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Introduction In people with Parkinson’s (PwP) impaired mobility is associated with an increased falls risk. To improve mobility, dopaminergic medication is typically prescribed, but complex medication regimens result in suboptimal adherence. Exploring medication adherence and its impact on mobility in PwP will provide essential insights to optimise medication regimens and improve mobility. However, this is typically assessed in controlled environments, during one-off clinical assessments. Digital health technology (DHT) presents a means to overcome this, by continuously and remotely monitoring mobility and medication adherence. This study aims to use a novel DHT system (DHTS) (comprising of a smartphone, smartwatch and inertial measurement unit (IMU)) to assess self-reported medication adherence, and its impact on digital mobility outcomes (DMOs) in PwP.Methods and analysis This single-centre, UK-based study, will recruit 55 participants with Parkinson’s. Participants will complete a range of clinical, and physical assessments. Participants will interact with a DHTS over 7 days, to assess self-reported medication adherence, and monitor mobility and contextual factors in the real world. Participants will complete a motor complications diary (ON-OFF-Dyskinesia) throughout the monitoring period and, at the end, a questionnaire and series of open-text questions to evaluate DHTS usability. Feasibility of the DHTS and the motor complications diary will be assessed. Validated algorithms will quantify DMOs from IMU walking activity. Time series modelling and deep learning techniques will model and predict DMO response to medication and effects of contextual factors. This study will provide essential insights into medication adherence and its effect on real-world mobility in PwP, providing insights to optimise medication regimens.Ethics and dissemination Ethical approval was granted by London—142 Westminster Research Ethics Committee (REC: 21/PR/0469), protocol V.2.4. Results will be published in peer-reviewed journals. All participants will provide written, informed consent.Trial registration number ISRCTN13156149.

Summary: The past decade has seen a dramatic rise in consumer technologies able to monitor a variety of cardiovascular parameters. Such devices initially recorded markers of exercise, but now include physiological and health-care focused measurements. The public are keen to adopt these devices in the belief that they are useful to identify and monitor cardiovascular disease. Clinicians are therefore often presented with health app data accompanied by a diverse range of concerns and queries. Herein, we assess whether these devices are accurate, their outputs validated, and whether they are suitable for professionals to make management decisions. We review underpinning methods and technologies and explore the evidence supporting the use of these devices as diagnostic and monitoring tools in hypertension, arrhythmia, heart failure, coronary artery disease, pulmonary hypertension, and valvular heart disease. Used correctly, they might improve health care and support research.

IntroductionParkinson's disease (PD) is a neurodegenerative disorder which requires complex medication regimens to mitigate motor symptoms. The use of digital health technology systems (DHTSs) to collect mobility and medication data provides an opportunity to objectively quantify the effect of medication on motor performance during day-to-day activities. This insight could inform clinical decision-making, personalise care, and aid self-management. This study investigates the feasibility and usability of a multi-component DHTS to remotely assess self-reported medication adherence and monitor mobility in people with Parkinson's (PwP).MethodsThirty participants with PD [Hoehn and Yahr stage I (n = 1) and II (n = 29)] were recruited for this cross-sectional study. Participants were required to wear, and where appropriate, interact with a DHTS (smartwatch, inertial measurement unit, and smartphone) for seven consecutive days to assess medication adherence and monitor digital mobility outcomes and contextual factors. Participants reported their daily motor complications [motor fluctuations and dyskinesias (i.e., involuntary movements)] in a diary. Following the monitoring period, participants completed a questionnaire to gauge the usability of the DHTS. Feasibility was assessed through the percentage of data collected, and usability through analysis of qualitative questionnaire feedback.ResultsAdherence to each device exceeded 70% and ranged from 73 to 97%. Overall, the DHTS was well tolerated with 17/30 participants giving a score > 75% [average score for these participants = 89%, from 0 (worst) to 100 (best)] for its usability. Usability of the DHTS was significantly associated with age (ρ = −0.560, BCa 95% CI [−0.791, −0.207]). This study identified means to improve usability of the DHTS by addressing technical and design issues of the smartwatch. Feasibility, usability and acceptability were identified as key themes from PwP qualitative feedback on the DHTS.ConclusionThis study highlighted the feasibility and usability of our integrated DHTS to remotely assess medication adherence and monitor mobility in people with mild-to-moderate Parkinson's disease. Further work is necessary to determine whether this DHTS can be implemented for clinical decision-making to optimise management of PwP.

Cardiovascular diseases kill 18 million people each year. Currently, a patient’s health is assessed only during clinical visits, which are often infrequent and provide little information on the person’s health during daily life. Advances in mobile health technologies have allowed for the continuous monitoring of indicators of health and mobility during daily life by wearable and other devices. The ability to obtain such longitudinal, clinically relevant measurements could enhance the prevention, detection and treatment of cardiovascular diseases. This review discusses the advantages and disadvantages of various methods for monitoring patients with cardiovascular disease during daily life using wearable devices. We specifically discuss three distinct monitoring domains: physical activity monitoring, indoor home monitoring and physiological parameter monitoring.

PurposeThis paper aims to gauge developers’ perspectives regarding the participation of the public and anonymous crowd testers worldwide, with a range of varied experiences. It also aims to gather their needs that could reduce their concerns of dealing with the public crowd testers and increase the opportunity of using the crowdtesting platforms.Design/methodology/approachAn online exploratory survey was conducted to gather information from the participants, which included 50 mobile application developers from various countries with diverse experiences across Android and iOS mobile platforms.FindingsThe findings revealed that a significant proportion (90%) of developers is potentially willing to perform testing via the public crowd testers worldwide. This on condition that several fundamental features were available, which enable them to achieve more realistic tests without artificial environments on large numbers of devices. The results also demonstrated that a group of developers does not consider testing as a serious job that they have to pay for, which can affect the gig-economy and global market.Originality/valueThis paper provides new insights for future research in the study of how acceptable it is to work with public and anonymous crowd workers, with varying levels of experience, to perform tasks in different domains and not only in software testing. In addition, it will assist individual or small development teams who have limited resources or who do not have thousands of testers in their private testing community, to perform large-scale testing of their products.

