Clinical research in children is challenging to perform due to the invasive and time-consuming nature of current study protocols. One option to overcome these problems is frequent, non-invasive monitoring of symptoms and disease activity in a home-setting. With the observational studies currently running in our Trial@Home project, we aim to validate and improve the use of these home monitoring techniques in future clinical trials in pediatric patients.
CHDR has developed a home-monitoring platform – CHDR MORE® – that comprises several devices, one of which is the Nokia Steel HR. This wearable device can monitor physical activity levels, measure pulse rate and analyze sleep pattern and sleep duration. The platform also consists of a Nokia thermometer, Nokia Body+ Scales, a Nokia Blood Pressure Monitor and an in-house developed smartphone app that collects and transmits the data, adds a questionnaire function and which can utilize other android phone functions. Additionally, a NuvoAir spirometer is included, which allows subjects to collect full spirometry data with their smartphone. This spirometer home-monitoring device has been tested and improved last year in the Children’s hospital in Basel.
The Trial@Home project contains three parts, all of which are performed with the Juliana Children’s Hospital in the Hague. In the first part we will demonstrate the feasibility of using wearable technology in an at home setting in healthy/undiagnosed pediatric control groups. In the second part we will home-monitor physical activity and vital parameters in pediatric patients following admission due to pneumonia, bronchiolitis, preschool wheezing or asthma, which are four of the most common diagnoses worldwide. The third part is aimed at quantifying disease-activity in pediatric patients with fatigue, obesity, sickle cell disease and chronic lung disease. Next to validating our home-monitoring platform, the data will also be used to for example compare activity levels of the patients to the healthy controls and to evaluate correlations between physical activity, heart rate, environmental factors and symptoms.
This is one of the first studies evaluating objective parameters concerning the short term prognosis and recovery period in pediatric pneumonia, bronchiolitis, preschool wheezing and asthma, and one of the first investigating the feasibility of this type of home-monitoring in several pediatric patient groups with chronic disease. This will provide valuable information regarding the impact on daily life during the period following discharge and the impact of several chronic diseases. In the future, we expect to be able to perform therapeutic home-monitoring trials in pediatric subjects by using this platform, which we expect to be a valuable addition to the possibilities in pediatric research.
