6 tips for integrating a connected device into a digital health program

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This article is based on our November 1, 2024 interview with Dr. Solomon Tesfaye.

 

When Solomon Tesfaye was a 16-year-old boy in Addis Ababa, Ethiopia, a military regime closed his school and forced the students into national service. Tesfaye, who had by then developed a true passion for learning, desperately hoped to continue his intellectual development and academic journey.

On the urging of his brother, he took a chance and applied for an international scholarship to the prestigious Sevenoaks School in Kent, England. Sevenoaks, a storied boarding school founded in 1432, may have seemed like an unlikely next home for Tesfaye. But they also decided to take a chance on him. Those bets ultimately paid off.

 

Dr. Tesfaye is now a globally recognized diabetes expert at the University of Sheffield whose research has played a significant role in understanding diabetic nerve damage, how to identify it earlier, and how to potentially treat it before the complications become debilitating. In September, Dr. Tesfaye was honored with a Lifetime Achievement Award at the 34th NeuroDiab annual meeting in recognition of his pioneering research in the field. Tesfaye credits his experience at Sevenoaks School as having kindled his interest in science and his enduring passion for grappling with difficult problems, like diabetic peripheral neuropathies (DPN).

 

Fast forward to today and Dr. Tesfaye is leading some of the most exciting work on early diagnosis of DPN and clinical strategies for altering its relentless progression. His team at University of Sheffield recently presented findings at The American Diabetes Association Scientific Sessions that found the use of point-of-care testing devices by clinicians (Withings’ Sudoscan in combination with DPNCheck) could significantly improve the detection of DPN over current standard of care methods and provide a rapid, reproducible, and quantitative assessment for busy clinicians.

 

“For diabetic retinopathy, we’ve been successful using technology to improve diagnosis and care,” said Tesfaye. “But for neuropathy, we're using these Stone Age implements. With a monofilament, even the best doctors cannot diagnose neuropathy the same two days in a row. Meanwhile, fifty percent (of patients) die within 5 years, it costs more than breast or colon cancer, and is devastating because it's so painful patients can't sleep. Sadly, advanced neuropathy is the strongest risk factor for diabetic foot ulceration that results in fifty percent mortality within 5 years, and costs more than breast, colon and prostate cancers, combined. Neuropathy also is devastating as it can also cause distressing foot and leg pain that interferes with sleep.”

 

Tesfaye is now immersed in a major new study with 160 participants – called OCEANIC – that seeks to determine whether early diagnosis, coupled with robust, early intervention can alter the course of DPN for the better. OCEANIC is using Withings Body Pro 2 smart scales with Electrochemical Skin Conductance (ESC) technology, wearable sensors, and activity trackers, to monitor and share patient progress on metrics including body fat, muscle mass, and ESC score, with the aim of reinforcing lifestyle changes. The study group will receive personalized diabetes education and exercise programs, and weight loss interventions including GLP-1s, to significantly reduce HbA1C. 

 

“Our goal is to explore whether these intensive strategies to manage risk factors can halt or even reverse diabetes-related nerve damage when it is identified at an early stage,” said Dr. Tesfaye. “We want to do for neuropathy what early and routine screening has done for retinopathy – bringing better outcomes to millions of people with diabetes.”

 

If Solomon Tesfaye’s history is any guide, achieving clear answers to the big questions in the OCEANIC study will be but a waypoint on his journey. He credits a mentor, the late Professor John Ward, with encouraging him to tackle the most meaningful problems. “He told me not to worry about publishing too many studies, but rather focus on a few big questions that will fundamentally change people’s lives.”

Interested in partnering with us?

Contact Us [post_title] => Turning Challenges into Opportunities: Dr. Solomon Tesfaye and His Quest to Eradicate Preventable Amputations [post_excerpt] => Dr. Solomon Tesfaye is one of the world’s leading researchers in the field of diabetic peripheral neuropathies (DPN). His life has been a story of overcoming challenges with a mission to tackle one of the biggest problems facing people with diabetes - preventable amputations. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => turning-challenges-into-opportunities-dr-solomon-tesfaye-and-his-quest-to-eradicate-preventable-amputations [to_ping] => [pinged] => [post_modified] => 2024-12-09 16:45:25 [post_modified_gmt] => 2024-12-09 16:45:25 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=1724 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [1] => WP_Post Object ( [ID] => 1727 [post_author] => 11 [post_date] => 2024-12-09 16:36:58 [post_date_gmt] => 2024-12-09 16:36:58 [post_content] =>

Withings products not only help individuals and their clinicians better monitor and understand health, but they are contributing to a wide body of research. Withings is honored that researchers are increasingly turning to our products across an impressive number of therapeutic areas. Among them are diabetic neuropathy, retinopathy, sudomotor function, hypertension, sleep quality, sleep apnea, dementia, ECG intervals in children, arrhythmias, cardiovascular autonomic neuropathy (CAN), public health monitoring, and health technology adoption.

