Respiratory Comorbidity Detection Using Digital Devices

Leg weakness and immobility caused by ALS increases the risk of developing a blood clot, especially in the leg, a condition called a deep venous thrombosis (DVT). A DVT can travel to the lungs to become a pulmonary embolism, causing shortness of breath and even sudden death. In addition, ALS causes swallowing and breathing muscles to weaken, increasing the risk of developing pneumonia, which is a leading cause of death in people living with ALS. To better treat these disease complications, we need to be able to detect them sooner, even as they are developing, so treatment can be started earlier. We plan to use digital technology to identify these ALS complications, track disease progression, and study whether a common blood test used in the screening and management of blood clots (D-dimer) has a role in screening/management of people living with ALS. (People living with ALS may have abnormal D-dimers when they don't have a blood clot.) A finger/ring wearable device will continuously record vital signs (e.g., heart rate, breathing rate, blood oxygen, temperature). We will also use a smartphone app to passively collect phone sensor data to better interpret the data collected by the ring and to administer periodic surveys. These surveys will help monitor disease progression using the ALS Functional Rating Scale and enable participants to report events to study staff. We will screen for clots and infections periodically to detect asymptomatic or developing events. By comparing the data collected during healthy periods versus during a clinical event (e.g., pneumonia, blood clot), we will identify what variables or combinations could be used to detect and predict a developing/active event, allowing for earlier treatment and promoting better outcomes.