Production of a device to obtain continuous ambulatory vestibular assessment (CAVA)

在英格兰和威尔士，每年每1000个病人中就有8个会向他们的全科医生抱怨头晕。头晕是医生去看75岁以上病人的最常见原因，65岁以上的成年人中有三分之一每年至少经历一次跌倒。这一点尤其重要，因为1999年60岁以上老年人的医疗服务和社会服务费用为9.81亿英镑。然而，我们目前在评估头晕患者可用的专家测试方面受到很大限制，因为在社区中没有可用的测试来评估实际头晕发作的患者。如果这是可能的，准确的诊断就可以当场做出，而不是在病人恢复后的几天或几周内猜测头晕发作的原因。美国国立卫生研究院报告称，在得到正确诊断之前，眩晕患者平均要去看4.5次医生，英国的专业平衡中心也有类似的发现。我们已经开发并成功测试了一种可穿戴设备的原型，用于诊断社区头晕的原因，并正在向医学研究委员会申请资助下一阶段的设备开发。一旦在临床研究中完全开发和测试，我们希望我们的设备将在最初转诊给医生或护士时可用，以避免诊断延误，并确保经济有效地使用适当的资源。我们目前的原型设备只开发了一部分，因此目前需要一个大的、笨重的、不舒服的佩戴模块；因为它是用未精制的电子设备和现成的材料建造的，以证明这是一个可行的概念。我们向医学研究委员会提出的申请是资助开发一种完整的定制设备，这种设备将是一种轻便、耐用、可以日夜佩戴的身体监测设备。除此之外，来自医学研究委员会的资金将支持专业计算机软件的开发，以分析我们的精密设备产生的数据。

In England and Wales, 8 out of every 1,000 patients are likely to consult their GP complaining of dizziness every year. Dizziness is the most common reason for a doctor to visit a patient over the age of 75 years old, and one-third of adults over the age of 65 years experiences at least one fall each year. This is particularly important as the cost of falls to the NHS and social services in people over 60 years old in 1999 was £981 million. However, we are currently significantly restricted with respect to what specialist tests are available for assessing patients with dizziness, because there are no tests available to evaluate a patient during an actual dizziness attack in the community. If this were possible, an accurate diagnosis could be made there and then, rather than speculating as to what the cause of the dizziness attack was days or weeks after the event when the patient has recovered. The US National Institutes of Health reports that the average number of doctors that a patient with dizziness visits before receiving a correct diagnosis is 4.5, and a similar finding is reported from specialist balance centers in the UK. We have developed and successfully tested a prototype body worn device to diagnose the cause of dizziness in the community, and are applying to the Medical Research Council to fund the next stage of device development. Once fully developed and tested in clinical studies, it is hoped that our device will be made available at the point of initial referral to a doctor or nurse to avoid delay in diagnosis and ensure cost-effective use of appropriate resources. Our current prototype device is only partly developed, and as such currently requires the involvement of a large, bulky and uncomfortable to wear module; as it has been constructed using unrefined electronics and off the shelf materials to prove that it is a viable concept. Our application to the Medical Research Council is to fund the development of a complete bespoke device that would be a lightweight, durable, body worn monitoring device that could be worn day and night. In addition to this, funding from the Medical Research Council would support the development of specialist computer software to analyse the data produced by our refined device.