iMStrong, an innovative remote monitoring system for detecting cocaine use

描述（由申请人提供）：本提案描述了“iMStrong”，这是一种远程监测系统，使用最先进的技术来确定接受治疗的可卡因依赖患者使用可卡因的开始和持续时间。iMStrong由三个集成组件组成。第一种是不引人注目的可穿戴传感器，其连续记录并无线传输交感神经系统（SNS）唤醒的生理测量（例如，增加的皮肤电活动、皮肤温度和运动）。第二个组件是智能手机，其用作用于数据输入和存储的移动的计算设备。第三个组件是智能手机上的iMStrong应用程序（“app”）。该应用程序将解释传输的生理数据，寻找强烈的SNS唤醒期， 可卡因使用的特点。我们将测试iMStrong在进入可卡因依赖治疗的患者（N=40）中识别30天内可卡因使用发作的能力。iMStrong应用程序将使用商业面部识别协议验证用户的身份。该应用程序还将识别SNS唤醒增加的时期，并要求参与者注释这些事件周围的时间动态社会，行为和环境背景。每周三次，我们将获得可卡因的定量尿液分析。每周，研究工作人员将使用时间轴随访方法对受试者进行访谈，以评价药物使用事件。研究完成后，我们将使用参与者的总结性访谈来评估iMStrong的用户体验。具体目标是：1）技术部署：部署和测试移动的技术，用于远程识别可卡因使用事件; 2）技术评价：评价已开发技术的经验，以了解技术利用的障碍和促进因素，特别关注可卡因使用的检测以及可能构成患者-技术关系质量基础的作用机制。这项研究将获得可卡因使用的四种不同测量方法（实时、连续的生物物理监测;来自移动的空间的注释;可卡因代谢物的连续尿液分析;以及自我报告），初步数据表明我们有能力在自然环境中检测可卡因使用。iMStrong不仅将确定可卡因使用发作的开始和持续时间，还将获得有关复发时间事件的形成信息。iMStrong收集有关接受治疗的个人使用可卡因的时间、地点、背景和持续时间的连续数据，将通过提供一种新的能力来证明药物滥用干预措施的有效性，从而推进药物滥用治疗研究。 公共卫生相关性：高复发率困扰着可卡因依赖的治疗;因此，我们将评估“iMStrong”，这是一种移动的系统，可检测治疗中可卡因依赖患者中可卡因诱导的生理学变化。iMStrong通过其最先进的传感功能，将确定可卡因使用发作的开始和持续时间，并获得有关复发事件的信息。这项研究开发的增强技术将提供一种评估药物滥用干预治疗有效性的新方法。

DESCRIPTION (provided by applicant): This proposal describes "iMStrong", a remote monitoring system that uses state-of-the-art technologies to identify the onset and duration of cocaine use in cocaine-dependent patients under treatment. iMStrong comprises three integrated components. The first are unobtrusive, wearable sensors that continuously record and wirelessly transmit physiologic measures (eg, increased electrodermal activity, skin temperature, and motion) of sympathetic nervous system (SNS) arousal. The second component is a smartphone that functions as a mobile computing device for data entry and storage. The third component is the iMStrong application ("app") on the smartphone. The app will interpret the transmitted physiology data, looking for periods of intense SNS arousal that are characteristic of cocaine use. We will test iMStrong's ability to recognize cocaine use episodes over a 30 day period among patients (N=40) entering treatment for cocaine dependence. The iMStrong app will validate the identity of the user using commercial facial recognition protocols. The app will also identify periods of increased SNS arousal and request that participants annotate temporally dynamic social, behavioral, and environmental contexts surrounding these events. Three times a week we will obtain a quantitative urinalysis for cocaine. On a weekly basis, study staff will interview participants using the timeline follow back method to evaluate drug use episodes. After completion of the study we will evaluate user experience with iMStrong using summative interviews of participants. The specific aims are: 1) Technology deployment: To deploy and test a mobile technology for the remote identification of cocaine use episodes; and 2) Technology evaluation: To evaluate experience with the developed technology to understand the barriers and facilitators of technology utilization with a specific focus on detection of cocaine use as well as mechanisms of action that might underlie the quality of the patient-technology relationship. This study, which will obtain four different measures of cocaine use (real-time, continuous biophysical monitoring; annotations from mobile space; sequential urinalysis for cocaine metabolite; and self-report), is supported by preliminary data demonstrating our ability to detect cocaine use in natural environments. iMStrong will not only identify the onset and duration of episodes of cocaine use, it obtain formative information on temporal events surrounding relapse. iMStrong's collection of continuous data regarding the timing, location, contexts, and durations of cocaine use in individuals under treatment will advance drug abuse treatment research by providing a new capability to demonstrate efficacy of drug abuse interventions. PUBLIC HEALTH RELEVANCE: High rates of relapse beset treatment for cocaine dependence; therefore we will evaluate "iMStrong", a mobile system that detects cocaine-induced changes in physiology in cocaine- dependent patients under treatment. iMStrong, through its state-of-the-art sensing function, will identify the onset and duration of cocaine use episodes and obtain information on the events surrounding relapse. The enhanced technology developed in this study will provide a new means of assessing the effectiveness of drug abuse intervention treatments.