A new University of Alberta feasibility study involving 40 patients could help those dealing with long-term chronic respiratory issues by using new wearable technology and artificial intelligence to monitor symptoms and warn of coming exacerbation episodes.
ADAMM-RSM is a wearable device developed in the U.S. for patients with asthma, with the goal of expanding its use in predicting medical events in other respiratory conditions as well. Giovanni Ferrara, a professor and director of the Division of Pulmonary Medicine in the Faculty of Medicine & Dentistry, is testing the new technology in a pilot project, alongside team members Pierre Boulanger in the Faculty of Science, Michael Stickland in the Division of Pulmonary Medicine and Breanne Stewart, a U of A clinical trials project lead.
According to Ferrara, ADAMM-RSM tracks clinical signs and symptoms that can inform treatment decisions tailored to the patient's needs, providing more precise control over the disease. The device also allows health-care providers to fine-tune the intensity of treatment based on the intensity of symptoms related to the phase of the pulmonary disease.
The device is worn on the torso under the clothes, and can be placed on the chest, side or back to suit patient comfort and maintain privacy.
Predicting when patients should see their doctor
Chronic respiratory diseases are among the most common causes of admission to the University of Alberta Hospital's emergency department. Currently, pulmonary conditions require patients to visit their physicians every three to six months. The wearable technology offers the opportunity for ongoing monitoring that would detect worsening symptoms or consistently anticipate respiratory events, making it easier to know if they should see the doctor before that, or if their condition remains stable.
"ADAMM-RSM is able to collect the respiratory rate, heart rate, temperature, coughing, wheezing and level of activity for at least eight hours per day," said Ferrara. "This is important because we want to detect any variations as they occur, before the patient needs to go to the ER.
"The study will explore the possibility to predict when it's the right time to see your physician based on the data collected by the device and artificial intelligence algorithms, before you get in trouble. That's what we really want to see in health care today. We don't want a different way to look at the same thing—we want new tools."
Testing innovative technology
The new Edmonton-based feasibility study expands on work conducted in the U.S. by Health Care Originals, the New York-based company that initially developed the technology. The hope is to eventually tailor ADAMM-RSM to be suitable for numerous respiratory conditions including cystic fibrosis, idiopathic pulmonary fibrosis, recent lung transplants and tuberculosis, among others.
"The beauty of the technology is that Dr. Ferrara is looking at a lot of conditions using the same platform," said Jared Dwarika, co-founder of Health Care Originals. "This could include conditions that he might not be considering now. ADAMM-RSM can collect a vast amount of data, and he can retroactively review the data to apply this technology to other diseases."
The project was made possible by what Ferrara calls "unique circumstances" in Edmonton, where there's a combination of clinical and technological expertise—including experts in artificial intelligence—that lends to the development of new medical devices and research. The level of medical innovation currently seen in Alberta is not the norm in other parts of the world, Ferrara added, and he hopes to see further innovations as a result of local expertise and a thriving entrepreneurial environment.
Should the pilot project prove successful, next steps will include running a second and third trial that target specific populations and larger groups of participants. Further work would include analyzing and finding algorithms that will enable the prediction of major respiratory events such as admissions or ER visits.
"If everything works, it could easily be done within two to three years," Ferrara said.
In total, the study will include three phases, with the technology being narrowed for use with specific respiratory conditions over time.
The project is additionally supported by the Northern Alberta Clinical Trials and Research Centre (NACTRC), ST Innovations and the U of A's Precision Health Innovation, Research and Technology Ecosystem (PRECISE) platform, part of the Precision Health Signature Area.
