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Researchers at Royal Papworth Hospital NHS Foundation Trust will receive £3.4 million to fund new UK-wide trials investigating if machine-learning technology can transform how people living with chronic respiratory conditions manage their health.
Previous studies have shown it has the potential to improve health and spot signs of lung infections days before symptoms appear, avoiding admissions to hospital.
The team, led by Professor Andres Floto (Royal Papworth Hospital and the University of Cambridge), will examine the impact of home monitoring and machine-learning decision support algorithms for people with cystic fibrosis (CF) and non-CF bronchiectasis (NCFB).
The team has previously completed a multicentre UK-wide feasibility study (SmartCare CF) which demonstrated the potential benefits of home monitoring in CF. From that, the team ran a clinical implementation programme (Project Breathe), introducing home monitoring into routine clinical care in four CF centres in the UK and Ontario, Canada.
Research participants were provided with equipment – such as a FitBit, pulse oximeter, spirometer and electronic scales – to measure key indicators such as blood oxygen levels, lung function, weight, sleep and temperature every day, and then upload the results via a software platform (Breathe RM).
Data scientists from the University of Cambridge and Microsoft Research have now used this anonymised home monitoring data to train machine-learning algorithms to predict future health deteriorations 10 days earlier than currently possible. This would allow clinicians to begin treating patients sooner to potentially head off serious, lung damaging infections.
The researchers will receive £1.9m from medical research charity LifeArc and £1.5m from the National Institute for Health and Care Research to test the artificial intelligence technology at scale in a clinical trial.
They will explore the application of novel sensors to monitor health at home and to test the feasibility of home monitoring for patients with NCFB.
Starting in early 2023, the programme, which has been co-developed by people with direct experience of CF and NCFB, will enrol up to 500 adults with CF and NCFB across the UK.
The team will receive advice and support from LifeArc to develop the technology to commercial standard so it can be made available to patients worldwide.
If proven to be effective at scale, the technology could transform the lives of patients and deliver substantial cost and time savings for the NHS.
Professor Floto, Honorary Consultant at the Cambridge Centre for Lung Infection at Royal Papworth Hospital, said: “These studies are incredibly exciting. They have the potential to provide both immediate and long-term benefits to people living with chronic and debilitating lung conditions.
“It is a unique opportunity to empower people to take control of their own health and reduce the impact the disease has on their daily life, in turn improving their quality of care and saving time and money for the NHS.”
Dr Catherine Kettleborough, who leads the LifeArc Chronic Respiratory Infection Translational Challenge, said: “This new technology has the potential to transform how people living with chronic lung conditions like BE and CF monitor and manage their condition. By detecting infections before symptoms appear, this technology could enable patients to start treatment earlier before they become seriously unwell, avoiding unnecessary hospital admissions and massive disruption to their lives.”
“Self-monitoring my health through Project Breathe has helped me pick up signs of exacerbations more quickly, meaning problems have been intercepted earlier,” said Sammie Read, 42, from Stowmarket, Suffolk. “This has given me a better quality of life as I do not need to be admitted as an inpatient for intravenous antibiotics as often.”
Steve Churchill, 44 from Hertfordshire, also has CF and has been monitoring his health from home using technology since November 2019. “It was perfect timing for me with the COVID-19 pandemic arriving a few months later when I needed to shield. I have been able to keep an eye on my health more closely myself, a benefit that was particularly useful during the pandemic.
“There have been a few times when I have started oral antibiotics earlier than I would have done otherwise, which may have prevented some hospital stays because I’ve been able to spot a possible problem early.”
An additional arm of the trial will investigate the impact and effectiveness of novel, small wearable devices that continuously monitor the health of people with CF.
“It would be great to have the recording done passively,” added Steve. “Managing my CF takes a long time – four hours a day when I am well and far longer when I am ill. Anything that can reduce the burden of my health regime would be very welcome.”
“Having the data picked up more easily or automatically without having to record it myself would be even easier,” Sammie concluded. “It would save more time, allowing me to continue living my life without having to upload data daily.”
A reminder that PB aims to measure vital indicators in participant’s health every day from home. This gives participants more control over their condition and a better understanding of when they are showing early signs of deterioration or exacerbation.
The data can be viewed by clinicians remotely or at appointments to assist clinical decisions, for example when antibiotics are required, earlier than would have previously been possible.
Data analysis is currently in process which will facilitate further studies.
The project started at Royal Papworth Hospital in February 2019
We truly appreciate your participation.
We have offered an incentive of £50 to all of those involved in Project Breathe at Royal Papworth Hospital to provide intensive data. We have paid £50 to 43 participants for their valuable commitment (some of these payments have taken longer than expected, and we truly apologise for the delay).
There are currently three other sites in the UK recruiting for Project Breathe: Edinburgh, Glasgow and Cardiff.
Regular data collection allows individuals with CF to track their own health, with many users stating that have found the whole experience of self-monitoring extremely empowering and that it has motivated them to stick to their treatments and exercise routine more rigorously.
At Papworth we have other studies running that aim to assess and compare the current devices used with PB. In order to participate in any of these you must be part of the PB study. These studies include:
ADAM: This is a multi-sensor that monitors temperature, activity, cough, respiratory rate and heart rate. The sensor needs to be worn for 6 weeks, about 20 hours a day.
Circardia: This is a bedside device that monitors the respiratory rate and chest wall movement including cough of patients during a chest infection. This is done with a contactless device and can be only performed during hospitalisation.
Sonde Voice: We aim to identify if changes are present in the voice, and if so, can supplement current data collection methods that help detect chest infections.
We continue to address some technical issues that individuals may be experiencing when entering data, with equipment, or when people just feel like their daily input with PB is going nowhere.
Please remember to check that you are connected to your clinic on your Breathe app. You can do this by checking in your settings. See below as reference.
We are very pleased to inform you that the PB team is growing.
We are all working together in several projects (linked to PB) that aim to improve your health and lifestyle. Please get in touch if you would like further information.
Royal Papworth Hospital– Papworth.email@example.com
Cardiff Hospital– firstname.lastname@example.org