The increasing ageing global population is causing an upsurge in ailments related to old age, primarily dementia and Alzheimer’s disease, frailty, Parkinson’s, and cardiovascular disease, but also a general need for general eldercare as well as active and healthy ageing. In turn, there is a need for constant monitoring and assistance, intervention, and support, causing a considerable financial and human burden on individuals and their caregivers. Interconnected sensing technology, such as IoT wearables and devices, present a promising solution for objective, reliable, and remote monitoring, assessment, and support through ambient assisted living. This paper presents a review of such solutions including both earlier review studies and individual case studies, rapidly evolving in the last decade. In doing so, it examines and categorizes them according to common aspects of interest such as health focus, from specific ailments to general eldercare; IoT technologies, from wearables to smart home sensors; aims, from assessment to fall detection and indoor positioning to intervention; and experimental evaluation participants duration and outcome measures, from acceptability to accuracy. Statistics drawn from this categorization aim to outline the current state-of-the-art, as well as trends and effective practices for the future of effective, accessible, and acceptable eldercare with technology.

In this paper, we demonstrate the potential of a knowledge-driven framework to improve the efficiency and effectiveness of care through remote and intelligent assessment. More specifically, we present a rule-based approach to detect health related problems from wearable lifestyle sensor data that add clinical value to take informed decisions on follow-up and intervention. We use OWL 2 ontologies as the underlying knowledge representation formalism for modelling contextual information and high-level concepts and relations among them. The conceptual model of our framework is defined on top of existing modelling standards, such as SOSA and WADM, promoting the creation of interoperable knowledge graphs. On top of the symbolic knowledge graphs, we define a rule-based framework for infusing expert knowledge in the form of SHACL constraints and rules to recognise patterns, anomalies and situations of interest based on the predefined and stored rules and conditions. A dashboard visualizes both sensor data and detected events to facilitate clinical supervision and decision making. Preliminary results on the performance and scalability are presented, while a focus group of clinicians involved in an exploratory research study revealed their preferences and perspectives to shape future clinical research using the framework.

Decentralized clinical trials (DCTs) are becoming increasingly popular. Digital clinical trial platforms are software environments where users complete designated clinical trial tasks, providing investigators and trial participants with efficient tools to support trial activities and streamline trial processes. In particular, digital platforms with a modular architecture lend themselves to DCTs, where individual trial activities can correspond to specific platform modules. While design features can allow users to customize their platform experience, the real strengths of digital platforms for DCTs are enabling centralized data capture and remote monitoring of trial participants and in using digital technologies to streamline workflows and improve trial management. When selecting a platform for use in a DCT, sponsors and investigators must consider the specific trial requirements. All digital platforms are limited in their functionality and technical capabilities. Integrating additional functional modules into a central platform may solve these challenges, but few commercial platforms are open to integrating third-party components. The lack of common data standardization protocols for clinical trials will likely limit the development of one-size-fits-all digital platforms for DCTs. This viewpoint summarizes the current role of digital platforms in supporting decentralized trial activities, including a discussion of the potential benefits and challenges of digital platforms for investigators and participants. We will highlight the role of the digital platform in the development of DCTs and emphasize where existing technology is functionally limiting. Finally, we will discuss the concept of the ideal fully integrated and unified DCT and the obstacles developers must address before it can be realized.

Activities of daily living (ADLs) are fundamental routine tasks that the majority of physically and mentally healthy people can independently execute. In this paper, we present a semantic framework for detecting problems in ADLs execution, monitored through smart home sensors. In the context of this work, we conducted a pilot study, gathering raw data from various sensors and devices installed in a smart home environment. The proposed framework combines multiple Semantic Web technologies (i.e., ontology, RDF, triplestore) to handle and transform these raw data into meaningful representations, forming a knowledge graph. Subsequently, SPARQL queries are used to define and construct explicit rules to detect problematic behaviors in ADL execution, a procedure that leads to generating new implicit knowledge. Finally, all available results are visualized in a clinician dashboard. The proposed framework can monitor the deterioration of ADLs performance for people across the dementia spectrum by offering a comprehensive way for clinicians to describe problematic behaviors in the everyday life of an individual.

While decentralized clinical trials (DCTs) hold great promise for improving trial accessibility and efficiency, the effective deployment of DCT elements requires robust technological infrastructure and careful system integration. Although several innovative technologies are now available for implementing DCT elements, most existing setups integrate single‐vendor solutions, which restrict the potential for tailored trial designs as well as seamless interoperability between different platforms and solutions. This paper presents operational learnings from the Trials@Home RADIAL proof‐of‐concept trial. RADIAL implemented a modular, multi‐vendor technology package. RADIAL adopted a deliberate strategy to avoid a monolithic “one‐vendor‐for‐all” solution, instead selecting technologies and integrating them only where it added clear value. Core systems—such as eConsent and Bluetooth glucometer—were fully integrated into the central platform, while other components were deliberately managed outside the core system. The aim was to implement and validate a multi‐vendor technology setup and generate learnings that would help DCT trialist in designing DCTs, especially in terms of technology selection and integration. Key challenges arose from Bring Your Own Device (BYOD) variability, immature device technologies, and infrastructure limitations at clinical sites—particularly affecting components like telemedicine. The results emphasize the significance of investing in participant support infrastructure, as well as early cross‐functional support, while automated, multichannel notifications seem to guide participant engagement. Finally, embedding compliance by planning early streamlines documentation through a clear governance model seemed to enhance agility and reduce burden.

Intending to enable a broader collaboration with the scientific community while maintaining privacy of the data stored and generated in Living Labs, this paper presents the Shareable Data Publishing and Access Service for Living Labs, implemented within the framework of the H2020 VITALISE project. Building upon previous work, significant enhancements and improvements are presented in the architecture enabling Living Labs to securely publish collected data in an internal and isolated node for external use. External researchers can access a portal to discover and download shareable data versions (anonymised or synthetic data) derived from the data stored across different Living Labs that they can use to develop, test, and debug their processing scripts locally, adhering to legal and ethical data handling practices. Subsequently, they may request remote execution of the same algorithms against the real internal data in Living Lab nodes, comparing the outcomes with those obtained using shareable data. The paper details the architecture, data flows, technical details and validation of the service with real-world usage examples, demonstrating its efficacy in promoting data-driven research in digital health while preserving privacy. The presented service can be used as an intermediary between Living Labs and external researchers for secure data exchange and to accelerate research on data analytics paradigms in digital health, ensuring compliance with data protection laws.