Aug 03,2023

Integrating metabolic expenditure information from wearable fitness sensors into an AI-augmented automated insulin delivery system: a randomised clinical trial

Exercise can rapidly drop glucose in people with type 1 diabetes. Ubiquitous wearable fitness sensors are not integrated into automated insulin delivery (AID) systems. The researchers hypothesised that an AID can automate insulin adjustments using real-time wearable fitness data to reduce hypoglycaemia during exercise and free-living conditions compared with an AID not automating use of fitness data. Study population comprised of individuals (aged 21–50 years) with type 1 diabetes, who were enrolled into a 76 h single-centre, two-arm randomised (4-block randomisation), non-blinded crossover study to use an AID that detects exercise, prompts the user, and shuts off insulin during exercise using an exercise-aware adaptive proportional derivative (exAPD) algorithm or an AID that automates insulin adjustments using fitness data in real-time through an exercise-aware model predictive control (exMPC) algorithm. 27 participants (18 females) were enrolled into the study. Across the 76 h study, both algorithms achieved clinical time in range targets and time below range , significantly lower than run-in period. AIDs can integrate exercise data from smartwatches to inform insulin dosing and limit hypoglycaemia while improving glucose outcomes. Future AID systems that integrate exercise metrics from wearable fitness sensors may help people living with type 1 diabetes exercise safely by limiting hypoglycaemia.

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Aug 01,2023

Diabetic Retinopathy Screening at the Point of Care (DR SPOC): detecting undiagnosed and vision-threatening retinopathy by integrating portable technologies within existing services

The aim of this study was to determine the prevalence of diabetic retinopathy (DR) in a low socioeconomic region of a high-income country, as well as determine the diagnostic utility of point-of-care screening for high-risk populations in tertiary care settings. a cross-sectional study of patients with diabetes attending foot ulcer or integrated care diabetes clinics at two Western Sydney hospitals (n=273). DR was assessed using portable, two-field, non-mydriatic fundus photography and combined electroretinogram/ pupillometry (ERG). With mydriatic photographs used as the reference standard, sensitivity and specificity of the devices were determined. Among 273 patients, 39.6% had any DR, while 15.8% had VTDR, of whom 59.3% and 62.8% were previously undiagnosed, respectively. Non-mydriatic photography demonstrated 20.2% sensitivity and 99.5% specificity for any DR, with a 56.7% screening failure rate. Meanwhile, mydriatic photography produced high-quality images with a 7.6% failure rate.

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Aug 01,2023

Artificial intelligence for diabetic retinopathy in low-income and middle-income countries: a scoping review

Diabetic retinopathy (DR) is a leading cause of blindness globally. There is growing evidence to support the use of artificial intelligence (AI) in diabetic eye care, particularly for screening populations at risk of sight loss from DR in low-income and middle-income countries (LMICs) where resources are most stretched. However, implementation into clinical practice remains limited. The researchers conducted a scoping review to identify what AI tools have been used for DR in LMICs and to report their performance and relevant characteristics. The majority of studies focused on sensitivity and specificity only and there was limited information on cost, regulatory approvals and whether the use of AI improved health outcomes. Further research that goes beyond reporting sensitivities and specificities is needed prior to wider implementation.

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May 31,2023

Canopy Publishes Research at 2023 American Society of Clinical Oncology Meeting

Canopy today announced results from a 21-month, real-world study demonstrating that electronic patient-reported outcomes (ePROs) can help identify common side effects in lung cancer patients receiving immunotherapy, both as monotherapy and in combination with chemotherapy. Regardless of treatment type, patients receiving less than 6 months of therapy were more likely to report severe symptoms than those on treatment for 6 months or longer. The identification of key symptomatic differences in patients with shorter duration of therapy could suggest that aggressive early management can extend time on therapy, leading to improved outcomes. 

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Oct 19,2022

Canopy Findings Published in Journal of Clinical Oncology

Canopy today announced results from a seventeen-month, real-world study of their ePRO-based patient monitoring platform. The single-site study of 923 patients at Highlands Oncology Group demonstrates the Canopy platform can be effectively implemented at a large scale with a high level of long-term patient enrollment, engagement, and retention. The study also found that the vast majority of patient issues were effectively resolved by nurse specialists and physician intervention was infrequently required. 

