Table 2.
Potential values, shortcomings and unknown aspects of body worn sensors in the monitoring and management of PD.
| Potential value of technologies applied to PD management | Risks, Hot-points, shortcomings and unknown aspects |
|---|---|
| Objectively, continuous, remote monitoring of PD symptoms over several days | Induce a risky reduction of the frequency of face-to-face appointments (helpful to have a complete clinical picture and avoid patient’s isolation) |
| Possibly helpful in informing on treatment changes | Remote assessment cannot replace in-person visit, just be an add-on to the actual standard of care |
| Possibly helpful in identifying patients who need treatment changes | Need for continuous technical support and patients being familiar with technology |
| Helpful in better identifying symptoms for PD patients with/without caregivers or with caregivers not able to help in symptoms recalling | Hardly applicable to demented patients or patients with severe mobility impairment (HY 5) |
| +/− Reduction of the need to travel to hospital and associated costs | No data compared different wearable sensors: not known which is the one with highest accuracy (highest performance, highest wearability) and the most suitable for a specific patient/symptom |
| +/− Reduce the length and number of clinic appointments and related stress if any | No large, randomized studies having evaluated or showed a higher benefit in treatment adjustment based on wearable sensors outputs if compared to standard of care (only data on one blinded not randomized trial on PKG suggested its additional value as add-on tool for treatment management) |
| +/− A support to remember pills intake | Not known how long any benefit of the devices lasted once they were not used any more |
| +/− A support to face the increment of PD prevalence against the lack of neurologists and the low rate of neurological visit/year | Is the accuracy the best outcome to evaluate a wearable sensor performance or rather its impact on PD symptoms/management and QoL? |
| +/− If a benefit on motor symptoms management will be strongly demonstrate (still not reached) this could impact on motor symptoms complications (reductions of falls, hip fractures and hospitalisation rate) | Not clear impact on QoL |
| Not clear cost effectiveness profile |
+/− indicates possible benefit, still not proven. HY Hoehn and Yahr.