Pulmonologists Seek to Improve Asthma Home Monitoring

Noting early symptoms of airway obstruction is a critical part of good management of childhood asthma, a disease that affects seven million young people in the United States. Ngoc Ly, MD, MPH, chief of the Division of Pediatric Pulmonology, is working with a biotechnology start-up to develop an affordable, hand-held spirometer for home use that will give parents and children a new tool for managing their disease. The device is designed to wirelessly transmit data to an interactive mobile device application also in development.

According to Ly, currently patients and families are taught to track their asthma by monitoring indicators such as coughing, wheezing, behavior changes, or other non-specific signs. When warning symptoms of airway problems occur, families are instructed to administer bronchodilators or other medications to stave off an asthma attack. The problem, Ly said, is that children do not always complain of their symptoms in the early stages. In addition, it may be hard to notice subtle differences in symptoms when children have chronic asthma.

Quantitative tools for measuring airway obstruction are limited. Many patients use peak flow meters to help monitor lung function at home, but these devices are not consistently reliable, said Ly. A spirometer provides more accurate readings in a medical setting, but the size and cost have made them prohibitive for home use.

Over the past two years, Ly and her co-investigator, pediatric pulmonologist Kensho Iwanaga, MD, MS, have been collaborating with medical engineers on the development of an affordable, hand-held spirometer for home use. Ly and Iwanaga received a UCSF Clinical and Translational Science Institute Catalyst Award in 2015, which supported early phase development of the hardware and software component of the device. They are currently testing a prototype to determine its accuracy in comparison to conventional spirometry. The team also received a grant from the National Science Foundation Small Business Technology Transfer (STTR) program to build an interactive mobile device application, which can coach patients on use of the device and provide feedback. The research team has submitted a Phase II STTR grant application to fund a clinical trial to determine whether using the device is more accurate than the current standard of qualitative symptom monitoring.

“Our goal is to give parents more objective information to help them monitor their child and reduce urgent visits to the doctor,” said Ly.

Story by Leslie Lingaas