The results of a six-year project involving 22 organizations across Europe and the United States have provided landmark insights into how technology in the form of wearables and smartphones could transform how we monitor and manage depression, multiple sclerosis (MS) and epilepsy.

RADAR-CNS

Since its launch in 2016, the Remote Assessment of Disease and Relapse – Central Nervous System Consortium (RADAR-CNS) has recruited 1,450 participants in a study to answer questions that are central to harnessing the potential of wearable devices to measure and predict depression, MS, and epilepsy. Collectively, these conditions affect more than 330 million people globally, are a major cause of disability and have an enormous impact on wellbeing¹.

Together with participants, researchers assessed seven wearable devices including smart watches and activity trackers alongside smartphones. In total the project has amassed over 62 terabytes of data.

Quality reporting in digital health studies has traditionally been poor, with small datasets and short-lived adherence to studies². In contrast, RADAR-CNS achieved very high recruitment, retention, and engagement rates. The project has set a quality benchmark for future studies in this field.

Major achievements

Among the major achievements of the project are:

• Identifying digital signals and use of machine learning. The project team has taken the first steps to develop new digital signals to indicate the course and severity of the disorders. Researchers have derived signals from smartphone and activity tracker data to estimate social activity, home stay, sleep, and gait to track depression severity. For MS, the RADAR-CNS team has identified signals which correlate with disability, fatigue and functional impairment, facets of MS that are very important to patients. In the work on epilepsy, researchers have shown that wearables can measure the length of time without motion after an epileptic seizure which can signify risk of sudden unexpected death in epilepsy (SUDEP).

• Building a secure, open source, versatile platform for remote data collection. At the heart of the project was the development of a new technical platform to enable the shift to more continuous and objective monitoring of the disorders from the in-built data collection mechanisms in phones and other devices. The platform – RADAR-base – can integrate data streams from numerous sources and is compatible with any traditional operating system. It allows accurate, real-time collection of data through sensors and questionnaires. RADAR-base is open source and is now in use by multiple projects including RADAR-CNS’ sister IMI2 project RADAR-AD, which is exploring the potential of mobile and digital technologies to improve the assessment of Alzheimer’s disease.

• An integrated and comprehensive approach to patient involvement. A Patient Advisory Board (PAB) of people living with the three conditions was active throughout the project, with members of the PAB influencing study design and data analysis and co-authoring scientific papers. The PAB helped researchers understand issues associated with acceptability of data collection methods and barriers that might make wearable devices less feasible in a real-world setting.

Looking to future application of remote monitoring, researchers surveyed over 1,000 healthcare professionals to understand how tech can complement face-to-face treatment and care and the potential for data to empower people to manage their own condition.

Led jointly by King’s College London and Janssen Pharmaceutica NV, RADAR-CNS is funded by the Innovative Medicines Initiative 2 Joint Undertaking (IMI2), a public private partnership between the European Federation of Pharmaceutical Industries and Associations (EFPIA) and the European Union.

Researcher comments

Professor Matthew Hotopf CBE, co-lead for the project at King’s College London, commented:

“Huge advances have been made in the area of using phones and other tech to track our health but, until now, the quality and robustness of available data to properly evaluate these has been largely lacking. Over six years, RADAR-CNS has been finding answers to questions about the viability and usefulness of smartphones and wearable tech for managing illness, and the steps that need to be taken to integrate these into clinical practice.

“Perhaps most importantly, we have throughout this process been working alongside people who live with depression, epilepsy and MS day to day. Their insights have been invaluable. I look forward to seeing the impact of the remarkable work done by the various RADAR-CNS teams and have every confidence that it will be far-reaching and has the potential to improve the lives of thousands of people.”

Vaibhav Narayan*, co-lead for the project at Janssen Pharmaceutica NV, commented:

“RADAR-CNS has been a hugely ambitious, multifaceted project that can have a positive impact for years to come. We are now in a significantly stronger position to be able to harness data from wearables and other technology to enable development of more precise treatments and improve how we track, predict, and manage diseases in the real world. I anticipate that this work will continue to evolve and drive the field – the project itself may be over but its legacy in terms of real-world benefit is really just beginning.”

Simon Lees, who is a member of the RADAR-CNS Patient Advisory Board, remarked:

“This project has set an excellent baseline for future development of AI technologies to assess and improve patient care within practical settings such as clinics. Staff, researchers, and those trialling the products worked closely together, and regular virtual meetings were extremely beneficial.

“Each member of the Patient Advisory Board has lived experience of one of the three medical conditions, and our perspectives helped the researchers to appreciate similarities and differences that would affect data collection. We were able to work alongside the researchers in a logical and systematic way. We could see the value our diverse perspectives added to the project, and I look forward to seeing how this work will help both patients and professionals to benefit from wearable technology.”

Dr Jacob Andrews, who worked on RADAR-CNS as a Research Fellow at NIHR MindTech MedTech Co-operative shared his views as project draws to a close:

"Throughout this project I have had the privilege to interview clinicians and researchers at the forefront of developing new treatment pathways for patients, as well as leaders in the pharmaceutical industry and patients themselves. It has been fascinating to explore the potential of these technologies and to consider how remote measurement technology might change clinical pathways and treatment programmes for patients. It has been really important to us to understand how these changes could be measured and recorded to show evidence of benefit, and it is our hope that our work has made the path toward implementation of these technologies easier."

Further information

This project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 115902. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and the European Federation of Pharmaceutical Industries and Associations (EFPIA) (www.imi.europa.eu).

For more information and to request interviews with the study team, please contact RADAR-CNS Communications Manager, Franca Davenport: This email address is being protected from spambots. You need JavaScript enabled to view it.

More detail on the results and achievements from the programme can be viewed on the RADAR-CNS results infographic.

* Vaibhav Narayan is Vice President, Digital Health Innovation, Johnson & Johnson Science for Minds, part of Johnson & Johnson Services, Inc.

About RADAR-CNS

Remote Assessment of Disease and Relapse in Central Nervous System Disorders (RADAR-CNS) is a major international research project that aims to develop new ways of measuring major depressive disorder, epilepsy, and multiple sclerosis (MS) using wearable devices and smartphone technology. RADAR-CNS aims to improve people’s quality of life and change how depression, epilepsy and multiple sclerosis are managed and treated. RADAR-CNS brings together clinicians, researchers, engineers, computer scientists and bioinformaticians from all over the world and includes 22 organisations from across Europe and the US. https://www.radar-cns.org/