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Drummond D, Roukema J, Pijnenburg M. Home monitoring in asthma: towards digital twins. Curr Opin Pulm Med 2023; 29:270-276. [PMID: 37102597 DOI: 10.1097/mcp.0000000000000963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
PURPOSE OF REVIEW We highlight the recent advances in home monitoring of patients with asthma, and show that these advances converge towards the implementation of digital twin systems. RECENT FINDINGS Connected devices for asthma are increasingly numerous, reliable and effective: new electronic monitoring devices extend to nebulizers and spacers, are able to assess the quality of the inhalation technique, and to identify asthma attack triggers when they include a geolocation function; environmental data can be acquired from databases and refined by wearable air quality sensors; smartwatches are better validated. Connected devices are increasingly integrated into global monitoring systems. At the same time, machine learning techniques open up the possibility of using the large amount of data collected to obtain a holistic assessment of asthma patients, and social robots and virtual assistants can help patients in the daily management of their asthma. SUMMARY Advances in the internet of things, machine learning techniques and digital patient support tools for asthma are paving the way for a new era of research on digital twins in asthma.
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Affiliation(s)
- David Drummond
- Department of Pediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, AP-HP, Université Paris Cité, Inserm UMR 1138, HeKA team, Centre de Recherche des Cordeliers, Paris, France
| | - Jolt Roukema
- Department of Paediatrics/Paediatric Pulmonology, Radboud University Medical Centre, Amalia Children's Hospital, Nijmegen
| | - Mariëlle Pijnenburg
- Department of Paediatrics/Paediatric Respiratory Medicine and Allergology, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands
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Ward T, Jha A, Daynes E, Ackland J, Chalmers JD. Review of the British Thoracic Society Winter Meeting 23 November 2022 23-25 November 2022. Thorax 2023; 78:e1. [PMID: 36717241 DOI: 10.1136/thorax-2022-219941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 01/06/2023] [Indexed: 02/01/2023]
Abstract
The British Thoracic Society Winter Meeting at the QEII Centre in London provided the first opportunity for the respiratory community to meet and disseminate research findings face to face since the start of the COVID-19 pandemic. World-leading researchers from the UK and abroad presented their latest findings across a range of respiratory diseases. This article aims to represent the range of the conference and as such is written from the perspective of a basic scientist, a physiotherapist and two doctors. The authors reviewed showcase sessions plus a selection of symposia based on their personal highlights. Content ranged from exciting new developments in basic science to new and unpublished results from clinical trials, delivered by leading scientists from their fields including former deputy chief medical officer Professor Sir Jonathan Van-Tam and former WHO chief scientist Dr Soumya Swaminathan.
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Affiliation(s)
- Tom Ward
- Department Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Akhilesh Jha
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Enya Daynes
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Jodie Ackland
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - James D Chalmers
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
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Gonsard A, AbouTaam R, Prévost B, Roy C, Hadchouel A, Nathan N, Taytard J, Pirojoc A, Delacourt C, Wanin S, Drummond D. Children's views on artificial intelligence and digital twins for the daily management of their asthma: a mixed-method study. Eur J Pediatr 2023; 182:877-888. [PMID: 36512148 PMCID: PMC9745267 DOI: 10.1007/s00431-022-04754-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022]
Abstract
New technologies enable the creation of digital twin systems (DTS) combining continuous data collection from children's home and artificial intelligence (AI)-based recommendations to adapt their care in real time. The objective was to assess whether children and adolescents with asthma would be ready to use such DTS. A mixed-method study was conducted with 104 asthma patients aged 8 to 17 years. The potential advantages and disadvantages associated with AI and the use of DTS were collected in semi-structured interviews. Children were then asked whether they would agree to use a DTS for the daily management of their asthma. The strength of their decision was assessed as well as the factors determining their choice. The main advantages of DTS identified by children were the possibility to be (i) supported in managing their asthma (ii) from home and (iii) in real time. Technical issues and the risk of loss of humanity were the main drawbacks reported. Half of the children (56%) were willing to use a DTS for the daily management of their asthma if it was as effective as current care, and up to 93% if it was more effective. Those with the best computer skills were more likely to choose the DTS, while those who placed a high value on the physician-patient relationship were less likely to do so. Conclusions: The majority of children were ready to use a DTS for the management of their asthma, particularly if it was more effective than current care. The results of this study support the development of DTS for childhood asthma and the evaluation of their effectiveness in clinical trials. What is Known: • New technologies enable the creation of digital twin systems (DTS) for children with asthma. • Acceptance of these DTSs by children with asthma is unknown. What is New: • Half of the children (56%) were willing to use a DTS for the daily management of their asthma if it was as effective as current care, and up to 93% if it was more effective. •Children identified the ability to be supported from home and in real time as the main benefits of DTS.
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Affiliation(s)
- Apolline Gonsard
- Department of Pediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, AP-HP, 149 Rue de Sèvres, 75015 Paris, France
| | - Rola AbouTaam
- Department of Pediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, AP-HP, 149 Rue de Sèvres, 75015 Paris, France
| | - Blandine Prévost
- Department of Pediatric Pulmonology, University Hospital Armand Trousseau, AP-HP Paris, France
| | - Charlotte Roy
- Department of Pediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, AP-HP, 149 Rue de Sèvres, 75015 Paris, France
| | - Alice Hadchouel
- Department of Pediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, AP-HP, 149 Rue de Sèvres, 75015 Paris, France
- Université Paris Cité, Paris, France
| | - Nadia Nathan
- Department of Pediatric Pulmonology, University Hospital Armand Trousseau, AP-HP Paris, France
| | - Jessica Taytard
- Department of Pediatric Pulmonology, University Hospital Armand Trousseau, AP-HP Paris, France
- UMRS1158 Neurophysiologie Respiratoire Expérimentale Et Clinique, Sorbonne Université, INSERM, Paris, France
| | | | - Christophe Delacourt
- Department of Pediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, AP-HP, 149 Rue de Sèvres, 75015 Paris, France
- Université Paris Cité, Paris, France
| | - Stéphanie Wanin
- Department of Pediatric Allergology, University Hospital Armand Trousseau, APHP, Paris, France
| | - David Drummond
- Department of Pediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, AP-HP, 149 Rue de Sèvres, 75015 Paris, France
- Université Paris Cité, Paris, France
- Inserm UMR 1138, Centre de Recherche Des Cordeliers, HeKA Team, 75006 Paris, France
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Drummond D, Coulet A. Technical, Ethical, Legal, and Societal Challenges With Digital Twin Systems for the Management of Chronic Diseases in Children and Young People. J Med Internet Res 2022; 24:e39698. [DOI: 10.2196/39698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/11/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Advances in digital medicine now make it possible to use digital twin systems (DTS), which combine (1) extensive patient monitoring through the use of multiple sensors and (2) personalized adaptation of patient care through the use of software. After the artificial pancreas system already operational in children with type 1 diabetes, new DTS could be developed for real-time monitoring and management of children with chronic diseases. Just as providing care for children is a specific discipline—pediatrics—because of their particular characteristics and needs, providing digital care for children also presents particular challenges. This article reviews the technical challenges, mainly related to the problem of data collection in children; the ethical challenges, including the need to preserve the child's place in their care when using DTS; the legal challenges and the dual need to guarantee the safety of DTS for children and to ensure their access to DTS; and the societal challenges, including the needs to maintain human contact and trust between the child and the pediatrician and to limit DTS to specific uses to avoid contributing to a surveillance society and, at another level, to climate change.
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