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Wearable Electronics for Effective Lung Monitoring

Periodic Reporting for period 3 - WELMO (Wearable Electronics for Effective Lung Monitoring)

Reporting period: 2021-07-01 to 2022-06-30

The diagnosis, monitoring and treatment of lung diseases depend on the availability of medical products {stethoscopes, spirometers, plethysmographs, X-ray, CT, MRI & electrical impedance tomography (EIT)} that are monitoring the lung disease progression and treatment. Such medical products are placed inside hospitals, labs, special care units and healthcare professionals’ sites, requiring patients to have regular visits to assess their status and receive therapy treatments. However, such examination methods are not portable (with the exception of stethoscopes and simple spirometers) and allow a momentary patient assessment. Short-term trends in disease development, either deterioration or improvement, are not accessible. Up to now, continuous, wearable and real-time monitoring, especially in remote settings (e.g. patients’ home) is not available. Other medical devices, especially the radiological ones, are massive, expensive, requiring specialized personnel, increasing the radiation load on the patient. Moreover, the fusion of both visual and sound information, is difficult, leaving their interpretation on the healthcare profession’s experience. WELMO with the adoption of Application-Specific-Integrated-Circuits (ASIC) will be prototyped and demonstrated for Electrical Impedance tomography (EIT) and for lung sounds. The incorporation of low-cost and power electronics will enable for the first time the combination of both visual & sound information enabling the systematic, accurate and real-time evaluation of respiratory conditions. The collected signals can be securely stored and processed, towards revealing linkages with specific clinical outcomes. WELMO comfortable vest is enabling the effective and accurate monitoring of the lungs, through the collection, fusion and interpretation of sound and image signals with innovative algorithms. According to EUROSTAT, there are 382.000+ deaths in the EU-28 from respiratory diseases, (7.7 % of all deaths). 235+ million people world-wide suffer from asthma (WHO). 40 billion Euros are wasted annually across EU through lost productivity due to employee absenteeism related to COPD & asthma. WELMO holistic solution is expected to have a radical impact: By continuously monitoring lung function with novel methods of signal acquisition of respiratory patients. By providing physicians with enhanced awareness of their patient's health status and enable early identification of disease exacerbations. By minimizing the healthcare associated costs due to earlier detection of disease deterioration and the resulting fewer hospitalizations. It will be one of the first applications of effective lung imaging, giving insights to patients to understand their disease. WELMO targets to the development of a high-usable, easy-to-wear, machine-washable wearable that will enable the efficient & accurate real-time monitoring of the lungs. Main Objectives are: To develop and produce miniaturized and low-power sensors. To use smart-garments and cabling: enabling the integration of all sensors in a single wearable. To align with relevant standards regarding developed electronics. To perform real-time acquisition of sensor data accelerating the decision-making process. To design and develop algorithms for the lung sound signal analysis. To develop a Decision Support System to perform accurate assessment of respiratory function deficits & to assist, even not EIT-expert, in timely detection of lung abnormalities. To link measured signals with certain lung functions and clinical conditions. To develop a set of secure apps for enabling the dynamic presentation of the results.
Work performed
Clinical trial in Kiel with healthy subjects performed successfully
Clinical trial in Thessaloniki with pulmonary patients performed successfully
Delivery of 11 male and female vests (with Discrete components) in clinical sites
2 different deployments in Kiel and Thessaloniki
Privacy and safety by design architecture
ASIC harness produced integrated and tested successfully
Development of the event store and query API of the data management
Development of the DSS of the WELMO backend
(EIT) feature extraction methods were enhanced and were made independent of EIDORS package
Creation of Lung Sounds and EIT database under Open and FAIR principles
Main results
19 publications + 6 book chapters
Final workshop performed physically in Italy with 3 other EU project representatives
6 groups of respiratory diseases validations. [Obstructive Disease (Asthma, COPD, Bronchiectasis), Pleural Effusion, Interstitial/Alveolar insult (Pulmonary Fibrosis, Proteinosis), Post COVID-19 and vascular disease (Pulmonary Embolism, Pulmonary Hypertension), Pneumonia, Infection, Thoracic Wall Insult (Trauma, Myopathy)]
Co-organization of SINTEC Summer School
1 patent for electronic sensors (CSEM)
3 design patents filed from SMARTEX
Spin off created from AUTH team (HiSpin)
The WELMO vest monitors the lungs continuously or when necessary based on the proposition of the physician, without the necessity for the patient to move to the hospital. WELMO is based on modern technology with no single, sticky electrodes, a wearable and washable textile vest that does not restrict chest movement, the integration of sound and EIT signals in one wearable and a DSS that leverages the capabilities provided by the sensor vest to provide a holistic analysis and progress report application for the clinician. The appliance of EIT is considered early stage in various sectors. Over the next years and as research advances, the impact for WELMO outcomes and its published research can grow significantly. In WELMO, the RSD database was further increased, impacting the research on algorithms for respiratory analysis. WELMO will create a publicly available chest EIT image dataset, annotated with respiratory diseases and forced expiratory volume (FEV) values. The WELMO sensor technology can be applied in a much broader range of illnesses, namely cardiovascular diseases. WELMO sensors and electronic modules increase the competitiveness of the European industry, as they measure health-relevant signals in an unprecedented quality and quantity, independent of stationary facilities. The WELMO vest exceeds existing solutions because of its non-invasiveness and radiation-free technology. By utilization of the EIT method the physician can check lung functioning and evaluate the spatial heterogeneity of lung ventilation. The continuous assessment of respiratory status, as provided by WELMO, is of the cornerstones of future ICU monitoring systems. EIT is considered the most promising monitoring tool for the identification of adverse events. In addition, the ability of EIT to measure regional ventilation and aeration without an interface at the airway opening, suggests that it could be used outside of pulmonary function laboratories without expertise training. The Decision Support System (DSS) that was developed targets exactly this and is designed to consider also non-EIT experts, towards a wider adoption and clinician acceptance. WELMO aims to improve the patients’ life by making advanced imaging monitoring available to patients everywhere. As lung diseases are related to an increase in the aging population, providing a solution that would require the minimum discomfort or effort on behalf of the patient (for example, having to visit a hospital while living in a rural area) is the heart of the WELMO solution.
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