A Scoping Review Using the TRACE Framework to Map Readiness ...
tremorjournal.org
June 28, 2026, 3:18 p.m.
Essential Tremor, the most prevalent movement disorder in adults, lacks comprehensive digital biomarker validation despite evolving therapeutic options. This scoping review introduces TRACE, a five-tier validation maturity framework assessing technology readiness and clinical evidence, applied across 165 ET digital biomarker studies spanning wearable sensors, handwriting analysis, computer vision, and other modalities. While 93% of studies achieved basic technical validation, only 11 progressed beyond supervised clinical settings to demonstrate ambulatory or longitudinal utility, with the Cala Health TAPS wristband being the sole platform reaching clinical trial readiness. Key gaps include limited home deployment, insufficient minimum detectable change derivation, and minimal patient-reported outcome integration. These prerequisites remain essential before digital tremor metrics can serve as validated trial endpoints or support routine clinical practice, highlighting a significant translational opportunity in movement disorder research.