Mobile Health in Remote Patient Monitoring for Chronic Diseases: Principles, Trends, and Challenges

Chronic diseases are becoming more widespread. Treatment and monitoring of these diseases require going to hospitals frequently, which increases the burdens of hospitals and patients. Presently, advancements in wearable sensors and communication protocol contribute to enriching the healthcare system in a way that will reshape healthcare services shortly. Remote patient monitoring (RPM) is the foremost of these advancements. RPM systems are based on the collection of patient vital signs extracted using invasive and noninvasive techniques, then sending them in real-time to physicians. These data may help physicians in taking the right decision at the right time. The main objective of this paper is to outline research directions on remote patient monitoring, explain the role of AI in building RPM systems, make an overview of the state of the art of RPM, its advantages, its challenges, and its probable future directions. For studying the literature, five databases have been chosen (i.e., science direct, IEEE-Explore, Springer, PubMed, and science.gov). We followed the (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) PRISMA, which is a standard methodology for systematic reviews and meta-analyses. A total of 56 articles are reviewed based on the combination of a set of selected search terms including RPM, data mining, clinical decision support system, electronic health record, cloud computing, internet of things, and wireless body area network. The result of this study approved the effectiveness of RPM in improving healthcare delivery, increase diagnosis speed, and reduce costs. To this end, we also present the chronic disease monitoring system as a case study to provide enhanced solutions for RPMsThis research work was partially supported by the Sejong University Research Faculty Program (20212023)S

Development of machine learning schemes for use in non-invasive and continuous patient health monitoring

Stephanie Baker developed machine learning schemes for the non-invasive and continuous measurement of blood pressure and respiratory rate from heart activity waveforms. She also constructed machine learning models for mortality risk assessment from vital sign variations. This research contributes several tools that offer significant advancements in patient monitoring and wearable healthcare

Improving Access and Mental Health for Youth Through Virtual Models of Care

The overall objective of this research is to evaluate the use of a mobile health smartphone application (app) to improve the mental health of youth between the ages of 14–25 years, with symptoms of anxiety/depression. This project includes 115 youth who are accessing outpatient mental health services at one of three hospitals and two community agencies. The youth and care providers are using eHealth technology to enhance care. The technology uses mobile questionnaires to help promote self-assessment and track changes to support the plan of care. The technology also allows secure virtual treatment visits that youth can participate in through mobile devices. This longitudinal study uses participatory action research with mixed methods. The majority of participants identified themselves as Caucasian (66.9%). Expectedly, the demographics revealed that Anxiety Disorders and Mood Disorders were highly prevalent within the sample (71.9% and 67.5% respectively). Findings from the qualitative summary established that both staff and youth found the software and platform beneficial

The Impact of Digital Technologies on Public Health in Developed and Developing Countries

This open access book constitutes the refereed proceedings of the 18th International Conference on String Processing and Information Retrieval, ICOST 2020, held in Hammamet, Tunisia, in June 2020.* The 17 full papers and 23 short papers presented in this volume were carefully reviewed and selected from 49 submissions. They cover topics such as: IoT and AI solutions for e-health; biomedical and health informatics; behavior and activity monitoring; behavior and activity monitoring; and wellbeing technology. *This conference was held virtually due to the COVID-19 pandemic

The Impact of Digital Technologies on Public Health in Developed and Developing Countries

This open access book constitutes the refereed proceedings of the 18th International Conference on String Processing and Information Retrieval, ICOST 2020, held in Hammamet, Tunisia, in June 2020.* The 17 full papers and 23 short papers presented in this volume were carefully reviewed and selected from 49 submissions. They cover topics such as: IoT and AI solutions for e-health; biomedical and health informatics; behavior and activity monitoring; behavior and activity monitoring; and wellbeing technology. *This conference was held virtually due to the COVID-19 pandemic

