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Global Contest Will Lead to Help during Heart Attacks

PHILADELPHIA, Pa. -- Around the world, the hunt is on for thousands of lifesaving portable medical devices that are hanging in public places -- in Philadelphia.

Why would someone in, say, Abu Dhabi care about finding devices in Philadelphia?

Because a University of Pennsylvania project to map the locations of automated external defibrillators (AEDs) throughout the city has mushroomed into a global "crowdsourcing" competition fueled by the Internet, Facebook, Twitter, smartphones -- and the chance to win cash prizes up to $10,000.

The ultimate prize, of course, will be saving the lives of cardiac-arrest victims. Penn plans to create an interactive online AED registry that will, for the first time, enable the city's 911 system, emergency responders - and any bystander with a phone - to quickly locate an AED.

Beginning Tuesday, participants in Philadelphia will use a free app downloaded to their phones to transmit photos and locations of the city's estimated 5,000 AEDs. These backpack-size machines can assess a cardiac-arrest victim and, if appropriate, deliver an electric shock to restart the heart. Studies show even sixth graders can follow an AED's step-by-step audio directions.

But in this age of cyber collaboration, the contest, called "MyHeartMap Challenge," is reaching far beyond the City of Brotherly Love. One gung-ho team of searchers is made up of computer gurus located at four universities in the United States, England, and the United Arab Emirates (thus the Abu Dhabi connection).

"From a scientific standpoint, crowdsourcing is a hot area," said team leader Manuel Cebrian, a University of California-San Diego researcher who read about the Penn contest in an online magazine. "We very rarely have a chance to piggyback on an experiment like this."

Indeed, the six-week-long experiment may push the scientific envelope, adding a public health coup to the many examples of successful crowdsourcing projects (for a list, see Wikipedia, the crowdsourced encyclopedia).

"We have hundreds of computer models simulating the challenge," Cebrian said. "That's useful for designing strategies, but nothing can fully anticipate reality."

Penn emergency physician Raina Merchant, who is leading the heart-map project, said the public is a powerful but unknown quantity. Among the crowds Penn has enlisted to help find AEDs: Philadelphia schools, emergency responders, bike messengers, social media "meet-up" groups - and The Inquirer, which created a special web page with clues and puzzles.

"Engaging 'citizen scientists' is unpredictable," Merchant said. "It could be our database will be full in 24 hours. Or, because it can be hard to find these devices," the hunt may go on for the full six weeks.

Defibrillation - shocking a heart after a deadly arrhythmia - is a vital step in responding to a heart attack, along with performing cardiopulmonary resuscitation and calling 911.

The problem is that no one, not even 911 systems or ambulance companies, has a comprehensive map of the AEDs that have been installed in malls, train stations, fitness centers, and many other places.

When Merchant proposed creating such a map for Philadelphia about a year ago, she thought she could simply assign the work.

"I sent my four research assistants out to find AEDs," she recalled. "They spent six weeks over the summer and went into more than 1,300 buildings, and they only found 200 AEDs."

Merchant embraced crowdsourcing after learning about the 2009 "Red Balloon" challenge, a Pentagon-sponsored experiment in which social media users raced to be the first to submit the locations of giant red weather balloons moored at 10 spots across the United States.

Cebrian, then at Massachusetts Institute of Technology, was part of the winning team, which captured the $40,000 prize in just nine hours. To mobilize enough helpers, the researchers paid a sliding scale of rewards to people who physically located a balloon - as well to their social media friends who provided information leading to the location.

Some of the successful search "trees" had members on three continents, Cebrian said.

Last year, a far more daunting Pentagon contest, which required reconstructing shredded documents, did not go well for Cebrian's computer whizzes. They were stymied by misinformation submitted to them by the (ruthless) whizzes on a competing team.

Cebrian predicts that with the heart-map contest, "90 percent of the submissions [to Penn] are going to be incorrect. People will be malicious in the worst case, or just mistaken in the best case."

He and his colleagues have built in a verification task to try to weed out incorrect AED information sent to them.

"But you can't make the process too complex or it will discourage participation," Cebrian said. "And you can't make it too open or it will enable cheating."

Penn organizers are also working to detect and deter sabotage, Merchant said.

"We've built in lots of fire walls and algorithms to identify incorrect entries," she said. "But we're also asking participants to play fair as this information will ultimately be used to help people who have suffered a cardiac arrest."

Earlier this month, the life-and-death stakes were dramatically illustrated when Tod Streets, 56, of Philadelphia, collapsed at 30th Street Station during the evening rush hour.

Because SEPTA station manager Garry Deans knew the location of an AED, he was able to grab it and revive Streets within minutes. Then another bystander, nurse Jeanne Pundt, administered CPR until Streets could be rushed to the Hospital of the University of Pennsylvania.

Deans later talked to Streets, who is doing well but remembers nothing of his heart attack.

"All the stars were aligned," Deans said. "Tod could have gotten on that train and then collapsed. Or the nurse could have gotten on her train. All the pieces fell in place."

How to join the effort Each year, about 300,000 Americans suffer cardiac arrest. Only 6 percent live because the window to prevent catastrophic brain injury is four to six minutes.

Automatic external defibrillators (AEDs) that shock the heart can save lives - but only if bystanders can readily find them.

You can join the University of Pennsylvania's MyHeartMap Challenge, a crowdsourced effort to create a full AED locator map. If your team finds the most AEDs, you will win $10,000. You can also win $50 for a photo of a "golden" AED. Penn has found, but not marked, dozens of these devices to motivate folks.

Find daily clues to the locations of "golden" AEDs by going to www.philly.com/aed. Go to Penn's contest Web page: http://www.med.upenn.edu/myheartmap/ Follow the contest on Facebook or Twitter:www.facebook.com/myheartmap or @myheartmap.



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