Here’s just a sampling of the diversity and reach of Withings products in medical research this year.

• From Sudoscan to bedside: theory, modalities, and application of electrochemical skin conductance in medical diagnostics

An October 2024 article in Frontiers in Neuroanatomy looks at the history and technical development of electrochemical skin conductance (ESC), as measured by Withings’ Sudoscan, and compares it to other measures of skin conductance such as galvanic skin response (GSR) and electrodermal activity (EDA). ESC was developed specifically to diagnose sudomotor function as opposed to GSR/EDA which is a continuous monitoring tool. EDA is increasingly incorporated into wearable technology. While both use skin/sweat conductance, it is important to differentiate EDA which can be used for physiological and psychological measures of stress from ESC which is used to evaluate sudomotor function and diagnose neuropathy. Withings has incorporated ESC in its smart scales which show a near perfect correlation with the Sudoscan clinical device. The Withings smart scales allow for easier and more frequent individual time series data as well as large scale data collection. 

• Using mobile health data to monitor and predict public stress levels

Public health surveillance has largely relied on self-reported surveys. This study applied mobile and wearable technologies to collect objective, real-time, continuous health data. Data from a variety of Withings products (Withings Sleep, Withings BPM Connect, Withings Thermo, and Withings Body+), were used to predict stress. Findings showed that a system, such as the Mobile Health Platform used here, could complement self-reported health data to better monitor and predict stress in a population.

 

• Validation of smartwatch electrocardiogram intervals in children

This study compared the 1-lead ECG intervals available via the Withings ScanWatch with the standard 12-lead ECGs in children and adolescents. Smart watch intervals have previously been shown to be accurate for adults. The heart rate measure was found to be reliable for children, The automated QTc interval was less reliable but can be improved with manual measurements. It is worth noting that the study used pediatric subjects rather than adapting adult research, as is often the case.

 

• Are we getting enough sleep? An analysis of 11 million nights of sleep data by noted sleep researcher, Dr. Danny Eckert

This study of 67,254 adults showed that 30% of adults do not get the recommended 7-9 hours of sleep per night, and that even those who did average 7-9 hours, 40% of the nights fell outside the range. Only 15% of participants slept 7-9 hours for at least 5 nights per week. In addition to the findings of irregular sleep, the study highlights the usefulness of the at home Withings Sleep for large-scale and/or longitudinal sleep studies. 

As we close out a year of significant knowledge advancements, we look forward to seeing what the global healthcare research community has in store for 2025. 

If you are conducting research that might benefit from Withings technology, please contact us at contact-pro@withings.com.

Interested in partnering with us?

Contact Us [post_title] => Withings 2024 Year in Review: Research Highlights [post_excerpt] => 2024 was an exciting year for Withings. We’re honored that the global research community is increasingly turning to our solutions for studies across an impressive number of therapeutic areas. Among them are diabetic neuropathy, retinopathy, sudomotor function, hypertension, sleep quality, sleep apnea, dementia, ECG intervals in children, arrhythmias, cardiovascular autonomic neuropathy (CAN), public health monitoring, and health technology adoption. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => researchers-have-used-our-solutions-for-studies-across-an-impressive-number-of-therapeutic-areas-among-them-are-diabetic-neuropathy-retinopathy-sudomotor-function-hypertension-sleep-quality-slee [to_ping] => [pinged] => [post_modified] => 2024-12-12 15:55:36 [post_modified_gmt] => 2024-12-12 15:55:36 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=1727 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [2] => WP_Post Object ( [ID] => 1729 [post_author] => 11 [post_date] => 2024-12-09 16:36:44 [post_date_gmt] => 2024-12-09 16:36:44 [post_content] =>

Several new, large-scale studies^{1, 2, 3, 4} from the Flinders Medical Research Institute (FHMRI) in Australia found studying sleep in real-world settings over multiple nights can greatly reduce the high 30% error rate of sleep apnea diagnosis from polysomnography (PSG), the traditional, single night, in hospital gold standard technique. Using Withings Sleep Analyzer, researchers were able to easily track multiple biomarkers for participants over time revealing large variability in sleep indicators from night to night.

