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Low-Cost Mobile Detection of Opioid Overdose Events

阿片类药物过量事件的低成本移动检测

基本信息

批准号：
10358652
负责人：
Jacob Sunshine
金额：
$ 19.02万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-03-15 至 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10358652
关键词：
Acute Acute respiratory failure Algorithms Antidotes Apnea British Columbia Caring Cellular Phone Clinical Controlled Environment Cost Savings Data Detection Development Devices Diagnosis Diagnostic Early Diagnosis Elements Emergency medical service Emergency treatment Environment Epidemic Equipment Event Evolution Feedback Fentanyl Future General Anesthesia Goals Health Hospitals Human Human Resources Impairment Individual Injections Intervention Interview K-Series Research Career Programs Knowledge Legal Life Measures Medical Medical emergency Mentored Patient-Oriented Research Career Development Award Mission Modality Modeling Monitor Morbidity - disease rate Naloxone Operating Rooms Operative Surgical Procedures Opioid Outcome Overdose Participant Patients Persons Physicians Physiological Population Public Health Qualitative Methods Research Respiratory Mechanics Respiratory physiology Running Savings Scientist Short Interspersed Nucleotide Elements Signal Transduction Structure Supervision Supportive care System Technology Time Training United States United States Dept. of Health and Human Services United States National Institutes of Health Ventilatory Depression base chronic pain patient cost detection platform disability efficacy evaluation experience health care settings high risk innovation interdisciplinary approach mobile sensing mortality novel novel strategies opioid epidemic opioid injection opioid mortality opioid overdose opioid use opioid use disorder patient oriented research patient safety portability preference prevent programs randomized trial respiratory therapy design

项目摘要

PROJECT SUMMARY/ABSTRACT A fundamental challenge of the opioid epidemic is that overdose victims die because they are alone or among untrained or impaired bystanders. Yet opioid deaths are readily preventable with early detection and appropriate supportive care. As mortality continues to rise, new approaches are needed to prevent deaths from opioid overdose. The long-term goal of this research program is to develop low-cost, mobile overdose detection and signaling modalities to optimize outcomes in patients at high risk for opioid overdose. The overall objective of this specific proposal is to evaluate whether two existing, clinically validated, low-cost respiratory sensing systems can be modified to reliably detect overdose events. The central hypotheses are that: (1) existing, portable respiratory sensing systems can be modified to accurately detect the entire spectrum of abnormal respiratory mechanics arising from overdose events; and (2) high-risk individuals will use such a sensing system as a low-cost life-saving intervention. This K23 award is an essential element of my evolution as an independent physician scientist, as it will allow me to obtain new training in patient-oriented research and enable me to collect key preliminary data for a future, larger scale intervention. Guided by strong preliminary data on two existing mobile respiratory sensing systems, the central hypotheses will be investigated in 3 specific aims: Aim 1. Determine the feasibility of mobile, low-cost, non-invasive respiratory sensing systems to accurately identify rapid and prolonged apnea events in a safe, controlled, operating room setting, using induction of general anesthesia during elective surgery as an acute, fentanyl-induced overdose model; Aim 2. Determine the feasibility and preliminary efficacy of mobile sensing systems to detect opioid-induced respiratory depression and overdose events in a real-world opioid using population, in a pilot diagnostic study of participants self-injecting opioids in a supervised injection facility (SIF) in nearby Vancouver, BC; Aim 3. Measure stakeholder acceptance of using and disseminating mobile overdose detection technologies, using a qualitative approach involving structured interviews with opioid prescribers, chronic pain patients and people who inject opioids. The approach is innovative because it will utilize existing, low-cost mobile sensing systems to identify potentially lethal prolonged apnea events in humans, using induction of general anesthesia as a physiologic overdose model. The study will also be the first to utilize a SIF to measure the continuum of respiratory physiology generated from real-world opioid self-injection events. The proposed research is significant, because at the completion of the 3 Aims, the team will have obtained user feedback and generated the necessary data to implement a low-cost, truly ubiquitous system capable of identifying (and eventually signaling to EMS and bystanders) acute overdose events.

项目总结/摘要阿片类药物流行的一个根本挑战是，过量的受害者死亡，因为他们是单独或未经训练或受损的旁观者。然而，阿片类药物死亡是很容易预防的早期发现，适当的支持性护理。随着死亡率的持续上升，需要新的方法来防止死亡。阿片类药物过量该研究计划的长期目标是开发低成本、移动的药物过量检测和信号模式，以优化阿片类药物过量高风险患者的结局。整体该特定提案的目的是评估两种现有的、临床验证的、低成本的呼吸系统可以修改传感系统以可靠地检测过量事件。核心假设是：（1）现有的便携式呼吸感测系统可以被修改以准确地检测呼吸的整个频谱。过量事件引起的异常呼吸力学;和（2）高风险个体将使用这种传感系统作为一种低成本的救生干预措施。这个K23奖是我发展的一个重要因素作为一个独立的医生科学家，因为它将使我获得新的培训，以病人为导向的研究，使我能够为将来更大规模的干预收集关键的初步数据。以强有力的初步指导两个现有的移动的呼吸传感系统的数据，中心假设将在3 具体目标：目标1。确定移动的、低成本、无创呼吸传感系统的可行性，在安全、受控的手术室环境中，使用择期手术期间全身麻醉作为急性芬太尼诱导的过量模型; 目标二。确定移动的传感系统检测阿片类药物诱导的在一项初步诊断研究中，真实世界阿片类药物使用人群中的呼吸抑制和过量事件参与者在不列颠哥伦比亚省温哥华附近的监督注射设施（SIF）自行注射阿片类药物; 目标3.衡量利益相关者对使用和传播移动的过量检测技术的接受程度，使用定性方法，包括对阿片类药物处方者、慢性疼痛患者和注射阿片类药物的人这种方法是创新的，因为它将利用现有的低成本移动的传感系统来识别使用全身麻醉诱导作为生理性呼吸暂停，过量模型这项研究也将是第一个利用SIF来测量呼吸连续性的研究。从真实世界的阿片类自我注射事件产生的生理学。拟议的研究意义重大，因为在完成3个目标时，团队将获得用户反馈并生成必要的数据，以实现低成本，真正无处不在的系统，能够识别（并最终向EMS和旁观者发出信号）急性过量事件。