ObeSense

Monitoring the Consequences of Obesity

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Motivations

Obesity is associated with multiple health problems

Cardiovascular diseases
Atrial fibrillation
Hypertension
Obstructive sleep apnea
Diabetes
Certain types of cancer
Has been proven to reduce life expectancy :
10% of premature adult deaths
Is reaching epidemic proportions
Ex : Switzerland : 48.7% overweight, 8.3% obese
7.3% of the total healthcare expenses
Guidelines about identification, evaluation and treatment exist
Those guidelines require long-term monitoring
Such monitoring systems do not exist
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Objectives

Answer a clear medical need by joining research in

physiological markers sensors with clinical end-users
Develop innovative and non-invasive sensors
Integrate them into single long-term monitoring systems adapted
to obese patients
Multi-parametric, low-power, allergy-free, comfortable, with on-line feedback.
Innovations in
Sensors (including robustness & cost)
Algorithms (in real-life conditions)
Ultra-low power HW & SW design
Integration into smart textiles
Clinical practice
Central involvement of end-users
Through well defined clinical scenarios
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Technical developments & validations

Sensors, systems and algorithms

Respiratory rate and volume
Dedicated exploratory platform (CSEM)
6 measurement channels
Certified for medical application
(IEC 60601-1)
USB battery recharger
Charge pump module
New optical fiber belt system (EMPA)
Water vapor permeable
Adjustable in size
is protected from external light

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Technical developments & validations

Sensors, systems and algorithms

Respiratory rate and volume
Dedicated exploratory platform (CSEM)
6 measurement channels
Certified for medical application
(IEC 60601-1)
USB battery recharger
Charge pump module
New optical fiber belt system (EMPA)
Water vapor permeable
Adjustable in size
is protected from external light
Validation (on-going)

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Technical developments & validations

Sensors, systems and algorithms

Respiratory rate and volume
Cardiac Output
EIT (EPFL & CSEM) :
Better understanding of the origin of the EIT signal
3D dynamic bio-impedance model from MR data
Confirmation of the feasibility of estimating stroke volume (SV) by EIT
Evidence of the sensitivity to electrode displacement
Optimization of the EIT measurement setup
Clinical validation ongoing (Swissethics ID: 2015-00203)
Systolic Volume Balance (EPFL-LHTC)
Processing of pressure waveforms
Comparison with commercial systems
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Technical developments & validations

Sensors, systems and algorithms

Respiratory rate and volume
Cardiac Output
Energy expenditure (CSEM, USZ, IRR, EPFL-ASPG)
Prediction of the AT from the variability of different measures (VT,
BR, HR)
Prediction of EE from acceleration forces and bio-potentials,
advanced classification algorithm
NIRS oximeter (USZ) : tested in phantoms and humans, and new
Java based mobile app for cell phones and tablets
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Technical developments & validations

Sensors, systems and algorithms

Respiratory rate and volume
Cardiac Output
Energy expenditure (CSEM, USZ, IRR, EPFL-ASPG)
Prediction of the AT from the variability of different measures (VT, BR, HR)
Prediction of EE from acceleration forces and bio-potentials, advanced
classification algorithm
NIRS oximeter (USZ) : tested in phantoms and humans, and new Java
based mobile app for cell phones and tablets
New monitoring device for EE and other parameters : CE certified and
tested
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Technical developments & validations

Sensors, systems and algorithms

Respiratory rate and volume
Cardiac Output
Energy expenditure (CSEM, USZ, IRR, EPFL-ASPG)
Blood pressure
BP from Multi-channel Photo-Plathysmography (PPG), Electro-Cardiography (ECG),
and Impedance-Cardiography (ICG)
New datalogger
Verified on healthy volunteers
Validation protocol with the CHUV
Safety and conformity test passed
Swissmedic approval for a clinical study obtained in Oct 2015
Ethical Committee approval at the CHUV in December 2015
On-going clinical trial
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Technical developments & validations

Sensors, systems and algorithms

Respiratory rate and volume
Cardiac Output
Energy expenditure (CSEM, USZ, IRR, EPFL-ASPG)
Blood pressure
Smart ECG t-shirts (EMPA)
Small single electrode with integrated humidification pad
Integrated and validated in smart t-shirts
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Technical developments & validations

Sensors, systems and algorithms

Respiratory rate and volume
Cardiac Output
Energy expenditure (CSEM, USZ, IRR, EPFL-ASPG)
Blood pressure
Smart ECG t-shirts (EMPA)
Wireless body sensor network
Completion of the design of the CSEM platform :
Two dedicated microcontrollers
Certified 12-lead ECG frontend
3D accelerometer
Li-Polymer battery
Bluetooth & WiFi
Wireless charger Qi
Li-Polymer battery
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Technical developments & validations

Sensors, systems and algorithms

Respiratory rate and volume
Cardiac Output
Energy expenditure (CSEM, USZ, IRR, EPFL-ASPG)
Blood pressure
Smart ECG t-shirts (EMPA)
Wireless body sensor network
ECG Analysis (EPFL-ASPG)
Respiratory rate estimation from ECG
Instantaneous baroreflex estimation from BP
PPG based instantaneous baroreflex sensitivity measurements
Estimating physiological rhythms with a very low time-delay
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Technical developments & validations

Sensors, systems and algorithms

Respiratory rate and volume
Cardiac Output
Energy expenditure (CSEM, USZ, IRR, EPFL-
ASPG)
Blood pressure
Smart ECG t-shirts (EMPA)
Wireless body sensor network
ECG Analysis (EPFL-ASPG)
Scientific outcomes
18 journal papers (IEEE, ACM, Sensors, Physiological measurement, )
39 conference papers
8 PhD students
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Clinical scenarios
Scenario 1: physical activity & lifestyle
interventions
Supervised by Dr O. Driaz (IRR) and Dr U. Mder
(SFISM) on patients following activity regimen in lab
settings and at home
Scenario 2: hospitalization monitoring
Obesity and atrial fibrillation, hypertension and type-2
diabetes
Supervised by Dr E. Pruvot (CHUV)
Scenario 3: ambulatory monitoring
Obesity and outpatient cardiovascular complications
Supervised by Dr E. Pruvot (CHUV)
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Platform development versus clinical scenarios
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Scenario I : Physical activity monitoring

Platform WES (activity tracker)

Validation of physiological parameters with
scientific publications (MET model, walking
and running speed and distance)
Validation of ECG quality sufficient for
diagnosis (on going - to be published)
CE marking with medical safety standards
Compatible with off-the-shelf smart textiles
(Polar, Addidas, Victorias secret, etc.)
Ready for industrial transfer
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Scenario II : Blood pressure monitoring

Platform BP (dedicated multi-

sensors)
Target medical CE marking
Approved Swissmedic & Ethics committee
Validation of estimated central blood pressure
against catheter measurements (on-going
clinical trials at the CHUV)
Almost-ready for industrial transfer
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Overweight / Obese acceptability
Overweight: 25 < BMI < 29.9
Obese: 30 < BMI < 35
Cardiac output
Clinical validation
N=4
BMI = 26.7 +/- 5.5
Results = interval of confidence +/- 12ml (95%)

Cardiac ambulatory monitoring

Clinical validation
N = 80
BMI = 25.7 +/- 5.2
Results = equivalent to medical
grade stress test monitors

Non-occlusive blood pressure

Clinical validation
N = 30
BMI = 26.4 +/- 5.6
Results = Correlation of 0.66
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Conclusions

ObeSense contributed
A series of methods and devices
Leading edge scientific research
Prototype integration
Focus on the validation
Several fully integrated, validated and
certified
Several on-going clinical validation
studies