Tag Archive for: Julia Finkel

Behind the Nociometer: Q&A with Julia Finkel, MD

Julia Finkel

Julia Finkel, MD, is a pediatric anesthesiologist and the director of Pain Medicine Research at the Sheikh Zayed Institute for Pediatric Surgical Innovation.

What if doctors could measure pain as precisely as they measure blood pressure? That’s the vision driving Julia Finkel, MD, a pediatric anesthesiologist and director of Pain Medicine Research at the Sheikh Zayed Institute for Pediatric Surgical Innovation. Recently featured in The Washington Post, Dr. Finkel is pioneering the Nociometer, a new device that could transform how we understand and treat pain.

This new innovation uses a painless electrical current on a finger or toe to gently stimulate the body’s three main sensory nerve fibers. It then measures pupil response — linked to the brain’s pain centers — to identify the type and intensity of pain.

Now heading into clinical trials, the Nociometer shows how federal funding fuels innovation for patients. Here, Dr. Finkel shares the inspiration behind her work and the vital role of federal support in pediatric research.

Q: What started you on the path to developing this device?

A: My father is a theoretical physicist. He often talked in lay terms about everything he was thinking. When I was a child, we’d go for walks at night and look at the stars, and he’d explain the universe. My mother was an artist, but she struggled with constant pain from rheumatoid arthritis. There weren’t very good therapeutics at the time. Pain impacted her quality of life.

As an undergraduate, I was a chemistry major and interested in the mechanisms of how things worked. I planned to be a rheumatologist, but switching to anesthesia was transformative.

Q: What did you love about anesthesiology?

A: I love how it profoundly impacts patients. You induce unconsciousness, you induce wakefulness and you eliminate pain. When pain stops for a child, it also lessens the suffering of the parents. Our research is all about gaining a deeper understanding of the mechanisms of pain.

The Nociometer helps identify the mechanism behind the pain symptom so we can treat it appropriately. Research shows us that pain has a recognizable signature in the body. Because we can recognize it, we can treat it better. It’s like having an X-ray to look at before treating a broken leg.

Q: What is it like to work with children experiencing chronic pain? Why is measuring pain this way more effective than the typical scale?

A: Families become desperate. Often, they have seen many doctors before coming to a specialist. But pain is a single word for many different disease states. Not everyone has the right expertise. We often see children with chronic abdominal pain. Perhaps they struggle in school or can’t go at all. They don’t eat well, they have trouble engaging in regular activities. The Nociometer helps us determine the cause of the pain to better treat the problem. The device also gives us a way to validate pain while the pain scale tells us perception. The Nociometer provides objective data, very similar to a blood pressure reading.

Q: How has federal funding, and support from Children’s National, shaped your work?

A: Federal funding has been absolutely critical. Initially, we had grants from multiple agencies within the National Institutes of Health (NIH). This shows how ubiquitous and problematic pain is across the board. It’s the underpinning of many disease states and an upstream driver of the opioid epidemic.

We have grants from the Small Business Innovation Research program within the National Cancer Institute. We have funding from the National Institute of Arthritis and Musculoskeletal and Skin Diseases and an award from the Advanced Research Projects Agency for Health. This federal funding comes with scientific rigor and the ecosystem at Children’s National has allowed me to accomplish so much.

Q: What makes Children’s National the right place for this kind of innovation?

A: Children’s National has given me the space to think creatively and pursue unconventional ideas. In 2011, I became a founding member of the Sheikh Zayed Institute for Pediatric Surgical Innovation. With early institutional support, I was able to explore questions that led to the discovery of a physiological biomarker for pain — the basis of the Nociometer.

“Creative” isn’t a word you often hear in medicine, but here, it’s part of the process. I was able to spin out a company, secure funding and build a prototype — steps that wouldn’t have been possible elsewhere. The culture at Children’s National embraces discovery and fuels real impact.

Julia Finkel, MD, is a pediatric anesthesiologist and Director of Pain Medicine Research and Development, The Sheikh Zayed Institute for Pediatric Surgical Innovation and Professor of Anesthesiology, Pediatrics and Critical Care Medicine at The George Washington University.

In the news: Researchers in the quest for accurate pain measurement

Two interacting nerve cells connected with synapse with blue background

New technology could revolutionize pain management by offering more accurate diagnoses and treatment.

