Steve Xu MD, MSc, FAAD is Medical Director of the Querrey Simpson Institute for Bioelectronics and Assistant Professor in the Department of Dermatology at Northwestern’s Feinberg School of Medicine. We had an opportunity to speak with Dr. Xu about the current status and future development of flexible electronics and wearable sensors in the field of dermatology.
Could you tell me a little about your background and how you became interested in medical device innovation?
In terms of background, I trained as a biomedical engineer at Rice University and when I was there, I was involved as an early engineer in a technology to monitor heart failure patients at home. It was my first taste of device development - and I was hooked. I felt that being a physician was essential because understanding the problems patients faced was so essential to technology development, so I elected to pursue medicine as well after Rice at Harvard Medical School.
What role do wearable sensors currently have in the care of dermatologic disease?
The revolution in digital health over the last 10 years has truly been astonishing. It started with fitness wearables but has exploded to nearly every specialty. COVID-19 has certainly accelerated this. For dermatology, we’re a field where there is so much scope. From sensors for wound care to sensors tracking UV exposure and scratch sensors for itch, there is so much intersection between dermatology and digital health.
As you mentioned, wearable device technology has progressed tremendously over the past 10 years. What important problems within the field do you see wearables innovation helping solve, and what promising technologies are being developed for those?
Skin problems of course! At the end of the day, skin intolerance and irritation is one of the biggest drivers of wearable abandonment, particularly medical wearables like continuous glucose monitors. I think the other gap is around what we’re measuring – they have to be useful and lead to clinically meaningful action. Measuring step count, sleep quality, and heart rate is really not that useful for skin conditions. We need to do more – skin barrier, flare prediction, itch quantification, skin cancer risk are examples where that kind of data from sensors will be useful and impactful for dermatologic health.
Can and how would solving some of these needs for skin health provide leadership for other areas in medicine?
Cardiology and endocrinology have shown us the way for arrhythmias and diabetes monitoring. However, they are relatively narrow measurements. The ability for us to use skin – the basis of all of this information - to glean more important insights will impact all of medicine. As experts of skin our understanding of outputs, irritation, tolerance, and biology will unlock new use cases for other specialties.
The ability to quantify symptoms or outcomes is important for the approval of new therapeutic treatments and for demonstrating their value to various stakeholders. How can wearable sensors play a unique role for clinical outcome assessments and what are the challenges in doing so?
Sensors offer the ability to augment and supplement patient reported outcomes, which are critically important. They can provide data in populations where patient reported outcomes are not as reliable such as in children, or in patients with cognitive challenges. They also provide objective, repeatable data that can be used to detect small but clinically meaningful changes that patient reported outcomes or physician scales cannot. I think one of the advantages of dermatology is that the skin is visible – we are able to see disease or not. However, skin disease is not just what you can see on the surface. There is sub-clinical inflammation. There may be no visible skin disease, but tremendous symptoms like itch or pain. This is where sensors can play a powerful role. Lastly, for insurance companies, the coverage costs of new biologics, topicals, and oral medications need to be defended by clear outcomes that patients are getting better. Sensors can help there too.
On May 5th, Dr. Steve Xu, along with his colleagues presented a webinar titled: DIGITAL DERMATOLOGY: OPPORTUNITIES AND CHALLENGES FOR NOVEL SENSORS IN CLINICAL TRIALS.
Be sure to follow Dr. Xu on Twitter at @stevexumd