Dr. Frances Chung, a clinician investigator at UHN's Krembil Brain Institute, is the winner of the 20^th annual UHN Inventor of the Year Award for her work re-imagining the standards of care for patients living with sleep apnea through the development of the STOP-Bang clinical questionnaire.

A screening tool originally created to identify patients with undiagnosed sleep apnea for the prevention of critical incidents during surgery, STOP-Bang has broadened its adoption as a global standard diagnostic tool within 40 geographic regions and 500 institutions across a wide range of industries, informing preventative care and treatment for sleep apnea.

"It was curiosity and perseverance that led to the development of the STOP-Bang tool, and today, it is saving and improving lives around the globe," says Dr. Chung.

Sponsored by Commercialization at UHN, the Inventor of the Year Award recognizes an individual or team whose invention has made a substantial and noteworthy commercialization contribution leading to A Healthier World.

"The rapid scaling of Dr. Chung's revolutionary yet simple STOP-Bang clinical tool is changing the vast landscape of sleep apnea diagnosis and treatment, ultimately contributing to A Healthier World," says Dr. Brad Wouters, Executive Vice President of Science and Research at UHN.

"Other sleep scales exist out there, but none are simple enough for patients to do at home with such a high degree of accuracy."

Sleep apnea is the most prevalent sleep-breathing disturbance, associated with other health conditions such as coronary artery disease, hypertension, diabetes mellitus, renal disease, congestive heart failure and even cognitive impairment.

Even though globally 936 million people are thought to have the condition, an overwhelming 80 per cent to 90 per cent of cases are estimated to remain undiagnosed, according to CPAP.com.

"UHN is proud to have commercialized th​is highly effective clinical tool with rapid access for partners and patients around the world," says Laura Farran, Principal, Licensing and Commercialization, Biomaterials and Clinical Tools, UHN.

"Key to STOP-Bang's widespread adoption has been the deployment of a simple, standardized contract and a pricing model that facilitates broad adoption," she says. “The tool is available either free-of-charge for non-profit use, a low annual fee for corporate health partners, and a pay-per-administration fee for valued industry partners, such as administration during clinical trials."

(L to R), Mark Taylor, Director, Commercialization at UHN; Dr. Frances Chung; Laura Farran, Principal, Licensing and Commercialization, Biomaterials and Clinical Tools; and Ernest (Ernie) Ho, Principal, Business Development and Commercialization, UHN's Krembil and McEwen Research Institutes. (Photo: UHN StRIDe Team)

About the Inventor

Well-regarded in the field of anesthesiology, Dr. Chung is the ResMed Chair in Anesthesia, Sleep and Perioperative Medicine Research at UHN. She is the co-Founder and Past President of the Society of Anesthesia and Sleep Medicine at UHN, a professor of the Department of Anesthesiology and Pain Medicine at the University of Toronto, and is ranked as one of the top 30 female scientists in Canada and best 1000 female scientists in the world, according to Research.com.

Dr. Chung developed the STOP-Bang tool after hypothesizing that post-operative critical incidents and deaths might be related to sleep apnea due to its obstruction of the upper airway. After conducting polysomnography (sleep studies) on hundreds of patients, she determined that a high proportion of patients had undiagnosed sleep apnea – with morbidly obese Caucasian patients (especially males) and East Asian populations with retrognathia (receding jaw) at increased risk.

Dr. Chung created the STOP-bang questionnaire as a simple yet effective way to screen for sleep apnea.

About STOP-Bang: simple yet life-saving

With the support of the Department of Anesthesiology and Pain Medicine at UHN, Dr. Chung developed and validated STOP-Bang over a period of two years, and worked to advance its applications within surgical settings. STOP-bang is now widely embraced by numerous institutions globally – with contracts in place with various hospitals, dental clinics, transportation services including the railway industry, and even NASA – a total of nearly 600 licences bringing in nearly $3 million in licensing revenues reinvested into further research at UHN.

A simple online tool, STOP-Bang – an acronym for snoring, tiredness and other commonplace symptoms of sleep apnea – has a diagnostic accuracy of over 80 per cent as validated by laboratory polysomnography (sleep studies). The tool has over 2,600 citations and has been well validated in the general population across multiple ethnicities.

Celebrating invention – in every form

"The success of STOP-Bang proves that even a clinical tool such as a questionnaire can be an important invention when you consider both the incredible patient impact and widespread commercialization potential," says Laura Farran.

Remarkably, even Dr. Chung was initially unaware that her important clinical tool was an invention ripe for commercialization. Today, reflecting on the success of STOP-Bang and her UHN Inventor of the Year achievement, Dr. Chung offers a key piece of advice about perseverance.

"I call it the Black Swan phenomenon," explains Chung. "Every problem has a solution.

"If you see something out of the ordinary, keep on probing and don't give up."

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Source: UHN News

Drs. Heather Ross and Joseph Cafazzo are the winners of UHN's 19^th annual Inventor of the Year Award.

The researchers are being recognized for their discovery leading to the commercialization of the Medly platform, a fit-in-your pocket companion for heart care powered by software and artificial intelligence developed at UHN.

Medly is also the basis of UHN new venture Medly Therapeutics, poised to bring heart care benefits to patients around the world.

