Our project is advancing person-centered health and care models for patients suffering from chronic obstractive pulumonary disease (COPD) by utilizing novel digital technologies.
Our main purpose is to reduce disease worsening by early prediction of exacerbation events, which allows better management and prevention of complications. In the long term, we aim to reduce the burden on the healthcare systems, and indirectly improve access to services. To accomplish this, OREO will pioneer the development of a holistic digital platform, supported by an underlying AI framework, that combines analysis of speech and text narratives collected via a self-assessment app with health parameters related to comorbidities and with a plethora of triggering factors such as sleep related aspects, diet, stress, and environmental variables.
Involving over 300 users (patients, carers, and medical professionals) from 3 European countries, we aspire to make OREO significantly enhance the quality of life of people suffering from COPD.
Phase 1
Activity 1.1: Studies regarding the protocol for piloting activities:
As part of this activity, inclusion and exclusion criteria for participants in the pilot studies were identified. All participants must have a confirmed diagnosis of COPD, regardless of disease severity. As part of our analytical approach, the collected data will be stratified based on several criteria—one of the main ones being disease severity, which will be classified using the GOLD ABE classification system (presented in the following sections). Also, during this stage, we selected the tools that can provide a comprehensive initial assessment of each patient's clinical status, psychological well-being, quality of life, and health status. The use of validated questionnaires (ADL, VAS, EQ-5D-5L) will allow for consistent and comparable data to be obtained within the study population and will support the AI framework in interpreting diary entries in the broader context of each COPD patient's experience.
Activity 1.2: Design and implementation of storage, communication, and security mechanisms for the OREO server:
The OREO platform will use MongoDB as a document-oriented NoSQL database system. Each entry in the database is a document, a structure composed of field-value pairs. The database will be populated with data provided directly by participants in the pilot studies (audio recordings, responses to digital questionnaires) as well as data obtained through devices integrated into the platform. A client–server architecture (Figure 3) will be developed, which is used in most modern applications, from websites (the client is the browser, the server is the web server) to banking systems, cloud applications, or online games. Such an architecture allows for the centralization of resources and, therefore, better management of them as well as of the services that use files, databases, and applications. For managing platform users and sessions, OREO will use the Flask-Login plugin. This is a plugin (extension) for the Flask framework in Python, which facilitates user authentication management in a web application. The system exposes an authentication endpoint that other components can use to obtain Json Web Tokens (JWT) that allow access to various components of the system, cryptographically signed with a private key that services obtain access to for decryption when registering in the system.
Activity 1.3: Development of user manuals for the OREO components:
The project will use state-of-the-art features and gadgets to achieve its objectives: continuous monitoring via wearable devices such as smart watches or smart rings, which measure things such as heart rate, activity, sleep, stress, etc.; speech and natural language processing using a self-reporting application; air quality monitoring using internal sensors and, where possible, verified with third-party data (such as https://airly.org/); and digital questionnaires. During this stage, the smart medical devices to be used in the project were identified and presented. Appropriate user manuals were developed, highlighting the use of important functionalities for the OREO platform, which are presented in a way that is accessible to as many users as possible.
Activity 1.4: Website, social media:
We have developed the OREO logo for the visual identity of the OREO project. The project website has been developed and is maintained at the following address: http://www.citst.ro/projects/oreo/. The project also has a presence on social media with a Facebook page: https://www.facebook.com/profile.php?id=61578745282063#.
Phase 2
Activity 2.1: Extension of the protocol and analyses related to the pilot activities, submission of the analysis to the Bioethics Commission:
The study protocol started in the first stage was completed and extended within this report. It includes information on the reasoning and objectives of the study, how it was designed, the target population (inclusion and exclusion criteria from the study), the timing of the study (recruitment phase, baseline assessment, final assessment) and a brief risk-benefit analysis. At the same time, the protocol includes how the management of personal data will be carried out and legal and technical aspects that the OREO consortium undertakes to respect. The pilot study will not start without the submission of an information sheet and the signing of an informed consent by the participants.
The Commission for Bioethics of Medicines and Medical Devices (CNBMDM) was notified on 4.12.2025, by email, of the start of the collection phase using the voice acquisition interface. The notification was accompanied by the developed protocol, the informed consent form, the withdrawal form from the study and the patient information sheet.
Activity 2.2: Development of new components for the OREO platform – part I:
The OREO project aims to integrate more smart devices for better control and management of chronic obstructive pulmonary disease (COPD) symptoms. Such a device is to be an air quality monitor/sensor that will be connected to the OREO health monitoring system, and that will transmit real-time information about the pollution present in the environment in the homes of seniors suffering from COPD. Another important component will be a voice acquisition interface that will be part of a more complex structure, with the aim of creating a prediction model of COPD exacerbation episodes. The voice acquisition interface will ask questions and voice record seniors suffering from COPD, after which it will send these recordings to the OREO platform's database. The platform will analyse seniors' narratives related to their daily experience with COPD to train artificial intelligence (AI) models that summarize, note, and identify speech traits and disease-specific words/phrases/feelings. The ultimate goal is to correlate these speech characteristics with other parameters collected by the platform to identify COPD exacerbation events early.
Of these components, the air quality monitor/sensor will be purchased as such from those existing on the market, while the voice acquisition/analysis interface will be designed and implemented within the project by the technical teams involved.
Activity 2.3: Elaboration of user manuals for new components – part I:
As mentioned in the previous activity, the OREO system will use several smart components to be able to: track the air quality inside the homes of the elderly and help manage COPD symptoms; It allows the identification of expressions used by seniors to describe the COPD symptoms they suffer from.
