Even before the COVID pandemic, respiratory disease was already one of the top three leading causes of death. It was, and continues to be, a global healthcare and social burden, with chronic conditions like chronic obstructive pulmonary disease (COPD), asthma and obstructive sleep apnoea (OSA) affecting almost a billion people worldwide. Despite the far-reaching individual, social and financial impact of these illnesses (untreated OSA costs the U.S. economy an estimated $6k per patient per year), diagnosis and management has traditionally been difficult and costly due to the need for intensive human resources at each step of the process.
OSA diagnosis, for instance, requires patients to wear a cumbersome wired device overnight and a specialist clinician to manually interpret signals obtained from the device, which can take 1-2 hours per patient. This, in turn, causes huge bottlenecks and waiting lists, with some patients waiting several months for a diagnosis and subsequent treatment. As a result, despite the serious health implications of untreated OSA, which include heart attack, diabetes, and an increased risk of road traffic accidents, a staggering 85% of patients remain undiagnosed.
But this has the potential to change, thanks to promising work that could lead to new technological innovations in respiratory healthcare, such as the remote monitoring of COPD patients or intelligent ventilators and continuous positive airway pressure (CPAP) machines, which provide compliance and performance metrics that can lead to an optimization of different patients’ treatments.
Another example is smart inhalers. Conditions like COPD and asthma have long been managed with inhalers, in fact inhalers administer nearly 90% of medications prescribed for respiratory illness, but incorrect and inadequate use has often limited their effectiveness. Smart inhalers link to a mobile application, which can not only remind and encourage patients to use the device when needed, but also records data on usage. This can be fed back to both clinicians and the patient themselves, providing invaluable information about symptoms and triggers which allows for better management of the condition.
For OSA diagnosis, a new tiny wearable acoustic sensor called AcuPebble is offering patients and clinicians a more user-friendly and efficient solution. This new device has the ability to completely transform the current OSA testing process, which is complex and expensive and requires patients to visit a hospital to be trained to use the testing equipment. Because the testing process involves using so many wires, around 10-20% of these sleep tests have to be repeated because sensors get detached or are not placed correctly by the patient.
The new wearable device, which recently obtained a new FDA clearance, can be sent to patients at home, where they can conduct their own sleep study guided by a mobile application, so there is no need for patients to visit a hospital to be trained by a clinician to use the device.
It’s extremely simple to use – all a patient has to do is attach the device to the front of their neck with a single-use medical adhesive before going to sleep. The sensor then transfers the signals to a mobile device, which uploads the data to a secure platform and is analysed by proprietary algorithms and an automated diagnosis report is sent to clinicians within minutes. The newly cleared version of the device includes a complete sleep report and offers a comprehensive set of channels, including heart rate and signals, activity, snoring, oxygen saturation, respiratory phases and airflow, and more.
While artificial intelligence (AI) is a buzzword currently on everyone’s lips, and though this certainly has a part to play in the technological advancement of healthcare, in the case of AcuPebble for OSA diagnosis, there is no AI involved. The device works through proprietary signal processing techniques based on unique physiological and engineering modelling, and is the result of over a decade of research at Imperial College London and Acurable.
When it comes to technological advances in healthcare, there is no doubt that AI is powerful and can certainly help some bottlenecks, but there are also important risks associated with it. Lack of interpretability is one of them – or to put it in simple words, we can’t really know what the algorithms are doing or why they are doing it. In the case of the current AcuPebble products, the algorithms do work, are fully interpretable and every single step is backed by modelling of physiological processes.
The need for intuitive technology to help medical professionals diagnose and treat respiratory conditions has never been so high. Technological innovations like the aforementioned have the potential to transform respiratory healthcare, reduce costs and reduce wait times, and improve adherence to treatment. Adopting innovations like these will allow people to take control of our own health and give clinicians the opportunity to spend more time doing what they were trained to do – taking care of patients and getting them the treatment they need to make their lives better.
Esther Rodriguez Villegas
Esther Rodriguez-Villegas is Founder & Co-CEO of Acurable.
