For those who don’t have asthma, it is surprising to hear that many sufferers (especially teens) do not always recognize symptoms in order to know what to report to their doctors, resulting in under treatment. We are proud to report a professor of Nursing at the University of Rochester designed a device that can detect sounds such as wheezing and coughing that are then transmitted to an iPod.
By Kristen Stewart
March 10th, 2016
Anyone with asthma knows how difficult it can be to control. This can be especially true for teenagers.
Dr. Hyekyun Rhee, an Associate Professor at the University of Rochester School of Nursing and longtime asthma researcher, observed this firsthand when interacting with younger people. “In my previous studies about asthma self-management when I’ve spoken with teens, I realize they have a lot of symptoms but they don’t necessarily perceive those symptoms,” she said. “Some kids are wheezing when they talk to me and I ask if they are OK and they say, ‘Oh, I’m fine, what’s the problem?’ They didn’t even realize they had symptoms!”
These interactions made her better appreciate some of the failings of common symptom monitoring methods. If teens didn’t even notice they were having symptoms, they wouldn’t report them to their doctors, and might end up being under treated. She also understo3od that teens’ compliance with existing symptom monitoring methods such as self-reported diaries and peak flow meters is poor.
What began as a problem, however, turned into inspiration--and Overall Winner of the 2015-16 Innovation World Cup for the product known as Automated Device for Asthma Monitoring and Management (aka A.D.A.M.M.).
Knowing that the main asthma symptoms like wheezing and coughing are sound-based, Dr. Rhee began thinking about a small compact device that could detect such sounds automatically instead of having to rely on self-reporting. She worked with a sound engineer and recorded asthma symptoms to create an algorithm to detect the sounds from background noise as well as their pitch, frequency and amplitude.
Teens were given a tiny microphone to wear around their necks to capture breathing sounds, which then were processed and analyzed based on the symptom algorithms programmed in an iPod. Teens could also record their medication, self-perceived symptoms and triggers in the iPod program (“app”) that can keep track of activity levels using the iPod’s built-in accelerometer function. This would allow teens to understand their symptoms in the context of medication use, exposure to triggers and activity levels.
While other devices already existed that monitored asthma symptoms, they were limited by the fact that their recorded data was accessible only after it was downloaded and interpreted by experts. Dr. Rhee wanted to change that.
“The innovation with this device is that everything happens in real time,” she said. “Information can be accessed by patients and symptom patterns can be checked by going to the iPod and seeing all the symptoms that occurred during the day or week or month. Patients can know if symptoms get worse or better in the day or at night or if they are worse on a certain day of the week.” The feedback can also be useful for uncovering trigger patterns such as symptoms worsening if they go to a friend’s house that has a pet.
Health Care Originals, Inc., an upstate New York start-up company specializing in developing products for the management of chronic respiratory diseases, liked the idea so much they obtained the license from the University of Rochester to commercialize the device. They have made some modifications to Dr. Rhee’s prototype design such as transforming the iPod-based device into a wearable piece that can attach directly to the skin of the chest or back which would then be paired with the management app on a mobile device for displaying data and recording medications. Although Dr. Rhee does not work for the company, she has been in communication with them throughout the development process. The company plans to have the product available for purchase late this summer.
Dr. Rhee also has more plans of her own.
“To make sure that the device was really picking up symptoms, my team did validity testing by comparing the device data with conventional measures of asthma conditions such as spirometer and asthma symptom diaries,” she said. “We have a really good correlation so we are comfortable that the device is doing what it’s supposed to do in terms of monitoring asthma.”
Now she wants to study whether the device use will change people’s self-care behavior and asthma outcomes. She hopes with the data from the device people will take medication when they need to as well as be more careful around triggers and become more serious about taking preventive measures. She anticipates that these changes in behaviors will eventually improve asthma outcomes in teens.
She also envisions its usefulness in the future for more than teens and asthma. Children, the elderly and anyone else with certain respiratory issues who are unable to communicate symptoms correctly or accurately could benefit.
Living with asthma can be a challenge. A.D.A.M.M. might just help lighten the load.
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