{'fraction_non_alphanumeric': 0.02159827213822894, 'fraction_numerical': 0.0046282011724776305, 'mean_word_length': 5.484, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Web‐based clinical assessments for Parkinson's disease: Reliable and feasible

We read with great interest the article by Cubo et al. examining the feasibility, efficacy, and reliability of using Web-based assessments compared with in-person, office-based assessments in individuals with Parkinson’s disease (PD). This article is timely, as neurological care in PD has been associated with reductions in mortality and improvement in relevant clinical outcomes; however, access to neurologists let alone movement disorders specialists is limited. Telemedicine is a useful tool for implementing quality care and may be an effective means of enhancing recruitment and retention in clinical trials. The article by Cubo et al adds to the growing literature suggesting that Web-based assessments are feasible and produce reliable data. Their study is unique in the validation of not only motor but also nonmotor, functional, and qualityof-life outcomes remotely. They also showed the feasibility and reliability of conducting quantitative motor assessments (timed motor tests), and this may be an important objective means of remotely evaluating progression in PD. Since 2007, we have been providing care to patients with PD via telemedicine (Web-based video-conferencing), originating initially in nursing homes and now directly into the homes of individuals worldwide. Previously, in the context of a randomized study of telemedicine versus usual care in PD, we showed the motor UPDRS conducted via telemedicine to have excellent reliability (ICC, 0.78) compared with in-person assessment of the UPDRS, and similarly to Cubo et al, we found individuals receiving care via telemedicine were more satisfied with the care received. Currently we are conducting a randomized controlled multicenter (University of Rochester and John Hopkins University) feasibility, reliability, and economic trial of telemedicine directly into the homes (virtual house calls) versus in-person care for individuals with PD (clinicaltrials.gov #NCT01476306). Our preliminary data suggest that individuals receiving care via telemedicine may save time and travel compared with those receiving in-person care. Anecdotally, we have not found the UPDRS assessment to be more time consuming remotely and suspect that increasing familiarity with Web-based assessments will ultimately reduce physician burden and improve satisfaction. We are encouraged by the findings of Cubo et al that add to and are supportive of our previous and ongoing research into telemedicine and remote assessments in PD. Remote technologies to assess meaningful clinical outcomes and to improve access to neurologists and movement disorders specialists are likely to be invaluable tools in the future management of chronic disease. We agree that Web-based assessments could also add value to clinical trials by reducing the burden of frequent in-person assessments and thereby facilitating recruitment and retention and allowing for the inclusion of geographically remote populations who often cannot access clinical research. The efforts of Cubo et al are laying the foundation for the day when people with Parkinson’s disease can receive care and participate in research independent of geography.