 

Withings under-the-mattress sleep trackers have enabled researchers to study large groups over time. The FHMRI studies tracked 67,278 and 12,287 participants respectively over a total of 11 million nights, a feat not feasible with traditional polysomnography.

 

A key finding from the study of 12,000 users is the variability in the severity of Obstructive Sleep Apnea (OSA) from night to night. The variability of OSA, independent of severity, is associated with uncontrolled hypertension which is the leading cardiovascular risk factor. Sleep Analyzer also reveals other risks associated with hypertension, such as snoring, irregular waking and sleep hours, and duration of sleep.

 

Using the same hardware technology as Withings Sleep Analyzer, Sleep Rx is a noninvasive, at home device that users place under their mattresses to gather biomarkers such as heart rate, respiratory rate, snoring, sleep cycles, and the Withings Sleep Index, a measure of breathing events per hour, which can aid in the diagnosis of sleep apnea. Using this simple device for at least 14 nights gives a much clearer picture of sleep quality.

 

The multi-night Sleep Rx data can be used to predict the right patients at the right time for in hospital PSG. Better identification of patients who most need PSG will reduce overall spending on the costly tests and ease scheduling difficulties.

 

Sleep Rx offers an inexpensive, easy to use method to better target high risk cardiovascular patients, reduce the high error rate of sleep apnea diagnosis, and efficiently gather longitudinal, large-scale sleep data for a variety of chronic diseases. For more information about the Withings Sleep Rx, click here.

References

1 Lechat, Bastien et al. “Multinight Prevalence, Variability, and Diagnostic Misclassification of Obstructive Sleep Apnea.” American journal of respiratory and critical care medicine vol. 205,5 (2022): 563-569. doi:10.1164/rccm.202107-1761OC

2 Lechat, Bastien et al. “High night-to-night variability in sleep apnea severity is associated with uncontrolled hypertension.” NPJ digital medicine vol. 6,1 57. 30 Mar. 2023, doi:10.1038/s41746-023-00801-2

3 Lechat, Bastien et al. “Regular snoring is associated with uncontrolled hypertension.” NPJ digital medicine vol. 7,1 38. 17 Feb. 2024, doi:10.1038/s41746-024-01026-7

4 Scott, Hannah et al. “Sleep Irregularity Is Associated With Hypertension: Findings From Over 2 Million Nights With a Large Global Population Sample.” Hypertension (Dallas, Tex. : 1979) vol. 80,5 (2023): 1117-1126. doi:10.1161/HYPERTENSIONAHA.122.20513

Interested in partnering with us?

Contact Us [post_title] => Sleep Apnea Data from Multiple Nights is Key to Predicting Hypertension and Cardiovascular Risk [post_excerpt] => New large-scale, longitudinal studies show that monitoring sleep for at least 14 nights at home with a connected sleep tracking mat, can reduce the 30% high error rate of sleep apnea diagnosis from the usual single-night, in hospital polysomnography (PSG) technique. This technology can identify which patients most need expensive, intrusive, and difficult to access PSG. Longitudinal data also detects variability of Obstructive Sleep Apnea from night to night which is associated with hypertension [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => sleep-apnea-data-from-multiple-nights-is-key-to-predicting-hypertension-and-cardiovascular-risk [to_ping] => [pinged] => [post_modified] => 2024-12-10 18:14:34 [post_modified_gmt] => 2024-12-10 18:14:34 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=1729 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) ) [post_count] => 3 [current_post] => -1 [before_loop] => 1 [in_the_loop] => [post] => WP_Post Object ( [ID] => 1724 [post_author] => 11 [post_date] => 2024-12-09 16:37:06 [post_date_gmt] => 2024-12-09 16:37:06 [post_content] =>

This article is based on our November 1, 2024 interview with Dr. Solomon Tesfaye.

 

When Solomon Tesfaye was a 16-year-old boy in Addis Ababa, Ethiopia, a military regime closed his school and forced the students into national service. Tesfaye, who had by then developed a true passion for learning, desperately hoped to continue his intellectual development and academic journey.

On the urging of his brother, he took a chance and applied for an international scholarship to the prestigious Sevenoaks School in Kent, England. Sevenoaks, a storied boarding school founded in 1432, may have seemed like an unlikely next home for Tesfaye. But they also decided to take a chance on him. Those bets ultimately paid off.

