Usability and Acceptability of ASSESS MS: Assessment of Motor Dysfunction in Multiple Sclerosis Using Depth-Sensing Computer Vision

Abstract

BackgroundSensor-based recordings of human movements are becoming increasingly important for the assessment of motor symptoms in neurological disorders beyond rehabilitative purposes. ASSESS MS is a movement recording and analysis system being developed to automate the classification of motor dysfunction in patients with multiple sclerosis (MS) using depth-sensing computer vision. It aims to provide a more consistent and finer-grained measurement of motor dysfunction than currently possible.ObjectiveTo test the usability and acceptability of ASSESS MS with health professionals and patients with MS.MethodsA prospective, mixed-methods study was carried out at 3 centers. After a 1-hour training session, a convenience sample of 12 health professionals (6 neurologists and 6 nurses) used ASSESS MS to capture recordings of standardized movements performed by 51 volunteer patients. Metrics for effectiveness, efficiency, and acceptability were defined and used to analyze data captured by ASSESS MS, video recordings of each examination, feedback questionnaires, and follow-up interviews.ResultsAll health professionals were able to complete recordings using ASSESS MS, achieving high levels of standardization on 3 of 4 metrics (movement performance, lateral positioning, and clear camera view but not distance positioning). Results were unaffected by patients’ level of physical or cognitive disability. ASSESS MS was perceived as easy to use by both patients and health professionals with high scores on the Likert-scale questions and positive interview commentary. ASSESS MS was highly acceptable to patients on all dimensions considered, including attitudes to future use, interaction (with health professionals), and overall perceptions of ASSESS MS. Health professionals also accepted ASSESS MS, but with greater ambivalence arising from the need to alter patient interaction styles. There was little variation in results across participating centers, and no differences between neurologists and nurses.ConclusionsIn typical clinical settings, ASSESS MS is usable and acceptable to both patients and health professionals, generating data of a quality suitable for clinical analysis. An iterative design process appears to have been successful in accounting for factors that permit ASSESS MS to be used by a range of health professionals in new settings with minimal training. The study shows the potential of shifting ubiquitous sensing technologies from research into the clinic through a design approach that gives appropriate attention to the clinic environment.

The Use of Digital and Remote Communication Technologies as a Tool for Multiple Sclerosis Management: Narrative Review

“…Another tool, ASSESS MS, which captures depth videos (video images in which each pixel has a three-dimensional, 3D, position) of movement, is under evaluation for the assessment of motor dysfunction in MS within the clinical setting [ 22 ]. In a prospective, mixed-methods study that included six neurologists (mean MS experience: 4.3 years) and six nurses (mean MS experience: 2.7 years), ASSESS MS was used to record a predefined set of standard movements in 51 patients [ 22 ]. The tool was found to be usable by, and acceptable to, both patients and HCPs, and generated data of sufficient quality for clinical analysis.…”

Reference videos reduce variability of motor dysfunction assessments in multiple sclerosis

“…Our RV approach may also have a role in training machine-learning algorithms (MLAs). Such an example is the Assess MS system, a potentially finer-grained tool to measure motor dysfunction in MS. 3 This system uses advanced MLAs to analyze three-dimensional-depth-sensor recordings of MS patients performing standard tests of motor function, like the FNT. Reducing the variability of clinical assessments that are used to train MLAs should also contribute to improved algorithms that are derived from machine learning.…”

“…This study was a subproject of “Assess MS,” 3 a study approved by the local ethics committees. All patients gave their written informed consent to the video recordings.…”

Ehealth Solutions in Multiple Sclerosis: Use of Digital and Remote Communication Technologies

“…Another tool, ASSESS MS, which captures depth videos (video images in which each pixel has a three-dimensional position) of movement, is under evaluation for the assessment of motor dysfunction in MS within the clinical setting [22]. In a prospective, mixed-methods study that included six neurologists (mean MS experience, 4.3 years) and six nurses (mean MS experience: 2.7 years), ASSESS MS was used to record a predefined set of standard movements in 51 patients [22].…”

“…In a prospective, mixed-methods study that included six neurologists (mean MS experience, 4.3 years) and six nurses (mean MS experience: 2.7 years), ASSESS MS was used to record a predefined set of standard movements in 51 patients [22]. The tool was found to be usable by, and acceptable to, both patients and healthcare professionals, and generated data of sufficient quality for clinical analysis.…”