Improving Remote Breathalyzer Procedures used by Clinicians and Researchers to Remotely Monitor Alcohol Use

项目摘要/摘要 可持续和/或远程监测酒精使用的可穿戴生物传感器的可用性是 并为临床实践和法医领域的研究和干预创造了新的机会 设置。我们之前在这一领域的工作主要集中在酒精透皮监测仪上，它可以远程和 持续监测酒精通过皮肤排泄的情况。虽然这样的设备，如安全连续 远程酒精监控器，已经过验证并发现是可靠的，它们有一些限制 广泛采用，包括可获得性、成本、大小、对身体活动的干扰和耻辱。一 另一种选择是使用酒精测定仪，远程采样和报告一天中的呼吸酒精水平。 这些方法正在成为监测连续饮酒环境中酒精使用的首选方法 需要对酒精消费进行监测。尽管远程呼气测定仪可以准确地检测到 目前的血液酒精水平并通过面部识别识别提供样本的个人， 它们的主要限制可能是在没有监控的情况下无法检测到饮酒- 周期“；晚上9点到早上6点之间的10个小时，这段时间可能会发生重度饮酒。拥有 难以保持戒酒，并可能采取在“非周期”期间饮酒的模式，以避免 与阳性呼气样本相关的负面后果。我们建议，目前的做法是 研究、临床和司法环境中的远程酒精呼气监测不足以检测饮酒。 具体地说，我们的目标是评估远程呼气酒精监测检测饮酒事件的准确性； 并确定通过远程酒精呼气监测未检测到的饮酒是否可以通过 磷脂酰乙醇测定。我们预计酒精呼气监测(和罕见的血斑 采样)将比经皮酒精监测更容易被接受。这项工作是对当前的挑战 提供“非周期”饮酒的证据(目标1)，并将通过以下方式改进现有方法 确认远程呼气测试加上定期测量磷脂酰乙醇(目标2)。我们也会 确定磷脂酰乙醇测量的最佳频率，以自信地确认戒酒或 找出那些可能有动机采取饮酒模式以避免被发现和后果的人 (目标2)。这项工作将有助于重新定义远程酒精使用监测程序，并显著改进 临床、法医和研究实践。

Project Summary/Abstract The availability of wearable biosensors that continuously and/or remotely monitor alcohol use is increasing and has created new opportunities for research and intervention in clinical practice and forensic settings. Our previous work in this area has focused on transdermal alcohol monitors, which remotely and continuously monitor alcohol excreted through the skin. While such devices, like Secure Continuous Remote Alcohol Monitors, have been validated and found reliable, they have some disadvantages that limit widespread adoption including availability, cost, size, interference with physical activities, and stigma. One alternative is the use of breathalyzers that remotely sample and report breath alcohol levels across the day. These are becoming the preferred method for monitoring alcohol use in settings where continuous monitoring for alcohol consumption is required. Although remote breathalyzers are accurate for detecting current blood alcohol levels and identifying the individual providing the sample through facial recognition, their primary limitation could be the failure to detect drinking when monitoring is absent during the "off- cycle”; the 10 hours between early 9pm and 6am when heavy alcohol use could occur. Individuals who have difficulty remaining abstinent and may adopt a pattern of drinking during “off-cycle” periods to avoid the negative consequences associated with positive breath samples. We propose that current practices for remote alcohol breath monitoring in research, clinical, and judicial settings are inadequate to detect drinking. Specifically, we aim to evaluate the accuracy of remote breath alcohol monitoring to detect drinking events; and determine if drinking undetected by remote breath alcohol monitoring can be identified by phosphatidylethanol measurement. We expect that breath alcohol monitoring (and infrequent blood spot sampling) will be more acceptable than transdermal alcohol monitoring. This work challenges current practices by providing evidence of “off-cycle” drinking (Aim 1) and will improve existing methods by validating remote breath testing plus periodic measures of phosphatidylethanol (Aim 2). We also will determine the optimal frequency of phosphatidylethanol measurements to confidently confirm abstinence or identify those who may be motivated to adopt patterns of drinking to avoid detection and consequences (Aim 2). This work will help redefine remote alcohol-use monitoring procedures and significantly improve clinical, forensic and research practices.