For听much of his career as an anesthesiologist and researcher,听Jake听Sunshine, 鈥�12,听has been preoccupied with a question: What if听the smart technology听all around us听鈥斕齩ur speakers, phones, watches, etc.听鈥斕齝ould save听our听lives听in听an听emergency?听听
A 鈥渙nce-in-a-generation investigator,鈥� as one colleague put it, Sunshine began exploring options nearly a decade ago through his work at the 天美影视传媒 as an associate professor in the School of Medicine. After countless interdisciplinary partnerships, hours of research, trials and tribulations, he has this year debuted smartwatch technology that can detect a wearer鈥檚 cardiac arrest and call for help. 听
The need speaks for itself: Without intervention, out-of-hospital cardiac arrest is one of the world鈥檚 leading causes of death, carrying a 90% mortality rate for the approximate 350,000 Americans who experience it every year. Getting help there to administer CPR quickly can mean the difference between life and death. 听
What if?
Sunshine鈥檚 first attempt at answering his lifesaving technology question began with research examining how smart devices could detect another emergency frequently experienced without witnesses: overdose. Together with colleagues in computer science, he identified how a person鈥檚 smart device (smartphone or smart speaker) could be used to , the mechanism of how people die from opioid overdose, through听inaudible听tones that pinpoint breathing motion.听听
With a proof of principle that everyday tech could be used for health purposes beyond fitness, Sunshine and his team began exploring other ways to answer that big 鈥渨hat if?鈥�. As it turns out, most people experiencing cardiac arrest also develop a particular respiratory problem called agonal breathing, classified by shallow, infrequent, irregular gasps that don鈥檛 deliver enough oxygen to the body. Because agonal breathing has such a distinct sound, Sunshine realized his team could use machine learning to train a smart device to identify the sound in the same way wake words like 鈥淗ey Siri鈥� or 鈥淎lexa鈥� signal devices to pay attention.听
Sunshine wants to build smart-device features that average people can use to protect themselves in an emergency.
Agonal breathing, though, isn鈥檛 a word 鈥� and it鈥檚 not a sound that can be replicated in a lab. Instead, Sunshine partnered with Thomas Rea, UW professor of medicine and medical director for King County鈥檚 Emergency Medical Services Division, to gain access to agonal breathing samples collected in 911-call audio that the team could use in testing and training. With graduate student Justin Chan and professor Shyam Gollakota from the UW computer science department, Sunshine demonstrated that a smartphone and smart speaker could 听agonal breathing audio听arising from cardiac arrest.听
Based on听this research,听Sunshine听had听all the reassurance he needed to understand that听smart听devices could play a role in saving lives听and could be听scalable. In 2018,听he co-founded听Sound Life Sciences听(SLS),听through the UW with the help of听, which has helped facilitate 1,756 licenses and 48 UW spinoffs in the last five years. SLS established its headquarters on campus in Startup Hall, one of UW CoMotion Labs鈥� incubator spaces for early-stage tech startups. CoMotion served a critical role in the company鈥檚 early success, connecting Sunshine and SLS with resources and guidance on licensing, funding and bringing an invention through the regulatory process. 听
鈥淵ou can do research and write papers all the time, but something that takes the next step toward actually getting out into the world is a really, really,听really听long journey, and there are only a few examples of technological innovations that actually do that,鈥� Sunshine says. 鈥淏ut this is a great example of the University being a multidisciplinary environment 鈥� people bringing different areas of expertise together to solve a problem. Using smart devices for detecting cardiopulmonary emergencies really got its start at the 天美影视传媒.鈥�听
SLS received an FDA clearance for their smartphone breathing monitor in 2021. The following year, the company was acquired by Google. Sunshine stayed on to lead a team pursuing that important question: 鈥淲hat if?鈥�
Sunshine says the UW鈥檚 collaborative environment helps him brainstorm and research with colleagues across campus.
Finally, bringing an idea to market听
Last March, the Google Pixel Watch 3 launched the first publicly available version of a feature that builds on the idea that our everyday devices can be used to save someone鈥檚 life. The technology smartwatches already use to measure heart rate can be applied to detect when someone loses their pulse (when the heart stops beating in a life-sustaining fashion) and call for help. 听
Sunshine explains that watches are well-suited as sensing devices for emergencies because they鈥檙e worn consistently and have connective capabilities that allow them to call for help. Smartwatches can calculate wearers鈥� heart rates using rays of green light, a color absorbed by red blood cells, to measure blood flow 鈥� a process called photoplethysmography. Using this technology, Sunshine and his team developed a complex algorithm that can detect if a loss of pulse occurs, confirm if someone is not responsive (consistent with cardiac arrest) and call for help. All of this happens in around one minute. That speed is critical: Survival rate decreases by 10% every minute without treatment like CPR.听 听
鈥淭his is a great example of the University being a multidisciplinary environment 鈥� people bringing different areas of expertise together to solve a problem.鈥�
Sunshine adjusts his Google Pixel Watch, capable of detecting when a wearer鈥榮 pulse stops.
Sunshine says the technology correctly identifies loss of pulse in about two out of every three occurrences. It鈥檚 a balancing act between sensitivity (a higher degree of accuracy) and specificity (which, if too low, could yield more false positives and overwhelm emergency services). 鈥淪tatus quo is that when people experience unwitnessed cardiac arrest, the survival rate hovers around zero,鈥� Sunshine says. 鈥淪o even if the watch catches two out of three, it could potentially be helpful and could lead to lives saved.鈥� He hopes that performance will improve with additional research.听
Sunshine鈥檚听loss-of-pulse research was published in the journal听鈥�鈥澨齩n the same day the device听was cleared by the FDA.听Currently, the technology is only available on the Pixel Watch in 17 countries, but Sunshine is hopeful that it will be more widely available in the future. After all, he says, the use of everyday devices for passive detection of everyday emergencies is baked into the DNA of his original company 鈥� and that technology saves the most lives when it鈥檚 available to everyone.听
Story by Chelsea Lin // Photos by Mark Stone