 

Dr. Tesfaye is now a globally recognized diabetes expert at the University of Sheffield whose research has played a significant role in understanding diabetic nerve damage, how to identify it earlier, and how to potentially treat it before the complications become debilitating. In September, Dr. Tesfaye was honored with a Lifetime Achievement Award at the 34th NeuroDiab annual meeting in recognition of his pioneering research in the field. Tesfaye credits his experience at Sevenoaks School as having kindled his interest in science and his enduring passion for grappling with difficult problems, like diabetic peripheral neuropathies (DPN).

 

Fast forward to today and Dr. Tesfaye is leading some of the most exciting work on early diagnosis of DPN and clinical strategies for altering its relentless progression. His team at University of Sheffield recently presented findings at The American Diabetes Association Scientific Sessions that found the use of point-of-care testing devices by clinicians (Withings’ Sudoscan in combination with DPNCheck) could significantly improve the detection of DPN over current standard of care methods and provide a rapid, reproducible, and quantitative assessment for busy clinicians.

 

“For diabetic retinopathy, we’ve been successful using technology to improve diagnosis and care,” said Tesfaye. “But for neuropathy, we're using these Stone Age implements. With a monofilament, even the best doctors cannot diagnose neuropathy the same two days in a row. Meanwhile, fifty percent (of patients) die within 5 years, it costs more than breast or colon cancer, and is devastating because it's so painful patients can't sleep. Sadly, advanced neuropathy is the strongest risk factor for diabetic foot ulceration that results in fifty percent mortality within 5 years, and costs more than breast, colon and prostate cancers, combined. Neuropathy also is devastating as it can also cause distressing foot and leg pain that interferes with sleep.”

 

Tesfaye is now immersed in a major new study with 160 participants – called OCEANIC – that seeks to determine whether early diagnosis, coupled with robust, early intervention can alter the course of DPN for the better. OCEANIC is using Withings Body Pro 2 smart scales with Electrochemical Skin Conductance (ESC) technology, wearable sensors, and activity trackers, to monitor and share patient progress on metrics including body fat, muscle mass, and ESC score, with the aim of reinforcing lifestyle changes. The study group will receive personalized diabetes education and exercise programs, and weight loss interventions including GLP-1s, to significantly reduce HbA1C. 

 

“Our goal is to explore whether these intensive strategies to manage risk factors can halt or even reverse diabetes-related nerve damage when it is identified at an early stage,” said Dr. Tesfaye. “We want to do for neuropathy what early and routine screening has done for retinopathy – bringing better outcomes to millions of people with diabetes.”

 

If Solomon Tesfaye’s history is any guide, achieving clear answers to the big questions in the OCEANIC study will be but a waypoint on his journey. He credits a mentor, the late Professor John Ward, with encouraging him to tackle the most meaningful problems. “He told me not to worry about publishing too many studies, but rather focus on a few big questions that will fundamentally change people’s lives.”

Interested in partnering with us?

Contact Us [post_title] => Turning Challenges into Opportunities: Dr. Solomon Tesfaye and His Quest to Eradicate Preventable Amputations [post_excerpt] => Dr. Solomon Tesfaye is one of the world’s leading researchers in the field of diabetic peripheral neuropathies (DPN). His life has been a story of overcoming challenges with a mission to tackle one of the biggest problems facing people with diabetes - preventable amputations. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => turning-challenges-into-opportunities-dr-solomon-tesfaye-and-his-quest-to-eradicate-preventable-amputations [to_ping] => [pinged] => [post_modified] => 2024-12-09 16:45:25 [post_modified_gmt] => 2024-12-09 16:45:25 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=1724 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [comment_count] => 0 [current_comment] => -1 [found_posts] => 34 [max_num_pages] => 12 [max_num_comment_pages] => 0 [is_single] => [is_preview] => [is_page] => [is_archive] => 1 [is_date] => [is_year] => [is_month] => [is_day] => [is_time] => [is_author] => [is_category] => 1 [is_tag] => [is_tax] => [is_search] => [is_feed] => [is_comment_feed] => [is_trackback] => [is_home] => [is_privacy_policy] => [is_404] => [is_embed] => [is_paged] => [is_admin] => [is_attachment] => [is_singular] => [is_robots] => [is_favicon] => [is_posts_page] => [is_post_type_archive] => [query_vars_hash:WP_Query:private] => c2cc8fab039c2aec8a65b3e048ad7fae [query_vars_changed:WP_Query:private] => [thumbnails_cached] => [allow_query_attachment_by_filename:protected] => [stopwords:WP_Query:private] => [compat_fields:WP_Query:private] => Array ( [0] => query_vars_hash [1] => query_vars_changed ) [compat_methods:WP_Query:private] => Array ( [0] => init_query_flags [1] => parse_tax_query ) )