The participants in our Trial@home studies can download the REMOS app to their smartphone. When the study starts, they use this app to scan a personal QR code. From that moment on, the app runs continuously in the background, providing a steady flow of data.
The subject’s QR code is used to activate the study protocol, determining the measurements and sampling frequencies that the REMOS app will use, sending the data directly back to the Promasys database at CHDR. Via the app, subjects can be prompted to use the study medication, take a picture the medication and/or the lesion, answer questions, or use a peripheral device to measure blood pressure, body weight, etc.
The app can also be used to monitor social interactions, including social media. For example, it can track the subject’s use – but of course not the content – of social media apps, providing a basic timeline of the subject’s activity. Using the phone’s built-in microphone, REMOS can also track when the subject converses with others. A wide variety of functions are currently being tested and validated in a range of settings. For example, we used the app to track the use of social media by our interns. Using self-reported data, we are now developing algorithms to measure when a subject is walking, riding a bicycle, or riding in a car, bus, or train. When we introduce REMOS into our clinical studies, new features will undoubtedly need to be developed and validated
REMOS in Psychiatry
REMOS can also be used to increase the collection of data in the field of psychiatry. In this field, the ability to collect objective information regarding the subject’s day-to-day behaviour is particularly important. For example, wearable devices can be used to track the subject’s physical movements, health parameters, sleep patterns, and many other relevant factors, including data regarding the subject’s social interactions with others. These data can provide an objective measure of psychological health in patients with depressive and/ or anxiety disorders, providing a robust platform for studying the effects of antidepressants and anxiolytics. And of course, REMOS can be used to ask subjects to rate their general well-being, to report on their positive and/or negative emotions, and to provide other data regarding their daily experiences. Obtaining this information at regular intervals throughout the day can reveal important insight into the feelings and behaviour of patients with psychiatric disorders, complementing standard questionnaires that simply ask the patient how he/she ‘felt’ during the past seven days. In coming years, CHDR will further develop the REMOS app for use in psychiatry and other research areas.
REMOS in Paediatric research
Pharmacological research involving children is one of the more promising applications of these new mobile technologies. In paediatric clinical research, it is essential to minimise the burden placed on the participants; that’s why many drugs are not routinely tested in children. However, if the child can participate in a study while remaining in the safe, familiar environment of their home, the study can be relatively stress-free for both the child and his/her parents.Thanks to wearable devices, the child can stay at home and we can still collect a wealth of high-quality data. In collaboration with Basel University Hospital in Switzerland, CHDR used a special smartwatch to measure the physical activity of children before and after undergoing a tonsillectomy. The data clearly show how the children’s activity steadily returns to previous levels following surgery; thus, this approach may also have added value in pharmacological studies involving children.
RADAR – Remote Assessment of Disease and Relapse
The RADAR-base community emerged from the IMI project RADAR-CNS, where a consortium of clinicians, developers, researchers, patient organizations and EFPIA partners joined forces to transform care by leveraging sensor data from wearable devices like fitness trackers and smartphones. The combination of passively collected physiological data with active self assessment via questionnaires and scheduled cognitive tests allows a comprehensive picture of the participant’s health state. RADAR-CNS is attempting to evaluate the clinical value of sensor data for relapse prediction with the focus on three disorders of the central nervous system (CNS), epilepsy, multiple sclerosis and major depression disorder.