Dr. Heather Ross is the Division Head of Cardiology at the Peter Munk Cardiac Centre (PMCC), the Scientific Lead for the Ted Rogers Centre for Heart Research at PMCC, the Loretta A. Rogers Chair in Heart Function and the Pfizer Chair in Cardiovascular Research. Dr. Joseph Cafazzo is the Executive Director, Biomedical Engineering, the Centre for Digital Therapeutics, and Healthcare Human Factors (HHF) at UHN, and is the Wolfond Chair in Digital Health.

"Their pioneering digital health innovations are changing the face of heart health for patients nationwide," says Dr. Brad Wouters, Executive Vice President of Science and Research at UHN. "Commercialization of the Medly platform is an example of translating world-class research into precision medicine – for the benefit of cardiac patients, as well as for individuals living other chronic diseases."

Sponsored by Commercialization at UHN, the Inventor of the Year Award recognizes an individual or team whose invention has made a substantial and noteworthy commercialization contribution leading to A Healthier World.

Drs. Ross and Cafazzo worked closely with Commercialization at UHN to pivot the Medly technology into a foundational platform for UHN spinoff Medly Therapeutics. The process included the selection of a seasoned entrepreneur-in-residence (EIR) to lead company formation efforts. Commercialization at UHN continues to steward ongoing augmentations to Medly's core technology.

The journey leading to the development and commercialization of Medly would not have been possible without important contributions from members of TeamUHN and the University of Toronto, including Emily Seto, Shumit Saha, Bo Wang, Michael McDonald, Amika Shah, Kenneth R Chapman, Philip Segal, as well as UHN's Centre for Digital Therapeutics team, the Ted Rogers Centre for Heart Research, PMCC and HHF. Drs. Ross and Cafazzo are also grateful for the vast philanthropic support from donors to UHN Foundation who have enabled the development of the Medly platform.

Medly has proven clinically effective at UHN and other sites

According to Dr. Ross, nearly one million Canadians are living with heart failure (HF) and one-in-five people over the age of 40 will experience HF. Challenges in treating HF include timing patient treatment with HF episodes, a lack of real-time, actionable patient data and limited patient involvement along the journey to better health.

To counteract these challenges, Drs. Ross and Cafazzo devised Medly to be an innovative digital self-management solution with 24/7 monitoring technology, making it accessible and easy to use for patients wherever they might be.

The Medly technology has proven to be effective clinically at UHN and other sites, supporting more than 800 patients with chronic heart failure (CHF) at the PMCC. It has also led to a 50 per cent reduction in HF-related hospitalizations and a 24 per cent reduction in other hospitalizations, with patients reporting greater self-management support, confidence and peace of mind, and a better relationship with their care team.

"In delivering health care today, we are often still overly focused on treating patients once they become acutely ill and end up in hospital," says Dr. Ross. "Leveraging the incredible power of big data, artificial intelligence and predictive analytics, Medly provides a more proactive, scalable and affordable solution to manage the epidemic of heart failure – and research is continually ongoing to enhance it.

"Working with the team at Commercialization at UHN to scale Medly nationally and beyond will allow this technology to reach more patients than ever before."

Dr. Cafazzo says, "innovative digital therapeutic solutions like Medly give patients an incredibly advanced capacity to manage their care at home, right at their fingertips, while still staying connected to their healthcare team.

"By detecting changes in a patient's health status, Medly also allows care providers to intervene earlier, before the patient needs to be re-hospitalized for a serious complication such as heart failure, which can be an immense added comfort to patients living with complex chronic conditions," Dr. Cafazzo adds.

Commercialization at UHN is thrilled to recognize the world-class science, collaboration and commercialization of this groundbreaking digital health technology. It is exciting to see another UHN and Toronto ecosystem technology making bold strides towards improving health and reaching more patients in need.

Congratulations Drs. Ross and Cafazzo and teams!

About Medly

How it works

Based on core technology invented at UHN, Medly includes an application that can be used on hand-held devices such as smart phones, home medical devices and wearables to help individuals self-manage heart disease. Every day, patients enter key details such as their weight, blood pressure and heart rate and answer questions about their symptoms. Using a sophisticated, expert system and machine learning algorithms, Medly assesses health risks in real-time and notifies the patient's care team of any signs of deteriorating health. The app then triggers alerts to the health care team, which are presented alongside the patient's list of medications, lab results, graphs and contact information. Medly enables care providers to intervene proactively, before the patient would otherwise recognize a need to visit a clinic or hospital. The team is now working to incorporate additional features into the Medly platform, including an automated solution to optimize medication dosages based on data from patient visits.

What's next?

Medly's technology is currently being channeled into Medly Therapeutics, a new venture partnership between Commercialization at UHN and Toronto Innovation Acceleration Partners (TIAP), scaling the technology for maximum patient impact.

For more information about the Medly platform, visit: www.medly.ca

For more information, including past winners of the Inventor of the Year Award, please visit: www.uhncommercialization.ca

With generous support from many donors to UHN Foundation, including the Rogers Foundation, the Peter and Melanie Munk Charitable Foundation, and the Greg and Henry Wolfond families, clinical care through Medly continues to be available to patients at UHN and beyond. Ongoing philanthropic support and industry partnerships create a ripe setting to explore enhancements such as cutting-edge wearables, novel sensor-based technologies and artificial intelligence enabled algorithms, all with the goal of creating new systems of care for more patients.

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