Expert comments

Comments on this technology were invited from clinical experts working in the field and relevant patient organisations. The comments received are individual opinions and do not represent NICE's view.

One out of 3 experts was familiar with and had used this technology before.

Level of innovation

Two experts thought that RespiraSense is an innovative technology and 1 expert said that it was a minor variation on an existing procedure. One expert said that continuous pulse oximetry and heart rate monitoring deliver the same information as RespiraSense clinically and are widely available.

Potential patient impact

Two experts noted that respiratory rate is often poorly recorded and is an important indicator of deterioration. One expert said that RespiraSense may recognise respiratory deterioration earlier, which could lead to earlier intervention, improved outcomes, avoidance of admission to critical care, and reduced length of hospital stay. One expert stated that the benefit from additional respiratory rate monitoring is marginal. Two experts felt that any acutely ill person could benefit from continuous respiratory rate monitoring with RespiraSense, particularly for those whom respiratory rate has been shown to be a prognostic factor, such as people with pneumonia or sepsis. Experts noted that RespiraSense may also be beneficial in a virtual ward setting, or could be used for infection control purposes, allowing nurses to record respiratory rate remotely with minimal contact with patients.

Potential system impact

Experts agreed that RespiraSense would be used in addition to standard care. Two experts felt that it would not replace the need for other regular clinical observations, and 1 felt it could make monitoring people in acute care more burdensome. All experts agreed that RespiraSense would initially cost more than standard care, and 2 felt that it would cost significantly more than standard care in the long term. One expert noted that there is no evidence to suggest RespiraSense would lead to reduced costs by reducing length of stay or critical care admission. One expert felt that, despite the initial cost, improved outcomes could lead to cost savings quickly in the correct setting. Two experts noted that good Bluetooth and Wi-Fi connections, as well as significant support from IT departments would be needed, which could be challenging in older hospitals. Experts agreed that training on device use and maintenance would be needed.

General comments

Two experts stated that no clinical harms have been identified but noted that the current evidence base is limited. One expert said that small potential risks include a reaction to the device sticky pad, patient disturbance because of device alerts, and potential loss of data and failure to identify early deterioration if the lobe runs out of battery. However, it was noted that these risks were not seen during their experience using RespiraSense.

Experts agreed that further research is needed to establish the validity of the device and confirm its superiority against other methods of respiratory rate measurement, as well as the effect on clinical and financial outcomes. Beneficial outcomes for future research may include detection of deterioration, time of intervention, length of stay, unplanned admission to critical care, mortality rate and patient acceptability.