Method Article 2026-04-20 posted v1

Measurement-grade video for computer vision in neurology: an international consensus framework for acquisition and reporting

J
Jane Alty University of Tasmania, Hobart, Australia
G
Gianluca Amprimo Politecnico di Torino, Turin, Italy
J
Jung Hwan Shin Seoul National University Hospital, Seoul, South Korea
M
Max Wuehr German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, Munich, Germany
M
Michal Novotny Czech Technical University in Prague, Prague, Czech Republic
H
Helga Haberfehlner Department of Rehabilitation Medicine, Amsterdam Movement Sciences Amsterdam University Medical Center, Amsterdam, Netherlands
C
Claudia Ferraris Institute of Electronics, Computer and Telecommunication Engineering (IEIIT) - National Research Council (CNR), Turin, Italy
R
Renjie Li University of Tasmania, Hobart, Australia
M
Marcelo Merello University of Buenos Aires, CONICET, Buenos Aires, Argentina
M
Marina de Koning-Tijssen Expertise Center Movement Disorders, Department of Neurology, University of Groningen, Groningen, Netherlands
S
Samuel Relton Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
D
David Wong Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
J
Johannes Taeger HNO Praxis Taeger, Muenchen, Germany
A
Andreas Zwergal German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, Munich, Germany
S
Sebastian Walther Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
J
Jochen Weishaupt Department of Neurology, University Hospital Ulm, Ulm, Germany
K
Karl Georg Häusler Department of Neurology, University Hospital Ulm, Ulm, Germany
J
Jan Rusz Czech Technical University in Prague, Prague, Czech Republic
B
Babak Taati KITE Research Institute, University Health Network, Toronto Western Hospital, Toronto, ON, Canada
R
Ryan Roemmich Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD, USA
M
Martin McKeown Pacific Parkinson's Research Centre and Division of Neurology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia and Vancouver Coastal Health, Vancouver, BC, Canada
A
Anoopum S. Gupta Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
M
Maximilian U. Friedrich Department of Neurology, University Hospital Ulm, Ulm, Germany

Abstract

Background: Neurological motor assessment relies on semi-quantitative, scale-based measures with inherent clinimetric limitations that disproportionately affect clinical trials aimed at early disease stages, where sensitivity is critical. Computer vision (CV) enables objective, scalable quantification of motor signs from standard video, yet clinical translation remains limited. A central bottleneck lies in the dependence of these methods on visual input: variability in video acquisition propagates into algorithmic outputs, constraining reproducibility and generalizability, while inconsistent reporting obscures a major source of variance. These limitations necessitate a clear definition of measurement-grade video as a prerequisite for developing reliable and scalable computer vision-based biomarkers in neurology. Methods: We conducted an international, multidisciplinary two-round modified Delphi process (n=23/20 experts across five continents) to define requirements for measurement-grade video in neurological motor assessment. In round one, items were elicited through predominantly open-ended queries on acquisition practices, failure modes, and outcome priorities. In round two, 16 acquisition and 21 metadata items were evaluated using a tiered scheme, with consensus pre-specified at ≥70% endorsement. In parallel, four domain-specific workgroups synthesized literature and real-world experience into domain-specific extensions. Results: Acquisition variability emerged as a principal barrier to reliable measurement across domains, with disagreement reflecting differences in enforceability rather than relevance. Three acquisition items reached mandatory consensus: continuous body-region coverage, protocolized video setup, and standardized task instructions. For metadata, task script, patient characteristics, video frame rate, and patient demographics were deemed mandatory. Feasibility varied by domain, highest for hand movements and lowest for eye movements. Most panelists identified underrepresentation of patient diversity and insufficient reference standards as key limitations in current studies. Notably, none of the mandatory elements requires additional hardware or substantial setup. Conclusion: This consensus-defined framework establishes measurement-grade video as a prerequisite for reliable and scalable computer vision-based movement analysis, providing an immediate, infrastructure-independent foundation for digital biomarker development in neurology.

Citation Information

@article{janealty2026,
  title={Measurement-grade video for computer vision in neurology: an international consensus framework for acquisition and reporting},
  author={Jane Alty and Gianluca Amprimo and Jung Hwan Shin and Max Wuehr and Michal Novotny and Helga Haberfehlner and Claudia Ferraris and Renjie Li and Marcelo Merello and Marina de Koning-Tijssen and Samuel Relton and David Wong and Johannes Taeger and Andreas Zwergal and Sebastian Walther and Jochen Weishaupt and Karl Georg Häusler and Jan Rusz and Babak Taati and Ryan Roemmich and Martin McKeown and Anoopum S. Gupta and Maximilian U. Friedrich},
  journal={Research Square},
  year={2026},
  doi={https://doi.org/10.21203/rs.3.rs-9437116/v1}
}
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