Measuring pain remains one of the most challenging and imprecise tasks in medicine. However, new groundbreaking research led by Julia Finkel, MD, anesthesiologist, is underway to change that.

Dr. Finkel and scientists are pioneering the development of new tools like the Nociometer to measure pain objectively by analyzing nerve responses. This technology could revolutionize pain management by offering more accurate diagnoses and treatment, especially for those who struggle to express their pain, such as children or those with chronic conditions.

“In order to be most effective, I need to know why; what are the underpinnings of why you feel this way. Different components impact one’s perception of pain. Depression can exacerbate it. Happiness can mitigate it.”

Read more about the Nociometer on The Washington Post.

ARPA-H awards $8m to advance device for precision pain measurement

Pain assessment in medicine often relies on imprecise visual rating scales featuring smiling or crying faces, frustrating patients and physicians alike. Children’s National Hospital researchers aim to change this with a new device designed to precisely measure pain, backed by an $8-million award from the Advanced Research Projects Agency for Health (ARPA-H) Sprint for Women’s Health.

The sprint addresses critical unmet challenges in women’s health, champions transformative innovations and tackles health conditions that uniquely or disproportionately affect women. Children’s National researchers – with their collaborators from Johns Hopkins University and Medstar Research Institute – are furthering the development of the AlgometRx Nociometer, a pain measurement device to better understand and treat pain.

Julia Finkel, M.D., pediatric anesthesiologist and director of Pain Medicine Research at the Sheikh Zayed Institute for Pediatric Surgical Innovation (SZI) at Children’s National, said she hopes to improve the understanding of gender differences in pain and better treat patients of all ages with analgesics. Children’s National will receive the $8 million over two years through the Sprint for Women’s Health’s launchpad track for later-stage health solutions.

“As physicians, we often feel helpless to understand how our patients are experiencing pain and whether treatments are working,” Dr. Finkel said. “We use the Visual Analog Scale, which fails to classify the pain’s etiology or help guide a specific intervention, often leaving us to treat by trial and error. The Nociometer will change that.”

The patient benefit

Using a nonpainful stimulus, the portable Nociometer uses noninvasive technology and algorithms to analyze pupil dilation and the body’s response to stimulation along select nerves.  In under one minute, the data collected can formulate a patient profile quantifying how the nervous system is processing painful stimuli. This new construct can be used to characterize pain type, intensity and assess the impact of pain relief medications.

Dr. Finkel spent nine years developing the Nociometer at SZI and her spin-out company, AlgometRx, which receives commercialization support from Children’s National Innovation Ventures. She said this transformative platform technology can be applied to any population – including elderly, nonverbal or pediatric patients – and will be instrumental in studying women’s pain experiences.

“Research studies have long shown that pain in women and girls is underestimated and undertreated,” Dr. Finkel said. “Creating a novel technology to quantify pain has tremendous applications in pinpointing and effectively treating pain, potentially altering treatment in nearly any medical setting.”

The big picture

ARPA-H sought solutions within six topics of interest in women’s health and received an unprecedented response of submissions. ARPA-H launched the Sprint for Women’s Health in February, with First Lady Jill Biden announcing the funding as the first major deliverable from the White House Initiative on Women’s Health Research.

The ARPA-H Sprint for Women’s Health is conducted in collaboration with the Investor Catalyst Hub of ARPANET-H, the agency’s nationwide health innovation network that connects people, innovators and institutions to accelerate better health outcomes for everyone. Children’s National is a spoke member of the Investor Catalyst Hub.

Children’s National will work with an ARPA-H program manager and the Investor Catalyst Hub over two years to develop their proposed solution, receiving milestone-based payments aligned to research activities and performance objectives.

The ARPA-H launchpad program accelerates transformative health solutions’ path to impact by providing funding and market transition support. As a launchpad performer, Dr. Finkel will also work with an entrepreneur-in-residence and participate in Launchpad Accelerator, which includes a customized curriculum, virtual events, and in-person workshops to support the transition from research to commercialization.