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Apr 28,2023

A New Digital Health Program for Patients With Inflammatory Bowel Disease: Preliminary Program Evaluation

This study aimed to perform a preliminary program evaluation, analyzing engagement and preliminary effectiveness and the effect on participants’ energy levels (fatigue), stress, and sleep quality, of a newly developed 16-week digital health program (Sidekick-311 and Sidekick-321) for patients with IBD. Adults with IBD were recruited to participate in a real-world, live, digital health program via Finnish IBD patient association websites and social media. No inclusion or exclusion criteria were applied for this study. The outcome measures of stress, energy levels (fatigue), and quality of sleep were reported by participants through the platform. Of the 444 adults who registered for the digital health program, 205 (46.2%) were included in the intention-to-treat sample. The intention-to-treat participants logged events on average 41 times per week (5.9 times per day) during the weeks in which they were active on the digital platform. Analysis of the completers (80/205, 39%) showed significant improvements for stress and energy levels; however, no significant improvements were observed for quality of sleep.

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Oct 06,2020

Preliminary Outcomes of a Digital Therapeutic Intervention for Smoking Cessation in Adult Smokers: Randomized Controlled Trial

The objective of the study was to test the preliminary effectiveness of Quit Genius, a novel digital therapeutic intervention for smoking cessation. A 2-arm, single-blinded, parallel-group randomized controlled trial design was used. A total of 556 adult smokers (aged 18 years or older) smoking at least 5 cigarettes a day for the past year were recruited. Of these, 530 were included for the final analysis. Participants were randomized to one of 2 interventions. Treatment consisted of a digital therapeutic intervention for smoking cessation consisting of a smartphone app delivering cognitive behavioral therapy content, one-to-one coaching, craving tools, and tracking capabilities. The control intervention was very brief advice along the Ask, Advise, Act model.All participants were offered nicotine replacement therapy for 3 months. Participants in a random half of each arm were pseudorandomly assigned a carbon monoxide device for biochemical verification. At 4 weeks post quit date, 44.5% of participants in the treatment arm had not smoked in the preceding 7 days compared with 28.7% in the control group.

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Apr 18,2018

Evaluation of Two Mobile Health Apps in the Context of Smoking Cessation: Qualitative Study of Cognitive Behavioral Therapy (CBT) Versus Non-CBT-Based Digital Solutions

Although the evidence base for computerized CBT in mental health is strong, there is limited literature on its use in smoking cessation. This, combined with the cost-effectiveness of mHealth interventions, advocates a need for research into the effectiveness of CBT-based smoking cessation apps. The objective of this study was, first, to explore participants’ perceptions of 2 mHealth apps, a CBT-based app, Quit Genius, and a non-CBT-based app, NHS Smokefree, over a variety of themes. Second, the study aimed to investigate the perceptions and health behavior of users of each app with respect to smoking cessation. A qualitative short-term longitudinal study was conducted, using a sample of 29 smokers allocated to one of the 2 apps, Quit Genius or Smokefree. Each user underwent 2 one-to-one semistructured interviews, 1 week apart. Quit Genius users reported increased motivation to quit smoking, as well as greater willingness to continue using their allocated app after 1 week.

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Dec 21,2022

A Voice App Design for Heart Failure Self-management: Proof-of-Concept Implementation Study

This study aimed to evaluate how participants with heart failure interacted with a voice app version of a DTx, Medly, through a proof-of-concept implementation study design. The objective was to understand whether the voice app would enable the participants to successfully interact with the DTx, with a focus on acceptability and feasibility. A mixed methods concurrent triangulation design was used to better understand the acceptability and feasibility of the use of the Medly voice app with the study participants (N=20) over a 4-week period. The Medly voice app had an overall accuracy rate of 97.8% and was successful in sending data to the clinic. From an acceptability perspective, the voice app was ranked in the 80th percentile, and overall, the users felt that the voice app was not a lot of work.

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May 08,2023

Implementation and workflow strategies for integrating digital therapeutics for alcohol use disorders into primary care: a qualitative study

Alcohol use disorders (AUD) are prevalent and often go untreated. Patients are commonly screened for AUD in primary care, but existing treatment programs are failing to meet demand. The goal of this study was to identify implementation needs and workflow design considerations for integrating digital therapeutics for AUD into primary care. Researchers conducted qualitative interviews with clinicians, care delivery leaders, and implementation staff (n = 16) in an integrated healthcare delivery system in the United States. All participants had experience implementing digital therapeutics for depression or substance use disorders in primary care. Key insights regarding the implementation of digital therapeutics for AUD and unhealthy alcohol use from the study data include implementation strategy selection to be driven by digital therapeutic design and target population characteristics, minimizing burden on clinicians, to be offered alongside many other treatment options.

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