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Abstract Details

Estimating Digital Therapy Progress Using Large-Scale Speech and Cognitive Rehabilitation Data
Neuro-rehabilitation
P7 - Poster Session 7 (5:30 PM-6:30 PM)
15-003
To estimate therapeutic progress for patients with various neurological conditions using digital therapy for cognitive and speech rehabilitation.
Digital therapy has been shown to be an effective supplement to traditional in-clinic delivery. The opportunity for increased data collection presented by digital therapy can help answer clinical questions at a much larger scale, such as the impact of individualized factors on achieving therapeutic milestones.
Twelve weeks of data from 1,994 patients with stroke, traumatic brain injury, and dementia that used Constant Therapy, a remotely delivered cloud-based rehabilitation program for speech and cognitive therapy, was retrospectively analyzed. As a user demonstrates progress by successfully completing exercises within a given skill domain (e.g., speech, reading, writing), the program assigns more difficult/functional exercises. For all domains, an average weekly progress score ranging from 0-100% was calculated for each patient, with 100% indicating all available difficulty levels being passed. A multilayer perceptron neural network was trained on the resulting 20,000 weekly domain scores, with various demographic and platform usage statistics as inputs. Five-fold cross validation was used to determine average out-of-sample prediction error.

The trained model was able to estimate weekly domain completion within ±7.86% over the course of therapy. Prediction error increased with duration during the first month of therapy, but stabilized to ±11% from 6-12 weeks, demonstrating the model’s ability to predict at longer durations. A patient’s first week score was the most important model feature, with model accuracy decreasing by an average of 59.5% (±4.2%) with its exclusion. Age and the average number of days practiced per week were both associated with slower therapeutic progress, and were important model features (5% decrease in predictive accuracy with their exclusion).

Large-scale models derived from digital therapeutics can be used to provide guidance on expected patient progress with reasonable accuracy.
Authors/Disclosures
Shaheen E. Lakhan, MD, PhD, MEd, FÂé¶¹´«Ã½Ó³»­
PRESENTER
Dr. Lakhan has received personal compensation for serving as an employee of Zogenix, Fern Health, Thriveworks, The Learning Corp, TriNet, Click Therapeutics. Dr. Lakhan has received personal compensation in the range of $1,000,000+ for serving as a Consultant for Shaheen Lakhan, MD, PhD, LLC. Dr. Lakhan has received personal compensation in the range of $100,000-$499,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurocrine, Fern Health, Lin Health. Dr. Lakhan has received personal compensation in the range of $500,000-$999,999 for serving as an officer or member of the Board of Directors for Click Therapeutics, SpineThera. Dr. Lakhan has stock in Zogenix, NeuroSport, Click Therapeutics, SpineThera.
No disclosure on file
No disclosure on file
No disclosure on file