The Neuropathy Tracker—A mobile health application for ambulatory and selfadministred assessment of neuropathy

Peripheral neuropathy is a common neurological disease and is a common complication of diabetes or cancer treatment. Early detection and treatment are crucial for improving the treatment of e.g., diabetic foot ulcers. However, neuropathy detection and monitoring requires examination of the motor and sensory systems and needs to be carried out in a clinical setting by trained professionals, leading to waiting time and delayed treatment. This paper presents the Neuropathy Tracker which is a Mobile Health (mHealth) tool for ambulatory self-assessment of neuropathy, which can be done by the patient at home. The app was designed in an iterative user-centered design (UCD) process involving neurologists, patients, and healthy subjects, thereby ensuring a high degree of clinical validity and usability. The assessment methodology in the app applies state-of-the-art neuropathy assessment methods and the app embodies a user-friendly and systematic assessment flow that guides the patient through the self-assessment. The Neuropathy Tracker tool was subject to a small feasibility study (N = 17), which showed a statistically significant (Pearson correlation ρ = 0.86, p < 0.05) but moderate (Concordance Correlation Coefficient (ρc) = 0.69) concurrent validity when compared with a standard clinical assessment method. All patients were able to complete the self-assessment without any help. As such, the technical and user experience design of the Neuropathy Tracker presents a stable mHealth tool that may be feasible for ambulatory self-assessment of neuropathy. Further clinical validation studies are, however, warranted before it is used in the clinical treatment of neuropathy.