Two pediatric medical device companies awarded at pitch competition

Participants at the annual “Make Your Medical Device Pitch for Kids!”™ competition

Winners and finalists competed at UCLA during annual L.A. MedTech Week 2024. Left to right are: Nada Hanafi, MedTech Color Board treasurer; Vernessa Pollard, MedTech Color Board secretary; Dr. Sanna Gaspard, CEO and founder of Rubitection, (winner -$35,000 first prize); Dr. Kolaleh Eskandanian, Children’s National vice president and chief innovation officer; Kwame Ulmer, MedTech Color founder and board chair. Photo credit: MedTech Color

Alliance for Pediatric Device Innovation (APDI), a federally funded consortium led by Children’s National Hospital, and member MedTech Color announced the winners of the recent edition of the Make Your Medical Device Pitch for Kids!competition, which focused on recognizing and supporting African American and Hispanic pediatric medical device innovators. The awardees received a combined $50,000 in grant funding from APDI, made possible by the U.S. Food and Drug Administration (FDA) to support the advancement of pediatric medical technologies to the market.

The winners were selected from a field of five finalists who gave pitch presentations on their innovation’s attributes, benefits to patients and pathway to commercialization before a panel of five expert judges. The event was held on March 15 at the University of California, Los Angeles, as part of the annual MedTech Color Pitch Competition during L.A. MedTech Week 2024, powered by BioscienceLA.

The award-winning pediatric devices and companies are:

  • Rubitection, Pittsburgh, Pa.A low-cost skin assessment management tool for chronic wounds, Rubitection measures the properties of the skin. The system allows the user to monitor incremental changes in skin health to predict risk, monitor progression and customize care.
  • Kofimi Technology Inc., Danvers, Mass. This patent-pending pulse oximeter device is designed specifically for pediatric populations to provide superior accuracy for all levels of skin pigmentation. A pulse oximeter measures oxygen levels in the blood.

Why we’re excited

Funding innovators of African American and Hispanic backgrounds is crucial for advancing diversity, equity, and inclusion initiatives because it addresses systemic barriers and inequities that have historically hindered this group from accessing resources and opportunities in the life sciences sector,” said Kolaleh Eskandanian, Ph.D., M.B.A., P.M.P., vice president and chief innovation officer at Children’s National and APDI program director and principal investigator. “Supporting a diverse group of innovators enriches the research and development process by bringing a variety of perspectives and viewpoints representing all populations.”

Along with the grant award, all finalists receive access to a network of supportive resources and expertise as part of their connection to APDI and MedTech Color.

Along with the pitch presentations, the event program included a keynote talk from Tonya Kinlow, vice president of Community Engagement, Advocacy and Government Affairs at Children’s National, highlighting advocacy initiatives leading to an all-inclusive system of care for children.

Children’s National leads the way

Julia Finkel, M.D., pediatric anesthesiologist at Children’s National and principal investigator for APDI, participated in the panel discussion “Inequity within Inequity,” which highlighted how racial disparities in pediatric healthcare remain a critical challenge across the United States. APDI’s goal is to advance pediatric devices that meet patient needs while promoting a more inclusive approach to discovering and supporting talented innovators.

“We believe there is a community of companies focused on platforms that treat or diagnose pediatrics,” said Kwame Ulmer, founder of MedTech Color. “This partnership allows us to significantly increase the support we provide for entrepreneurs in this area. We are delighted to be a part of the Children’s National community to drive positive patient outcomes.”

The patient benefit

Founded in 2017, MedTech Color is a nonprofit organization built on the same ideal: diverse leadership in the medical technology ecosystem leads to greater innovation and better outcomes. The organization works to advance the representation of people of color in the medical device industry and to nurture the next generation of founders. For more information on MedTech Color, visit medtechcolor.org.

APDI is one of five nonprofit consortia in the FDA’s Pediatric Device Consortia program that receives funding to provide a platform of services, expertise and grants to support pediatric innovators in bringing medical devices to the market that address the needs of children. Along with Children’s National, APDI members include Johns Hopkins University, CIMIT at Mass General Brigham, Tufts Medical Center, Medstar Health Research Institute, OrthoPediatrics Corp. and MedTech Color.

