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Big data solutions for healthy sleep
H. Woehrle
Sleep and Ventilation Center Blaubeuren/
Lung Center Ulm
hwoehrle@lungenzentrum-ulm.de
Disclosures
 Lecture Fees/Consulting: Astra Zeneca,
Allergopharma, Bayer, Boehringer Ingelheim,
GSK, Inspire, ResMed, Vital Air, Weinmann
 Research grants: Weinmann, MAP/ResMed
 Employment as Medical Director (SERVE-HF
study management) by ResMed (PAP-device
manufacturer) 2006-16
Quelle: TheAtomicMoose.ca
Digitzation = Data storage and analytics
Source: duden.de; deacademic.com
eHealth
Pagliari C, et al. What Is eHealth (4): A Scoping Exercise to Map the Field; J Med Internet Res 2005;7(1):e9
mHealth
Quellen: redmondpie.com; mhealthwatch.com
Big Data
Big data is data sets that are so voluminous and
complex that traditional data processing
application software are inadequate to deal with
them.
The term “big data” refers not only to large data sets, but also to the
frameworks, techniques, and tools used to analyze it.
It can be collected through any data-generating process such as
social media, public utility infrastructure, and search engines.
Big data may be either semi-structured, structured, or unstructured.
The Five V‘s of Big Data: 4 + value
https://www.mosaiq.com; http://onlinembapage.com/data-analytics-mba/; http://www.phonecruncher.com; resmed.com
Big Data
Pros
 Insights (e.g., phenotyping,
precision medicine)
 Safety (long-term, real time;
interactions)
 Trends, trajectories
 Monitoring
Cons
 Inherent biases in how all
data are collected and
interpreted.
 Objections to the idea that
data mining can replace
hypothesis driven theory by
content experts.
 The observation that the
larger the data set the more
likely that spurious
correlations that are not
useful will be identified
Bottles et al; PEJ JULY•AUGUST/2014
Big Data growing fast
Big Data
Source: blog.ness-ses.com; http://www.enterrasolutions.com
Validity of Machine Learning
https://www.reddit.com; https://twitter.com/teenybiscuit/status/707727863571582978/photo/1
Machine Learning in Medicine
Big Data and Medicine
Quo vadis?
A new research paper, published Jan. 24 with 34 co-authors and not peer-
reviewed, claims better accuracy than existing software at predicting
outcomes like whether a patient will die in the hospital, be discharged and
readmitted, and their final diagnosis. To conduct the study, Google obtained
de-identified data of 216,221 adults, with more than 46 billion data points
between them. The data span 11 combined years at two hospitals,
University of California San Francisco Medical Center (from 2012-2016)
and University of Chicago Medicine (2009-2016).
Digital health - Sleep
Source: sleepcycle.com, apple.com, fitbit.com, sleepscore.com
Digital health - Sleep
„self-managment program“
Source: sleepio.com
Polysomnographie - Digitalisierung
Quellen: thieme-connect.de; askaboutsleep.com
Telehealth in sleep apnea management
1. Telediagnostics
2. Teleconsultation
3. Teletherapy
4. Telemonitoring
e-Health/telemonitoring during PAP-Tx
Quelle: JMIR, ResMed
CPAP-Therapy
VORTEX BLOWER and SOFT
MASK
(Sullivan) 1981 - 87
Emerging central sleep apnea during CPAP
oAHI=43/h, no central Apnea
Morgenthaler, Sleep 2006
CPAP mit p=8cm H20, cAI=28/h
Case study – CSA persistent
Case study – CSA transient
Telehealth for Sleep Apnea
Trajectories of CSA
n=133.006
“CSA Trajectories”
Liu et al., Chest 2017
55,1%
25,2%
19,7%
Transient CSA
(CAI ≥5/h week 1, <5/h week 12)
Emergent CSA
(CAI <5/h week 1, ≥5/h week 12)
Persistent CSA
(CAI ≥ 5/h week 1, ≥5/h week 12)
n = 133,006
90 days therapy data
CSA
Prevalence
3.5%
“CSA Trajectories”
HR = 1.0
HR = 1.3
HR = 1.5
HR = 1.7
79%
76%
72%
83%
CSA = CAI > 5
Therapy Termination
Liu et al., Chest 2017
AirView – ASV Big Data: Switchers
AirView – ASV Big Data: Switchers
AirView – ASV Big Data: Switchers
e-health/m-Health and “Patient Engagement”
Quelle: ResMed, Respironics
Patient engagement
Effect of Tele- Education and Telemonitoring on
CPAP Adherence:
The Tele-OSA Randomized Trial
Hwang et al. AJRCCM 2017 Aug 31
Hwang et al. AJRCCM 2017 Aug 31
Effect of Tele- Education and Telemonitoring on
CPAP Adherence:
The Tele-OSA Randomized Trial
Reactive
Service
Pro-active
Service
health care
provider
health care
provider
Proactive TM guided patient care
Source: ResMed
Proaktive TM gestützte Patientenversorgung
The future of respiratory medicine is digital!
Big data solutions for healthy sleep
H. Woehrle
Sleep and Ventilation Center Blaubeuren/
Lung Center Ulm
hwoehrle@lungenzentrum-ulm.de
Digital Spirometry
Three Major Lung-Function Pathways That Lead to
Stage 2 Chronic Obstructive Pulmonary Disease
Martinez FD. N Engl J Med 2016;375:871-878
Smarthaler/E-haler
http://www.incadevice.com;/https://de.pinterest.com/pin/178947785173369028/
Compliance der inhalativen Tx bei COPD
Sulaiman, AJRCCM 2016
Tueo Health
The future of respiratory medicine is digital
-
we need so start developing it!

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