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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 

Abstract A type of haptic device is described that delivers two modes of stimulation simultaneously and at the same location on the skin. The two modes of stimulation are mechanical (delivered pneumatically by inflatable air pockets embedded within a silicone elastomer) and electrical (delivered by a conductive polymer). The key enabling aspect of this work is the use of a highly plasticized conductive polymer based on poly(3,4‐ethylenedioxythiphene) (PEDOT) blended with elastomeric polyurethane (PU). To fabricate the “electropneumotactile” device, the polymeric electrodes are overlaid directly on top of the elastomeric pneumatic actuator pockets. Co‐placement of the pneumatic actuators and the electrotactile electrodes is enabled by the stretchability of the PEDOT:tosylate/PU blend, allowing the electrotactiles to conform to underlying pneumatic pockets under deformation. The blend of PEDOT and PU has a Young's modulus of ≈150 MPa with little degradation in conductivity following repeated inflation of the air pockets. The ability to perceive simultaneous delivery of two sensations to the same location on the skin is supported by experiments using human subjects. These results show that participants can successfully detect the location of pneumatic stimulation and whether electrotactile stimulation is delivered (yes/no) at a rate significantly above chance (mean accuracy = 94%).