Advancements in pediatric medical devices continue to lag significantly behind those of adults, which is why APDI is focused on helping more pediatric medical device innovations achieve commercialization. For more information on APDI, visit innovate4kids.org

Children’s National awarded nearly $7.5 million by FDA to lead pediatric device innovation consortium

Alliance for Pediatric Device Innovation consortium membersChildren’s National Hospital was awarded nearly $7.5 million in a five-year grant to continue its leadership of an FDA-funded pediatric device consortium. Building upon a decade of previous consortium leadership, the new consortium is Alliance for Pediatric Device Innovation (APDI) and features a new and expanded roster of partners that reflects its added focus on providing pediatric innovators with expert support on evidence generation, including the use of real-world evidence (RWE), for pediatric device development.

Collaborating for success

With the goal of helping more pediatric medical devices complete the journey to commercialization, APDI is led by Children’s National, with Kolaleh Eskandanian, Ph.D., M.B.A., vice president and chief innovation officer, serving as program director and principal investigator, and Julia Finkel, M.D., pediatric anesthesiologist and director of Pain Medicine Research and Development in the Sheikh Zayed Institute for Pediatric Surgical Innovation, serving as principal investigator.

Consortium members include Johns Hopkins University, CIMIT at Mass General Brigham, Tufts Medical Center, Medstar Health Research Institute and MedTech Color. Publicly traded OrthoPediatrics Corp., which exclusively focuses on advancing pediatric orthopedics, is serving as APDI’s strategic advisor and role model for device innovators whose primary focus is children.

Why we’re excited

Consortium initiatives got underway quickly with the announcement of a special MedTech Color edition of the “Make Your Medical Device Pitch for Kids!”competition that focuses on African American and Hispanic innovators. Interested innovators can find details and apply at MedTech Color Pitch Competition. The competition was announced at the recent MedTech Color networking breakfast on Oct. 10,2023 at The MedTech Conference powered by AdvaMed.

“We all benefit from greater equity and inclusion among pediatric MedTech founders, decision-makers, investigators and developers in more effectively addressing the needs of the entire pediatric population,” said Eskandanian. “We need the expertise and insights of innovators from diverse backgrounds, and we want to provide these talented individuals with more opportunities to present their work and share their perspectives on pediatric device development.”

Additional details

APDI is one of five FDA-funded consortia created to provide a platform of services, expertise and funding to help pediatric innovators bring medical devices to the market that specifically address the needs of children.

 

Research campus provides opportunities for entrepreneurs and innovators

Research & Innovation Campus building entrance

Artist’s rendering of the entrance to the research building on the Children’s National Research & Innovation Campus.

In 2021, Children’s National Hospital intends to open a one-of-a-kind pediatric research and innovation hub, located on a portion of the former Walter Reed Army Medical Center campus. Called the Children’s National Research & Innovation Campus, this collection of facilities will house both our Research and Rare Disease Institutes. In the 160,000 square foot space, we are excited to pursue breakthrough potential discoveries that aim to quickly translate into new treatments and technologies benefitting our most vulnerable population, children and babies.

The campus also represents an opportunity for entrepreneurs and innovators who share our passion for finding new and better ways to care for children thanks to a collaboration with Johnson & Johnson Innovation called JLABS @ Washington, DC, a facility within the campus.

Strategically located with proximity to leading academic research institutions, medical schools and federal research institutions and agencies, the JLABS @ Washington, DC site will be open to emerging pharmaceutical, medical device, consumer and health technology companies aiming to advance the development of new drugs, medical devices, precision diagnostics and health technologies, including applications in pediatrics.

Johnson & Johnson Innovation – JLABS, in addition to offering emerging life science companies modular lab units, office space, shared core laboratory equipment and business facilities, aims to link the entrepreneurs within the District and across the greater Virginia and Maryland regions with the full breadth of the Johnson & Johnson Innovation model, including opportunities for collaboration, a resource hub, educational events and mentorship from experts from the Johnson & Johnson Family of Companies. AlgometRx, a spin-off company from Children’s National Hospital, will be among the first residents of JLABS @ Washington, DC, which aims to opens in 2021, as an awardee of the JLABS @ Washington, DC Children’s QuickFire Challenge.

AlgometRx’s novel technology was developed by hospital pain medicine expert Julia Finkel, M.D., The non-invasive handheld device aims to objectively measure pain by capturing real-time images of a patient’s pupillary response and applies proprietary algorithms to determine the patient’s pain type and intensity.

Do you have a pharmaceutical, medical device, consumer health or health technology innovation that could benefit from this unique and transformational ecosystem? If so, we invite you to submit an application to be considered for joining us at JLABS @ Washington, DC. Learn more by visiting the JLABS website.

