Project Overview

Feasibility RCT of a digital tool for management of bulbar disease in ALS

Losing the ability to speak and swallow/eat are among the most devastating consequences of amyotrophic lateral sclerosis (ALS). Speech language pathology (SLP) clinicians are key specialists who support patients with bulbar ALS, providing means of tracking/monitoring the development of bulbar signs and symptoms and offering timely management recommendations. However, patients and caregivers face challenges accessing and receiving SLP services and/or feel unsatisfied with the quality of services provided. Various factors have been identified, including high caseloads, late referrals to SLP services, and a lack of efficient assessment and management tools.

To address these barriers to quality patient care, VirtualSLP was developed. It is an innovative artificial intelligence (AI) powered, remote, multimodal clinical management platform designed to streamline SLP clinical assessment and decision-making practices around bulbar symptom management using previously validated AI models. This platform will enable SLP clinicians to receive objective assessments in a timely manner and collaboratively develop an individualized management plan with patients and caregivers.

To date, all key modules of the VirtualSLP have been developed and individually tested. In the proposed research, our first aim is to examine the feasibility of incorporating the entire VirtualSLP platform within multidisciplinary ALS clinics through a randomized feasibility trial. We hypothesized that VirtualSLP will be well-received by both SLP clinicians and patients due to its accurate outputs (i.e., assessments and recommendations), streamlined workflow, and ease of use.

Our second aim is to establish the feasibility of conducting a randomized control trial to determine the effectiveness of VirtualSLP. This involves measuring trial recruitment rates, protocol adherence, and the accuracy of automated outcome measures (e.g., speaking rate, severity assessments). We expect strong recruitment and adherence rates. Additionally, we hypothesize that the automatic outcome measures will show a high correlation with clinical assessments made by SLPs.

Lastly, our third aim is to examine factors that influence the implementation of VirtualSLP. This includes investigating organizational, cultural, and individual-level facilitators and barriers perceived by SLP clinicians, patients, and caregivers. Characterizing these facilitators and barriers will help with the iterative updating of VirtualSLP, enhancing its features to better serve patients with bulbar ALS. The completion of the proposed research is crucial for paving the way for the full integration of VirtualSLP into daily SLP practice, thereby alleviating the barriers experienced by patients with bulbar ALS related to SLP services.

Principal Investigator

Jennifer Soriano , University of Toronto

Partners and Donors

ALS Society of Canada