EMUs: Enhanced Monitoring Using Sensors After Surgery

NCT ID: NCT06565559

Last Updated: 2025-08-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

1332 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-02-28

Study Completion Date

2026-04-30

Brief Summary

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Patients can become critically unwell following surgical operations. Delay in recognition of this deterioration can result in patient harm and even death. Wearable wireless sensors that record patients vital signs such as heart rate could help improve recognition of patient deterioration. The goal of this observational study: Enhanced Monitoring Using Sensors After Surgery (EMUs) is to determine if data from wearable physiological monitors can be used for the early detection of postoperative deterioration, while being acceptable to patients and healthcare staff. The study participants and surgical inpatients undergoing open surgery. There are 3 objectives which each represent a stage of the study:

1. To perform usability testing of device with clinicians, nurses, and healthcare workers in non-clinical environment.
2. To determine baseline postoperative monitoring practice across our network and perform device usability testing in clinical environment.
3. To perform a shadow-mode cohort study with collection of time-stamped sensor clinical event data to determine relationships between physiological waveforms and patient deterioration.

This registration focuses on the shadow-mode cohort study.

Participants will wear wireless sensors on their chest and fingers, pre-, intra-, and post-operatively for up to 10 days. The sensors will record their vital signs such as heart rate, and oxygen levels. This will then be analysed, and used to aid the design of early detection algorithms that may be able to predict clinical illness or complications in this patient group. This is an observational study gathering real time data only. No changes in patient care will result, and in Stages 2 and 3 no sensor data will be available to clinical teams. This study will be performed in departments of general surgery in Benin, Ghana, Guatemala, India, Mexico, Nigeria, Rwanda, and the United Kingdom.

Detailed Description

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Patients who die after surgery frequently have treatable complications which are not identified in a timely manner. This is due to a failure to "recognize", "relay" or "react" to the deterioration of a patient in the postoperative period. This study aims to determine whether data from wearable physiological monitors can be used for the early detection of patient deterioration, while being acceptable to patients and healthcare staff. If found useful, future studies would be conducted to determine the performance and safety of such a device.

This study has three objectives which will be addressed in three stages.

STAGE 1. Usability testing of device with clinicians, nurses, and healthcare workers in non-clinical environment.

STAGE 2. Baseline postoperative monitoring practice assessment and device usability testing in clinical environment.

STAGE 3. Shadow-mode cohort study with collection of time-stamped sensor and clinical event data to determine relationships between physiological waveforms and patient deterioration.

This registration focuses on the shadow-mode cohort study.

This study will be performed in departments of general surgery in Benin, Ghana, Guatemala, India, Mexico, Nigeria, Rwanda, and the UK. In Stages 2 and 3, patients will have undergone major surgery and will be recovering in postoperative wards.

This study can be performed using any suitable wearable device (it is device agnostic), as it seeks to gather generalisable information. In the first instance, the Sibel ANNE® One device will be used. ANNE® One is a wireless ICU-grade dual sensor system that provides real-time physiological monitoring. The system features two skin-mounted, bio-integrated sensors that provide continuous storage of vital sign measurements and physiological waveforms.

This is an observational study gathering real time data only. No changes in patient care will result, and in Stages 2 and 3 no sensor data will be available to clinical teams. True equipoise exists: it is not clear whether these data are useful or how they should be used. Patients will be managed with standard care throughout.

Wearable sensors have potential application in improving postoperative monitoring and consequently, the reduction of avoidable morbidity and mortality. Sensor data may be used to generate prediction algorithms providing a continuous readout of individual patient risk. Such algorithms could enhance healthcare workers' capacity to identify and intervene upon patients with early complications. However, few high-quality studies have yet been performed in this area.

This study has approvals form the following ethical review boards:

Edinburgh Medical School Research Ethics Committee West of Scotland Research Ethics Service (on behalf of NHS Health Research Authority) Health and Care Research Wales (on behalf of NHS Health Research Authority) Ghana Health Service Ethics Review Committee Comite de Investigacion, Hospital General San Juan de Dios, Guatemala, Guatemala Christian Medical College and Hospital, Institutional Ethics Committee, Ludhiana, India El Comite de Etica en Investigacion del Hospital General de Boca del Rio, Veracruz, Mexico Lagos University Teaching Hospital Health Research Ethics Committee, Lagos Nigeria Lagos State University Teaching Hospital Health Research Ethics Committee, Ikeja, Nigeria Obafemi Awolowo University Hospitals Teaching Complex, Ethics and Research Committee, Ife, Nigeria Ethics Committee of University Teaching Hospital of Kigali, Kigali, Rwanda

Conditions

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Surgery Inpatients

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Study Cohort

All surgical patients that fit the study eligibility criteria.

Wearable Wireless Sensor

Intervention Type DEVICE

Stage III is a shadow mode evaluation of the device with participants wearing sensors pre-, intra-, and post-operatively. Sensor and clinical data will be collected contemporaneously in the clinical environment. No sensor data is made available to clinical teams for decision making, with no change in patient care.

Interventions

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Wearable Wireless Sensor

Stage III is a shadow mode evaluation of the device with participants wearing sensors pre-, intra-, and post-operatively. Sensor and clinical data will be collected contemporaneously in the clinical environment. No sensor data is made available to clinical teams for decision making, with no change in patient care.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Adults 18 years and older.
* Undergoing an elective or emergency major surgery procedure with a planned skin incision of 5 cm or greater. Any indication for surgery can exist, including benign, malignant, and trauma.
* Willing and able to provide written informed consent.