During this stage, the smart medical devices that will be used in the project – air quality sensors – were identified and presented and the functioning of the components developed within the project by the consortium – the voice acquisition/analysis interface – was described. Appropriate user manuals have been developed that highlight the use of important functionalities for the OREO platform, and they are presented in such a way that they are accessible to as many users as possible. Four user manuals are presented, of which 3 for indoor air quality monitoring sensors and one for voice acquisition interface. The 3 sets of instructions for the sensors have been chosen according to their functionalities and price: the first is a basic model, the second is a middle product, and the last is a premium model. The user manual for the OREO voice recording interface is also presented, along with screenshots that make it easy to identify its functionalities. Everything is presented step-by-step for an intuitive experience.
Activity 2.4: Updating the website, social media account, making a scientific publication and leaflet:
The dissemination of the OREO project has been carried out in several ways: the website and Facebook page (https://www.facebook.com/profile.php?id=61578745282063#) have been updated with the latest information, a new scientific article about the project has been presented at the EHB 2025 conference by the OREO consortium, and a brief description of this initiative has been made in the form of a comprehensive leaflet intended for all people who could benefit or could be interested in the project – seniors suffering from COPD, informal caregivers, health professionals, etc. Screenshots and links with all these achievements are available within this section.
Phase 3
Activity 3.1: Development of the Platform Architecture:
The OREO platform is an Internet of Things (IoT) system designed for monitoring patients with Chronic Obstructive Pulmonary Disease (COPD). It integrates data collected from medical devices, air quality sensors, wearable devices, digital questionnaires, and voice recordings. Data are collected via an Android tablet and transmitted to the OREO cloud infrastructure, where they are preprocessed and analyzed using artificial intelligence algorithms to predict disease exacerbations. The platform employs modern communication and processing technologies, including Bluetooth Low Energy (BLE), Wi-Fi, REST APIs, containerized services, and AI models for the analysis of physiological data, speech, and user sentiment, thereby providing advanced support for personalized patient monitoring and disease management.
Activity 3.2: Development of New Components for the OREO Platform – Part II:
The OREO project aims to integrate multiple software applications and smart devices to improve the monitoring and management of Chronic Obstructive Pulmonary Disease (COPD) symptoms.
An Android mobile application has been developed to collect voice responses from COPD patients, with the objective of monitoring symptoms and enabling the early detection of disease exacerbations through the analysis of both audio signals and their text transcriptions. Users respond daily to questions grouped into four main categories: symptoms; sleep and energy; daily activities; and quality of life and emotions. The responses are recorded and transmitted to the OREO server for further processing.
In addition, a web application dedicated to informal caregivers has been developed, enabling them to view, download, and verify the recordings collected for each user.
Activity 3.3: Development of User Manuals for the New Components – Part II:
During this stage, several new hardware and software components were identified and presented, with the aim of improving the monitoring of the overall health status of users living with COPD.
The devices and applications used within the project perform data acquisition in an innovative manner by incorporating state-of-the-art technologies to support: continuous monitoring through wearable devices (smartwatches or smart rings) that measure heart rate, physical activity, sleep, stress, and other physiological parameters; speech and natural language processing through a self-reporting application.
This stage also describes and presents the user manuals developed for study participants. Their purpose is to ensure that users can easily understand the required steps and correctly use the medical devices, wearable technologies, and software functionalities. Building on the platform's unified approach, which simplifies the data collection process for participants, the manuals were developed internally while taking into account all recommendations provided by the respective device manufacturers.
Activity 3.4: Website and Social Media Updates, Preparation of a Scientific Publication:
The dissemination of the OREO project was carried out through multiple channels, including:
- publication of a scientific paper in a conference proceeding currently undergoing ISI indexing;
- registration of the OREO study protocol in an international database;
- an oral presentation at an international scientific congress;
- dissemination through social media; and
- updates to the project website.
Scientific Publications
- Marcin Kolakowski, Tiberiu Seceleanu, Irina Mocanu, Audio-Based Detection of COPD Exacerbations via Two-Stage Cough Detection and Classification, Proceedings of the 21st Conference on Computer Science and Intelligence Systems (FedCSIS 2026), Riga, Latvia, 23–26 August 2026.
- Giulia Bruschi, Elvira Maranesi, Margherita Osimani, Marcin Kolakowski, Karolina Piotrowicz, Jerzy Gasowski, Luca Gilardi, Oana Cramariuc, Jaouhar Ayadi, Jerzy Kolakowski, Irina Mocanu, Angelo Consoli, Katarzyna Gubernat, Tudor Teodorescu, Tiberiu Seceleanu, Predicting COPD Exacerbations in Older Adults Using AI: Home-Based Monitoring vs. Imaging – A Systematic Review. PROSPERO 2026, CRD420261297147. Available at https://www.crd.york.ac.uk/PROSPERO/view/CRD420261297147.
Oral Presentation
- Karolina Piotrowicz, Marcin Kołakowski, Elvira Maranesi, Oana Cramariuc, Irina Mocanu, Tiberiu Seceleanu, Jerzy Kołakowski, Barbara Gryglewska, Jerzy Gąsowski, The Rationale and Design of the "Advancing Personalized Prevention Strategies for Chronic Obstructive Pulmonary Disease and Associated Comorbidities That Utilize Existing IT Technologies and Novel AI-Based Tools" (OREO) – A THCS Study, presented at the 23rd IAGG World Congress of Gerontology and Geriatrics – Ageing Well in a Globalised World, 5–8 June 2026, RAI Amsterdam, The Netherlands.
Social Media
- To increase the visibility of the project, the OREO Facebook page is regularly updated with the consortium's latest achievements, including scientific publications, conference presentations, and recent medical news related to COPD. The page is available at: https://www.facebook.com/profile.php?id=61578745282063#.
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