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MSPEECH is a single-center, prospective, non-interventional Living Lab study at the MS Center Dresden conducted with ki:elements GmbH to co-create and iteratively refine the Mili smartphone\/tablet speech assessment app. The protocol comprises three demonstrator cycles with structured co-design (people with MS and clinicians), implementation within predefined boundaries while keeping core tasks\/schedules\/security stable, and a 12-week home-based evaluation per version. The battery includes multiple speech tasks (e.g., fluency, reading, \u201cPa\u2013Ta\u2013Ka,\u201d sustained phonation) and a dual-task module combining touchscreen fine-motor tracking with concurrent speech. A dedicated Ethical, Legal and Social Issues (ELSI) board provides continuous oversight. Primary outcomes are usability and acceptability (MAUQ plus qualitative feedback); secondary outcomes include feasibility\/engagement, privacy perceptions, report interpretability, clinician workflow fit, and exploratory associations with clinical reference indicators.<\/jats:p>","DOI":"10.3389\/fdgth.2026.1830655","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:40:41Z","timestamp":1784180441000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["MSPEECH (multiple sclerosis monitoring through speech interaction in clinic and at home): a Living Lab study protocol for co-created, speech-based digital biomarkers in multiple sclerosis"],"prefix":"10.3389","volume":"8","author":[{"given":"Tina","family":"Lemkau","sequence":"first","affiliation":[{"name":"Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD 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