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Wearable Electronics for Effective Lung Monitoring

Periodic Reporting for period 1 - WELMO (Wearable Electronics for Effective Lung Monitoring)

Reporting period: 2019-01-01 to 2019-12-31

[Problem] The diagnosis, monitoring and treatment of lung diseases depend on the availability of a variety 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 only 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 treatment cost. While radiological methods increase the radiation load. Moreover, the fusion of both visual and sound information, is almost impossible, leaving their interpretation solely 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 low-power electronics will enable for the first time the combination of both visual and sound information enabling the systematic, accurate and real-time evaluation of respiratory conditions. Additionally, the collected signals can be securely stored and further processed, towards revealing possible 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.

[Importance] 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). The economic burden for the healthcare systems constantly increases. 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: a) By continuously monitoring lung function with novel methods of signal acquisition of respiratory patients (Personalized Care) b) By providing physicians with enhanced awareness of their patient's health status and enable early identification of disease exacerbations (Predictive Care) c) By minimizing the healthcare associated costs due to earlier detection of disease deterioration and the resulting fewer hospitalizations (Preventative Care) d) It will be one of the first applications of effective lung imaging, giving insights to patients to understand their disease (Participatory Care).

[Objectives] WELMO targets to the development of a high-usable, easy-to-wear, machine-washable wearable that will enable the efficient and 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 link measured signals with certain lung functions and clinical conditions
-To develop a set of secure applications for enabling the dynamic presentation of process results
[Work performed]
-Internal quality & management procedures were set up
-A Survey was conducted for gathering feedback on the vest design (user requirements)
-Finalization of the system architecture
-5 circuit architectures for ASIC developed and evaluated for EIT and chest sound recording
-1st version of the digital board and the housing of the master sensor are designed.
-Design and implementation of the conductive cable to interconnect the sensors.
-Preliminary research in EIT features and signal analysis.
-Data collection activities were undertaken for the training & validation of the algorithms.
-Preliminary development of algorithms for classification and detection of wheezes and crackles.
-Preliminary development of EIT reconstruction and feature extraction algorithms.
-WELMO brand identity was developed
-Dissemination activities and publications

[Main results]
-User & System requirements
-WELMO architecture was designed defining interfaces among the overall system
-Various prototypes with ASIC & discrete components architecture are produced and evaluated
-Design of master sensor (digital board and housing)
-Design and implementation of the conductive cabling
-Detailed communication plan & Website

A highlight of this period was a patent application that was submitted still early in the project, showcasing the high commercialization potential.
[Progress beyond SotA] Lung function of patients with chronic lung diseases is monitored using spirometry. This method is not capable of assessing lung function on a regional level. EIT can determine lung function regionally within the chest cross-section. It can detect increased inhomogeneity of lung ventilation associated with the underlying disease and its deterioration during disease worsening. The big challenge in the setup and operation of EIT instruments is in the connection of the sensors and electrodes (16+ sensors are needed). The current technology is not ready for this due to the cabling. In WELMO, we will exemplify the power of cooperative sensors technology which will record EIT movies and lung sound maps integrated to a comfortable, easy-to-wear, machine-washable vest. The comfort of the sensor vest will be increased thanks to a further miniaturization of the sensors (via ASIC development) with simple cabling (only two wires, instead of 1-2 cables per sensor in compare to competition).
EIT is capable to provide early feedback on the exacerbation of the lung disease leading to earlier initiation of therapy and possibly prevention of hospitalisation. EIT might be able to reliably monitor patients with lung diseases even during spontaneous breathing without the necessity to perform the forced manoeuvres in compare to conventional spirometry. This would increase the user friendliness of lung function assessment.
For the first time both visual and sound information are fused in real time for lung monitoring enabling accurate evaluation of respiratory condition at lung-regional level through EIT methodology.

[Impact]
-Cost-effective intervention that can tackle the phenomenon of absenteeism and/or work impairment due to lung related diseases
-Lower cost for health services since early detection can reduce exacerbation and hospitalization days
-Continuously monitoring of lung function through a wearable improves the quality of life of respiratory patients
-Physicians will have access to (lung-regional level) rich information of their patients rather than just one-time snapshots
-Lung imaging insights can be provided to patients for a better engagement and understanding of their respiratory disease enhancing self-management

[Societal Implication] N/A.
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