bioRxiv2020
Home health monitoring technologies promise to improve care and reduce costs, yet they are limited by the need for adherence to self-monitoring, usage of an app, or application of a wearable. While implantable sensors overcome the adherence barrier, they are expensive and require invasive procedures. Here, we describe a non-invasive, non-contact, adherence-independent sensor, that when placed beneath the legs of a patients home bed, longitudinally monitors total body weight, detailed respiratory signals, and ballistocardiograms for months, without requiring any active patient participation. Accompanying algorithms demix weight and respiratory signals when the bed is shared by a partner or a pet. Validation studies during overnight clinical sleep studies exhibit quantitative equivalence to commercial sensors and allow discrimination of obstructive and central sleep apneas. In-home studies discriminate atrial fibrillation from normal sinus rhythm. To demonstrate real-world feasibility, we performed 3 months of continuous in-home monitoring in a patient with heart failure as he awaited and recovered from coronary artery bypass surgery. By overcoming the adherence barrier, Bedscales has the potential to create a multidimensional picture of chronic disease, learn signatures of impending hospitalization, and enable optimization of care in the home. DisclosuresDrs. King and Coleman and Nicholas Harrington are inventors on a patent application describing the Bedscales technology. Dr. Kevin R. King discloses consulting relationships with Bristol Myers Squibb and Astrazeneca, Medimmune and is founder of Nightingale Labs. Dr. Deepak L. Bhatt discloses the following relationships - Advisory Board: Cardax, Cereno Scientific, Elsevier Practice Update Cardiology, Medscape Cardiology, PhaseBio, Regado Biosciences; Board of Directors: Boston VA Research Institute, Society of Cardiovascular Patient Care, TobeSoft; Chair: American Heart Association Quality Oversight Committee; Data Monitoring Committees: Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the PORTICO trial, funded by St. Jude Medical, now Abbott), Cleveland Clinic (including for the ExCEED trial, funded by Edwards), Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine (for the ENVISAGE trial, funded by Daiichi Sankyo), Population Health Research Institute; Honoraria: American College of Cardiology (Senior Associate Editor, Clinical Trials and News, ACC.org; Vice-Chair, ACC Accreditation Committee), Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute; RE-DUAL PCI clinical trial steering committee funded by Boehringer Ingelheim; AEGIS-II executive committee funded by CSL Behring), Belvoir Publications (Editor in Chief, Harvard Heart Letter), Duke Clinical Research Institute (clinical trial steering committees, including for the PRONOUNCE trial, funded by Ferring Pharmaceuticals), HMP Global (Editor in Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (Guest Editor; Associate Editor), Medtelligence/ReachMD (CME steering committees), Population Health Research Institute (for the COMPASS operations committee, publications committee, steering committee, and USA national co-leader, funded by Bayer), Slack Publications (Chief Medical Editor, Cardiology Todays Intervention), Society of Cardiovascular Patient Care (Secretary/Treasurer), WebMD (CME steering committees); Other: Clinical Cardiology (Deputy Editor), NCDR-ACTION Registry Steering Committee (Chair), VA CART Research and Publications Committee (Chair); Research Funding: Abbott, Afimmune, Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Chiesi, CSL Behring, Eisai, Ethicon, Ferring Pharmaceuticals, Forest Laboratories, Fractyl, Idorsia, Ironwood, Ischemix, Lilly, Medtronic, PhaseBio, Pfizer, PLx Pharma, Regeneron, Roche, Sanofi Aventis, Synaptic, The Medicines Company; Royalties: Elsevier (Editor, Cardiovascular Intervention: A Companion to Braunwalds Heart Disease); Site Co-Investigator: Biotronik, Boston Scientific, CSI, St. Jude Medical (now Abbott), Svelte; Trustee: American College of Cardiology; Unfunded Research: FlowCo, Merck, Novo Nordisk, Takeda. Dr. Akshay S. Desai discloses the following relationships - Research grants to Brigham and Womens Hospital to support clinical trial activities from Alnylam, AstraZeneca, and Novartis; Consulting fees from Abbott, Alnylam, AstraZeneca, Biofourmis, Boehringer-Ingelheim, Boston Scientific, Merck, Novartis, Relypsa, Regeneron. Dr. Owens reports consulting fees from Novartis, and research grants to UCSD from Snoozeal, Nitto Denko, and Masimo.