Building a Digital Respiratory Disease Framework for COPD management in Central Appalachia

为阿巴拉契亚中部的慢性阻塞性肺病管理建立数字呼吸系统疾病框架

• 批准号: 10480681
• 负责人: STARLA KISER
• 金额: $ 25.95万
• 依托单位: MEDENTUM INNOVATIONS INC.
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-26 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10480681
• 关键词: Address; Adoption; American; Appalachian Region; Artificial Intelligence; Artificial Intelligence platform; Behavioral; Biometry; Caring; Cause of Death; Chronic Disease; Chronic Obstructive Pulmonary Disease; Clinic; Clinic Visits; Clinical; Communication; Communities; Companions; Computer software; Cost Savings; Cost of Illness; County; Data; Data Collection; Data Set; Devices; Diagnosis; Disease; Disease Management; Electronic Health Record; Environmental Risk Factor; Geography; Goals; Hand; Health; Health care facility; Health system; Home; Hospitalization; Incidence; Insurance; Knowledge; Lead; Measures; Medical; Medical History; Mississippi; Modeling; Monitor; Morbidity - disease rate; Non-Malignant; Outcome; Oxygen; Ozone; Patient Triage; Patients; Phase; Physicians; Physiologic pulse; Population; Poverty; Preventive; Provider; Pulse Oximetry; Questionnaires; Reading; Records; Respiration; Respiratory Disease; Respiratory Signs and Symptoms; Risk; Risk Factors; Rural; Rural Community; Rural Population; Secure; Self Administration; Self Management; Small Business Innovation Research Grant; Specialist; Steroids; Stethoscopes; Surveys; Symptoms; Technology; Telemedicine; Telephone; Temperature; Testing; Time; Travel; Treatment Cost; Triage; Uninsured; Virginia; Visit; Weather; adherence rate; artificial intelligence algorithm; base; commercial application; cost; demographics; design; digital; disorder control; effective therapy; evidence base; handheld equipment; health care quality; health disparity; improved; innovation; intelligent algorithm; mortality; remote monitoring; respiratory; respiratory health; rural America; rural Americans; rural area; rural dwellers; satisfaction; sensor; smartphone Application; social; social culture; social factors; socioeconomics; sound; standard of care; technological innovation; telehealth; treatment planning; usability; wearable device

PROJECT SUMMARY/ABSTRACT Compared to urban residents, rural communities have higher rates of chronic obstructive pulmonary disease (COPD) with worse disease control, resulting in higher rates of morbidity and mortality. In general, rural residents suffer from higher poverty and uninsured rates, further compounded by geographic isolation and limited access to quality healthcare. This and other social factors have resulted in higher incidence and worse outcomes of nearly every chronic disease. Telehealth holds promise to address these challenges and expand access to specialist care in these communities, but qualitative telehealth visits often lack necessary patient data for physicians to make informed management decisions. Telemedicine is also often hindered by limited broadband access in rural areas. Wearable technologies for remote monitoring suffer similar limitations, and, due to cost and burdensome daily engagement requirements, lead to poor adherence rates in an older, sicker population. To address these challenges, Medentum is developing an affordable and accessible, multi-functional, home-use device featuring a camera, low-cost sensors (temperature, pulse oximeter) and a digital stethoscope. A companion phone application allows the recording of demographics, sociocultural data, medical history, and symptoms, and guides the patient to collect their biometric readings with the handheld device. Without the necessity of broadband, the patient can transmit their information securely to a remote physician/chronic disease specialist who can make a diagnosis and treatment plan. For this SBIR, Medentum will adapt its device and software platform for respiratory disease, layering it with artificial intelligence (AI) algorithms, to create a digital respiratory disease framework (DRDF) that empowers self-management of COPD. The aims of this SBIR are to 1) study the usability and feasibility of this COPD respiratory framework in a rural Central Appalachian population of 75 patients in Southwest Virginia and 2) build preliminary AI algorithms that autonomously predict COPD exacerbation risk by analyzing low burden variables including risk factors (social, behavioral, environmental), symptoms, COPD Assessment tests, and device biometrics (temperature, pulse, oxygen saturation, respiration rate and breath sounds). In Phase II, the platform will incorporate smart triggers that will alert patients if certain environmental risk factors are met, prompting them to engage with the platform. The smart algorithms will then automatically predict their COPD exacerbation risk, ultimately triaging them to appropriate treatment. Predicting and pre-empting disease exacerbation by facilitating early connections to medical providers for prompt and effective treatment will have an enormous impact on health outcomes and treatment costs for rural COPD patients. Ultimately, this platform will augment COPD self-management, promote preventive respiratory care, and disseminate evidence-based COPD treatments, all designed to reduce the significant health disparities in a remote, underserved Central Appalachian population with worse respiratory outcomes.

项目摘要/摘要 与城市居民相比，农村社区的慢性阻塞性肺疾病率更高 （COPD）疾病控制较差，导致发病率和死亡率较高。通常，农村居民 遭受较高的贫困和未保险率的折磨，地理隔离和有限的访问进一步加剧了 进行优质的医疗保健。这个和其他社会因素导致了更高的发病率和更糟的结果 几乎每种慢性病。远程医疗有望应对这些挑战并扩大对 这些社区的专业护理，但是定性远程医疗访问通常缺乏必要的患者数据 医生做出明智的管理决定。远程医疗也经常受到有限的宽带的阻碍 农村地区的通道。用于远程监控的可穿戴技术受到类似的限制，并且由于成本 以及繁重的每日参与要求，导致年龄较大，病人的依从率差。 为了应对这些挑战，Medentum正在开发一种负担得起的，可访问的，多功能的家庭用途 具有相机，低成本传感器（温度，脉搏血氧仪）和数字听诊器的设备。一个 伴侣电话应用程序允许记录人口统计学，社会文化数据，病史和 症状，并引导患者使用手持设备收集生物识别读数。没有 宽带的必要性，患者可以将其信息牢固地传输到远程医师/慢性病 可以制定诊断和治疗计划的专家。对于此SBIR，Medentum将调整其设备，并 呼吸道疾病的软件平台，将其与人工智能（AI）算法分层，以创建数字 呼吸道疾病框架（DRDF）赋予COPD自我管理的能力。这个Sbir的目的是 1）研究该COPD呼吸道框架的可用性和可行性 在西南弗吉尼亚州的75名患者和2）构建自动预测COPD的初步AI算法 通过分析低负担变量（包括风险因素（社会，行为，环境））来加剧风险， 症状，COPD评估测试和装置生物识别技术（温度，脉搏，氧饱和度，呼吸 速率和呼吸声音）。在第二阶段，该平台将合并智能触发器，如果​​某些确定 满足环境风险因素，促使他们与平台互动。然后，智能算法将 自动预测其COPD加剧风险，最终将其分类为适当的治疗。预测 通过促进与医疗提供者的早期联系，以提示和 有效的治疗将对农村COPD的健康结果和治疗成本产生巨大影响 患者。最终，该平台将增加COPD自我管理，促进预防性呼吸护理， 并传播基于证据的COPD治疗，旨在减少一个重大健康差异 偏远，服务不足的阿巴拉契亚中部人口呼吸较差。