{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T21:20:45Z","timestamp":1776979245656,"version":"3.51.4"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T00:00:00Z","timestamp":1728432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Digit. Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Parkinson's Disease affects over 8.5 million people and there are currently no medications approved to treat underlying disease. Clinical trials for disease modifying therapies (DMT) are hampered by a lack of sufficiently sensitive measures to detect treatment effect. Reliable digital assessments of motor function allow for frequent at-home measurements that may be able to sensitively detect disease progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Here, we estimate the test-retest reliability of a suite of at-home motor measures derived from raw triaxial accelerometry data collected from 44 participants (21 with confirmed PD) and use the estimates to simulate digital measures in DMT trials. We consider three schedules of assessments and fit linear mixed models to the simulated data to determine whether a treatment effect can be detected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We find at-home measures vary in reliability; many have ICCs as high as or higher than MDS-UPDRS part III total score. Compared with quarterly in-clinic assessments, frequent at-home measures reduce the sample size needed to detect a 30% reduction in disease progression from over 300 per study arm to 150 or less than 100 for bursts and evenly spaced at-home assessments, respectively. The results regarding superiority of at-home assessments for detecting change over time are robust to relaxing assumptions regarding the responsiveness to disease progression and variability in progression rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Overall, at-home measures have a favorable reliability profile for sensitive detection of treatment effects in DMT trials. Future work is needed to better understand the causes of variability in PD progression and identify the most appropriate statistical methods for effect detection.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fdgth.2024.1430994","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T05:10:45Z","timestamp":1728450645000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Impacts on study design when implementing digital measures in Parkinson's disease-modifying therapy trials"],"prefix":"10.3389","volume":"6","author":[{"given":"Jennie S.","family":"Lavine","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony D.","family":"Scotina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seth","family":"Haney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessie P.","family":"Bakker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena S.","family":"Izmailova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larsson","family":"Omberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,10,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"04160","DOI":"10.7189\/jogh.13.04160","article-title":"Global, regional, and national burden of neurological disorders in 204 countries and territories worldwide","volume":"13","author":"Huang","year":"2023","journal-title":"J Glob Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1002\/mdc3.12553","article-title":"Progression of MDS-UPDRS scores over five years in de novo Parkinson disease from the Parkinson\u2019s progression markers initiative cohort","volume":"5","author":"Holden","year":"2018","journal-title":"Mov Disord Clin Pract"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.3233\/JPD-230051","article-title":"Outcome measures for disease-modifying trials in Parkinson\u2019s disease: consensus paper by the EJS ACT-PD multi-arm multi-stage trial initiative","volume":"13","author":"Gonzalez-Robles","year":"2023","journal-title":"J Parkinsons Dis"},{"key":"B4","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1038\/s41746-022-00607-8","article-title":"Virtual exam for Parkinson\u2019s disease enables frequent and reliable remote measurements of motor function","volume":"5","author":"Burq","year":"2022","journal-title":"NPJ Digit Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1002\/mds.27376","article-title":"Evaluation of smartphone-based testing to generate exploratory outcome measures in a phase 1 Parkinson\u2019s disease clinical trial","volume":"33","author":"Lipsmeier","year":"2018","journal-title":"Mov Disord"},{"key":"B6","doi-asserted-by":"publisher","first-page":"12081","DOI":"10.1038\/s41598-022-15874-4","article-title":"Reliability and validity of the Roche PD Mobile application for remote monitoring of early Parkinson\u2019s disease","volume":"12","author":"Lipsmeier","year":"2022","journal-title":"Sci Rep"},{"key":"B7","doi-asserted-by":"publisher","first-page":"3600","DOI":"10.1038\/s41598-023-29382-6","article-title":"Analytical and clinical validity of wearable, multi-sensor technology for assessment of motor function in patients with Parkinson\u2019s disease in Japan","volume":"13","author":"Oyama","year":"2023","journal-title":"Sci Rep"},{"key":"B8","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1007\/s00415-012-6624-1","article-title":"Expanded and independent validation of the movement disorder society-unified Parkinson\u2019s disease rating scale (MDS-UPDRS)","volume":"260","author":"Martinez-Martin","year":"2013","journal-title":"J Neurol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1002\/mds.22340","article-title":"Movement disorder society-sponsored revision of the unified Parkinson\u2019s disease rating scale (MDS-UPDRS): scale presentation and clinimetric testing results","volume":"23","author":"Goetz","year":"2008","journal-title":"Mov Disord"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1002\/mds.20220","article-title":"Assuring interrater reliability for the UPDRS motor section: utility of the UPDRS teaching tape","volume":"19","author":"Goetz","year":"2004","journal-title":"Mov Disord"},{"key":"B11","doi-asserted-by":"publisher","first-page":"525","DOI":"10.3233\/JPD-223256","article-title":"Parkinsonian hand or clinician\u2019s eye? 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