Clinical Research Directory

VOCAL BIOMARKERS FOR HEALTH MONITORING: AN OPEN LONGITUDINAL HYBRID COHORT STUDY

Voice could be considered a new vital sign in the future, being collected in routine care and complement other medical assessments. Vocal biomarkers (VB) are voice characteristics that are specific to a disease or symptom. They can be utilized in clinical practice for remote disease monitoring, screening for diseases, or in clinical research as secondary endpoints to evaluate the efficacy of a treatment or intervention. They can also be used during enhanced consultations to screen for diseases or monitor the progression of a chronic disease, in services to identify at-risk patients, and at home to track patients' symptoms and general health status between consultations. Despite the potential of VB and many progresses, few have reached the stage of use in clinical routine. At LIH, the Deep Digital Phenotyping research lab gained experience in the voice-related research field since 2019, with the implementation of methodological tools to collect and pre-process voice recordings, and with the development of vocal biomarker candidates in several therapeutic domains or symptoms (Type 2 diabetes, fatigue, COVID-19 and Long COVID, respiratory health, mental health, etc.) VB is an early-stage research topic; one needs to accelerate the development, validation and integration of vocal biomarkers for personalized medicine and innovative tools - both for clinical practice and remote patient monitoring. Until now, VB candidates have been developed disease by disease, and there is a lack of data on the influence of concomitant diseases on voice signatures. Therefore, the next vital step to improve vocal biomarkers and assess their specificity is to compare them with both control groups, those without the disease, and those with other diseases. The study is a cohort of adult people attending one of the hospitals in Luxembourg, either for an hospitalization, a consultation, or a simple visit, regardless of their health conditions. Study will be conducted in French, English, German, and Portuguese which are the most frequent languages in Luxembourg. Study participants will be followed up over a 5 years period of time, with on-site study visits in study booths installed in the different hospitals in Luxembourg and at-home monitoring in-between visits, using a smartphone app to collect study data. During both study visits and at-home monitoring voice recordings will be collected together with health data. This will allow to understand how voice evolves with time in a given individual, and to identify VB specific to diseases like diabetes, or to symptoms common to several chronic diseases like fatigue or mental health problems.

Development and Psychometric Validation of the Medical Dismissal Scale

Some people living with long-term physical health conditions report feeling dismissed, disbelieved, or not taken seriously when they seek healthcare. Their symptoms may be downplayed, attributed to psychological causes without good reason, or deprioritised. These experiences are sometimes described as medical dismissal, medical gaslighting or medical invalidation. There is growing concern that these experiences are common and may affect people's willingness to seek care, their trust in healthcare professionals, and their physical and mental health over time. At present, there is no reliable questionnaire designed specifically to measure these experiences in UK healthcare. Without one, it is difficult to know how common medical dismissal is, who is most affected, or whether efforts to improve patient care are working. The aim of this study is to test a new questionnaire, the Medical Dismissal Questionnaire (MDQ). The MDQ has been developed from interviews with people who have used UK healthcare services and describes the range of ways in which patients can feel dismissed by the healthcare system. This study will examine whether the MDQ is a reliable and valid measure, and will look at how experiences of medical dismissal relate to people's health, wellbeing, and use of healthcare over six months. Approximately 1400 adults living in the UK who have used healthcare services at least five times in the past two years will be recruited. Participation is entirely online. People who are interested will be directed to a secure survey where they can read about the study, check their eligibility, and provide consent. Those who take part will be asked to complete four questionnaires over six months: At the start, participants will complete a baseline questionnaire (about 30 to 40 minutes). This asks about background information, long-term conditions, the new MDQ, and other questionnaires about trust in doctors, feeling invalidated, stigma, personality, social desirability, and health literacy. It also includes measures of mood, quality of life, pain, fatigue, and beliefs about health. One week later, participants will complete a shorter questionnaire (about 5 to 10 minutes) that repeats the MDQ and one other measure. This is to check whether MDQ scores are stable over a short period. Three months and six months after the start, participants will complete follow-up questionnaires including the MDQ and measures of mental and physical health. Findings from this study will be used to check whether the MDQ measures what it is intended to measure and whether scores relate to health outcomes over time. In the longer term, the MDQ may be used in research and in healthcare settings to better understand patient experiences and to evaluate efforts to improve patient care.