Clinical Feasibility of a Non-invasive Wearable Acoustic Device for Measuring Air Trapping in COPD

June 14, 2023 updated by: Respira Labs, Inc
This is a pilot observational study during which the investigators will conduct a longitudinal assessment of air trapping (with up to 2 visits) in 40 patients with COPD and variable degrees of air trapping and 20 healthy controls using ARIA. The investigators will characterize the clinical phenotype of the subjects by administering health and symptom-based questionnaires and obtaining lung function testing at rest and during exertion, and will then correlate and validate the ARIA-based indices with those of the more traditional physiologic measures of static and dynamic air trapping.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of hospitalization in the United States. Exacerbations, a worsening or "flare up" of symptoms cause most COPD hospitalizations. Early detection of lung function deterioration would facilitate early intervention and help prevent hospitalizations, since most exacerbations can be treated with changes of inhalers and/or oral medications. Air trapping, defined as an abnormal increase in the volume of air remaining in the lungs after exhalation, is a common finding in all forms of COPD. Air trapping has been shown to increase during exacerbations and decrease when exacerbations resolve. Moreover, increasing recent evidence indicates that air trapping is an earlier harbinger of deteriorating lung function than spirometric changes. Recent research shows that lung air trapping can be measured by low-frequency ultrasound (1-40 kHz). Thus, acoustic monitoring of air trapping could provide clinicians with a non-invasive tool to when medical intervention is needed to avoid unnecessary ER visits and hospitalizations. The investigators have developed a low-cost, non-invasive, acoustic-based wearable device, Sylvee that is capable of continuous monitoring of lung resonance. The device has machine-learning algorithms that can detect minor changes in lung resonance, which our preliminary results suggest corresponds to changes in air trapping. The overall objective of this pilot project is to validate Sylvee's algorithms in a cohort of 60 patients with COPD and variable degree of air trapping. Ultimately, Sylvee will allow physicians to remotely monitor their patients' lung function and adjust their medications to reduce healthcare costs and improve patients' quality of life.

Study Type

Observational

Enrollment (Actual)

8

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • California
      • Mountain View, California, United States, 94040
        • El Camino Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

N/A

Sampling Method

Non-Probability Sample

Study Population

Outpatients People who have a condition but who are not being seen as patients Students Staff of UCSF or affiliated institutions

Description

Inclusion criteria for cases (COPD patients) are:

  1. Men or women over 40 years old.
  2. Spirometric COPD.
  3. A history of smoking at least 20 pack-years.

Exclusion Criteria:

