Under the leadership of Professor Eco de Geus, the VU-AMS device has developed in recent years to the point where it is now considered one of the best measuring devices in the world. Using this device, researchers worldwide look at how the body responds to stress. For example, by measuring what happens when people give a presentation: breathing patterns change, the heart rate goes up and skin resistance goes down because people sweat more. This does not have to take place in a laboratory. Instead, the device is designed to measure what happens in people's daily lives and to be widely applicable. From monitoring stress in the workplace to separation anxiety in young children.
What were your expectations when you got involved in this VU-AMS project?
I have for a long time been interested in developing new techniques that enable data collection in everyday life. When I started working with the VU-AMS device here as a postdoc, I was very impressed by how easy, reliable and ingenious it was. I also saw that it was only known in a small circle and then thought: it is such a shame that it is only used within this academic field. After all, in other research areas and outside the academy, there is also interest in it, because everyone now wants to measure their health with wearables, for example via a Fitbit or a Garmin. In themselves, these are interesting gadgets, only they do not yet have that measurement quality required for good research.
Consumers buy these wearables and believe that the information, which these watches produce using built-in sensors, reflects exactly how their health is doing. If you look at it critically, and we researchers naturally do, you will see that there are mostly lots of pretty graphs being produced, but they are often based on poor measurement data. Often, missing metrics are even filled in afterwards without the user being able to see it. Most consumers are not worried about this. But academics and clinicians who think they can confidently use these products for research unfortunately are frequently disappointed.
Doesn't that problem rest more with the manufacturer who can't put your sensors in their design well enough on a technical level?
As researchers, we always put the scientific perspective first. In doing so, we want the best quality measurement data. And not unimportantly, we want that data to be verifiable at all times. In doing so, the practical aspect sometimes gets lost. I really do understand that for manufacturers who make the wearables, ease of use and design are high on their list of priorities. The flashier it looks and the more it gives the impression that it can do everything at once, the more wearables they can sell.
In our product development, we do consider both sides of the coin and believe that we can make attractive measurement devices for the user that are reliable enough to do science with. If you want to bring measurements from the lab to the real world, you have to do it in a way that people find acceptable and as comfortable as possible. There are decades of experience in the VU-AMS device and we continue to continuously tweak and improve the product based on user feedback.
It does explain your success and why you receive many grants.
The research for which I first came to work at Vrije Universiteit Amsterdam was partly funded by Philips. They wanted to know how well their latest smartwatch compared with the highly regarded VU-AMS system. And the fact that Professor Eco de Geus with the Stress in Action consortium recently received a huge Gravitation Grant is not unrelated to the fact that we are considered a centre of expertise in the field of wearables and that the VU-AMS is so well regarded. The development of the device is partly funded by renting and selling it. Because we have users who are highly regarded scientifically, it is often mentioned in publications in academic journals and presentations at conferences. Thus, more than two hundred devices have already been sold worldwide and are used from Patagonia to Australia. We are quite proud that we managed to do that without ever advertising. But we do run into limits on what you can do within the university if you want to make this available on a larger scale.
Can you give an example of what those limits are?
Take, for example, creating a budget that allows us to advertise our products. That's not so easy to get. For courses, that is core business of the university, but for a scientific product, that investment is more complicated. By the way, there is support in that area. For example, we are a member of the Demonstrator Lab, which makes marketing budgets available for research projects that add value to society. Recently, we participated in the Starthub Launch, where we won a Rough Diamond award. That was not only a cheque, but also coffee with someone from an investment fund who found our story interesting. Who knows, we might soon move to those newly risen containers of the Starthub in the middle of campus to take the next step.
When you were a student, did you always have the drive to pursue a career in science? Or felt pressure from your parents to make your studies your profession?
No, my parents never interfered with my career choices. But neither did I have a master plan to make it all the way as a scientist.
So who or what pushed you to stay in that scientific world?
For my research master's thesis, I had put endless subjects in front of a screen and constantly flashed letters there in their field of vision. In doing so, I recorded how fast they could react to them, but also felt I was boring them to death. And myself too. I also wondered strongly: does anyone benefit from this extreme abstraction of reality?
I then went to Maastricht for my PhD. There I did research on social exclusion as a risk factor for psychotic disorders. My supervisor, Jean-Paul Selten, told me that non-Western migrants in the Netherlands had a higher risk of developing a psychotic disorder, such as schizophrenia. For some migrant groups, that risk was even five times higher. When I heard that, I thought: wow, that really is a big difference. So it's important to understand where that lies. Some experts gave the explanation that a large proportion of non-western migrants were already mentally extra vulnerable before they moved to the Netherlands and passed on that vulnerability to their children via their genetic material.
