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Kadirvelu B, Bellido Bel T, Wu X, Burmester V, Ananth S, Cabral C C Branco B, Girela-Serrano B, Gledhill J, Di Simplicio M, Nicholls D, Faisal AA. Mindcraft, a Mobile Mental Health Monitoring Platform for Children and Young People: Development and Acceptability Pilot Study. JMIR Form Res 2023; 7:e44877. [PMID: 37358901 DOI: 10.2196/44877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/24/2023] [Accepted: 05/15/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Children and young people's mental health is a growing public health concern, which is further exacerbated by the COVID-19 pandemic. Mobile health apps, particularly those using passive smartphone sensor data, present an opportunity to address this issue and support mental well-being. OBJECTIVE This study aimed to develop and evaluate a mobile mental health platform for children and young people, Mindcraft, which integrates passive sensor data monitoring with active self-reported updates through an engaging user interface to monitor their well-being. METHODS A user-centered design approach was used to develop Mindcraft, incorporating feedback from potential users. User acceptance testing was conducted with a group of 8 young people aged 15-17 years, followed by a pilot test with 39 secondary school students aged 14-18 years, which was conducted for a 2-week period. RESULTS Mindcraft showed encouraging user engagement and retention. Users reported that they found the app to be a friendly tool helping them to increase their emotional awareness and gain a better understanding of themselves. Over 90% of users (36/39, 92.5%) answered all active data questions on the days they used the app. Passive data collection facilitated the gathering of a broader range of well-being metrics over time, with minimal user intervention. CONCLUSIONS The Mindcraft app has shown promising results in monitoring mental health symptoms and promoting user engagement among children and young people during its development and initial testing. The app's user-centered design, the focus on privacy and transparency, and a combination of active and passive data collection strategies have all contributed to its efficacy and receptiveness among the target demographic. By continuing to refine and expand the app, the Mindcraft platform has the potential to contribute meaningfully to the field of mental health care for young people.
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Affiliation(s)
- Balasundaram Kadirvelu
- Brain & Behaviour Lab, Department of Computing and Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Teresa Bellido Bel
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Xiaofei Wu
- Brain & Behaviour Lab, Department of Computing and Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Victoria Burmester
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Shayma Ananth
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Bianca Cabral C C Branco
- Brain & Behaviour Lab, Department of Computing and Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Braulio Girela-Serrano
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Julia Gledhill
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Martina Di Simplicio
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Dasha Nicholls
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - A Aldo Faisal
- Brain & Behaviour Lab, Department of Computing and Department of Bioengineering, Imperial College London, London, United Kingdom
- Chair in Digital Health, Faculty of Life Sciences, University of Bayreuth, Bayreuth, Germany
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Kadirvelu B, Gavriel C, Nageshwaran S, Chan JPK, Nethisinghe S, Athanasopoulos S, Ricotti V, Voit T, Giunti P, Festenstein R, Faisal AA. A wearable motion capture suit and machine learning predict disease progression in Friedreich's ataxia. Nat Med 2023; 29:86-94. [PMID: 36658420 PMCID: PMC9873563 DOI: 10.1038/s41591-022-02159-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/29/2022] [Indexed: 01/21/2023]
Abstract
Friedreich's ataxia (FA) is caused by a variant of the Frataxin (FXN) gene, leading to its downregulation and progressively impaired cardiac and neurological function. Current gold-standard clinical scales use simplistic behavioral assessments, which require 18- to 24-month-long trials to determine if therapies are beneficial. Here we captured full-body movement kinematics from patients with wearable sensors, enabling us to define digital behavioral features based on the data from nine FA patients (six females and three males) and nine age- and sex-matched controls, who performed the 8-m walk (8-MW) test and 9-hole peg test (9 HPT). We used machine learning to combine these features to longitudinally predict the clinical scores of the FA patients, and compared these with two standard clinical assessments, Spinocerebellar Ataxia Functional Index (SCAFI) and Scale for the Assessment and Rating of Ataxia (SARA). The digital behavioral features enabled longitudinal predictions of personal SARA and SCAFI scores 9 months into the future and were 1.7 and 4 times more precise than longitudinal predictions using only SARA and SCAFI scores, respectively. Unlike the two clinical scales, the digital behavioral features accurately predicted FXN gene expression levels for each FA patient in a cross-sectional manner. Our work demonstrates how data-derived wearable biomarkers can track personal disease trajectories and indicates the potential of such biomarkers for substantially reducing the duration or size of clinical trials testing disease-modifying therapies and for enabling behavioral transcriptomics.
