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How Would A Remote Health Monitoring System Detect Flares in Crohn Disease?
The Emerald sensor, a contactless device, could be ‘the next big thing’ in technology by determining flares among patients with Crohn disease (CD) even before the flares become clinically detectable, Joshua Korzenik, MD, said during a presentation at the Digestive Disease Week (DDW) 2023 in Chicago.
Dr Korzenik is an assistant professor in the department of gastroenterology, hepatology and endoscopy at Brigham and Women's Hospital Department of Medicine in Boston, Massachusetts.
“Current clinical management to determine if an individual with CD is flaring relies on imaging, colonoscopy, calprotectin and other biochemical markers which involve significant risks, expense and delays complicating a quick initiation of therapy,” Dr Korzenik addressed the audience on new and upcoming tools for assessing IBD disease activity. Instead, he proposed the use of a contactless monitoring service that would passively and remotely monitor a person’s health to predict the occurrence of a flare.
A total of 105 patients participated in the prospective study for a total of 24,786 nights. Of these, 44 patients were in CD remission, 35 has active CD, and 26 were healthy controls. The experiment required no interaction or input from the patients. “The sensor utilizes a radio wave with frequencies similar to WiFi to assess a variety of metrics that may be associated with flares, including sleep stages, respiratory rate and gait speed,” Dr Korzenik explained.
Based on the data collected, the researchers analyzed the calprotectin measurements, patient reported outcomes and other clinical data.
Data revealed the mean age of the participants to be 47, and mean disease duration to be 13.25 years. Additionally, 83% were on biologics at enrollment. They observed that flares were associated with decreased sleep quality and more nocturnal awakenings, and slower gait speed and respiratory rates.
In some cases, the sensor was able to predict a disease flare “at least 20 days or more before a flare was clinically apparent,” Dr Korzenik noted.
What about other stressors or viral upper respiratory leading to false positives? The false positives were low, Dr Korzenik said. “Stress itself doesn’t seem to throw off gait movements and breathing. But yes, if someone breaks their leg, it can alter the results. These are some of the kinks we are still working out,” he explained.
—Priyam Vora
Reference:
Korzenik J. Presentation #354. Assessment of a passive monitoring device to track flares in individuals with Crohn’s disease. Digestive Disease Week 2023. Chicago, Illinois.