Abstracts

Epicare@home: Remote Wearable Seizure Monitoring For People with Epilepsy can Improve Delivery of Care

Abstract number : 1.106
Submission category : 2. Translational Research / 2B. Devices, Technologies, Stem Cells
Year : 2022
Submission ID : 2204713
Source : www.aesnet.org
Presentation date : 12/3/2022 12:00:00 PM
Published date : Nov 22, 2022, 05:26 AM

Authors :
Julie Nys, PhD – Byteflies; Waverlee Harvey, BSc – Byteflies NV; Cindy Cottyn, - – AZ Damiaan; Adinda De Pauw, MD – Neurologist, AZ Damiaan; Benjamin De Ridder, MSc – Pediatric Neurology – University Hospital Ghent; Jean Delbecq, MD – Neurologist, AZ Sint-Maria Halle, Neurocenters; Chantal Depondt, MD – Neurologist, Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles; Riem El Tahry, MD, PhD – Neurologist, Cliniques universitaires Saint-Luc; Susana Ferrao Santos, MD, PhD – Neurologist, Cliniques universitaires Saint-Luc, Reference center for refractory epilepsy; Guy Fontey, MD – Neurologist, AZ Damiaan; Annelies Terwecoren, MD – Neurologist, AZ Damiaan; Helene Verhelst, MD, PhD – Neurologist, Pediatric Neurology, University Hospital Ghent; Sarah Weckhuysen, MD, PhD – Neurologist, University Antwerpen, Translational Neuroscience; Benjamin Vandendriessche, PhD – CMO, Byteflies NV

Rationale: For people with epilepsy, the journey to adequate treatment and an acceptable quality of life may be long and cumbersome. Lack of or insufficient real-world seizure information is the main bottleneck. This poses a crucial need for accurate and user-friendly multimodal seizure monitoring devices to assess seizure frequency and burden outside the hospital over longer periods of time.

Methods: We developed EpiCare@Home based on extensive clinical research (NCT04284072, NCT04642105; NCT04584385) as an end-to-end remote monitoring service to support neurologists and generate outpatient insights in epilepsy. The CE-certified EpiCare@Home solution was rolled out in Belgium as an epilepsy decision support tool. After a telemonitoring prescription by a neurologist, patients were set up with unobtrusive wearable technology (Byteflies Sensor Dot) during a consultation, in the clinic or EMU or directly at home. Sensor Dot measures 2-channel behind-the-ear EEG, ECG (heart rate, respiration rate), and motion (accelerometer, gyroscope and activity index). Depending on the type and localization of epileptic seizures, patients were equipped with a personalized electrode setup for 1 day up to 2 weeks. All patients used the EpiCare@Home Assistant App as a digital seizure diary. The EpiCare@Home Dashboard is used by the provider to manage enrolled patients, and visualize recorded raw data with annotated potential epileptic events to ultimately support clinical decisions.

Results: A total of 16 subjects, including 2 pediatric patients, diagnosed with (or with a suspicion of) generalized (13) or focal-onset epilepsy (3), were included. A retrospective, preliminary case review was done to assess the clinical and patient value reached after remote monitoring. Leveraging the collected multimodal data, we captured >400 potential epileptic events, including typical and atypical absences, GTCs, and a FIA that were matched (clinical), missed or unclear in nature based on self-reporting. In 75% (n = 12) of cases, a positive, direct clinical impact, defined as the ability of the real-world data to support a clinical decision, was achieved for people with epilepsy after a multi-day follow-up outside the hospital. Examples are: starting or adjusting (dosage or type) medication, or confirming or complementing the results of a standard (video-)EEG (Diagnosis, seizure frequency) outside the hospital. These clinical decisions are potentially associated with improved quality of life. In the remaining 25% of cases, no clinical insights and decisions were derived due to 1 case of low EEG quality and 3 with an uncertainty around the epilepsy diagnosis.

Conclusions: We showcase the potential importance and clinical utility of remote patient monitoring in epilepsy care. The preliminary 75% positive clinical impact indicates EpiCare@Home can deliver actionable medical insights based on real-world data that supports more informed and timely decisions to improve the delivery of care for those affected by epilepsy. EpiCare@Home is actively being rolled out in Belgium and other countries and with it our ability to capture meaningful long-term outcome data.

Funding: None
Translational Research