epicare@home validation study for focal onset seizures

Conditions: Epilepsy; Seizures; Seizures, Focal; Seizure, Refractory

Summary: the goal of this clinical trial is to validate a wearable seizure monitoring device, epicare@home, as an objective seizure monitoring tool for people with focal onset epileptic seizures. the device continuously records brain, cardiorespiratory, and physical activity data. the study aims to 1) collect benchmark data for seizure detection algorithm development and validation, and 2) evaluate the performance of the device in clinical and at home workflows. participants will wear the device during a routine epilepsy monitoring unit (emu) admission. additionally, they can continue wearing the device at home after the emu admission.

epilepsy, a neurological disorder characterized by recurrent epileptic seizures of often complex etiology, affects 65 million people globally. the current reference for home use is self-reported outcomes (typically via a seizure diary) which leads to significant under and inaccurate reporting of seizures. as seizure counting is the basis for many medical decisions, the ability to accurately and unobtrusively log seizures during activities of daily living would: 1) improve clinical practice by reducing the need for patients to spend time in an epilepsy monitoring unit (emu) and more quickly identify an appropriate treatment plan; and 2) provide a means to collect real-world data (rwd) for research and clinical purposes. epicare@home is a multimodal device that can continuously record eeg with unobtrusive behind-the-ear electrodes, in addition to cardiorespiratory and physical motion data. the device is intended to be used by a trained healthcare professional (hcp) as a clinical decision support tool during the management of people with epilepsy. the clinical trial aims to analytically validate the performance of the seizure detection component of the device, specifically for focal onset seizures. in addition, it intends to clinically validate the ability of the device to support clinical workflows, from the perspective of healthcare professional and patient users alike.

Eligibility criteria:
inclusion criteria: * adult (age ≥ 18) and adolescent (12 ≤ age \< 18) patients with a known history or suspicion of focal onset epilepsy, including focal-to-bilateral tonic-clonic seizures * a clinical indication for ≥ 1 h emu observation. * participants should be able to maintain a seizure diary in the provided epicare@home patient app (themselves or via a caregiver). alternatively, the use of a paper seizure diary is allowed. exclusion criteria: * inability to provide written informed consent, either direct or via a proxy. * known allergy or skin-sensitivity to the materials used in the byteflies adhesives or any 3rd party biopotential electrode. * having an implanted device may be grounds for exclusion, depending on the type and location of the implant. implanted devices, such as (but not limited to) pacemakers, cardioverter defibrillators (icd), and/or neural stimulation devices may contain magnetic switches. byteflies sensor dots contain magnets that may interfere with the operation of these devices. the chance of this happening based on the strength of the magnets is exceedingly low (for comparison, the magnet strength is 10x lower than what is found in apple magsafe cases) but it has not been excluded by formal testing either. the risk will be evaluated on a case-by-case basis. * any other condition or finding that would compromise the safety of the participant or the quality of the study data, or otherwise interfere with achieving the study objectives, as determined by the investigator or research coordinator.

Keywords: wearable device seizure monitoring diagnostic support epicare@home clinical decision support (cds)