Landmark King’s project uses wearable tech to manage depression, MS and epilepsy

A technology platform has been developed that allows the real-time collection of health data from numerous sources, making it possible to remotely monitor multiple conditions.

The platform is the result of a six-year project led by King’s College London and Janssen Pharmaceutica NV and involving 22 organisations across Europe and the United States. The Remote Assessment of Disease and Relapse – Central Nervous System Consortium (RADAR-CNS) project, which recruited 1,450 participants, investigated the potential of wearable devices to measure and predict three chronic conditions: depression, multiple sclerosis (MS) and epilepsy. These conditions affect more than 330m people across the world, and are a major cause of disability.

The scale of RADAR-CNS was unusual. While most digital health projects tend to be small-scale, RADAR-CNS achieved very high recruitment, retention and engagement rates and, according to the researchers, it has set a quality benchmark for future studies in this field.

Researchers assessed seven wearable devices including smartphones, smart watches and activity trackers. The project had three major outcomes:

• A secure, open source, versatile platform for remote data collection. This platform, RADAR-base, can integrate data streams from numerous sources and is compatible with any traditional operating system. It allows accurate, real-time collection of data through sensors and questionnaires and is now in use in multiple other projects.
• Identifying digital signals and use of machine learning. The researchers have taken the first steps towards developing new digital signals from smartphone and activity tracker data that can indicate the course and severity of the disorders. Data on social activity, home stay, sleep and gait, for example, can be used to track depression severity. For MS, the RADAR-CNS team has identified signals which correlate with disability, fatigue and functional impairment. In epilepsy patients, researchers have shown that wearables can measure the length of time without motion after an epileptic seizure which can signify risk of sudden unexpected death in epilepsy (SUDEP).
• An integrated approach to patient involvement. A Patient Advisory Board (PAB) of people living with the three conditions was active throughout the project. Members of the PAB influenced study design and data analysis and co-authoring scientific papers. They helped researchers understand issues related to the acceptability of data collection methods and barriers that might make wearable devices less feasible in a real-world setting.

Helping patients manage their own condition

As well as involving patients, the research team surveyed more than 1,000 healthcare professionals to understand how technology can complement face-to-face treatment and how data can help people to manage their own condition.

Professor Matthew Hotopf, co-lead for the project and vice-dean of research at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London, said that while “huge advances” had been made in the use of technology to track health, until now the “quality and robustness of available data to properly evaluate these has been largely lacking.” He went on: “Over six years, RADAR-CNS has been finding answers to questions about the viability and usefulness of smartphones and wearable tech for managing illness, and the steps that need to be taken to integrate these into clinical practice.”

Hotopf said that the insights provided by patients with the three conditions had been “invaluable”. He had every confidence, he said, that the impact of the work would be “far-reaching and has the potential to improve the lives of thousands of people.”