SBIR Phase II: Defining the Multimodal Signature of Stroke

小型企业创新研究(SBIR)第二阶段项目的更广泛的影响/商业潜力属于卫生信息学的重大挑战的范围。有很好的方案来管理和治疗急性中风，然而，这些方案只有在患者被纳入医疗系统后才有效。缺血性中风影响着70万美国人，每年造成约330亿美元的损失，是美国第五大死亡原因和主要残疾原因。然而，卫生保健提供者与患者的互动有限，而且这些互动发生在高度受限的临床环境中。医生对患者行为的控制有限，帮助患者识别临床之外的中风症状的工具也有限。对于中风风险较高的患者，目前还没有可用的系统来监测中风症状并实时启动应对措施。因此，有必要远程监测患者，而目前的中风反应系统无法提供覆盖。拟议的解决方案将把中风症状监测扩大到患者的日常生活。跟踪患者的日常生活将极大地丰富我们对中风的知识，并将允许扩展到对其他神经和神经精神障碍和疾病的监测。该小型企业创新研究(SBIR)第二阶段项目致力于中风的实时检测。自1995年以来，静脉注射组织纤溶酶原激活剂(TPA)一直是FDA批准的治疗方法，但只有5%-10%的符合条件的患者接受了这种治疗。首次中风症状后到达急诊室的时间与tPA和血管内治疗后的较好结果直接相关，这两种治疗的时间窗口分别为4.5小时和24小时。尽管开展了大规模的公共卫生运动，但识别中风症状和启动应急响应系统仍然是一项重大挑战。该项目的目标是开发和测试一种可穿戴和计算的解决方案，以有效地提醒缺血性中风患者并及时启动应急响应。该解决方案包括一个基于云的分析系统，通过穿戴在身上的传感器和移动应用程序实现对中风发作的实时检测。一旦部署，该设备有望显著改善中风急救反应，并增加及时到达医院接受静脉注射tPA治疗和其他再灌注治疗的患者数量。这一奖项反映了NSF的法定使命，并通过使用基金会的智力优势和更广泛的影响审查标准进行评估，被认为值得支持。

The broader impact/commercial potential of this Small Business Innovation Research (SBIR) Phase II project falls within the scope of the grand challenges in health informatics. There are excellent protocols for the management and treatment of acute stroke, however, these protocols are only effective once patients have been admitted into the healthcare system. Ischemic stroke affects 700,000 Americans, costs approximately $33 billion annually, and is the fifth leading cause of death and a leading cause of disability in the US. Health care providers, however, have limited interaction with their patients, and these interactions occur in the highly constrained environment of the clinical setting. Physicians have limited control over patient behavior and limited tools to help patients recognize stroke symptoms outside the clinical setting. For patients with high stroke risk, there is currently no system available to monitor stroke symptoms and initiate a response in real-time. Thus, there is a need to monitor patients remotely, where the current systems for stroke response fail to provide coverage. The proposed solution will expand the provision of stroke symptom monitoring to the daily lives of patients. Tracking patients as they go through their daily lives will considerably enrich our knowledge of stroke and will allow extension to monitoring for other neurological and neuropsychiatric disorders and diseases. This Small Business Innovation Research (SBIR) Phase II project addresses the real-time detection of stroke. IV tissue plasminogen activator (tPA) has been an FDA approved therapy since 1995, yet only 5-10% of eligible patients receive this therapy. Arrival time in the emergency room after initial stroke symptoms is directly associated with better outcomes after tPA and endovascular therapy, with a time window of 4.5 hours and 24 hours for these treatments, respectively. Despite massive public health campaigns, identifying symptoms of stroke and activating emergency response systems remains a major challenge. The goal of this project is to develop and test a wearable and computational solution to effectively alert ischemic stroke victims and initiate emergency response in a timely manner. The solution consists of a cloud-based analysis system for real-time detection of stroke onset, enabled by body-worn sensors and a mobile app. Once deployed, the device is expected to dramatically improve stroke emergency response and increase the number of patients arriving in the hospital in time for IV tPA treatment and other reperfusion therapies.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.