Dataset Information

Population-scale hand tremor analysis via anonymized mouse cursor signals.

ABSTRACT: Tremors are a common movement disorder with a spectrum of benign and pathological causes, including neurodegenerative disease, alcohol withdrawal, and physical overexertion. Studies of tremors in clinical practice are limited in size and scope and depend on explicit tracking of tremor characteristics by clinicians. Data drawn from small numbers of patients observed in short-duration sessions pose challenges for understanding the nature and distribution of tremors over a large population. Methods are presented to estimate hand tremors based on anonymized computer mouse cursor movement data collected from millions of users of a web search engine. To determine the feasibility of using this signal for the estimation of the prevalence of tremors over a large population, the characteristics of tremor-like movements are computed and compared against user data that can be interpreted as self-reports, the findings of published clinical studies, and a target selection study where participants self-report hand tremors and known causes. The results demonstrate significant alignment between estimated tremors and both self-reports and clinical findings. Those with cursor tremor events are more likely to report tremor-related search interests. Variations in cursor tremor quantity and cursor tremor frequency with demographics mirror those from clinical studies. Distributions of cursor tremor frequencies vary as expected for different medical conditions. Overall, the study finds evidence for the validity of harnessing anonymized mouse cursor motion as a population-scale tremor sensor for epidemiologic studies. Feasible future applications include opt-in services for screening and for monitoring the progression of illness.

SUBMITTER: White RW

PROVIDER: S-EPMC6760188 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Population-scale hand tremor analysis via anonymized mouse cursor signals.

White Ryen W RW Horvitz Eric E

NPJ digital medicine 20190924

Tremors are a common movement disorder with a spectrum of benign and pathological causes, including neurodegenerative disease, alcohol withdrawal, and physical overexertion. Studies of tremors in clinical practice are limited in size and scope and depend on explicit tracking of tremor characteristics by clinicians. Data drawn from small numbers of patients observed in short-duration sessions pose challenges for understanding the nature and distribution of tremors over a large population. Methods ...[more]

PMID: 31583281

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Project description:Essential tremor (ET) patients often experience hand tremor that impairs daily activities. Non-invasive electrical stimulation of median and radial nerves in the wrist using a recently developed therapy called transcutaneous afferent patterned stimulation (TAPS) has been shown to provide symptomatic tremor relief in ET patients and improve patients' ability to perform functional tasks, but the duration of tremor reduction is unknown. In this single-arm, open-label study, fifteen ET patients performed four hand tremor-specific tasks (postural hold, spiral drawing, finger-to-nose reach, and pouring) from the Fahn-Tolosa-Marin Clinical Rating Scale (FTM-CRS) prior to, during, and 0, 30, and 60 min following TAPS. At each time point, tremor severity was visually rated according to the FTM-CRS and simultaneously measured by wrist-worn accelerometers. The duration of tremor reduction was assessed using (1) improvement in the mean FTM-CRS score across all four tasks relative to baseline, and (2) reduction in accelerometer-measured tremor power relative to baseline for each task. Patients were labeled as having at least 60 min of therapeutic benefit from TAPS with respect to each specified metric if all three (i.e., 0, 30, and 60 min) post-therapy measurements were better than that metric's baseline value. The mean FTM-CRS scores improved for at least 60 min beyond the end of TAPS for 80% (12 of 15, p = 4.6e-9) of patients. Similarly, for each assessed task, tremor power improved for at least 60 min beyond the end of TAPS for over 70% of patients. The postural hold task had the largest reduction in tremor power (median 5.9-fold peak reduction in tremor power) and had at least 60 min of improvement relative to baseline beyond the end of TAPS therapy for 73% (11 of 15, p = 9.8e-8) of patients. Clinical ratings of tremor severity were correlated to simultaneously recorded accelerometer-measured tremor power (r = 0.33-0.76 across the four tasks), suggesting tremor power is a valid, objective tremor assessment metric that can be used to track tremor symptoms outside the clinic. These results suggest TAPS can provide reductions in upper limb tremor symptoms for at least 1 h post-therapy in some patients, which may improve patients' ability to perform tasks of daily living.

Project description:ObjectiveElectronic medical records (EMRs) data is increasingly incorporated into genome-phenome association studies. Investigators hope to share data, but there are concerns it may be "re-identified" through the exploitation of various features, such as combinations of standardized clinical codes. Formal anonymization algorithms (e.g., k-anonymization) can prevent such violations, but prior studies suggest that the size of the population available for anonymization may influence the utility of the resulting data. We systematically investigate this issue using a large-scale biorepository and EMR system through which we evaluate the ability of researchers to learn from anonymized data for genome-phenome association studies under various conditions.MethodsWe use a k-anonymization strategy to simulate a data protection process (on data sets containing clinical codes) for resources of similar size to those found at nine academic medical institutions within the United States. Following the protection process, we replicate an existing genome-phenome association study and compare the discoveries using the protected data and the original data through the correlation (r(2)) of the p-values of association significance.ResultsOur investigation shows that anonymizing an entire dataset with respect to the population from which it is derived yields significantly more utility than small study-specific datasets anonymized unto themselves. When evaluated using the correlation of genome-phenome association strengths on anonymized data versus original data, all nine simulated sites, results from largest-scale anonymizations (population ∼100,000) retained better utility to those on smaller sizes (population ∼6000-75,000). We observed a general trend of increasing r(2) for larger data set sizes: r(2)=0.9481 for small-sized datasets, r(2)=0.9493 for moderately-sized datasets, r(2)=0.9934 for large-sized datasets.ConclusionsThis research implies that regardless of the overall size of an institution's data, there may be significant benefits to anonymization of the entire EMR, even if the institution is planning on releasing only data about a specific cohort of patients.

Project description:In a cursor-control task in which the motion of the cursor is rotated randomly relative to the movement of the hand, the sensed directions of hand and cursor are mutually biased. In our previous study, we used implicit and explicit measures of the bias of sensed hand direction toward the direction of the cursor and found different characteristics. The present study serves to explore further differences and commonalities of these measures. In Experiment 1, we examined the effects of different relative reliabilities of visual and proprioceptive information on the explicitly and implicitly assessed bias of sensed hand direction. In two conditions, participants made an aiming movement and returned to the start position immediately or after a delay of 6 s during which the cursor was no longer visible. The unimodal proprioceptive information on final hand position in the delayed condition served to increase its relative reliability. As a result, the bias of sensed hand direction toward the direction of the cursor was reduced for the explicit measure, with a complementary increase of the bias of sensed cursor direction, but unchanged for the implicit measure. In Experiment 2, we examined the influence of global context, specifically of the across-trial sequence of judgments of hand and cursor direction. Both explicitly and implicitly assessed biases of sensed hand direction did not significantly differ between the alternated condition (trial-to-trial alternations of judgments of hand and cursor direction) and the blocked condition (judgments of hand or cursor directions in all trials). They both substantially decreased from the alternated to the randomized condition (random sequence of judgments of hand and cursor direction), without a complementary increase of the bias of sensed cursor direction. We conclude that our explicit and implicit measures are equally sensitive to variations of coupling strength as induced by the variation of global context in Experiment 2, but are differently sensitive to variations of the relative reliabilities as induced by our additional unimodal proprioceptive information in Experiment 1.

Dataset Information

Population-scale hand tremor analysis via anonymized mouse cursor signals.

Publications

Population-scale hand tremor analysis via anonymized mouse cursor signals.

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