skip to main content
US FlagAn official website of the United States government
dot gov icon
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
https lock icon
Secure .gov websites use HTTPS
A lock ( lock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

Explore Research Products in the PAR
It may take a few hours for recently added research products to appear in PAR search results.


  • NSF Public Access
  • Search Results
  • Iterative Patient Testing of a Stimuli-Responsive Swallowing Activity Sensor to Promote Extended User Engagement During the First Year After Radiation: Multiphase Remote and In-Person Observational Cohort Study
Title: Iterative Patient Testing of a Stimuli-Responsive Swallowing Activity Sensor to Promote Extended User Engagement During the First Year After Radiation: Multiphase Remote and In-Person Observational Cohort Study
BackgroundFrequent sensor-assisted monitoring of changes in swallowing function may help improve detection of radiation-associated dysphagia before it becomes permanent. While our group has prototyped an epidermal strain/surface electromyography sensor that can detect minute changes in swallowing muscle movement, it is unknown whether patients with head and neck cancer would be willing to wear such a device at home after radiation for several months. ObjectiveWe iteratively assessed patients’ design preferences and perceived barriers to long-term use of the prototype sensor. MethodsIn study 1 (questionnaire only), survivors of pharyngeal cancer who were 3-5 years post treatment and part of a larger prospective study were asked their design preferences for a hypothetical throat sensor and rated their willingness to use the sensor at home during the first year after radiation. In studies 2 and 3 (iterative user testing), patients with and survivors of head and neck cancer attending visits at MD Anderson’s Head and Neck Cancer Center were recruited for two rounds of on-throat testing with prototype sensors while completing a series of swallowing tasks. Afterward, participants were asked about their willingness to use the sensor during the first year post radiation. In study 2, patients also rated the sensor’s ease of use and comfort, whereas in study 3, preferences were elicited regarding haptic feedback. ResultsThe majority of respondents in study 1 (116/138, 84%) were willing to wear the sensor 9 months after radiation, and participant willingness rates were similar in studies 2 (10/14, 71.4%) and 3 (12/14, 85.7%). The most prevalent reasons for participants’ unwillingness to wear the sensor were 9 months being excessive, unwanted increase in responsibility, and feeling self-conscious. Across all three studies, the sensor’s ability to detect developing dysphagia increased willingness the most compared to its appearance and ability to increase adherence to preventive speech pathology exercises. Direct haptic signaling was also rated highly, especially to indicate correct sensor placement and swallowing exercise performance. ConclusionsPatients and survivors were receptive to the idea of wearing a personalized risk sensor for an extended period during the first year after radiation, although this may have been limited to well-educated non-Hispanic participants. A significant minority of patients expressed concern with various aspects of the sensor’s burden and its appearance. Trial RegistrationClinicalTrials.gov NCT03010150; https://clinicaltrials.gov/study/NCT03010150  more » « less
Award ID(s):
2223566
PAR ID:
10547520
Author(s) / Creator(s):
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ;
Publisher / Repository:
JMIR Publications
Date Published:
Journal Name:
JMIR Cancer
Volume:
10
ISSN:
2369-1999
Page Range / eLocation ID:
e47359
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. ; ; ; ; ; ; ; ; ; ; et al (, Science Advances)
    Successful rehabilitation of oropharyngeal swallowing disorders (i.e., dysphagia) requires frequent performance of head/neck exercises that primarily rely on expensive biofeedback devices, often only available in large medical centers. This directly affects treatment compliance and outcomes, and highlights the need to develop a portable and inexpensive remote monitoring system for the telerehabilitation of dysphagia. Here, we present the development and preliminarily validation of a skin-mountable sensor patch that can fit on the curvature of the submental (under the chin) area noninvasively and provide simultaneous remote monitoring of muscle activity and laryngeal movement during swallowing tasks and maneuvers. This sensor patch incorporates an optimal design that allows for the accurate recording of submental muscle activity during swallowing and is characterized by ease of use, accessibility, reusability, and cost-effectiveness. Preliminary studies on a patient with Parkinson’s disease and dysphagia, and on a healthy control participant demonstrate the feasibility and effectiveness of this system. 
