AST@home: A rapid respiratory test for COPD using the smartphone
AST@home: A rapid respiratory test for COPD using the smartphone
Interview with Professor Volker Groß and Professor Keywan Sohrabi, Faculty of Health, University of Applied Sciences Mittelhessen (THM)
Chronic obstructive pulmonary disease often requires a detailed documentation of the course. As part of the AST@home project, Professor Keywan Sohrabi and Professor Volker Groß at the THM developed an app that enables the monitoring of the course of COPD via smartphone and includes family members or nursing staff.
Research group of the project "AST@home"; on the right: Prof. Volker Groß and Prof. Keywan Sohrabi
In this interview with MEDICA.tradefair.com, the researchers explain how the collection of medical data enables the prediction and prevention of acute exacerbations, describe how family members can be included in the process and disclose the larger telemedicine infrastructure the app is embedded in.
Professor Groß and Professor Sohrabi, how does your app work and what exactly is it designed to measure?
Prof. Volker Groß: The nature of COPD always includes phases of an acute worsening of symptoms, so-called exacerbations. These exacerbations are very dangerous because the patient’s condition deteriorates significantly and only completely improves in rare instances. We want to detect this acute inflammation in the lungs as early as possible. This can be achieved by analyzing the exhaled breath condensate for example. The patient’s exhaled air contains moist contents of the lungs that can be condensed. This condensate provides information about the condition of the lungs. In our case, the pH value is one significant marker that we can measure by using test strips. These test strips are analyzed by the smartphone. We have developed a special adapter for this. The patient is guided through the analysis, even acoustically and receives constant feedback. In addition, the app is also able to store other parameters, such as the patient’s mental state for example. This is very important because additional symptoms like coughing should also be measured. Coughing is a sign of an acute infection. It can also be measured and analyzed with our system. There is an entire telemedicine application behind this process.
AST@home can be used to evaluate the pH value of the respiratory condensate and thus predict worsening of respiratory diseases.
Prof. Keywan Sohrabi: We view our overall system as a platform that also offers open interfaces for additional options or equipment, making it possible to connect a sensor technology by another research group or provider for example. We would like to collect as much information as possible and make it available to physicians, patients, and even care facilities. At this point, we also integrated a type of journal into the app. Based on our experience, asking specific question adds maximum value to medical care. Even simple questions like, “How do you feel today?“ have great potential if you monitor the long-term trajectory. The point is not a spot measurement but rather to identify the long-term trajectory and certain trends.
Groß: We can interpret and analyze these types of long-term observations. In doing so, a change can show warning signs way ahead of time. Subsequently, exacerbations and thus a worsening of symptoms could possibly be prevented by administering medication.
Could you briefly explain the link to telemedicine?
Sohrabi: The telemedicine connection is presently very popular. AST@home is an automated, continuous documentation of parameters by a server. This ensures centralized management of data based on the data protection and data security requirements of the respective German state. There is no uniform data protection regulation standard at the national level yet. So we needed a general solution that is compatible with all the different data protection and security regulations.
Groß: We send our data to a central collection point, where nobody besides the patients themselves can draw conclusions on the data origin. This automatic analysis is entirely anonymous, meaning not even we know where the data originates and are unable to draw any conclusions about the physicians and patients. This entire process cannot be completed with a single device and requires a complete telemedicine concept.
Sohrabi: That’s a very important point. Only patients should decide who has access to their data. The individual owns his/her information, not some hospital or information system. When I (the individual) release my data, I also want to know who gets it and who has access to it. This aspect is particularly important to us in our projects.
Which opportunities do you see for the treatment or for patients with COPD thanks to this app?
Groß: The most important aspect is the usability for patients. What’s more, the concept is also suited to include family members. Telemedicine and other health decisions won’t work in the long run unless you include family members. Although telemedicine often has a reputation of being cold and uncaring about the individual and just mindful of numbers, the opposite is actually true. We are living in a world where adult children often live far away from their parents. With the help of this app, they can still find out how their parents are doing. The patients decide who has access to their data and can release dedicated information to family members for example. However, we believe it is vital for these medical apps to meet a quality standard. Policy-makers should address this and introduce a quality seal for medical apps to ensure better consumer orientation.
Is this project predominantly interesting for a specific patient group?
Groß: Tech-savvy patients are more likely to use the app. If someone has an aversion to technology, he/she won’t be as easily persuaded of course. Having said that, this is also where family members or nursing staff can try to help motivate the patient. We hope there will be a rethinking process in the long run, that being a great community involvement and a distribution of care responsibility. This is the only way to find an answer to the looming care deficit. This deficit can’t be eliminated just by healthcare personnel alone. We also need modern technology.
The interview was conducted by Julia Unverzagt and translated from German by Elena O'Meara. MEDICA-tradefair.com