VF Doppler Smart Sensor for Dialysis and Vascular Applications

描述（由申请人提供）：本申请涉及广泛的挑战领域15：转化科学和特定的挑战主题15-RR-101：应用转化技术开发。很明显，在透析通路故障（血栓形成）之前，每个透析患者的通路流量在一段时间内从基线值降至零。然而，接入失败的自然历史和变化仍然知之甚少，如在临床上实施接入流监测时的混合结果所证明的。已知的是，在许多临床环境中，常规的每月接入流监测不够频繁。由于通路监测的有效性取决于监测的频率，因此需要一种易于使用且准确的测量通路流量的方法，以了解流量变化并确定如何最佳地监测具有不同特征的患者。本项目中正在开发和测试的新仪器基于成熟的多普勒技术，可降低开发风险，但将采用新的测量方法、技术先进的电子设备和软件，以制作用户友好、低成本的基于多普勒的监测设备，专门用于透析通路监测。这种智能传感器将允许在每个患者的每次透析治疗期间进行具有成本效益的准确流量监测，这对于优化该临床应用的组合灵敏度和特异性至关重要。该提案的结果将：1）改善透析决策，导致范式转变，以优化通路监测; 2）为其他血管应用提供平台多普勒器械。此外，该项目将实际降低透析血管通路成本。现实的估计表明，仅在美国，每年就可节省3亿美元，同时刺激技术医疗保健部门的就业机会。 公共卫生相关性：重要的是要资助技术，通过降低整体医疗成本，使美国工人在全球市场上更具竞争力。该项目实现了ARRA的科学和经济目标。该项目将产生用于透析血管通路管理的低成本紧凑型基于多普勒的智能传感器。该设备和技术将降低透析医疗保健成本，并易于推广到其他血管应用，为现有多普勒设备提供高性能替代方案。该项目支持迅速转化为私营部门和创造就业机会，实现ARRA的科学和经济刺激目标。

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area 15: Translational Science and specific Challenge Topic 15-RR-101: Applied Translational Technology Development. It is evident that prior to dialysis access failure (thrombosis), access flow decreases for every dialysis patient from a baseline value to zero over some time period. However, the natural history and variation of access failure is still poorly understood, as evidenced by mixed results when access flow monitoring is implemented clinically. What is known is that customary monthly access flow monitoring is not frequent enough in many clinical settings. Since the effectiveness of access surveillance depends on the frequency with which monitoring can be performed, an easy-to-use and accurate method of measuring access flow is needed to understand flow variation and to determine how to optimally monitor patients with differing characteristics. The new instrument being developed and tested in this project is based on mature Doppler technology mitigating development risk, yet will employ a novel measurement method, technologically advanced electronics and software to make a user-friendly, low-cost Doppler- based monitoring device tailored for dialysis access monitoring. This smart sensor will allow cost-effective, accurate flow monitoring during each dialysis treatment for every patient, which is essential to optimize combined sensitivity and specificity for this clinical application. The results of this proposal will 1) improve dialysis decision-making leading to a paradigm shift to optimize access monitoring and 2) provide a platform Doppler device for other vascular applications. Further, this project will actually reduce dialysis vascular access cost. Realistic estimates indicate $300 million in annual savings in the US alone, while stimulating jobs in the technical healthcare sector. PUBLIC HEALTH RELEVANCE: It is important to fund technologies that will make US workers more competitive in the global marketplace by reducing overall healthcare costs. This project achieves the scientific and economic objectives of the ARRA. This project will result in a low-cost compact Doppler based smart sensor for dialysis vascular access management. This device and technology will reduce dialysis healthcare cost and are easily generalizable to other vascular applications, offering a high-performance alternative to existing Doppler devices. The project supports rapid translation into the private sector and job creation achieving scientific and economic stimulus objectives of the ARRA.