JMIR Publications

ABSTRACT

Background:

Multiple sclerosis, epilepsy and depression are chronic central nervous system (CNS) conditions where remote measurement technology (RMT) may offer benefits compared to the usual assessment of symptoms. We previously worked with clinicians, patients and researchers to develop 13 use cases for remote measurement technology in these conditions.

Objective:

In the present study, we used a Delphi exercise to evaluate these use cases with an expert panel of clinicians from across Europe who were external to the project consortium.

Methods:

The study had two survey rounds (n=23, n=17) and a follow-up interview round (n=9). Data were analysed for consensus between participants, and for stability between survey rounds. Interviews explored reasons for answers given in the survey.

Results:

Findings showed good stability between rounds on questions related to specific use cases, but less stability on questions relating to wider issues around the implementation of RMT. Questions on wider issues also had less consensus overall. All five use cases for epilepsy were considered beneficial, with consensus among participants at above the a priori threshold for most questions, although use case 3 (risk scoring) was considered less likely to facilitate or catalyse care. There was very little consensus on the benefits of the use cases in MS, though this may result from higher dropout of MS clinicians in the study (50%). Participants agreed that there would be benefits for all five of the depression use cases, although a smaller number of questions (4/7) reached consensus for depression use case 4 (comorbid monitoring), and use case 5 (carer alert) was critiqued in the interviews. The qualitative analysis revealed further insights on each use case and generated eight themes on practical issues relating to implementation.

Conclusions:

Overall, these findings inform the prioritisation of use cases to develop in future work, which may include clinical trials, cost-effectiveness studies and the commercial development of RMT products and services. Findings also offer understandings on how remote measurement technologies could be successfully implemented in clinical care.