Clinical markers of neonatal opioid withdrawal syndrome: onset, severity and longitudinal neurodevelopmental outcome

新生儿阿片戒断综合征的临床标志物：发病、严重程度和纵向神经发育结果

• 批准号: 10405202
• 负责人: Liz D Conradt
• 金额: $ 17.56万
• 依托单位: WOMEN AND INFANTS HOSPITAL-RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10405202
• 关键词: Acoustics; Administrative Supplement; Affect; Award; Birth; Caregivers; Characteristics; Clinical Markers; Computer software; Computerized Medical Record; Computers; Crying; Data Set; Development; Devices; Diagnosis; Diagnostic; Exposure to; Funding; Grant; Hair; Health; Hospitalization; Hospitals; Hour; Impairment; Infant; Judgment; Laboratories; Length of Stay; Manuals; Measurement; Measures; Morphine; National Institute of Drug Abuse; Neonatal Abstinence Syndrome; Neuraxis; Newborn Infant; Noise; Nurseries; Nurses; Nursing Records; Opioid; Outcome; Pharmacological Treatment; Procedures; Records; Sampling; Severities; Software Tools; Substance Withdrawal Syndrome; Symptoms; System; Technology; Telephone; Testing; Time; Training; Uncertainty; United States; Weaning; Withdrawal Symptom; Work; accurate diagnosis; application programming interface; automated analysis; base; clinical practice; cloud based; cost; drug withdrawal; fetal opioid exposure; gastrointestinal system; improved; infant outcome; machine learning algorithm; neurobehavioral; neurodevelopment; opioid epidemic; prenatal; research clinical testing; sociodemographic predictors; software systems

PROJECT SUMMARY/ABSTRACT This is an administrative supplement to our existing NIDA-funded grant entitled “Clinical markers of neonatal opioid withdrawal syndrome: onset, severity and longitudinal neurodevelopmental outcome” (R01DA049755). Every 15 minutes in the United States, an infant is born exposed to opioids, many of which develop the difficult to treat drug withdrawal syndrome, Neonatal Opioid Withdrawal Syndrome (NOWS). Unfortunately, the diagnosis of NOWS is highly subjective and includes “high pitched cry” simply based on the nurse’s judgement. The objective measurement of the acoustic characteristics of the cry in babies with NOWS is a pivotal component of the Specific Aims of the active award for this Administrative Supplement entitled “Clinical markers of neonatal opioid withdrawal syndrome: onset, severity and longitudinal neurodevelopmental outcome” (R01DA049755): Aim 1: Determine neurobehavioral, cry, prenatal opioid and other substance exposure measured via maternal hair, and sociodemographic predictors of NOWS onset and severity. Aim 2: Evaluate the predictive validity of these clinical markers and test whether NOWS severity predicts neurodevelopment impairment at 6 and 18 months. We developed a computer-based cry analyzer that extracts the acoustic features of an infant’s cry. We used the cry analyzer to determine the acoustic characteristics of the cries of babies with NOWS and developed a NOWS cry “signature” that can identify which babies develop NOWS with a 91% accuracy rate. However, the cry technology that we developed is not usable at the bedside. The Specific Aim of this Administrative Supplement Is to develop a cloud-based system for the automated analysis of infant cry acoustical characteristics for the diagnosis of NOWS. The proposed software will enable us to have a fully automatic system, where a user records a baby cry in the newborn nursery using a phone or other connected device, and within a few seconds, receives the diagnostic result. This Administrative Supplement will provide the cloud-based software to change clinical practice by providing a more accurate and reliable diagnosis of NOWS which will affect the pharmacological treatment of NOWS including length of hospital stay and potentially improve the long-term outcome of these infants.

项目概要/摘要 这是对我们现有的 NIDA 资助赠款的行政补充，题为“新生儿的临床标志物” “阿片类药物戒断综合征：发病、严重程度和纵向神经发育结果”（R01DA049755）。 在美国，每 15 分钟就有一名婴儿出生时就接触阿片类药物，其中许多会出现困难 治疗药物戒断综合症，新生儿阿片戒断综合症（NOWS）不幸地被诊断出来。 NOWS 的内容非常主观，包括仅基于护士判断的“高声哭泣”。 对患有NOWS 的婴儿哭声的声学特征进行客观测量是 题为“新生儿的临床标志物”的行政补充有效奖项的具体目标 “阿片类药物戒断综合征：发病、严重程度和纵向神经发育结果”（R01DA049755）： 目标 1：确定通过母亲测量的神经行为、哭泣、产前阿片类药物和其他物质暴露情况 头发、NOWS 发病和严重程度的社会人口学预测因素。 目标 2：评估这些临床标志物的预测有效性并测试 NOWS 严重程度是否可以预测 我们开发了一种基于计算机的哭泣分析仪，可以提取 6 个月和 18 个月时的神经发育障碍。 婴儿哭声的声学特征 我们使用哭声分析仪来确定婴儿哭声的声学特征。 患有NOWS 的婴儿的哭声，并开发了一个 NOWS 哭声“签名”，可以识别哪些婴儿患有 NOWS 准确率高达 91% 然而，我们开发的哭泣技术无法在床边使用。 本行政补充文件的具体目标是开发一个基于云的系统用于自动分析 所提出的软件将使我们能够利用婴儿哭声声学特征来诊断。 全自动系统，用户使用电话或其他设备记录新生儿托儿所中的婴儿哭声 连接的设备将在几秒钟内收到诊断结果。 提供基于云的软件，通过提供更准确、更可靠的诊断来改变临床实践 NOWS 的影响将影响 NOWS 的药物治疗，包括住院时间和 可能改善这些婴儿的长期结局。