According to my supervisor, however, things were different. He was convinced that the feeling of not belonging, being constantly put away, in short, being structurally belittled and bullied, is actually very damaging. Those negative social experiences are a source of chronic stress. That then causes your brain's metabolism to be affected. In other words, your dopamine system becomes supersensitive. An extreme manifestation of this is then that people develop psychosis.
To show that the genetic narrative was not the whole story, and environmental factors are at least as important, I got involved in stress research. Gradually, I did become more aware of how complicated that concept of 'stress' is. We use the word a lot, but what exactly is it and how can you best measure it?
I can imagine that people from, say, a Chinese background deal with stress differently than those from, say, a Moroccan background. Is that true?
There are definitely differences in that, depending on the local environment and circumstances they are in. I think it is important to measure what people experience in their own environment. That, combined with your genetic predisposition, shapes how you perceive and react to the world. If you live and work in a close-knit community like Chinatown, where everyone has a Chinese background, that can be protective. You are less confronted, so to speak, that you are different. But if you break with that or move out of that community, you end up in a more stressful situation.
And so you not only look within your field at what stress is, but you also take an interdisciplinary approach to see how other models from other scientific disciplines deal with it.
Yes, stress is related to so many different things that you do have to work interdisciplinarily, because otherwise you do not do justice to the subject. You can learn so much from each other, but within science it sometimes seems like the social compartmentalisation still exists. We don't read each other's journals and attend different conferences. And if we look a step further, at using our measurement data to prevent future stress symptoms, we see that potential interventions do not take place in a vacuum but in society. If you care that your research is for the benefit of public health, it is good to explore how your brain scans, your physiological measurements and your electronic diaries relate to, for example, the healthcare system and societal attitudes towards it.
With the VU-AMS, are you going more for social or economic impact?
In the past I would have shouted very loudly that only social impact interests me, but over time I have come to believe more and more that both can go hand in hand. It would also be incredibly cool if we could make money from it and thereby provide more people with fun and useful jobs. As I said before, at university we don't have the infrastructure and expertise to market a product. On a small scale, you can do that a bit, but it is too far from our core mission if you want to scale it up regionally or nationally.
Universities are basically slow organisations. If you want to do commercial business, you have to be able to anticipate and adapt quickly. It is precisely with the latter elements that there is sometimes a mismatch with the scientific environment in which we operate. To be able to make the VU-AMS device available to more people and invest the proceeds further in development, it is ultimately better to place it outside the university so that it can really take off.
Can you also put your personal stamp within this project?
I definitely experience support from within the organisation. For example, I was able to take an impact course with other enthusiastic colleagues to help this project move forward. We have the wind in our sails in that respect. Valorisation has recently been seen as a core task of the university, alongside education and research. All the time I put into technical development and promotion of the device did not go into academic publications. In the past, without an above-average amount of strong publications, it meant you could not get a permanent position. Now I have a permanent contract as a university lecturer and that is a sign within academia that this kind of commitment (focusing on achieving social and economic impact and less on publications) is also appreciated.
Don't get me wrong, it never hurts to be in journals like Nature with your research. You want to keep sharing your knowledge with other researchers, engage in discussions with them and thus advance the research field. And the scientific basis is one of your unique selling points as an academic entrepreneur, it makes your product extra attractive to people and companies outside the university. Our revamped website could also help increase our reach. I am convinced that if more people can get their hands on our product through that route, they can then do more good things with it. Then more innovations will come out that will benefit society.
And how do you feel about creating impact through the media?
We do, of course. I was recently a guest on the NTR TV programme Prikkels. The presenter of that programme lives in the busy city centre of Utrecht and he had a hypothesis that if he spent some time in a quiet place, his body would calm down better. We then went to measure his stress factor in his noisy home situation and then left for Boschplaat on Terschelling, one of the most isolated areas in the Netherlands. There we took the same measurements and compared them.
It is a fun way to demonstrate for a wide audience the potential of the technology we have developed. Ultimately, we need bulk, i.e. for many people to get involved and believe in it, and media attention contributes to that. I think it is ultimately attractive for the long term to commercialise VU-AMS, because that is also good for continuity. If the knowledge sticks to just a few people at the university, we are in a vulnerable position. The moment they all retire, the expertise disappears and eventually the project stops. I think that would be a great shame because this is a fantastic product that contains a lot of knowledge and passion. I want to secure that in the form of a start-up, which can grow outside the university on its own and at its own pace.
What advice would you give to the new generation of students who also want to pursue impact with their research?
Don't be put off by rigidity or conservatism that you may encounter within the university. If you have a good idea that can have impact, you can always find a platform for it. This could be within your academic career, but also in the corporate sector. As a springboard for academics and graduates who want to go into business, for example, you can find start-up hubs, such as the ones we now have here in the middle of campus. The value of the visibility of such a start-up hub should not be underestimated. It is not only a positive signal to students, but also to those working at the university. Hopefully, they will also bring us closer to society.
Text: Ryan Jessurun
Portrait photo: Peter Valckx