Clinical Applications and Measurement Properties of the Digitized Archimedes Spiral Drawing Test: A Scoping Review

The digitized Archimedes spiral drawing test (DAST) provides an objective approach for assessing tremor in Parkinson's disease (PD) and essential tremor (ET). Despite its growing adoption in patient care settings and clinical research, the measurement properties of the digitized spiral drawing test beyond tremor are underexplored. Additionally, methodological variability limits its clinical standardization and broader clinical application.

This scoping review evaluates various applications of the digitized spiral drawing test as a clinical outcome measurement instrument in adult populations, emphasizing its reliability, validity, and responsiveness.

This scoping review examined literature published in MEDLINE, Embase, CINAHL, PsycINFO, Scopus, and Web of Science, including studies on adults (≥18 years) using the DAST, to assess fine motor function.

Of 120 included studies, 84 focused on PD or ET, with emerging applications in other conditions. Digital tablets were the most used administration method (66.6%), but task design, metrics, and analysis varied. Measurement properties were reported in fifty-two studies (43.3%): 15 on reliability, 45 on validity, and 6 on responsiveness. Results demonstrated consistent reliability, strong correlations with gold-standard clinical measures, and sensitivity to interventions.

The digitized spiral drawing test shows strong promise as a reliable and valid tool for assessing fine motor function in clinical and research settings. However, significant variability in devices, drawing tasks, and analysis methods across studies highlights the need for standardized protocols. Future research should focus on harmonizing methods, expanding its application across different conditions, and ensuring its clinical relevance as a measurement instrument.