儿科试验中的数字健康技术。

Digital Health Technologies in Pediatric Trials.

机构信息

Office of Medical Policy, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA.

Office of Pediatric Therapeutics, Office of Clinical Policy and Programs, Office of the Commissioner, Food and Drug Administration, Silver Spring, MD, USA.

出版信息

Ther Innov Regul Sci. 2022 Nov;56(6):929-933. doi: 10.1007/s43441-021-00374-w. Epub 2022 Mar 27.

Abstract

BACKGROUND

Advances in the miniaturization of sensors and other technologies provide opportunities to collect physiological and/or functional data directly from patients participating in clinical trials. The use of such technologies in children is particularly promising. Objective, quantifiable measurements made by these technologies, often on a continuous or frequent basis, may provide more robust data than the episodic reports from caregivers that are used in traditional pediatric trials.

METHODS

We reviewed the pros and cons of these technologies for use in a variety of pediatric diseases, including seizure and neuromuscular disorders, cardiorespiratory diseases, and metabolic disorders.

RESULTS

Correlation between sensor measurements and patient observations or traditional clinical measurements varied depending on the disease being evaluated. There was a notable dearth of reports on the use of digital health technology in pediatric patients. Given the range of sensors and measurements that can be made by DHTs, selection of the design, metrics and types of sensors best suited to disease evaluation presents challenges for adoption of these technologies in clinical trials.

CONCLUSION

Traditional measurements of drug effects are often deficient, particularly in the evaluation of infants and young children. The opportunity to make objective, frequent measurements may increase our power to detect and quantify responses to therapy in these populations. Further research and evaluation are needed to realize the full scientific potential of remote monitoring in pediatric clinical trials.

摘要

背景

传感器和其他技术的小型化进步为直接从参与临床试验的患者身上收集生理和/或功能数据提供了机会。这些技术在儿童中的应用尤其有前景。这些技术进行的客观、可量化的测量,通常是连续或频繁进行的,可能比传统儿科试验中使用的来自护理人员的间歇性报告提供更可靠的数据。

方法

我们回顾了这些技术在各种儿科疾病中的优缺点,包括癫痫和神经肌肉疾病、心肺疾病和代谢疾病。

结果

传感器测量值与患者观察值或传统临床测量值之间的相关性因所评估的疾病而异。关于数字健康技术在儿科患者中的应用报告明显缺乏。鉴于 DHT 可以进行的传感器和测量范围广泛,选择最适合疾病评估的设计、指标和类型的传感器对于这些技术在临床试验中的采用提出了挑战。

结论

传统的药物效果测量往往存在缺陷,尤其是在评估婴儿和幼儿时。进行客观、频繁测量的机会可能会增加我们在这些人群中检测和量化治疗反应的能力。需要进一步的研究和评估才能实现远程监测在儿科临床试验中的全部科学潜力。

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