Pioneering research projects are developing wearables that offer an accurate and non-invasive way to treat disease, says Jane McCallion
Smartwatches can track your steps and monitor your runs, but there’s more to wearables and health than simply fitness. Wearable devices are also being used to monitor and treat medical conditions in more accurate and less invasive ways than have traditionally been available. And, if predictions bear out, they could eventually lead to treatments for currently incurable diseases.
LOOKING FOR A CURE
One example of how wearables are being used to monitor and treat disease is a partnership between Intel and The Michael J Fox Foundation (MJFF), where data is gathered to track the progression of Parkinson’s disease and assess how well a patient is responding to medication.
Patients involved in the project are given off-the-shelf smartwatches, and the accelerometers are used to monitor gait and tremors. The data, which can capture hundreds of readings a second, is sent back to the patient’s smartphone, which in turn relays it to an Intel-developed Big Data analytics platform.
“Our hope is that the use of these technologies can help develop a therapy to slow or stop Parkinson’s progression,” Todd Sherer, CEO of the MJFF, told us.
Currently, patients are expected to track their disease by keeping a diary of their symptoms. However, this is time-consuming, and the self-reported data is oftensubjective.
Vin Sharma, Big Data analytics strategist at Intel, added: “The ability to collect data from sensors could dramatically enhance our understanding of Parkinson’s disease by enabling scientists and physicians to gather data continuously and unobtrusively, with little burden on patients themselves.”
While Parkinson’s disease is one of the best-known illnesses that impairs patients’ motor control, other projects are underway to assess and monitor rarer diseases. Elin Haf Davies is a specialist in the use of wearable technologies to measure gait in patients suffering from ataxia, which affects balance and co-ordination. She’s currently working with Great Ormond Street Hospital and Niemann-Pick UK on a project called “aparito” that uses wearables to chart patients’ symptoms.
Currently, patients are assessed with a pair of six-minute walking tests, to establish the severity of their symptoms and the disease’s progression, as well as how they are responding to any treatment. The test has become “the gold standard” in clinical trials for ataxia drugs, where it is used once at the beginning of the trial and once at the end, said Davies.
“I want to try to use wearable technology so we have a continuous idea of how the patient is doing while they’re in a 12-month clinical trial, [rather than] just relying on 12 minutes’ worth of data,” she said. Currently, the team is focusing on tracking gait using off-theshelf smartbands containing accelerometers. Using these devices, the team is able to constantly monitor a child’s gait for the duration of the trial. As the project continues, sensors to measure other ataxia symptoms will be introduced.
As well as use in clinical trials, Davies says wearable technology can provide a better experience for paediatric patients in general, as having a smartband on their leg or wrist is easier for children than the tests they currently undergo. “Finding an age-appropriate and disease-specific test in the paediatric population is incredibly challenging, especially as a lot of the tests are lengthy, invasive or painful. For example, trying to keep the attention of a five-year-old for six minutes and keep them walking is incredibly diffcult,” she said. “This smartband is non-invasive, and you don’t have to subject the child to quite so many hospital visits.”
NEEDLE-LESS BLOOD TESTS
The use of wearables can go beyond monitoring the external symptoms of diseases, and researchers are using smart devices to reduce the pain associated with blood tests or drug administration – in other words, to cut the use of needles.
Of these, one of the best known is Google’s smart contact lens, which can monitor the blood-glucose levels of diabetics. Currently, most diabetic people monitor their blood sugar levels through “lancing” – using a needle to draw blood so it can be applied to blood-glucose strips and monitors, which can be painful. The Google smart lens looks like a standard contact lens, but it’s embedded with a wireless chip and miniaturised glucose sensor. A tiny hole in the lens lets tears seep through, allowing the sensors to measure glucose levels in the fluid and send the information back to the user’s smartphone.
Commercial development of the device has been licensed to Alcon, the eyecare division of pharmaceutical giant Novartis. It told us that when the device is made available commercially in a few years’ time, it will help diabetic people manage their disease in a “minimally invasive” way.
Rather than popping round to your GP for a blood test, researchers at the University of Southampton are working on another device that lets you monitor key health measures all the time, with little physical effort.
Dr Xize Niu, who is leading the project, said: “When people talk about wearable healthcare devices at the moment, they think about monitoring the user’s heart rate, blood pressure, and all these kinds of physical things. What we’re developing is a wearable [device] that can continuously monitor the chemicals in people’s bodies.”
The device is about half the size of a smartphone and samples one nanolitre of body fluid at a time through a microdialysis probe – a small needle no more than between 0.2 and 0.5mm in diameter. The fluid is then analysed by what Niu described as “a lab on a chip” embedded in the device.
“The analysis can look for one or more biomolecules or drug concentration in the fluids, such as blood sugar, lactate (the base of lactic acid) and other biological markers clinicians are interested in,” he said. This has the potential to prevent the need for painful blood draws, as well as providing medical personnel with a more accurate idea of what’s going on in a patient’s body, as the method produces significantly more data points than can normally be achieved.
The device currently uses a standard microdialysis probe, but since it can work at the nanolitre rather than microlitre level, it will ultimately support much smaller probes.
“If the probe can be less than 70 micrometres (0.07mm) in diameter, it will not cause any sensation or pain during the sampling,” said Niu.
The device has been patented but is still in the prototyping phase, so it’s not expected to be in use for a couple of years yet – although anything that takes the sting out of needles, and other medical procedures, is a wearable worth waiting for.