Boost to develop pioneering dizziness diagnostic device

Artist impression of the CAVA device

A pioneering project has received a £850,000 boost to develop a diagnostic device to help patients experiencing dizziness.

The Norfolk and Norwich University Hospital (NNUH) has joined forces with the University of East Anglia (UEA) to develop a wearable piece of technology that hopes to speed up the diagnosis of the most common causes of this condition.

Early prototypes of the Continuous Ambulatory Vestibular Assessment (CAVA) device have been in development since 2012. The research project has now received a grant from the Medical Research Council for the next three years to complete its design and to begin clinical trials to establish its effectiveness.

Dizziness is one of the most common reasons for a doctor to visit a patient over the age of 75 years old. However, due to the momentary characteristics of this symptom, patients are often well when they are assessed by a doctor.  This device is unique as it will allow patients to be evaluated during a real dizziness attack in the community.

The CAVA device, which uses five electrodes attached to a person’s head, has been designed to be lightweight, durable and can be worn day and night to monitor head and eye movements.

The School of Computing Sciences at the UEA is developing algorithms to identify seconds of eye flicker (nystagmus) from weeks of data recorded by the device.

Principal Investigator John Phillips, who is a Consultant Ear, Nose and Throat Surgeon at NNUH, said that they would be starting clinical studies later this year and would be seeking volunteers to test the device for a 30 day period.

Once fully developed and tested through NNUH sponsored trials, it is hoped that one day the device will be made available at the point of initial referral to a doctor or nurse to avoid delay in diagnosis and to ensure cost-effective use of precious NHS resources.

He said: “Dizziness can be caused by a problem with the inner ear, but dizziness can also be caused be a whole host of conditions, including heart and circulatory conditions, neurological conditions, metabolic conditions (such as diabetes) and even anxiety.

As such it can often be very hard to identify the exact cause of sporadic attacks of dizziness in many patients.  Currently, our CAVA device is entirely unique, and provides us with a special opportunity to gain insight into the workings of the ears and brain.  As a home-grown device trial, this is the first trial of this kind that NNUH has ever sponsored.”

The CAVA team have worked with Wright Design Limited in Cambridge to make the bespoke CAVA device.  Co-principal Investigator Professor Stephen Cox and Research Associate Dr Jacob Newman at the UEA are developing specialist computer software to analyse the data produced by the CAVA device using techniques involving deep neural networks, which is a specialised form of artificial intelligence (AI).

Prof Cox said: “We have to devise algorithms that can identify a few seconds of nystagmus buried within weeks of ‘noise’. This is very challenging and requires development of state-of-the-art AI techniques”.

For more information about this research project, visit: https://www.uea.ac.uk/cava-project/home

The CAVA team of Jacob Newman, John Phillips and Stephen Cox