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Technical feasibility and acceptance of the Remote Monitoring Application in Psychiatry (ReMAP)

By Daniel Emden, Janik Goltermann, Udo Dannlowski, Tim Hahn, Nils Opel

Posted 05 Nov 2020
medRxiv DOI: 10.1101/2020.11.04.20225730

BackgroundOver recent years smartphone-based monitoring has been recognized as a useful instrument in psychiatric research. Due to the phasic character of affective symptoms, mobile assessments of passive sensor data as well as active self-reported data via the participants smartphone might represent a cost-efficient and highly useful tool for prospective prediction of mood changes. Despite these promising opportunities, smartphone-based monitoring in psychiatry is still limited to pilot studies often focusing on a single disorder while large-scale, transdiagnostic studies are widely absent. ObjectivesThe present paper describes the functionality and development of the Remote Monitoring Application in Psychiatry (ReMAP). We aimed to investigate the technical feasibility, and the acceptance of the ReMAP app for the continuous assessment of affective symptoms among different patient groups. MethodsThe ReMAP app was distributed among a sample of n=997 composed of healthy control participants and psychiatric patients. Continuous passive sensor data were assessed comprising acceleration, geolocation, as well as walking distance and steps. Further, participants optionally provided standardized self-reports on mood and sleep, as well as voice samples. Technical feasibility and acceptance were assessed based on the amount and frequency of transferred data events, as well as participation duration. Preliminary results are presented while data collection is ongoing. ResultsRetention rates of 90.25% for the required minimum study duration of two weeks and 33.09% for one year respectively were achieved. On average, users participated for 150 days. An average of 51.83 passive events per day per participant was collected, with an average rate of 73.50% of days during participation containing passive events. An average of 34.59 active self-report events were transferred per participant, with a considerable range across participants (0-552 events). While clinical and non-clinical participant subgroups did not differ in participation duration, or in quantity or rate of passive or active data transfer, the rate of days with transferred passive data was considerably higher and less heterogeneous in iOS (mean=91.85%, SD=21.25) as compared to Android users (mean=63.04%, SD=35.09). ConclusionsThe ReMAP app is technically feasible and generally well accepted and therefore represents a viable complementary tool for the continuous assessment of affective symptoms in large-scale transdiagnostic psychiatric studies. Future studies should account for the observed systematic differences between operating systems.

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