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      Connecting real-world digital mobility assessment to clinical outcomes for regulatory and clinical endorsement–the Mobilise-D study protocol

      research-article
      1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 5 , 6 , 2 , 2 , 20 , 20 , 21 , 3 , 22 , 23 , 23 , 24 , 25 , 24 , 24 , 26 , 26 , 4 , 8 , 4 , 27 , 28 , 27 , 14 , 14 , 14 , 29 , 30 , 30 , 31 , 31 , 31 , 11 , 11 , 32 , 32 , 33 , 34 , 35 , 33 , 34 , 36 , 2 , 9 , 10 , 1 , 1 , * , , 1 , and members of the clinical validation study (WP4) on behalf of Mobilise-D consortium
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          Abstract

          Background

          The development of optimal strategies to treat impaired mobility related to ageing and chronic disease requires better ways to detect and measure it. Digital health technology, including body worn sensors, has the potential to directly and accurately capture real-world mobility. Mobilise-D consists of 34 partners from 13 countries who are working together to jointly develop and implement a digital mobility assessment solution to demonstrate that real-world digital mobility outcomes have the potential to provide a better, safer, and quicker way to assess, monitor, and predict the efficacy of new interventions on impaired mobility. The overarching objective of the study is to establish the clinical validity of digital outcomes in patient populations impacted by mobility challenges, and to support engagement with regulatory and health technology agencies towards acceptance of digital mobility assessment in regulatory and health technology assessment decisions.

          Methods/design

          The Mobilise-D clinical validation study is a longitudinal observational cohort study that will recruit 2400 participants from four clinical cohorts. The populations of the Innovative Medicine Initiative-Joint Undertaking represent neurodegenerative conditions (Parkinson’s Disease), respiratory disease (Chronic Obstructive Pulmonary Disease), neuro-inflammatory disorder (Multiple Sclerosis), fall-related injuries, osteoporosis, sarcopenia, and frailty (Proximal Femoral Fracture). In total, 17 clinical sites in ten countries will recruit participants who will be evaluated every six months over a period of two years. A wide range of core and cohort specific outcome measures will be collected, spanning patient-reported, observer-reported, and clinician-reported outcomes as well as performance-based outcomes (physical measures and cognitive/mental measures). Daily-living mobility and physical capacity will be assessed directly using a wearable device. These four clinical cohorts were chosen to obtain generalizable clinical findings, including diverse clinical, cultural, geographical, and age representation. The disease cohorts include a broad and heterogeneous range of subject characteristics with varying chronic care needs, and represent different trajectories of mobility disability.

          Discussion

          The results of Mobilise-D will provide longitudinal data on the use of digital mobility outcomes to identify, stratify, and monitor disability. This will support the development of widespread, cost-effective access to optimal clinical mobility management through personalised healthcare. Further, Mobilise-D will provide evidence-based, direct measures which can be endorsed by regulatory agencies and health technology assessment bodies to quantify the impact of disease-modifying interventions on mobility.

          Trial registration

          ISRCTN12051706.

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          Most cited references65

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          The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment.

          To develop a 10-minute cognitive screening tool (Montreal Cognitive Assessment, MoCA) to assist first-line physicians in detection of mild cognitive impairment (MCI), a clinical state that often progresses to dementia. Validation study. A community clinic and an academic center. Ninety-four patients meeting MCI clinical criteria supported by psychometric measures, 93 patients with mild Alzheimer's disease (AD) (Mini-Mental State Examination (MMSE) score > or =17), and 90 healthy elderly controls (NC). The MoCA and MMSE were administered to all participants, and sensitivity and specificity of both measures were assessed for detection of MCI and mild AD. Using a cutoff score 26, the MMSE had a sensitivity of 18% to detect MCI, whereas the MoCA detected 90% of MCI subjects. In the mild AD group, the MMSE had a sensitivity of 78%, whereas the MoCA detected 100%. Specificity was excellent for both MMSE and MoCA (100% and 87%, respectively). MCI as an entity is evolving and somewhat controversial. The MoCA is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing in the normal range on the MMSE.
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            SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials

            High quality protocols facilitate proper conduct, reporting, and external review of clinical trials. However, the completeness of trial protocols is often inadequate. To help improve the content and quality of protocols, an international group of stakeholders developed the SPIRIT 2013 Statement (Standard Protocol Items: Recommendations for Interventional Trials). The SPIRIT Statement provides guidance in the form of a checklist of recommended items to include in a clinical trial protocol. This SPIRIT 2013 Explanation and Elaboration paper provides important information to promote full understanding of the checklist recommendations. For each checklist item, we provide a rationale and detailed description; a model example from an actual protocol; and relevant references supporting its importance. We strongly recommend that this explanatory paper be used in conjunction with the SPIRIT Statement. A website of resources is also available (www.spirit-statement.org). The SPIRIT 2013 Explanation and Elaboration paper, together with the Statement, should help with the drafting of trial protocols. Complete documentation of key trial elements can facilitate transparency and protocol review for the benefit of all stakeholders.
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              CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials

              The CONSORT statement is used worldwide to improve the reporting of randomised controlled trials. Kenneth Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience
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                Author and article information

                Contributors
                Role: ConceptualizationRole: MethodologyRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: SupervisionRole: Writing – review & editing
                Role: InvestigationRole: SupervisionRole: Writing – review & editing
                Role: Funding acquisitionRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: Data curationRole: Funding acquisitionRole: InvestigationRole: Project administrationRole: SoftwareRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: Funding acquisitionRole: MethodologyRole: Writing – review & editing
                Role: Funding acquisitionRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: ResourcesRole: Writing – review & editing
                Role: Funding acquisitionRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: ResourcesRole: Writing – review & editing
                Role: Data curationRole: ResourcesRole: Writing – review & editing
                Role: ResourcesRole: Writing – review & editing
                Role: Funding acquisitionRole: InvestigationRole: Project administrationRole: Writing – review & editing
                Role: InvestigationRole: SupervisionRole: Writing – review & editing
                Role: InvestigationRole: SoftwareRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: Project administrationRole: ValidationRole: Writing – review & editing
                Role: Project administrationRole: ResourcesRole: Writing – review & editing
                Role: InvestigationRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: InvestigationRole: SupervisionRole: Writing – review & editing
                Role: InvestigationRole: Project administrationRole: Writing – review & editing
                Role: Funding acquisitionRole: InvestigationRole: SupervisionRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: Funding acquisitionRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: Project administrationRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: Funding acquisitionRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: InvestigationRole: SupervisionRole: Writing – review & editing
                Role: Funding acquisitionRole: InvestigationRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: Funding acquisitionRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: SupervisionRole: Writing – review & editing
                Role: Funding acquisitionRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: Funding acquisitionRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: Funding acquisitionRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: InvestigationRole: Project administrationRole: Writing – review & editing
                Role: Funding acquisitionRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: MethodologyRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: Data curationRole: Funding acquisitionRole: ResourcesRole: SoftwareRole: Writing – review & editing
                Role: Data curationRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: MethodologyRole: Project administrationRole: SoftwareRole: Writing – review & editing
                Role: MethodologyRole: Writing – original draft
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: InvestigationRole: MethodologyRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                6 October 2022
                2022
                : 17
                : 10
                : e0269615
                Affiliations
                [1 ] Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany
                [2 ] Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
                [3 ] Department of Neurology, University Medical Center Schleswig-Holstein, Kiel, Germany
                [4 ] Department of Neuroscience and Sheffield NIHR Translational Neuroscience BRC, Sheffield Teaching Hospitals NHS Foundation Trust & University of Sheffield, Sheffield, England, United Kingdom
                [5 ] Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
                [6 ] Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
                [7 ] Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
                [8 ] Insigneo Institute, Department of Mechanical Engineering, University of Sheffield, Sheffield, United Kingdom
                [9 ] Insight Centre for Data Analytics, O’Brien Science Centre, University College Dublin, Dublin, Ireland
                [10 ] UCD School of Public Health, Physiotherapy and Sports Science University College Dublin, Dublin, Ireland
                [11 ] Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain
                [12 ] Universitat Pompeu Fabra (UPF), Barcelona, Spain
                [13 ] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
                [14 ] Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
                [15 ] Clario, Geneva, Switzerland
                [16 ] Novartis Institutes for Biomedical Research, Cambridge, MA, United States of America
                [17 ] Research and Development, Pharmaceuticals, Bayer AG, Berlin, Germany
                [18 ] Clinical Science & Operations, Global Development, Sanofi R&D, Chilly-Mazarin, France
                [19 ] Specialty Clinical Development, Teva Pharmaceuticals, West Chester, PA, United States of America
                [20 ] Department of Molecular Neurology, University Hospital Erlangen, Erlangen, Germany
                [21 ] Digital Medicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg
                [22 ] Institute of Interdisciplinary Exercise Science and Sports Medicine, Medical School Hamburg, Hamburg, Germany
                [23 ] Pulmonary Research Institute at LungClinic Grosshansdorf GmbH, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany
                [24 ] Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle, England
                [25 ] Thorax Research Foundation & First Dept. of Respiratory Medicine, National & Kapodistrian University of Athens, Sotiria General Chest Hospital, Athens, Greece
                [26 ] KU Leuven, Department of Rehabilitation Sciences, Neurorehabilitation Research Group (eNRGy), Leuven, Belgium
                [27 ] Department of Neurology, San Raffaele University, Milan, Italy
                [28 ] Casa di Cura del Policlinico, Milan, Italy
                [29 ] Department of Physiotherapy, Oslo Metropolitan University (OsloMet), Oslo, Norway
                [30 ] Department of Geriatrics, Montpellier University Hospital and MUSE, Montpellier, France
                [31 ] Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
                [32 ] National Heart and Lung Institute, Imperial College London, London, England
                [33 ] Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
                [34 ] Department of Physical Therapy, Sackler Faculty of Medicine & Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
                [35 ] Rush Alzheimer’s Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, United States of America
                [36 ] McRoberts BV, The Hague, Netherlands
                Public Library of Science, UNITED KINGDOM
                Author notes

