Conditions related to the consumption of alcohol, such as #alcohol withdrawal, are among the most common problems encountered in emergency departments around the world, comprising up to 30 per cent of emergency room visits. But soon clinicians in all settings will be able to use an app that measures the biggest clinical indicator of withdrawal, tremors. Thanks to a team of researchers from Mount Sinai’s Schwartz/Reisman Emergency Medicine Institute and the University of Toronto, the new app will also be the world’s first objective measurement tool to guide diagnosis and treatment decisions for alcohol withdrawal patients.
Alcohol withdrawal occurs when a patient stops excessive alcohol consumption and can frequently result in seizures, or be fatal when not treated properly. Symptoms can include nausea, vomiting, and anxiety. The most common sign of withdrawal is tremor, unintentional trembling or shaking movements, especially in the hands and arms. But judging tremor severity requires considerable medical expertise, and even experienced doctors’ estimates can vary widely.
“Until now there has been no real objective way to determine the severity of withdrawal,” says Dr. Borgundvaag, emergency physician at Director of Schwartz/Reisman Emergency Medicine Institute who is also one of the creators of the new app. “Diagnosis has always been based on self-reporting from patients, and clinicians have been left to determine tremor severity based on their own experience. Uncertainty surrounding the severity of withdrawal is one factor that can complicate treatment decisions, and lead to prolonged stays in the ED.”
To help improve the care for withdrawal patients and make the diagnosis and treatment process easier for clinicians, Dr. Borgundvaag’s research team which includes physicians at St. Michael’s and Women’s College Hospitals, as well as researchers under the supervision of Professor Parham Arabi from the Department of Electrical & Computer Engineering at the University of Toronto, developed the world’s first app that measures tremor strength. The app also shows promise in making solid predictions about whether the tremors are real or fake.
“The exciting thing about our app is that the implications are global,” says Borgundvaag. “Alcohol withdrawal is commonly encountered not only in the emergency room, but also elsewhere in the hospital, and this gives clinicians a much easier way to assess patients using real data and can improve patient outcomes, with hopefully with less time spent in the ED and fewer complications.”
The app uses data from an iPod’s built-in accelerometer to measure the frequency of tremor for both hands for 20 seconds, and has the potential to be used widely by anyone on any iphone or ipod device. For example, detox management centers can use it to assess their patients before making the decision to send them to the emergency department. It can also be a tool for non-clinical people to determine whether or not someone needs to go to the hospital for treatment.
This new technology was unveiled Aug. 29, 2014 at the International Conference of the IEEE Engineering in Medicine and Biology Society in Chicago. The project was funded through #Mount Sinai Hospital and University Health Network Innovation Fund Program.