Children’s National pain expert and innovator shares global summit spotlight

Research & Innovation Campus

As a Johnson & Johnson Innovation Quickfire Children’s Challenge awardee, Dr. Finkel and AlgometRx will be among the first group of startups taking up residence at the new JLABS @ Washington, DC, located on the Children’s National Research & Innovation Campus, when it opens in 2021 at the historic former Walter Reed Army Medical Center site.

Medical technology innovator Julia Finkel, M.D., principal investigator for the Pain Medicine Initiative of the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National Hospital, recently participated in Galen Growth’s 2020 Global Healthtech Summit on a virtual panel featuring resident companies from Johnson & Johnson Innovation – JLABS who are utilizing artificial intelligence (AI) with the aim to create advanced solutions for diagnostics, treatment and clinical trials. The summit, hosted in Singapore, brought the innovators together to discuss their views on their progress, the challenges and opportunities for bringing medtech innovations to market in the current climate, as well as the tools needed to succeed.

Dr. Finkel’s innovation, AlgometRx, is a real-time pain measurement technology that captures a digital image of a patient’s pupillary response to a non-invasive stimulus and applies proprietary algorithms to measure pain type and intensity. AlgometRx, a spin-off of Children’s National, recently received a JLABS @Washington DC Quickfire Children’s Challenge award.

Joining Dr. Finkel on the panel were JLABS resident company leaders Don Crawford, CEO, Analytics 4 Life; Jim Havelka, CEO, Inform AI; and Kim Walpole, CEO, Trials.ai, which leverages AI to help research teams design more effective clinical trials. The 50-minute program, moderated by Kara Bortone, senior director, Portfolio and Sourcing Management, Johnson & Johnson Innovation – JLABS, focused on topics such as how these startups approached the market and regulatory processes as well as the up-and-coming trends in health technology.

A pediatric anesthesiologist, Dr. Finkel explained the significance of achieving real-time, objective pain measurement. “Pain is one word that represents a myriad of conditions,” she says. “Pain from acute post-operative conditions is very different from peripheral neuropathic pain and different from the type of inflammatory pain seen in lupus and rheumatoid arthritis. Being able to discern the drivers of pain, the etiology, is essential to treating it well and to developing better therapeutics in the future.”

Dr. Finkel points out that AlgometRx measures nociception, which is pain fiber activation, and that is also what medications are addressing. “We’re not discounting a patient’s perception of pain, as we recognize that one’s experience of pain is very complex,” she says. “What we aim to measure is the activity being transmitted by the pain nerve and the type of nerve fiber that is doing the transmitting.”

Aiming to identify pain phenotypes is an important part of current AlgometRx development work, says Dr. Finkel, as it could significantly aid clinical decision-making in treating and monitoring patients’ pain. The company’s current regulatory focus is to seek FDA clearance related to its potential use for patients with peripheral neuropathy, which is pain and numbness resulting from damage to the nerves outside of the brain and spinal cord. The company has also identified fibromyalgia cases as a place where the technology could potentially benefit a large number of patients as it considers regulatory clearance targets.

As the COVID-19 pandemic presented many unique challenges to healthcare startups this year, panel participants were asked to discuss the hurdles they faced and how it impacted device development.

Dr. Finkel notes that the pandemic slowed patient enrollment in AlgometRx clinical studies, but also presented some upside. “At first, that had a negative impact, but it wound up being a good thing,” she says. “It gave us a moment to pause, regroup and examine the data we’d already generated. That break gave us improved information and a new, more powerful approach. It changed our trajectory by altering our regulatory path in terms of the order of things in our pipeline, so we’ve been enormously productive.”

As a Johnson & Johnson Innovation Quickfire Children’s Challenge awardee, Dr. Finkel and AlgometRx will be among the first group of startups taking up residence at the new JLABS @ Washington, DC, located on the Children’s National Research & Innovation Campus, when it opens in 2021 at the historic former Walter Reed Army Medical Center site. Along with a one-year residency at the new JLABS @ Washington DC facility,* AlgometRx will receive mentorship from experts at the Johnson & Johnson Family of Companies and grant funding to help support its continued advancement to commercialization.

*Residency at JLABS @ Washington subject to acceptance and execution of a License Agreement with Children’s National.