The responsiveness of digital biomarkers as measurement tools in people with hip and knee osteoarthritis: A systematic review and meta-analysis
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: OBJECTIVE: To evaluate the responsiveness of objective, quantifiable physiological or behavioural data measures (digital biomarkers) as outcome measures for people living with hip and/or knee osteoarthritis (OA) in community or home settings. METHODS: This systematic review and meta-analysis identified eligible studies from four electronic databases. Studies were required to use a digital biomarker as an outcome measure or had data collected by a portable or wearable device, usable at home, and without expert oversight (e.g., accelerometers, smartphone devices), and collected at a minimum of two time points. Two independent reviewers conducted screening and data extraction. A meta-analysis was performed using a random-effects model. Results were reported as standardized response means (SRMs) and 95% confidence intervals (CIs). Subgroup analyses were conducted based on intervention versus non-intervention groups and across different time periods (short, medium, long-term). Risk of bias was assessed using modified criteria for evidence quality. RESULTS: We identified 40 studies evaluating 18 digital biomarkers. Participants had a mean age of 64 (SD=4) years, with most having knee OA. The overall quality of the studies was high. Accelerometers (95%) were the most commonly used technology type. Mobility related outcomes were the most responsive digital biomarker domain. Cadence, walking speed, and step count showed moderate (SRM = 0.65, 95% CI: ), 0.42-0.87), small (SRM = 0.43, 95% CI: 0.15-0.70), and trivial (SRM = 0.19, 95% CI: 0.02-0.36) degrees of responsiveness, respectively. Energy expenditure demonstrated a trivial negative responsiveness (SRM = -0.16, 95% CI: -0.31 to -0.01). All digital biomarkers identified were based on land-based activities, which limits their application for monitoring non-land-based activities such as water exercises, cycling or sleep. CONCLUSIONS: Digital biomarkers related to mobility measures, have the potential for greater uptake in OA clinical trials to assess mobility health in community and home-settings. SYSTEMATIC REVIEW REGISTRATION: PROSPERO ID: CRD42024600515.
Source: Osteoarthritis and Cartilage
Language: English
Subfield: Pharmacology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,700
OpenAlex ID: W7129614943