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Affiliation(s)
- Balasundaram Kadirvelu
- Brain & Behaviour Lab, Department of Bioengineering, Imperial College London, London, UK
- Brain & Behaviour Lab, Department of Computing, Imperial College London, London, UK
| | - Constantinos Gavriel
- Brain & Behaviour Lab, Department of Bioengineering, Imperial College London, London, UK
- Brain & Behaviour Lab, Department of Computing, Imperial College London, London, UK
| | - Sathiji Nageshwaran
- Epigenetic Mechanisms and Disease Group, Department of Brain Sciences, Imperial College London, London, UK
| | - Jackson Ping Kei Chan
- Epigenetic Mechanisms and Disease Group, Department of Brain Sciences, Imperial College London, London, UK
| | - Suran Nethisinghe
- NIHR Great Ormond Street Hospital Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Stavros Athanasopoulos
- Epigenetic Mechanisms and Disease Group, Department of Brain Sciences, Imperial College London, London, UK
| | - Valeria Ricotti
- NIHR Great Ormond Street Hospital Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Thomas Voit
- NIHR Great Ormond Street Hospital Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Paola Giunti
- Institute of Neurology, UCL, National Hospital for Neurology and Neurosurgery (UCLH), London, UK
| | - Richard Festenstein
- Epigenetic Mechanisms and Disease Group, Department of Brain Sciences, Imperial College London, London, UK
- Institute of Neurology, UCL, National Hospital for Neurology and Neurosurgery (UCLH), London, UK
- MRC London Institute of Medical Sciences, London, UK
| | - A Aldo Faisal
- Brain & Behaviour Lab, Department of Bioengineering, Imperial College London, London, UK.
- Brain & Behaviour Lab, Department of Computing, Imperial College London, London, UK.
- MRC London Institute of Medical Sciences, London, UK.
- Behaviour Analytics Lab, Data Science Institute, Imperial College London, London, UK.
- Brain & Behaviour Lab, Institute for Artificial and Human Intelligence, University of Bayreuth, Bayreuth, Germany.
- Chair in Digital Health, Faculty of Life Sciences, University of Bayreuth, Bayreuth, Germany.
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Ricotti V, Kadirvelu B, Selby V, Festenstein R, Mercuri E, Voit T, Faisal AA. Wearable full-body motion tracking of activities of daily living predicts disease trajectory in Duchenne muscular dystrophy. Nat Med 2023; 29:95-103. [PMID: 36658421 PMCID: PMC9873561 DOI: 10.1038/s41591-022-02045-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/14/2022] [Indexed: 01/21/2023]
Abstract
Artificial intelligence has the potential to revolutionize healthcare, yet clinical trials in neurological diseases continue to rely on subjective, semiquantitative and motivation-dependent endpoints for drug development. To overcome this limitation, we collected a digital readout of whole-body movement behavior of patients with Duchenne muscular dystrophy (DMD) (n = 21) and age-matched controls (n = 17). Movement behavior was assessed while the participant engaged in everyday activities using a 17-sensor bodysuit during three clinical visits over the course of 12 months. We first defined new movement behavioral fingerprints capable of distinguishing DMD from controls. Then, we used machine learning algorithms that combined the behavioral fingerprints to make cross-sectional and longitudinal disease course predictions, which outperformed predictions derived from currently used clinical assessments. Finally, using Bayesian optimization, we constructed a behavioral biomarker, termed the KineDMD ethomic biomarker, which is derived from daily-life behavioral data and whose value progresses with age in an S-shaped sigmoid curve form. The biomarker developed in this study, derived from digital readouts of daily-life movement behavior, can predict disease progression in patients with muscular dystrophy and can potentially track the response to therapy.
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Affiliation(s)
- Valeria Ricotti
- National Institute for Health and Care Research Great Ormond Street Hospital Biomedical Research Centre/University College London Great Ormond Street Institute of Child Health, London, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Balasundaram Kadirvelu
- Brain & Behaviour Lab, Department of Bioengineering, Imperial College London, London, UK
- Brain & Behaviour Lab, Department of Computing, Imperial College London, London, UK
- Behaviour Analytics Lab, Data Science Institute, Imperial College London, London, UK
| | - Victoria Selby
- National Institute for Health and Care Research Great Ormond Street Hospital Biomedical Research Centre/University College London Great Ormond Street Institute of Child Health, London, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Richard Festenstein
- Gene Control Mechanisms & Disease Group Department of Brain Sciences, Imperial College London, London, UK
- Institute of Neurology, University College London, National Hospital for Neurology and Neurosurgery (University College London Hospitals), London, UK
- Medical Research Council London Institute of Medical Sciences, London, UK
| | - Eugenio Mercuri
- Università Cattolica del Sacro Cuore, Rome, Italy
- Policlinico Universitario Agostino Gemelli University Hospital, Rome, Italy
| | - Thomas Voit
- National Institute for Health and Care Research Great Ormond Street Hospital Biomedical Research Centre/University College London Great Ormond Street Institute of Child Health, London, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - A Aldo Faisal
- Brain & Behaviour Lab, Department of Bioengineering, Imperial College London, London, UK.