                Competing Interests: McRoberts is the manufacturer of the DynaPort. JE is employee of McRoberts. CB has done consultation work for Philipps Healthcare, Bosch Healthcare, Eli Lilly and Gait-up; he has received speaker honoraria from Amgen, Pfizer and Nutricia. LS is working as the Chief Technical Officer for Rölke Pharma. JMH reports having submitted a patent for assessment of mobility using wearable sensors in 400 Parkinson’s disease; the intellectual property rights 401 are held by the Tel Aviv Medical Center. GC has received consulting and speaking fees from Novartis, Sanofi Genzyme, Genzyme Corporation, Merck KGgA, Merck Serono SpA, Celgene Group, F. Hoffman-La Roche, Almirall SpA, Janssen. MFG is a full-time employee of Teva Pharmaceuticals. RRM is a full-time employee of The Novartis Institutes for BioMedical Research. All other authors declare that they have no competing interests.

                ¶ Membership of the Mobilise-D consortium is provided in the Acknowledgments.

                Author information
                https://orcid.org/0000-0002-0271-3050
                https://orcid.org/0000-0002-8364-9803
                https://orcid.org/0000-0002-9595-6974
                https://orcid.org/0000-0003-0462-2395
                https://orcid.org/0000-0001-6786-4346
                https://orcid.org/0000-0003-3235-0454
                https://orcid.org/0000-0002-1520-2292
                https://orcid.org/0000-0002-2779-7019
                Article
                PONE-D-22-14638
                10.1371/journal.pone.0269615
                9536536
                36201476
                b83fa5bd-6cc1-4400-bb8b-5b2e33a1cd70
                © 2022 Mikolaizak et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 10 June 2022
                : 17 June 2022
                Page count
                Figures: 4, Tables: 2, Pages: 21
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100010767, Innovative Medicines Initiative;
                Award ID: 820820
                This work was supported by the Mobilise-D project that has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No. 820820. This JU receives support from the European Union's Horizon 2020 research and innovation program and the European Federation of Pharmaceutical Industries and Associations (EFPIA). The funding bodies do not have ultimate authority over any activities (study design, collection, management, analysis, interpretation of data, writing of reports and decision to submit for publication. A draft protocol for the clinical validation was provided as part of the grant/funding application. Content in this publication reflects the authors’ view and neither IMI nor the European Union, EFPIA, or any Associated Partners are responsible for any use that may be made of the information contained herein. ISGlobal acknowledges support from the Spanish Ministry of Science, Innovation and Universities through the “Centro de Excelencia Severo Ochoa 2019-2023” Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program. Heleen Demeyer is a post-doctoral fellow of the FWO Flanders. Heiko Gaßner is supported by the Fraunhofer Internal Programs under Grant No. Attract 044-602140 and 044-602150
                Categories
                Study Protocol
                Medicine and Health Sciences
                Pulmonology
                Chronic Obstructive Pulmonary Disease
                Biology and Life Sciences
                Physiology
                Biological Locomotion
                Walking
                Biology and Life Sciences
                Physiology
                Biological Locomotion
                Gait Analysis
                Medicine and Health Sciences
                Medical Conditions
                Neurodegenerative Diseases
                Movement Disorders
                Parkinson Disease
                Medicine and Health Sciences
                Neurology
                Neurodegenerative Diseases
                Movement Disorders
                Parkinson Disease
                Computer and Information Sciences
                Data Management
                Medicine and Health Sciences
                Clinical Medicine
                Clinical Immunology
                Autoimmune Diseases
                Multiple Sclerosis
                Biology and Life Sciences
                Immunology
                Clinical Immunology
                Autoimmune Diseases
                Multiple Sclerosis
                Medicine and Health Sciences
                Immunology
                Clinical Immunology
                Autoimmune Diseases
                Multiple Sclerosis
                Medicine and Health Sciences
                Medical Conditions
                Demyelinating Disorders
                Multiple Sclerosis
                Medicine and Health Sciences
                Neurology
                Demyelinating Disorders
                Multiple Sclerosis
                Medicine and Health Sciences
                Medical Conditions
                Neurodegenerative Diseases
                Multiple Sclerosis
                Medicine and Health Sciences
                Neurology
                Neurodegenerative Diseases
                Multiple Sclerosis
                Medicine and Health Sciences
                Oncology
                Cancer Treatment
                Physical Sciences
                Mathematics
                Statistics
                Statistical Data
                Custom metadata
                No datasets were generated or analysed during the current study. All relevant data from this study will be made available upon study completion.

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