JMIR Publications

ABSTRACT

Background:

Many apps have been designed to remotely assess clinical status and monitor symptom evolution in persons with multiple sclerosis (MS). These may one day serve as an adjunct for in-person assessment of persons with MS, providing valuable insight into the disease course that is not well captured by cross-sectional snapshots obtained from clinic visits.

Objective:

This study sought to review the current literature surrounding apps used for remote monitoring of persons with MS.

Methods:

A scoping review of published articles was conducted to identify and evaluate the literature published regarding the use of apps for monitoring of persons with MS. PubMed/Medline, EMBASE, CINAHL, and Cochrane databases were searched from inception to January 2022. Cohort studies, feasibility studies and randomized controlled trials were included in this review. All pediatric studies, single case studies, poster presentations, opinion pieces, and commentaries were excluded. Studies were assessed for risk of bias using the Scottish Intercollegiate Guidelines Network when applicable. Key findings were grouped in categories (convergence to neurological exam, feasibility of implementation, impact of weather, and practice effect) and trends were presented. In a parallel systematic search, the Canadian Apple App Store and the Google Play Store were searched to identify relevant apps that are available but have yet to be formally studied and published in peer-reviewed publications.

Results:

Eighteen articles and eighteen apps were included in this study. Although many MS-related apps exist, only ten apps had published literature supporting their use. Twelve articles examined convergence between app-based testing and the neurological exam. Overall, correlations between the app versions of standardized tests and their traditional counterparts were moderate to strong. Some novel app-based tests had a stronger correlation with clinician-derived outcomes than traditional testing. App-based testing correlated well with the Multiple Sclerosis Functional Composite, but less so with the Expanded Disability Status Scale; the latter correlated to a greater extent with patient quality of life questionnaire scores.

Conclusions:

While limited by a small number of included study and study heterogeneity, the findings of this study suggest that app-based testing may be used as an adjunct to and perhaps in lieu of specific neurological exam metrics documented at clinic visits, particularly if the latter is not readily accessible for persons with MS.