- Brain & Behaviour Lab, Department of Computing, Imperial College London, London, UK.
- Behaviour Analytics Lab, Data Science Institute, Imperial College London, London, UK.
- Medical Research Council London Institute of Medical Sciences, London, UK.
- Chair in Digital Health, Faculty of Life Sciences, University of Bayreuth, Bayreuth, Germany.
- Brain & Behaviour Lab, Institute of Artificial & Human Intelligence, University of Bayreuth, Bayreuth, Germany.
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Kadirvelu B, Burcea G, Quint JK, Costelloe CE, Faisal AA. Variation in global COVID-19 symptoms by geography and by chronic disease: A global survey using the COVID-19 Symptom Mapper. EClinicalMedicine 2022; 45:101317. [PMID: 35265823 PMCID: PMC8898170 DOI: 10.1016/j.eclinm.2022.101317] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/25/2022] [Accepted: 02/07/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND COVID-19 is typically characterised by a triad of symptoms: cough, fever and loss of taste and smell, however, this varies globally. This study examines variations in COVID-19 symptom profiles based on underlying chronic disease and geographical location. METHODS Using a global online symptom survey of 78,299 responders in 190 countries between 09/04/2020 and 22/09/2020, we conducted an exploratory study to examine symptom profiles associated with a positive COVID-19 test result by country and underlying chronic disease (single, co- or multi-morbidities) using statistical and machine learning methods. FINDINGS From the results of 7980 COVID-19 tested positive responders, we find that symptom patterns differ by country. For example, India reported a lower proportion of headache (22.8% vs 47.8%, p<1e-13) and itchy eyes (7.3% vs. 16.5%, p=2e-8) than other countries. As with geographic location, we find people differed in their reported symptoms if they suffered from specific chronic diseases. For example, COVID-19 positive responders with asthma (25.3% vs. 13.7%, p=7e-6) were more likely to report shortness of breath compared to those with no underlying chronic disease. INTERPRETATION We have identified variation in COVID-19 symptom profiles depending on geographic location and underlying chronic disease. Failure to reflect this symptom variation in public health messaging may contribute to asymptomatic COVID-19 spread and put patients with chronic diseases at a greater risk of infection. Future work should focus on symptom profile variation in the emerging variants of the SARS-CoV-2 virus. This is crucial to speed up clinical diagnosis, predict prognostic outcomes and target treatment. FUNDING We acknowledge funding to AAF by a UKRI Turing AI Fellowship and to CEC by a personal NIHR Career Development Fellowship (grant number NIHR-2016-090-015). JKQ has received grants from The Health Foundation, MRC, GSK, Bayer, BI, Asthma UK-British Lung Foundation, IQVIA, Chiesi AZ, and Insmed. This work is supported by BREATHE - The Health Data Research Hub for Respiratory Health [MC_PC_19004]. BREATHE is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. Imperial College London is grateful for the support from the Northwest London NIHR Applied Research Collaboration. The views expressed in this publication are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
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Affiliation(s)
| | - Gabriel Burcea
- Global Digital Health Unit, School of Public Health, Imperial College London, London, UK
| | - Jennifer K. Quint
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Ceire E. Costelloe
- Global Digital Health Unit, School of Public Health, Imperial College London, London, UK
| | - A. Aldo Faisal
- Brain & Behaviour Lab, Dept. Of Computing & Dept. Of Bioengineering, UKRI Centre for Doctoral Training in AI for Healthcare, and the Global Covid Observatory, Imperial College London, UK and MRC London Institute for Medical Sciences, London, UK
- Institute for Artificial & Human Intelligence, University of Bayreuth, Bayreuth, Germany
- Correspondence to: Aldo A. Faisal, Brain & Behaviour Lab, Dept. Of Computing & Dept. Of Bioengineering, UKRI Centre for Doctoral Training in AI for Healthcare, and the Global Covid Observatory, Imperial College London, UK.
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Ricotti V, Kadirvelu B, Auepanwiriyakul C, Zeng S, Selby V, Voit T, Faisal A. P.205Daily life digital biomarkers for longitudinal monitoring of Duchenne muscular dystrophy with wearable sensors. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ricotti V, Kadirvelu B, Rabinowicz S, Selby V, Voit T, Faisal A. P.204Full-body behaviour analytics reveals DMD disease state within the first few steps of the 6-minute-walk test. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ricotti V, Kadirvelu B, Selby V, Voit T, Faisal A. P.203Towards high-resolution clinical digital biomarkers for Duchenne muscular dystrophy. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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