    more » « less
  2. ; ; ; (, Head & Neck)
    Abstract BackgroundNew patient referrals are often processed by practice coordinators with little‐to‐no medical background. Treatment delays due to incorrect referral processing, however, have detrimental consequences. Identifying variables that are associated with a higher likelihood of surgical oncological resection may improve patient referral processing and expedite the time to treatment. The study objective is to develop a supervised machine learning (ML) platform that identifies relevant variables associated with head and neck surgical resection. MethodsA retrospective cohort study was conducted on 64 222 patient datapoints from the SEER database. ResultsThe random forest ML model correctly classified patients who were offered head and neck surgery with an 81% accuracy rate. The sensitivity and specificity rates were 86% and 71%. The positive and negative predictive values were 85% and 73%. ConclusionsML modeling accurately predicts head and neck cancer surgery recommendations based on patient and cancer information from a large population‐based dataset. ML adjuncts for referral processing may decrease the time to treatment for patients with cancer. 
    more » « less
  3. ; ; ; ; ; ; (, Advanced Materials Technologies)
    Abstract Dysphagia or difficulty swallowing is caused by the failure of neurological pathways to properly activate swallowing muscles. Current electromyography (EMG) systems for dysphagia monitoring are bulky and rigid, limiting their potential for long‐term and unobtrusive use. To address this, a machine learning‐assisted wearable EMG system is presented, utilizing self‐adhesive, skin‐conformal, semi‐transparent, and robust ionic gel electrodes. The presented electrodes possess good conductivity, superior skin contact, and good transmittance, ensuring high‐fidelity EMG sensing without impeding daily activities. Moreover, the optimized material and structural designs ensure wearing comfort and conformable skin‐electrode contact, allowing for long‐term monitoring with high accuracy. Machine learning and mel‐frequency cepstral coefficient techniques are employed to classify swallowing events based on food types and volumes. Through an analysis of electrode placement on the chin and neck, the proposed system is able to effectively distinguish between different food types and water volumes using a small number of channels, making it suitable for continuous dysphagia monitoring. This work represents an advancement in machine learning assisted EMG systems for the classification and regression of swallowing events, paving the way for more efficient, unobtrusive, and long‐term dysphagia monitoring systems. 
    more » « less
  4. ; ; ; ; ; ; ; (, 2019 BMES Conference Proceedings - REU Abstract Accepted Poster)
    Introduction: Head and neck cancer (HNC) and its treatment can result in facial disfigurement and functional defects in speech, swallowing, and vision that persist after reconstructive surgery. Body image concerns are pervasive among HNC patients, and a large portion of these concerns stem from worries about social interaction. Our overarching goal is to develop normative interventions to inform HNC patients about how others will respond to the changes in their facial appearance. In this study, we investigated saliency map algorithms for highlighting regions of interest on a clinically disfigured face that are expected to draw an observer’s eye based on color, intensity, etc. 
    more » « less
  5. ; (, American Journal of Speech-Language Pathology)
    null (Ed.)
    High-resolution cervical auscultation (HRCA) is an evolving clinical method for noninvasive screening of dysphagia that relies on data science, machine learning, and wearable sensors to investigate the characteristics of disordered swallowing function in people with dysphagia. HRCA has shown promising results in categorizing normal and disordered swallowing (i.e., screening) independent of human input, identifying a variety of swallowing physiological events as accurately as trained human judges. The system has been developed through a collaboration of data scientists, computer–electrical engineers, and speech-language pathologists. Its potential to automate dysphagia screening and contribute to evaluation lies in its noninvasive nature (wearable electronic sensors) and its growing ability to accurately replicate human judgments of swallowing data typically formed on the basis of videofluoroscopic imaging data. Potential contributions of HRCA when videofluoroscopic swallowing study may be unavailable, undesired, or not feasible for many patients in various settings are discussed, along with the development and capabilities of HRCA. The use of technological advances and wearable devices can extend the dysphagia clinician's reach and reinforce top-of-license practice for patients with swallowing disorders. 
    more » « less
  • Citation Formats
  • MLA
  • APA
  • Chicago
  • BibTeX
  • Save / Share this Record
  • Send to Email