Cocreating the Visualization of Digital Mobility Outcomes: Delphi-Type Process With Patients

Advances in wearable technology enable the measurement of real-world mobility. Mobilise-D has validated digital mobility outcomes (DMOs) as novel outcomes for clinical research in Parkinson disease, multiple sclerosis, chronic obstructive pulmonary disease, and proximal femoral fracture. While these outcomes are meaningful to patients, optimal methods for presenting such data, including effective visualization, remain underexplored.
To identify condition-specific meaningful mobility outcomes and determine how they should be visualized from the perspective of end users.
A Delphi-type process involving patients as subject matter experts was conducted over three questionnaire rounds. Round 1 used open-ended questions to identify mobility aspects affected by each condition. Responses were mapped to relevant DMOs and prioritized for visualization. Visualizations representing one week of mobility data were co-developed with patients, clinicians, and researchers. In rounds 2 and 3, participants rated usefulness and interpretability using 5-point Likert scales and provided qualitative feedback. Visualizations were refined between rounds.
Participation varied across rounds (n=48, n=79, n=78). Key outcomes differed by condition, including walking speed and stride length for Parkinson disease and multiple sclerosis, and step count for chronic obstructive pulmonary disease and proximal femoral fracture. Although consensus was not achieved, feedback was generally positive, and many participants reported that the visualizations were understandable.
Based on patient feedback and visualization principles, recommendations were developed. Visualizations should use clear, large fonts and be accessible for visual impairments such as color blindness. Incorporating contextual factors can better reflect condition variability. Continuous patient involvement is essential to ensure meaningful outcomes and visualizations.

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