Background Many apps have been designed to remotely assess clinical status and monitor symptom evolution in persons with multiple sclerosis (MS). These may one day serve as an adjunct for in-person assessment of persons with MS, providing valuable insight into the disease course that is not well captured by cross-sectional snapshots obtained from clinic visits. Objective This study sought to review the current literature surrounding apps used for remote monitoring of persons with MS. Methods A scoping review of published articles was conducted to identify and evaluate the literature published regarding the use of apps for monitoring of persons with MS. PubMed/Medline, EMBASE, CINAHL, and Cochrane databases were searched from inception to January 2022. Cohort studies, feasibility studies, and randomized controlled trials were included in this review. All pediatric studies, single case studies, poster presentations, opinion pieces, and commentaries were excluded. Studies were assessed for risk of bias using the Scottish Intercollegiate Guidelines Network, when applicable. Key findings were grouped in categories (convergence to neurological exam, feasibility of implementation, impact of weather, and practice effect), and trends are presented. In a parallel systematic search, the Canadian Apple App Store and Google Play Store were searched to identify relevant apps that are available but have yet to be formally studied and published in peer-reviewed publications. Results We included 18 articles and 18 apps. Although many MS-related apps exist, only 10 apps had published literature supporting their use. Convergence between app-based testing and the neurological exam was examined in 12 articles. Most app-based tests focused on physical disability and cognition, although other domains such as ambulation, balance, visual acuity, and fatigue were also evaluated. Overall, correlations between the app versions of standardized tests and their traditional counterparts were moderate to strong. Some novel app-based tests had a stronger correlation with clinician-derived outcomes than traditional testing. App-based testing correlated well with the Multiple Sclerosis Functional Composite but less so with the Expanded Disability Status Scale; the latter correlated to a greater extent with patient quality of life questionnaire scores. Conclusions Although limited by a small number of included studies and study heterogeneity, the findings of this study suggest that app-based testing demonstrates adequate convergence to traditional in-person assessment and may be used as an adjunct to and perhaps in lieu of specific neurological exam metrics documented at clinic visits, particularly if the latter is not readily accessible for persons with MS.

BACKGROUND Many apps designed to remotely assess clinical status and monitor symptom evolution in persons with multiple sclerosis (MS) exist. These may one day serve as an adjunct for in-person testing of persons with MS, providing valuable insight into disease course that is not accounted for by snapshots obtained from clinic visits. OBJECTIVE This study sought to review the current literature surrounding apps used for remote monitoring of persons with MS. METHODS A systematic review of published articles was conducted in January 2022 in 4 databases. The Apple App Store and the Google Play Store were also searched, and relevant apps were identified. RESULTS Eighteen articles and eighteen apps were included in this study. Although many MS-related apps exist, only ten apps were identified in the systematic review to have published literature surrounding their use. Twelve articles looked at convergence between app-based testing and neurological exam. Overall, correlation between app version of standardized tests and their traditional counterparts was moderate to strong. Some novel app-based tests had a stronger correlation with clinician-derived outcomes than traditional testing. App-based testing correlated well with Multiple Sclerosis Functional Composite, but less so with Expanded Disability Status Scale; the latter correlated to a greater extent with patient quality of life scores. CONCLUSIONS This study suggests that app-based testing may be used in lieu of some physical exams if or when the latter is not readily accessible for persons with MS.