Exclusion Criteria

* Those under the age of 18.
* A documented or suspected allergy to adhesive dressings.
* Obstetric patients
* Unwilling or unable to provide written informed consent.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Birmingham

OTHER

Sponsor Role collaborator

University for Development Studies, Tamale, Ghana

OTHER

Sponsor Role collaborator

Hospital San Juan de Dios Guatemala

OTHER_GOV

Sponsor Role collaborator

Christian Medical College and Hospital, Ludhiana, India

OTHER

Sponsor Role collaborator

Hospital Español de Veracruz, Veracruz, Mexico

UNKNOWN

Sponsor Role collaborator

University of Rwanda

OTHER

Sponsor Role collaborator

University of Lagos, Nigeria

OTHER

Sponsor Role collaborator

School of health sciences, University of Abomey Calavi, Benin

UNKNOWN

Sponsor Role collaborator

University of Edinburgh

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ewen Harrison

Role: PRINCIPAL_INVESTIGATOR

University of Edinburgh

Locations

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Hopital de Zone Atlantique Ouidah

Ouidah, Atlantique Department, Benin

Site Status RECRUITING

Centre Hospitalier Universitaire Departemental Borgou-Alibori

Parakou, Borgou Department, Benin

Site Status RECRUITING

Centre Hospitalier Universitaire Mere Enfant Lagune

Cotonou, Littoral Department, Benin

Site Status RECRUITING

Centre Hospitalier Universitaire et Departemental Oueme Plateau

Porto-Novo, Oeume, Benin

Site Status RECRUITING

Berekum Holy Family Hospital

Berekum, Berekum East, Ghana

Site Status RECRUITING

Techiman Holy Family Hospital

Techiman, Bono East, Ghana

Site Status RECRUITING

Tamale Teaching Hospital

Tamale, , Ghana

Site Status RECRUITING

Hospital General San Juan de Dios

Guatemala City, , Guatemala

Site Status RECRUITING

Lady Willingdon Hospital

Manali, Himachal Pradesh, India

Site Status RECRUITING

Padhar Hospital

Pādhar, Madhya Pradesh, India

Site Status RECRUITING

Christian Medical College and Hospital

Ludhiana, Punjab, India

Site Status RECRUITING

Hospital Español de Veracruz

Veracruz, , Mexico

Site Status RECRUITING

Obafemi Awolowo University Teaching Hospital Complex

Ife, , Nigeria

Site Status NOT_YET_RECRUITING

Lagos State University Teaching Hospital

Ikeja, , Nigeria

Site Status NOT_YET_RECRUITING

Lagos University Teaching Hospital

Lagos, , Nigeria

Site Status RECRUITING

University Teaching Hospital of Rwanda

Kigali, , Rwanda

Site Status NOT_YET_RECRUITING

Royal Infirmary of Edinburgh

Edinburgh, , United Kingdom

Site Status ACTIVE_NOT_RECRUITING

Countries

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Benin Ghana Guatemala India Mexico Nigeria Rwanda United Kingdom

Central Contacts

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Ewen Harrison

Role: CONTACT

+44 (0)131 651 7869

Eilidh Gunn

Role: CONTACT

+44 (0)131 651 7869

Facility Contacts

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Ismail Lawani

Role: primary

Ismail Lawani

Role: primary

Ismail Lawani

Role: primary

Ismail Lawani

Role: primary

Stephen Tabiri

Role: primary

Stephen Tabiri

Role: primary

Stephen Tabiri

Role: primary

Maria Lorena Aguilera Arévalo

Role: primary

Dhruv Ghosh

Role: primary

Dhruv Ghosh

Role: primary

Dhruv Ghosh

Role: primary

Antonio Ramos de la Medina

Role: primary

Adesoji Ademuyiwa

Role: primary

Adesoji Ademuyiwa

Role: primary

Adesoji Ademuyiwa

Role: primary

Faustin Ntirenganya

Role: primary

References

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Burke JR, Downey C, Almoudaris AM. Failure to Rescue Deteriorating Patients: A Systematic Review of Root Causes and Improvement Strategies. J Patient Saf. 2022 Jan 1;18(1):e140-e155. doi: 10.1097/PTS.0000000000000720.

Reference Type BACKGROUND
PMID: 32453105 (View on PubMed)

Ghaferi AA, Birkmeyer JD, Dimick JB. Variation in hospital mortality associated with inpatient surgery. N Engl J Med. 2009 Oct 1;361(14):1368-75. doi: 10.1056/NEJMsa0903048.

Reference Type BACKGROUND
PMID: 19797283 (View on PubMed)

Jiwa A, Cameron MM, Ademuyiwa AO, Adisa A, Aguilera Arevalo ML, Bahrami Hessari M, Bhangu A, Brennan PM, Clark N, Cresswell K, Czerwinska I, D'Adderio L, Gunn E, Haque PD, Ikegwuonu T, Lawani I, Morton D, Nganwa A, Ntirenganya F, Pius R, Ramos de la Medina A, Samuel S, Shaw CA, Tabiri S, Townsend RC, Varghese C, Ghosh D, Harrison EM; NIHR Global Health Research Unit on Global Surgery. Continuous physiological monitoring for the detection of postoperative deterioration: a protocol for a multistage, multicentre, international, prospective cohort study. BMJ Open. 2025 Oct 6;15(10):e104463. doi: 10.1136/bmjopen-2025-104463.

Reference Type DERIVED
PMID: 41057181 (View on PubMed)

Other Identifiers

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13344828

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

EMUs

Identifier Type: -

Identifier Source: org_study_id

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