Current Issue : October - December Volume : 2013 Issue Number : 4 Articles : 5 Articles
The purpose of this study was to validate a previously developed heart failure readmission predictive algorithm based on\r\npsychosocial factors, develop a new model based on patient-reported symptoms from a telemonitoring program, and assess the\r\nimpact of weight fluctuations and other factors on hospital readmission. Clinical, demographic, and telemonitoring data was\r\ncollected from 100 patients enrolled in the Partners Connected Cardiac Care Program between July 2008 and November 2011. 38%\r\nof study participants were readmitted to the hospital within 30 days. Ten different heart-failure-related symptoms were reported\r\n17,389 times, with the top three contributing approximately 50% of the volume. The psychosocial readmission model yielded an\r\nAUC of 0.67, along with sensitivity 0.87, specificity 0.32, positive predictive value 0.44, and negative predictive value 0.8 at a cutoff\r\nvalue of 0.30. In summary, hospital readmission models based on psychosocial characteristics, standardized changes in weight, or\r\npatient-reported symptoms can be developed and validated in heart failure patients participating in an institutional telemonitoring\r\nprogram. However, more robust models will need to be developed that use a comprehensive set of factors in order to have a\r\nsignificant impact on population health....
An m-health system for real-time wireless communication of medical video based on open-source software is presented. The\r\nobjective is to deliver a low-cost telemedicine platform which will allow for reliable remote diagnosis m-health applications such\r\nas emergency incidents, mass population screening, and medical education purposes. The performance of the proposed system is\r\ndemonstrated using five atherosclerotic plaque ultrasound videos. The videos are encoded at the clinically acquired resolution, in\r\naddition to lower, QCIF, and CIF resolutions, at different bitrates, and four different encoding structures. Commercially available\r\nwireless local area network (WLAN) and 3.5G high-speed packet access (HSPA) wireless channels are used to validate the developed\r\nplatform. Objective video quality assessment is based on PSNR ratings, following calibration using the variable frame delay (VFD)\r\nalgorithm that removes temporal mismatch between original and received videos. Clinical evaluation is based on atherosclerotic\r\nplaque ultrasound video assessment protocol. Experimental results show that adequate diagnostic quality wireless medical video\r\ncommunications are realized using the designed telemedicine platform. HSPA cellular networks provide for ultrasound video\r\ntransmission at the acquired resolution, while VFD algorithm utilization bridges objective and subjective ratings....
Incomplete patient adherence with nasal continuous positive airway pressure (CPAP) limits the effectiveness of treatment and\r\nresults in suboptimal obstructive sleep apnea (OSA) outcomes. An interactive website specifically designed for patients with\r\nOSA was designed and utilized in a randomized clinical trial to test its effect on increasing CPAP adherence. The goal of this\r\npaper is to report on CPAP adherence, internet use, privacy concerns and user satisfaction in using the website. The original\r\nproject was designed as a randomized, controlled clinical trial of Usual Care (UC, control) versus MyCPAP group (intervention).\r\nQuestionnaires were administered to evaluate the patient perspective of using the MyCPAP website. Participation in the MyCPAP\r\nintervention resulted in higher CPAP adherence at the two-month time point relative to participation in the UC group (3.4 �± 2.4\r\nand 4.1 �± 2.3 hrs/nt; ?? = 0.02; mean �± SD). Participants randomized to the MyCPAP website increased their use of the internet\r\nto obtain OSA related information, but did not increase their use of the internet to get information on general health or medical\r\nconditions. Users had very little concern about their CPAP data being viewed daily or being sent over the internet. Future studies\r\nshould consider the use of newer evaluation criteria for collaborative adaptive interactive technologies....
Despite recent advances in the area of home telemonitoring, the challenge of automatically detecting the sound signatures\r\nof activities of daily living of an elderly patient using nonintrusive and reliable methods remains. This paper investigates the\r\nclassification of eight typical sounds of daily life from arbitrarily positioned two-microphone sensors under realistic noisy\r\nconditions. In particular, the role of several source separation and sound activity detection methods is considered. Evaluations\r\non a new four-microphone database collected under four realistic noise conditions reveal that effective sound activity detection\r\ncan produce significant gains in classification accuracy and that further gains can be made using source separation methods based\r\non independent component analysis. Encouragingly, the results show that recognition accuracies in the range 70%ââ?¬â??100% can be\r\nconsistently obtained using different microphone-pair positions, under all but the most severe noise conditions....
Telepointer is a powerful tool in the telemedicine system that enhances the\r\neffectiveness of long-distance communication. Telepointer has been tested in\r\ntelemedicine, and has potential to a big influence in improving quality of health\r\ncare, especially in the rural area. A telepointer system works by sending additional\r\ninformation in the form of gesture that can convey more accurate instruction or\r\ninformation. It leads to more effective communication, precise diagnosis, and better\r\ndecision by means of discussion and consultation between the expert and the junior\r\nclinicians. However, there is no review paper yet on the state of the art of the\r\ntelepointer in telemedicine. This paper is intended to give the readers an overview\r\nof recent advancement of telepointer technology as a support tool in telemedicine.\r\nThere are four most popular modes of telepointer system, namely cursor, hand, laser\r\nand sketching pointer. The result shows that telepointer technology has a huge\r\npotential for wider acceptance in real life applications, there are needs for more\r\nimprovement in the real time positioning accuracy. More results from actual test (real\r\npatient) need to be reported. We believe that by addressing these two issues,\r\ntelepointer technology will be embraced widely by researchers and practitioners....
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