Pathway to Regulatory Approval of Digital Health Technologies in Progressive Supranuclear Palsy: A Scoping Review

Abstract

Background/Objectives: Progressive supranuclear palsy (PSP) is an atypical Parkinsonian disorder characterized by Parkinsonism with gait imbalance, vertical gaze palsy, and frontal cognitive dysfunction. Though digital health technologies (DHTs) are widely used both clinically and in research as outcome measures, there is a lack of consistency applied to these devices and their resulting metrics. This scoping review aims to identify efforts taken to validate wearable DHTs for use in PSP, identify gaps in research, and discuss the steps needed to expand their use and acceptance as primary trial endpoints. Methods: In this scoping review, we conducted a search of the MEDLINE database to examine the use of DHTs as outcome measures in Progressive Supranuclear Palsy. Results: A total of 17 publications were identified and reviewed. Included articles evaluated the use of DHT to measure lower extremity function/gait, balance, upper extremity function, and speech. Conclusions: Our scoping review highlights the importance of standardization of DHT metrics by thorough assessment of their content validity, reliability, construct validity, responsiveness, and discriminant validity. Efforts must be taken to ensure DHTs capture clinically relevant, patient-centered outcome measures that are comparable to conventional rating scales, that consistently discriminate disease progression. Incorporation of DHTs as clinical trial endpoints has the potential to encourage clinical research and to advance patient care.

Keywords: PSP; atypical Parkinsonism; digital biomarker; digital health technology; progressive supranuclear palsy; wearable sensor.

Figure 1

PRISMA flow diagram.