Durmaz Celik Nazli, Yaman Kula Asli, Murat Naci, Kuzu Kumcu Müge, Topal Aydan, Özkan Serhat
Department of Neurology, Eskişehir Osmangazi University, Faculty of Medicine, Eskişehir, Türkiye.
Department of Neurology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Türkiye.
Front Neurol. 2025 Jan 29;16:1522721. doi: 10.3389/fneur.2025.1522721. eCollection 2025.
BACKGROUND/OBJECTIVES: This study aimed to evaluate compliance and accuracy in comparison with traditional PD diaries for tracking motor symptoms using a new smartphone application (MyParkinson's) and paper diary strategies. Parkinson's disease (PD) is a neurodegenerative disorder with progressive motor symptoms. Treatment becomes more challenging as PD progresses, motor complications in the form of wearing-off phenomenon and levodopa-induced dyskinesia develop. Traditional paper diaries and clinical scales used to evaluate patients may be inadequate in assessing whether the patient is "on" or "off," resulting in less-than-ideal treatment changes.
A randomized crossover design was utilized to examine 22 advanced PD patients who underwent symptomatic assessment with both diaries during two separate 24-h periods seven days apart. The compliance and accuracy of data were assessed by comparing diary entries with the clinical examination notes and WhatsApp queries. LaOerly, patients' diary preferences were also evaluated.
The digital diary had significantly beOer compliance and accuracy than the paper diaries, with substantial/almost perfect levels of agreement ( = 0.615 to 0.818) between logged symptoms and clinical examination notes. 65% of patients preferred the digital diary for follow-ups, and there was no significant difference in ease of use compared to paper diaries.
Digital diaries are helpful in the clinical management of PD patients as they minimize recall bias and reduce data errors in appropriately selected patients. Our study suggests a broader adoption of digital health technologies in PD management. Still, additional research is necessary to improve the tools and assess long-term patient outcomes.
背景/目的：本研究旨在通过一款新的智能手机应用程序（MyParkinson's）和纸质日记策略，评估与传统帕金森病日记相比，在跟踪运动症状方面的依从性和准确性。帕金森病（PD）是一种具有进行性运动症状的神经退行性疾病。随着帕金森病的进展，治疗变得更具挑战性，会出现剂末现象和左旋多巴诱导的运动障碍等运动并发症。用于评估患者的传统纸质日记和临床量表在评估患者是“开”还是“关”时可能并不充分，导致治疗调整不理想。
采用随机交叉设计，对22例晚期帕金森病患者进行研究，在相隔7天的两个独立的24小时时间段内，使用两种日记对患者进行症状评估。通过将日记记录与临床检查记录和WhatsApp查询进行比较，评估数据的依从性和准确性。此外，还评估了患者对日记的偏好。
数字日记的依从性和准确性明显优于纸质日记，记录的症状与临床检查记录之间的一致性达到实质性/几乎完美水平（κ = 0.615至0.818）。65%的患者在随访时更喜欢数字日记，与纸质日记相比，易用性方面没有显著差异。
数字日记有助于帕金森病患者的临床管理，因为它们可以最大限度地减少回忆偏倚，并减少在适当选择的患者中的数据错误。我们的研究表明，数字健康技术在帕金森病管理中应得到更广泛的应用。然而，仍需要进一步的研究来改进工具并评估患者的长期预后。
