AWARE

Acoustic Waveform Respiratory Evaluation (AWARE)

A smartphone app that enables at-home lung function monitoring for people with lung disorders such as asthma, COPD, and COVID-19.

Highlights

• Respiratory diseases like asthma and COPD (chronic obstructive pulmonary disease) affect millions of people, yet we lack good solutions to regularly monitor their lung function beyond the hospital or clinic.
  
  
• The COVID-19 pandemic has emphasized the importance of having reliable and accessible tele-medicine options to measure pulmonary function objectively, which would benefit all patients with lung diseases.
  
  
• Using equipment and technology already built into most smartphones, AWARE uses acoustic waveforms to measure the caliber and patency of the airways, and to detect any narrowing or obstructions.
  
  
• Because AWARE directly “maps” the airways, it does not require difficult forced breathing maneuvers, and therefore it will be easy to perform by children, older adults, and those with advanced diseases of the airways.
  
  
• The ultimate goal is to provide long-term lung function monitoring in a reliable, affordable, accessible, and effortless manner.

Problem

People suffering from asthma, COPD, and other lung diseases have no convenient ways to monitor their lung function at home. They can only do so in the clinic, or with expensive portable instruments that require repeated forced breathing maneuvers.

Asthma and COPD affect 25 and 16 million people in the United States, respectively. For these and other lung diseases, changes in lung function are closely related to disease control, quality of life, and prognosis. Unfortunately, pulmonary function testing (PFT) is not widely available in primary care practices, so patients can only have their lung function measured when they visit subspecialty centers.

Easy, accurate, and convenient lung function monitoring at home would help identify acute or chronic changes. Acute changes could help patients spot asthma attacks early on, so they can administer rescue medications or seek proper care. Long-term monitoring could help patients and physicians evaluate whether treatments are working or if changes are needed.

Solution

AWARE is our solution to measure lung function at home simply using your smartphone. Leveraging speakers and microphones already built into most smartphones, AWARE acts as an ultrasonic sonar to map the airways. While the patient breathes normally, ultrasound waves produced by the speakers travel into the airways, reflect off the airway surfaces, and are sensed by the microphone. Using sophisticated signal processing techniques, AWARE separates true airway signals from the noise. Machine learning algorithms use those signals to map the airways, estimating airway caliber and quantifying airway narrowing or obstruction. Personalized reports can help patients recognize when to seek care (e.g., asthma attacks) and long-term trends can help physicians know when treatment changes are needed.

AWARE has several advantages over any existing solutions. It requires no expensive equipment. It directly maps the airways, rather than depending on air flow to indirectly measure lung function. Therefore, AWARE does not need forced breathing maneuvers, making it easy to use by vulnerable populations, including children, older adults, and those with severe lung disease.

We are currently in the final stages of laboratory testing to fine-tune signal processing algorithms, and we will start to gather normative data from healthy individuals in upcoming months.

Competition

The competitive landscape analysis below summarizes key features of this solution, and current competitors working to solve similar healthcare problems.

Team

• Erick Forno, MD, MPH, Assistant Professor of Pediatrics, University of Pittsburgh School of Medicine and UPMC Children’s Hospital of Pittsburgh. Dr. Forno is a pediatric pulmonologist and physician scientist with significant expertise in clinical research in pulmonary diseases in children and adolescents.
  
  
• Wei Chen, PhD, Associate Professor of Pediatrics, Biostatistics, and Human Genetics, University of Pittsburgh. Dr Chen is a biostatistician with significant expertise in big data analysis and machine learning methods.
  
  
• Wei Gao, PhD, Associate Professor, Electrical and Computer Engineering, University of Pittsburgh Swanson School of Engineering. Dr. Gao is a computer system researcher who focuses on the design and analysis of mobile, embedded and networked systems, as well as these systems’ applications in smart health care.

Milestones

• Milestone 1: Recruitment of study participants. We will recruit up to 100 adults and children with asthma, COPD, cystic fibrosis, and other respiratory diseases in up to three cycles/cohorts, and obtain AWARE measurements and standard PFTs.
  
  
• Milestone 2: Algorithm improvement and data analysis. We will compare AWARE measurements to classic PFT results, as well as to the AWARE normative data gathered from healthy subjects.
  
  
• Milestone 3: User interface development. We will work with software developers to move from the current prototype to a user-friendly interface (mobile app).
  
  
• Milestone 4: Abstract/manuscript submission. We will report the findings from our study to the broader scientific community.

Path to Impact Plan

We have secured funding to finish lab development and to gather normative data in healthy adult and pediatric subjects. Through PInCh, we will translate our research into the clinic and study AWARE in actual patients with lung diseases. We will work towards FDA approval using data collected during the project. We will also work to create a HIPAA-compliant interface that could be integrated to electronic health records or used to submit reports back to the patient’s primary care provider. We foresee the technology could be licensed to health systems and primary care practices. The device could also be sold directly to consumers (e.g., patients who want to monitor their lung function at home) as a stand-alone solution or as part of a subscription service to monitor lung health.

AWARE could easily be implemented for tele-medicine. This will be particularly important in the current pandemic. AWARE will allow for lung function monitoring at home, providing physicians with objective data during tele-medicine encounters. Patients will not need to attend health care settings and use shared equipment, minimizing their risk. AWARE could also be used to detect clinical worsening in patients with COVID-19 or to monitor their recovery.