An idea first dreamt of by a UK doctor (@wai2k) to measure respiratory rate using a mobile app has now been turned into a large scale observational trial using nothing more than a smartphone.
Dr Wai Keong first proposed the simple application based on the fact that basic physiological observations of heart and respiratory rate are central to identifying sick patients. Furthermore, he noted:
Respiratory rate is a parameter that is often measured inaccurately and often omitted by healthcare professionals. Reasons (and excuses) include:
Most bedside observation machines do not produce a number that people can write down unlike the Heart Rate, Blood Pressure, Oxygen Saturations
Requires the clinicians (often healthcare assistants) to count how many breaths a patient takes per minute. Over 30 patients, this observation alone can take 30 mins. (people get lazy). One minute is recommended is because unlike our pulse our respiratory rate can be quire irregular. (unless you are breathing very fast then it becomes more regular.)
You need a watch with a secondhand/ stopwatch and even then healthcare professionals often count the rate over 15 seconds and multiple by 4.
The idea was picked up by NHS Hackday. It is an organization that orchestrates weekend events that bring together doctors, nurses, developers and designers to create disruptive solutions to problems in health space.
A team consisting of multiple clinicians and developers successfully created an Android and iPhone version of 7Breaths, an app which counts respiratory rate using a mobile app. The interesting aspect of 7Breaths is that the algorithm is designed to generate an accurate respiratory rate after just counting…7….breaths.
In order to validate the data, the developers are storing data from users in a large scale observational trial as illustrated succinctly in the video below:
The app in its current incarnation will actually require the user to count the rate over a minute. This data is collated and the developers intend to analyze it to challenge the dogma of needing a minutes worth of breaths. Once the team has enough data to successfully assess the accuracy of the application, they plan to update the app to allow users to measure respiratory rate more efficiently and accurately. They hope that in time, apps like 7Breaths will be able to tie into existing ward management software systems to automate the process and reduce mistakes.
The launch of 7Breaths highlights one of the new innovative developments for medical apps which, as yet, has not been tapped into by the wider community–the ability for medical apps to be used for data collection in research. Ultimately, 7Breaths is a great demonstration of collaborative work to create a simple medical application which may make a significant impact on day to day clinical life.