I had the great pleasure of attending the RSM’s 10th Medical Innovations summit again this year and thought I would share a few of the wonderful presentations I saw.
1. Dr Geraldine Hamilton having been frustrated by the lengthy time for clinical trials to take place and have a new medicine approved on the market was inspired to create ‘Organs-on-Chips’.
Simply put it is a polymer about the size of a USB stick with three fluidic channels. The centre is a porous, flexible membrane where human cells can be added above and below and vacuum channels on the sides. In order to make it realistic the cells can be stretched and contract to experience the same mechanical forces as they do in the body. Air channels are above the cells and a liquid containing nutrients is passed through the blood channel underneath.
Using microchip computer technology, these devices produce levels of tissue and organ performance not possible with typical culture systems. A use of the technology is to mimic infection this was shown to us on a video where lung cells had bacteria infecting them, leukocytes were then added and we saw them engulfing the bacteria onscreen. ‘Organs-on-chips’ allow scientists to investigate the biochemical, genetic and metabolic responses of the cells.
The end goal is to connect different ‘organs-on-chips’ via fluid to create a ‘human-on-chip’ and recreate sufficient functionality to better predict the outcome in humans. Later on, there could be the possibility to put your own stem cells on the chip and therefore be able to see a personalised reaction to new medication. This technique could really revolutionise the way we test efficiacy of drugs via clinical trials and potentially eradicate the dependency of animal testing.
2. Neeti Kailas made a speech about designing a hearing screening test device that could be used under the busy constraints of Indian paediatric clinics. The company, Sohum Innovation Lab, aims to create “market-driven solutions to improve the health and incomes of people living in resource-poor settings.”
This was of particular interest to me having carried out work experience in September at a paediatric audiology clinic in East London where I was able to witness the different hearing tests being performed. With the Healthy Child programme in the UK it is routine to perform an otoacoustic emission test on newborns and sometimes a secondary automated auditory brainstem response test (which is what the Sohum device uses).
On the other hand, with 28 million babies being born each year and no routine screening in India, many cases of hearing impairment are discovered too late and can have a detrimental impact on the child’s later development. When accompanying a friend in India to a paediatric clinic she saw all too clearly that the healthcare system needed to be changed. When designing the hearing test device she needed to overcome some difficulties specific to clinics in India, such as the noisy environment, inability to afford soundproof rooms, need for quick tests in order to deal with busy crowds and can be used by unskilled workers. As a designer, she used her skills to create a non-invasive portable device that is self-explanatory and can be performed in three minutes. The device has the backing of the Department of biotechnology in the Indian government and they hope it may lead to hearing tests being routinely carried out.
3. Dr Claire Guest is the founder of Medical detection dogs, where they train dogs to help manage human sufferers of certain diseases. For example, people who have diabetes can be signalled by their dog when they are about to have a hypoglycemic attack. This is life-saving training as there are more than 300,000 people living in the UK with type 1 diabetes and it costs the NHS £1,700 per hypoglycemic episode. Dogs have 125- 300 million nose receptors and are therefore far more superior in smelling biochemicals produced in humans.
The other side of the charity is spent training dogs to detect cancer. The idea of dogs sniffing cancer first came about in 2004 when a paper was published in the BMJ about investigating bladder cancer via dogs smelling samples. In 20 minute intervals, the dogs are individually led round a carousel containing samples (in breast cancer this would be a breath sample on a fibre filter). The dogs are led round the carousel and taught to stop and sit when they detect a cancerous sample. It costs £10,000 to train a dog for 4 weeks and each dog is only trained to detect one type of cancer so there is no confusion for the dog. All samples used are before the patient has undergone any treatment for the cancer so that there is less chance of the dogs sensing the chemicals from chemotherapy.
The potential is that samples could be sent for the dogs to test and aid consultant’s in deciding whether to go ahead with an invasive procedure (e.g. biopsy), providing a second line screening. Cancer detection dogs can also be used to help scientists research into E-noses and enhance early detection via cheap tests. So far there have been promising results with a recent study in Italy showing sensitivity 98-100% and specificity 98-99% in recognising specific volatile compounds in prostate cancer samples. The number of false positives was significantly lower than traditional PSA tests which have a 75% rate.
4. Motivated by his grandfather’s struggle with Alzheimer’s and his family’s subsequent worrying about his frequent wanderings Kenneth Shinozuka has gone on to develop a wearable sensor on the foot to alert carers via an app when the patient steps onto the ground and is about to wander. There are currently 5.2 million sufferers of Alzheimer’s disease in the US with 65% of them wandering with a $220 billion cost in paying caregivers.
Kenneth first identified three main obstacles to overcome in order to make his vision into a reality; design a sensor, create a circuit and develop a phone app. He decided to use a film sensor with electrically conductive, pressure sensitive ink particles. The circuit uses Bluetooth low energy technology which can be driven by a coin-sized battery so it is not bulky. The device works because when pressure is applied the connectivity in the particles increases and electrical resistance can be measured.
Two prototypes have been made; one being integrated into a sock and another which is re-attachable. The device has since had an 10% success rate in detecting all his grandfather’s 437 cases of wandering. Kenneth is now working on developing the sensor to be able to track the patient using geo tagging and also commercialising the product.
I hope these snippets of some of the talks I heard have given you some inspiration to develop your own medical technologies so we can keep on advancing in healthcare. My next blog post is going to be a special feature on another speaker from the RSM summit, Dr Jonathan Landy who is the co-founder of Figure1 and it will feature a Q&A so look out for that.