ALS longitudinal studies with frequent data collection at home: study design and baseline data

Abstract

Objective: To design an ALS clinical study in which patients are remotely recruited, screened, enrolled and then assessed via daily data collection at home by themselves or caregivers. Methods: This observational, natural-history study included two academic medical centers, one providing overall clinical management and the other overseeing computing and web-services design and management. Both healthy and ALS subjects were recruited on the Internet via advertisement on governmental and foundation websites as well as through Facebook and Google paid advertisements. Individuals underwent screening and enrollment remotely, including signing an electronic informed consent form. Participants were then provided self-measurement equipment and instructed on their use through a series of web-based videos. The equipment included a handgrip dynamometer, spirometer with smartphone connection, electrical impedance myography device, and an activity tracker. ALS Functional Rating Scale-Revised data were also collected. Subjects were asked to collect data daily for three months and twice-weekly for the subsequent six months. Results: One hundred and eleven ALS patients and 30 healthy individuals enrolled in the study from across 41 states (74 men, 62 women). Baseline median ALSFRS-R score was 33. Seventy two percent of the ALS patients sent equipment and 88% of the healthy subjects sent equipment were able to complete a first set of measurements. Expected baseline differences between the ALS patients and healthy participants were identified for all measures. Conclusions: It is possible to design and institute an at-home based study in ALS patients, using a number of state-of-the-art approaches, including web-based consenting and training and Internet-connected measurement devices.

Trial registration: ClinicalTrials.gov identifier: NCT03016897.

Keywords:

• ALS
• clinical trial design
• biomarkers, self-assessment

Disclosure statement

Dr. Rutkove has equity in, and serves a consultant and scientific advisor to, Myolex, Inc. a company that designs impedance devices for clinical and research use; he is also a member of the company’s Board of Directors. The company also has an option to license patented impedance technology of which Dr. Rutkove is named as an inventor. Drs. Berisha and Liss serve as Chief Science Officer and Chief Clinical Officer at Aural Analytics, Inc, a company that develops objective measures of neurological health. Both Dr. Berisha and Dr. Liss have equity in the company and serve on the Board of Directors.

Additional information

Funding

ALS-Finding-A Cure provided primary support for this study. Additional support was provided via NIH grant R44 NS070385.