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Increasing digitization across the healthcare continuum has revolutionized medical research, diagnostics, and therapeutics. This digitization has led to rapid advancements in the development and adoption of Digital Health Technologies (DHT) by the healthcare ecosystem. With the proliferation of DHTs, the term ‘digital biomarker’ has been increasingly used to describe a broad array of measurements. Our objectives are to align the meaning of ‘digital biomarker’ with established biomarker terminology and to highlight opportunities to enable consistency in evidence generation and evaluation, improving the assessment of scientific evidence for future digital biomarkers.

The use of digital health products has gained considerable interest as a new way to improve therapeutic research and development. Although these products are being adopted by various industries and stakeholders, their incorporation in clinical trials has been slow due to a disconnect between the promises of digital products and potential risks in using these new technologies in the absence of regulatory support. The Foundation for the National Institutes of Health (FNIH) Biomarkers Consortium hosted a public workshop to address challenges and opportunities in this field. Important characteristics of tool development were addressed in a series of presentations, case studies, and open panel sessions. The workshop participants endorsed the usefulness of an evidentiary criteria framework, highlighted the importance of early patient engagement, and emphasized the potential impact of digital monitoring tools and precompetitive collaborations. Concerns were expressed about the lack of real‐life validation examples and the limitations of legacy standards used as a benchmark for novel tool development and validation. Participants recognized the need for novel analytical and statistical approaches to accommodate analyses of these novel data types. Future directions are to harmonize definitions to build common methodologies and foster multidisciplinary collaborations; to develop approaches toward integrating digital monitoring data with the totality of the data in clinical trials, and to continue an open dialog in the community. There was a consensus that all these efforts combined may create a paradigm shift of how clinical trials are planned, conducted, and results brought to regulatory reviews.

Digital health products have played an important role in the COVID-19 response, from supporting the remote monitoring of patients to enabling continuity in data collection for clinical trials. The U.S. Food and Drug Administration (FDA) has issued a number of temporary policies to support digital health innovation during the pandemic, such as guidance documents to expand the use of digital therapeutics for psychiatric disorders and medical devices for remote patient monitoring. In this article, we contextualize these policies to the agency’s existing regulatory framework for digital health, outline key considerations for patients and health care providers, and identify implications for the future of digital health innovation.

Biomass pellets are a source of renewable energy; although, the air pollution and exposure risks posed by the emissions from burning pellets in biomass boilers (BBs) are uncertain. The present study examines the organic species in fine particle matter (PM) emissions from an BB firing switchgrass (SwG) and hardwood (HW) biomass pellets using different test cycles. The organic and elemental carbon (OC and EC) content and select semivolatile organic compounds (SVOCs) in filter-collected PM were identified and quantified using thermal-optical analysis and gas chromatography–mass spectrometry (GC–MS), respectively. Fine PM emissions from the BB ranged from 0.4 g/kg to 2.91 g/kg of pellets burned of which 40% ± 17% w/w was carbon. The sum of GC–MS quantified SVOCs in the PM emissions varied from 0.13 to 0.41 g/g OC. Relatively high levels of oxygenated compounds were observed in the PM emissions, and the most predominant individual SVOC constituent was levoglucosan (12.5–320 mg/g OC). The effect of boiler test cycle on emissions was generally greater than the effect due to pellet fuel type. Organic matter emissions increased at lower loads, owing to less than optimal combustion performance. Compared with other types of residential wood combustion studies, pellet burning in the current BB lowered PM emissions by nearly an order of magnitude. PM emitted from burning pellets in boilers tested across multiple studies also contains comparatively less carbon; however, the toxic polycyclic aromatic hydrocarbons (PAH) in the PM tested across these pellet-burning studies varied substantially, and produced 2–10 times more benzo[k]fluoranthene, dibenz[a,h]anthracene and indeno[1,2,3-c,d]pyrene on average. These results suggest that further toxicological evaluation of biomass pellet burning emissions is required to properly understand the risks posed.