Introduction Existing mobility endpoints based on functional performance, physical assessments and patient self-reporting are often affected by lack of sensitivity, limiting their utility in clinical practice. Wearable devices including inertial measurement units (IMUs) can overcome these limitations by quantifying digital mobility outcomes (DMOs) both during supervised structured assessments and in real-world conditions. The validity of IMU-based methods in the real-world, however, is still limited in patient populations. Rigorous validation procedures should cover the device metrological verification, the validation of the algorithms for the DMOs computation specifically for the population of interest and in daily life situations, and the users’ perspective on the device.Methods and analysis This protocol was designed to establish the technical validity and patient acceptability of the approach used to quantify digital mobility in the real world by Mobilise-D, a consortium funded by the European Union (EU) as part of the Innovative Medicine Initiative, aiming at fostering regulatory approval and clinical adoption of DMOs.After defining the procedures for the metrological verification of an IMU-based device, the experimental procedures for the validation of algorithms used to calculate the DMOs are presented. These include laboratory and real-world assessment in 120 participants from five groups: healthy older adults; chronic obstructive pulmonary disease, Parkinson’s disease, multiple sclerosis, proximal femoral fracture and congestive heart failure. DMOs extracted from the monitoring device will be compared with those from different reference systems, chosen according to the contexts of observation. Questionnaires and interviews will evaluate the users’ perspective on the deployed technology and relevance of the mobility assessment.Ethics and dissemination The study has been granted ethics approval by the centre’s committees (London—Bloomsbury Research Ethics committee; Helsinki Committee, Tel Aviv Sourasky Medical Centre; Medical Faculties of The University of Tübingen and of the University of Kiel). Data and algorithms will be made publicly available.Trial registration number ISRCTN (12246987).

In this paper, we present a Bluetooth Low Energy (BLE) based indoor positioning system developed for monitoring the daily living pattern of old people (e.g. people living with dementia) or individuals with disabilities. The proposed sensing system is composed of multiple sensors that are installed in different locations in a home environment. The specific location of the user in the building has been pre-recorded into the proposed sensing system that captures the raw Received Signal Strength Indicator (RSSI) from the BLE beacon that is attached on the user. Two methods are proposed to determine the indoor location and the tracking of the users: a trilateration-based method and fingerprinting-based method. Experiments have been carried out in different home environments to verify the proposed system and methods. The results show that our system is able to accurately track the user location in home environments and can track the living patterns of the user which, in turn, may be used to infer the health status of the user. Our results also show that the positions of the BLE beacons on the user and different quality of BLE beacons do not affect the tracking accuracy.

Purpose - This paper aims to support small mobile application development teams or companies performing testing on a large variety of operating systems versions and mobile devices to ensure their seamless working. Design/methodology/approach - This paper proposes a “hybrid crowdsourcing” method that leverages the power of public crowd testers. This leads to generating a novel crowdtesting workflow Developer/Tester- Crowdtesting (DT-CT) that focuses on developers and crowd testers as key elements in the testing process without the need for intermediate as managers or leaders. This workflow has been used in a novel crowdtesting platform (AskCrowd2Test). This platform enables testing the compatibility of mobile devices and applications at two different levels, high-level (device characteristics) or low-level (code). Additionally, a “crowd-powered knowledge base” has been developed that stores testing results, relevant issues and their solutions. Findings - The comparison of the presented DT-CT workflow with the common and most recent crowdtesting workflows showed that DT-CT may positively impact the testing process by reducing time-consuming and budget spend because of the direct interaction of developers and crowd testers. Originality/value - To authors’ knowledge, this paper is the first to propose crowdtesting workflow based on developers and public crowd testers without crowd managers or leaders, which light the beacon for the future research in this field. Additionally, this work is the first that authorizes crowd testers with a limited level of experience to participate in the testing process, which helps in studying the behaviors and interaction of end-users with apps and obtains more concrete results.

Accurate, long-term data are needed in order to determine trends in active travel, to examine the effectiveness of any interventions and to quantify the health, social and economic consequences of active travel. However, most studies of individual travel behaviour have either used self-report (which is limited in detail and open to bias), or provided logging devices for short periods, so lack the ability to monitor long-term trends. We have developed apps using participants’ own smartphones (Android or iOS) that monitor and feed-back individual user’s physical activity whilst the phone is carried or worn. The nature, time and location of any physical activity are uploaded to a secure survey and allow researchers to identify large scale behaviour. Pilot data from almost 2000 users have been logged and are reported. This constitutes a natural experiment, collecting long-term physical activity, transport mode and route choice information across a large cross-section of users.

The impact of Crowdsourcing and citizen science activities on academia, businesses, governance and society has been enormous. This is more prevalent today with citizens and communities collaborating with organizations, businesses and authorities to contribute in a variety of manners, starting from mere data providers to being key stakeholders in various decision-making processes. The “Crowdsourcing for observations from Satellites” project is a recently concluded study supported by demonstration projects funded by European Space Agency (ESA). The objective of the project was to investigate the different facets of how crowdsourcing and citizen science impact upon the validation, use and enhancement of Observations from Satellites (OS) products and services. This paper presents our findings in a stakeholder analysis activity involving participants who are experts in crowdsourcing, citizen science for Earth Observations. The activity identified three critical areas that needs attention by the community as well as provides suggestions to potentially help in addressing some of the challenges identified.