RADAR-AD researchers: Interview series “Behind-the-scenes”

To show the variety of work we do in RADAR-AD, the following news items are dedicated to several RADAR-AD researchers. They share the work they do for the project, what excites and challenges them the most, especially at times of the present COVID-19 pandemic, and how they see the impact of our project for the wider field of Alzheimer’s research.

Marijn Muurling works in the Alzheimer center of the Amsterdam UMC hospital in The Netherlands and is a PhD student on RADAR-AD. She is involved in the clinical work package for our project, which means that her primary responsibility is to set-up the clinical study and to coordinate the clinical study in all countries involved. For example, she was involved in setting up the research protocol and she prepared study manuals used in the project. Marijn shares what she enjoys about her work on RADAR-AD:

“RADAR-AD is a very international project – there are many European countries involved in the research. In that sense, it is interesting to see differences between the way countries cooperate with patient care for Alzheimer’s disease and in the manner they conduct research. For instance, ethical approval takes different time to work through as regulations vary across countries. Also, I think that the use of smart technology to measure symptoms of Alzheimer’s disease remotely is the future and the way forward, so I am happy to be part of this research.”

Moreover, Marijn asserts that there are challenges to her work on the project. Given the large number of participating countries (13), the differences between countries can entail varying ways of using the devices and testing participants once the inclusion of participants has started, she asserts. Marijn hopes that through the use of the study manual and training for the researchers she prepared, countries will do the testing in the same way.

All in all, she believes that RADAR-AD will contribute to the wider field of Alzheimer’s research by helping to find better endpoints in clinical trials through providing more accurate ways to measure symptoms with Remote Measurement Technology, such as smart phones and smart watches. She hopes that this will eventually help to find a cure for Alzheimer’s Disease.

The COVID-19 pandemic has impacted Marijn’s work – she is currently working from home and she cannot see any patients: “We expected that we would have started the data collection in March 2020. Unfortunately, due to the crisis, we cannot include any patients for our study in any European country.”

Therefore, for the time being, Marijn is focused on writing a design paper for the RADAR-AD study She shares: “I can focus my efforts now on writing, as I am currently not arranging involvement of participants.”

Finally, Marijn is focused on the positives in these otherwise hard times: “I try to focus on the positives in this situation such as having the time to prepare the first patient inclusions, write papers and reflect on the data platform use.”

Thanos Stavropoulos from CERTH-ITI:

What is the focus of your work within the RADAR-AD project?
As a Postdoc Research Associate at the Information Technologies Institute of Centre for Research and Technology Hellas (CERTH-ITI) I work in data collection from sensors and Internet of Things (IoT) platforms, data analysis and interpretation. I do this by using Artificial Intelligence (AI) techniques and applications in smart environments and eHealth, including Active and Healthy Ageing and the care of dementia. Many of those activities are applied in RADAR-AD, where I work in device selection and data analysis, i.e. extraction of features related to the disease, for trials with wearable sensors (Tier 1), home sensors (Tier 2) and especially the trials that will take place in our Smart Home real living environment here at CERTH-ITI (Tier 3).

What do you enjoy the most about your work on the project?
RADAR-AD has allowed me to deepen my research in eHealth and bridge lab technology development with real-life applications, in touch with actual users in-need. I especially look forward to piloting and getting user feedback. Working with the pharmaceutical industry is also exciting, as we hope to promote the adoption of digital technologies and speed up trials as well as making care more accessible.

What is challenging about your work?
Technology is developing in a fast pace, greatly influenced by the market. On one hand, devices we are working with can now be found at common retail electronics stores. They are now ten times more affordable, comfortable and acceptable by the patients. On the other hand, they are also less robust and precise, while more suitable devices have gone extinct. One of our aims is to find the optimal balance between comfort and precision in a rapidly changing environment.

What do you think is the importance of the project for the wider field of Alzheimer research?
While many of the notions in RADAR-AD such as digital biomarkers for the progression and prediction of the disease have been established the last decade, its importance lies in their formal definition, development and well-defined inclusion in clinical trials and adoption by the pharmaceutical industry to help speed up drug discovery and care.

How has the COVID-19 crisis impacted your work?
COVID-19 has halted participant recruitment and trials. I believe that the project is well on-track and the impact has not affected it severely. However, lab work, research and development have continued in the same if not greater pace which is one of the benefits of technology-based research.

How have you adapted to the new circumstances created by the pandemic?
Working from home with just a computer and an internet connection is an immense privilege of us computer scientists as opposed to so many other lines of work severely affected by the pandemic. We are lucky and grateful to be able to work remotely in full capacity with no setbacks if not greater productivity.

How do you mitigate the (negative) impact of the crisis on your work?
Implications, however, are slightly apparent, such as the increase of teleconferencing to compensate for the lack of physical meetings. My next personal goal is to minimize teleconferencing to achieve some balance. It also makes sense to maintain a balance between “working from home” and “living at home” by time-tracking and expanding the range of activities indoors and outdoors. I personally use meditation, exercise and lots of dog walking!

Nivethika Mahasivam who works at The Hyve in Utrecht, The Netherlands. Her main tasks on RADAR-AD are to develop and deliver the technical platform to support RADAR-AD (based on RADAR-base) and integrate data sources needed for the studies.

About her experience working on the project, Nivethika shares: “Working on RADAR-AD is, in fact, quite interesting. I am also part of the RADAR-CNS consortium and it is exciting to see how we are adapting and extending the RADAR-base platform for use in the RADAR-AD studies. Of course, RADAR-AD is trying to answer different and specific questions related to Alzheimer's disease. While the expertise acquired throughout RADAR-CNS is used in RADAR-AD, new solutions and enhancements are also sought out and implemented specifically for RADAR-AD.”

However, Nivethika explains that the way the RADAR-AD study is conducted is different to the RADAR-CNS studies. She elaborates that RADAR-AD aims to look into different functional domains, resulting in various kinds of data sources such as apps and wearables which Nivethika and her colleagues are interested in. That, in turn, requires different methods of data integration from various sources. She continues: “We have to talk to different partners and providers who provide applications and wearable devices which can monitor a specific set of data. It can be challenging to have the whole data sources landscape in mind and provide solutions considering all data integration methods, whilst keeping these user-friendly to the end-users.”

Looking ahead, Nivethika is convinced that if we could actually improve the assessment of Alzheimer’s disease by using remote measuring technologies, that would be a huge contribution to the disease area. “This is a very important fact to consider, she asserts - if we find biomarkers that would be able to improve disease assessment using today’s commodities like mobile phones and wearables, that would be a giant contribution to the Alzheimer’s community.” 

As a matter of fact, the COVID-19 pandemic has not impacted much of Nivethika’s work on RADAR-AD. They have already set-up the infrastructure and platform to start the studies.  Most of her work related to RADAR-AD has to do with communication through the internet anyways, she shares. Since the studies got delayed, The Hyve has more time to develop and deliver additional solutions such as monitoring data quality and compliance monitoring. The challenge is that communications with partners sometimes get delayed. However, this is understandable, Nivethika explains, given that educational institutions have shifted their priorities as they have a lot of work on their plates. Although difficult to adapt in the beginning, Nivethika is now enjoying working from home.