  1. Inability to perform lung function testing.
  2. Inability to complete the study and return for follow-up visits.
  3. Pregnancy.
  4. A serious and active heart condition, defined by stable or unstable angina, recent myocardial infarction (within the last 2 years), active or decompensated congestive heart failure or cardiomyopathy.
  5. End-stage liver disease.
  6. Patients unable to do mild exercise (patients with orthopedic-neurologic problems; patients who have severe heart failure characterized by an ejection fraction of <20% or by New York Heart Association Class IV disease; patients who should be at complete rest, confined to a bed or chair; or patients for whom physical activity brings on discomfort and for whom symptoms occur at rest).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Cases with Air Trapping
20 COPD patients with lung volumes representing air trapping (RV/TLC and functional residual capacity to TLC [FRC/TLC])
The investigators have developed a small sensor that has the same characteristics as a combined hearing aid used for Tinnitus. It has a noise generator intended to transmit white noise (2 - 20 KHz) and a microphone similar to those used in hearing aids to provide sound amplification. Our sensor is substantially equivalent to legally FDA approved marketed devices that can be used for several hours per day. Although it will introduce new indications for use (lung resonance capture), it has the same technological characteristics and will not introduce new hazards or safety risks. Several sound-based devices are already in use for clearing mucus from the lungs by generating and delivering low frequency sound that vibrates the airways and lung secretions, causing them to thin and become expelled. The devices are placed on the patient's chest for up to 3-4 hours in COPD, cystic fibrosis (CF) and other lung diseases.
Cases without Air Trapping
20 COPD patients without lung volumes representing air trapping (RV/TLC and functional residual capacity to TLC [FRC/TLC])
The investigators have developed a small sensor that has the same characteristics as a combined hearing aid used for Tinnitus. It has a noise generator intended to transmit white noise (2 - 20 KHz) and a microphone similar to those used in hearing aids to provide sound amplification. Our sensor is substantially equivalent to legally FDA approved marketed devices that can be used for several hours per day. Although it will introduce new indications for use (lung resonance capture), it has the same technological characteristics and will not introduce new hazards or safety risks. Several sound-based devices are already in use for clearing mucus from the lungs by generating and delivering low frequency sound that vibrates the airways and lung secretions, causing them to thin and become expelled. The devices are placed on the patient's chest for up to 3-4 hours in COPD, cystic fibrosis (CF) and other lung diseases.
Healthy Controls
Non COPD patients and non-smokers
The investigators have developed a small sensor that has the same characteristics as a combined hearing aid used for Tinnitus. It has a noise generator intended to transmit white noise (2 - 20 KHz) and a microphone similar to those used in hearing aids to provide sound amplification. Our sensor is substantially equivalent to legally FDA approved marketed devices that can be used for several hours per day. Although it will introduce new indications for use (lung resonance capture), it has the same technological characteristics and will not introduce new hazards or safety risks. Several sound-based devices are already in use for clearing mucus from the lungs by generating and delivering low frequency sound that vibrates the airways and lung secretions, causing them to thin and become expelled. The devices are placed on the patient's chest for up to 3-4 hours in COPD, cystic fibrosis (CF) and other lung diseases.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change and variability fo acoustic resonance
Time Frame: 4 hours
The change and variability of acoustic resonance features before, during, and after all pulmonary tests, including those where dynamic hyperinflation will be tested: metronome-paced IC, 6-minute walk test and cardio-pulmonary exercise [every session]. Acoustic features will be extracted from the measurements with an active acoustic sensor worn on the chest, establishing a baseline before and after all tests. Acoustic resonance changes and their rate of change will be recorded.
4 hours
Correlation between acoustic resonance measurements with clinical testing
Time Frame: 2 hours
The correlation between acoustic resonance measurements and other measurements from pulmonary function tests and wearable devices (respiratory rate, heart rate and oxygen saturation with 80% accuracy rate) before, during (every minute) and after all tests [every session]. Acoustic features will be extracted from the measurements with active acoustic sensors worn on the chest. Other measurements will be measured using medical graded devices such as pulse-oximeters and wearables.
2 hours

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Correlation between acoustic resonance and symptoms
Time Frame: 1 hour
The correlation between acoustic resonance measurements and patient symptoms and vitals before, during and after all pulmonary function tests, including those where dynamic hyperinflation will be tested: metronome-paced IC, 6-minute walk test and cardio-pulmonary exercise [every session]. Acoustic features will be extracted from the measurements with an active acoustic sensor worn on the chest. Patient symptoms and vitals will be collected before and after all tests.
1 hour
Data quality and user experience with medical-grade adhesive
Time Frame: 30 minutes
The correlation between medical-grade adhesive options, session length, data quality and patient experience with sensor attachment and detachment procedures. For example: Medical-grade adhesive options will be presented to users at different sessions. Ease of setup, attachment, detachment and data quality will be recorded on a questionnaire for further correlation. A questionnaire with scales from easy-to-hard will be prepared to allow for quantification of different options. The correlation between companion app screens and flows: ease of performing tasks, reading measurements and free-form feedback. Pre-selected alternative application screens, flows and options will be shown to the user in the mobile app and their feedback recorded (free form notes) for User Experience iteration.
30 minutes

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Ganesh Krishna, MD, Principal Investigator

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 1, 2022

Primary Completion (Actual)

May 30, 2023

Study Completion (Actual)

June 1, 2023

Study Registration Dates

First Submitted

June 24, 2020

First Submitted That Met QC Criteria

June 24, 2020

First Posted (Actual)

June 29, 2020

Study Record Updates

Last Update Posted (Estimated)

June 16, 2023

Last Update Submitted That Met QC Criteria

June 14, 2023

Last Verified

June 1, 2023

More Information

Terms related to this study

Other Study ID Numbers

  • 20-30080

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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