In-ear sensors for monitoring vital parameters

Wearables offer practical solutions for the flexible measurement of data. The sensor from cosinuss° is worn directly in the ear and offers a precise monitoring of vital parameters.

In an interview with MEDICA.de Dr. Kreuzer explains the advantages of a wearable that takes measurements in the ear.

How does the earconnect™Technologie used by Cosinuss One work?

Dr. Johannes Kreuzer: We use established standard measuring methods such as plethysmography, infrared for temperature measurement and contact thermometers.  Because our device is placed in the ear canal, we can collect very good measurement data. Basically, we use standard processes, which have been miniaturized and optimized for our applications, so that the power consumption is significantly lower as well.

What are the advantages of the in-ear wearable as a fitness tracker compared to other wearables?

Dr. Kreuzer: Although we have equipment that is sold in the fitness sector, our focus is on medical technology. We have been offering the sensors in the consumer fitness area for four years. The advantage of our wearables is that they are much more comfortable to wear than a chest strap yet measure with the same precision. In the sports field it is not possible to obtain data with this precision with other wearables, such as a Smartwatch.

What can be measured with the device?

Dr. Kreuzer: The standard parameters include heart rate, body core temperature, oxygen saturation in the blood (SPO2) and respiratory rate. These are the basic parameters, from which further parameters such as stress level or fatigue level can be derived. All these parameters are based on heart rate variability (HRV). Other variables are then included in the medical set-up to use it as an early warning score system.

An example scenario where our device is used would be after an accident. When the patient is admitted to the clinic, various parameters are used to assess the patient's condition. Here the sensors can be used to check the patient's oxygen saturation or temperature.

How is the data managed and evaluated?

Dr. Kreuzer: In the field of sports, cosinuss° one can be directly linked as a sensor to your own Smartwatch or fitness application. In the clinical or medical field, the data can be pulled onto an app so that it can be accessed locally by the patient or user.

One goal for the future is that the data can also be stored on the sensor itself. This would allow the sensor to run autonomously and record data throughout the day, which would then be synchronized and downloaded with a mobile phone. This was planned as one of the next steps in the development, but now Corona is slowing us down a bit, as we are currently focusing entirely on solutions for Covid-19 patients.

To what extent is the sensor used for Covid-19 patients?

Dr. Kreuzer: Our sensor is now being used for Covid-19 patients who must stay at home because the clinics have to be kept clear for severe cases. For the patients this means that if you feel worse, you should admit yourself to the clinic. But here the question arises, what does worse mean? In Italy, there was a study that showed that older men particularly admitted themselves to the clinic too late and then arrived in such a desolate state that they could not be rescued. Our sensor supports the patients at home, because the data is transmitted to the health authority or clinic and with the help of an evaluation it is immediately visible if the condition of a patient deteriorates. The patient is then contacted and brought to the clinic before the condition becomes too bad.

How is artificial intelligence integrated into the device and the data management?

Dr. Kreuzer: We use AI for the development of algorithms. We stream the raw data to the server and then apply the algorithms using machine learning, and then re-apply the optimized algorithm to the sensor. At the same time, we run algorithms on the collected data to detect patterns. However, due to regulatory approvals in the medical field, this is all still very experimental.

What are the plans for the future?

Dr. Kreuzer: We are now certified as a company according to 13485, that is, as a medical technology company. In order to make the most of the time until certification, we have sold our products in the sports and consumer sector. This also brought about a fast learning process and some further developments, as we were able to receive direct user feedback. However, our focus is on medical technology and here it is the remote patient monitoring that keeps us busy. With our sensor, the patient no longer must stay in the hospital, but can go home earlier or, as with Covid-19, be admitted when it makes the most sense.

The trend in clinics is that the patient can get up alone the day after surgery and walk around in the following days. It has been shown that the earlier the patient is mobilized, the better he or she feels and the faster they recover. This is exactly the point where our sensors can be used. The patient can be monitored and at the same time move around the hospital. The sensor supports as a transitional solution between the intensive care unit and the normal ward.

What are alternative fields of application for the technology?

Dr. Kreuzer: There are many different possible applications for the sensor, for example in rescue services. One possible application scenario would be the rescue of a trapped person in an accident. In this case, the decision always has to be made whether the person concerned should be rescued quickly, i.e. the fire fighters open the car quickly with the risk that the patient loses his legs but survives, or they open it more gradually and he keeps his legs. But until they know how the patient is doing, they cannot make such a decision. Here, our sensor can be simply inserted in the ear. Then the paramedics have an overview and can see how stable the person is.

This versatility is both the good and bad thing about our technology, because it makes sense to use it anywhere. As a small company we cannot provide a solution for everything at once, and it's very difficult, with such huge markets, to think about what we want to focus on next.