalties from UNI-MED Verlag. A.B. has nothing to disclose. H.K. was employee of Global Kinetics, Melbourne, Australia. F.G. has received honoraria from AbbVie, BIAL, Merz, and STADA outside the submitted work. M.H. has been a consultant to Global Kinetics (manufacturer of the PKG<sup>\u00ae<\/sup>), since 2017. He is a founder of Global Kinetics and an inventor of the PKG<sup>\u00ae<\/sup>. Prior to 2017 he was a member of Global Kinetics and received shares in Global Kinetics as reimbursement. G.E. has received honoraria for advisory Boards, consultancy and presentations from AbbVie Pharma, BIAL, Biogen GmbH, Desitin Pharma, STADA Pharma, Neuroderm Inc., Licher GmbH, UCB Pharma, and Zambon Pharma. He has received royalties from Kohlhammer Verlag and Thieme Verlag. P.O. has received funding from AbbVie, Lund University Medical Faculty, Multipark, the Swedish Parkinson Foundation, Health Care Region Sk\u00e5ne, and \u00c5hlens Foundation. He has received honoraria for lectures and expert advice from AbbVie, Bial, Britannia, Ever Pharma, Global Kinetics, Lobsor, Nordic Infucare, Stada, and Zambon. He has received royalties from UNI-MED Verlag. A.S. has received funding from the Deutsche Forschungsgemeinschaft (German Research Association) and the Helmholtz-Association outside the present study. He has received honoraria for presentations\/advisory boards\/consultations from Global Kinetics Corporation (manufacturer of the PKG<sup>\u00ae<\/sup>), Desitin, Lobsor Pharmaceuticals, STADA, Bial, RG Gesellschaft, Zambon, NovoNordisk, and AbbVie outside the present study. He has received royalties from Kohlhammer Verlag and Elsevier Press. He serves as an editorial board member of Stem Cells International.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"194"}}