Advanced Signal Processing and Control in Anaesthesia

This thesis comprises three major stages: classification of depth of anaesthesia (DOA); modelling a typical patient’s behaviour during a surgical procedure; and control of DOAwith simultaneous administration of propofol and remifentanil. Clinical data gathered in theoperating theatre was used in this project. Multiresolution wavelet analysis was used to extract meaningful features from the auditory evoked potentials (AEP). These features were classified into different DOA levels using a fuzzy relational classifier (FRC). The FRC uses fuzzy clustering and fuzzy relational composition. The FRC had a good performance and was able to distinguish between the DOA levels. A hybrid patient model was developed for the induction and maintenance phase of anaesthesia. An adaptive network-based fuzzy inference system was used to adapt Takagi-Sugeno-Kang (TSK) fuzzy models relating systolic arterial pressure (SAP), heart rate (HR), and the wavelet extracted AEP features with the effect concentrations of propofol and remifentanil. The effect of surgical stimuli on SAP and HR, and the analgesic properties of remifentanil were described by Mamdani fuzzy models, constructed with anaesthetist cooperation. The model proved to be adequate, reflecting the effect of drugs and surgical stimuli. A multivariable fuzzy controller was developed for the simultaneous administration of propofol and remifentanil. The controller is based on linguistic rules that interact with three decision tables, one of which represents a fuzzy PI controller. The infusion rates of the two drugs are determined according to the DOA level and surgical stimulus. Remifentanil is titrated according to the required analgesia level and its synergistic interaction with propofol. The controller was able to adequately achieve and maintain the target DOA level, under different conditions. Overall, it was possible to model the interaction between propofol and remifentanil, and to successfully use this model to develop a closed-loop system in anaesthesia

Digital Traces of the Mind::Using Smartphones to Capture Signals of Well-Being in Individuals

General context and questions Adolescents and young adults typically use their smartphone several hours a day. Although there are concerns about how such behaviour might affect their well-being, the popularity of these powerful devices also opens novel opportunities for monitoring well-being in daily life. If successful, monitoring well-being in daily life provides novel opportunities to develop future interventions that provide personalized support to individuals at the moment they require it (just-in-time adaptive interventions). Taking an interdisciplinary approach with insights from communication, computational, and psychological science, this dissertation investigated the relation between smartphone app use and well-being and developed machine learning models to estimate an individual’s well-being based on how they interact with their smartphone. To elucidate the relation between smartphone trace data and well-being and to contribute to the development of technologies for monitoring well-being in future clinical practice, this dissertation addressed two overarching questions:RQ1: Can we find empirical support for theoretically motivated relations between smartphone trace data and well-being in individuals? RQ2: Can we use smartphone trace data to monitor well-being in individuals?Aims The first aim of this dissertation was to quantify the relation between the collected smartphone trace data and momentary well-being at the sample level, but also for each individual, following recent conceptual insights and empirical findings in psychological, communication, and computational science. A strength of this personalized (or idiographic) approach is that it allows us to capture how individuals might differ in how smartphone app use is related to their well-being. Considering such interindividual differences is important to determine if some individuals might potentially benefit from spending more time on their smartphone apps whereas others do not or even experience adverse effects. The second aim of this dissertation was to develop models for monitoring well-being in daily life. The present work pursued this transdisciplinary aim by taking a machine learning approach and evaluating to what extent we might estimate an individual’s well-being based on their smartphone trace data. If such traces can be used for this purpose by helping to pinpoint when individuals are unwell, they might be a useful data source for developing future interventions that provide personalized support to individuals at the moment they require it (just-in-time adaptive interventions). With this aim, the dissertation follows current developments in psychoinformatics and psychiatry, where much research resources are invested in using smartphone traces and similar data (obtained with smartphone sensors and wearables) to develop technologies for detecting whether an individual is currently unwell or will be in the future. Data collection and analysis This work combined novel data collection techniques (digital phenotyping and experience sampling methodology) for measuring smartphone use and well-being in the daily lives of 247 student participants. For a period up to four months, a dedicated application installed on participants’ smartphones collected smartphone trace data. In the same time period, participants completed a brief smartphone-based well-being survey five times a day (for 30 days in the first month and 30 days in the fourth month; up to 300 assessments in total). At each measurement, this survey comprised questions about the participants’ momentary level of procrastination, stress, and fatigue, while sleep duration was measured in the morning. Taking a time-series and machine learning approach to analysing these data, I provide the following contributions: Chapter 2 investigates the person-specific relation between passively logged usage of different application types and momentary subjective procrastination, Chapter 3 develops machine learning methodology to estimate sleep duration using smartphone trace data, Chapter 4 combines machine learning and explainable artificial intelligence to discover smartphone-tracked digital markers of momentary subjective stress, Chapter 5 uses a personalized machine learning approach to evaluate if smartphone trace data contains behavioral signs of fatigue. Collectively, these empirical studies provide preliminary answers to the overarching questions of this dissertation.Summary of results With respect to the theoretically motivated relations between smartphone trace data and wellbeing (RQ1), we found that different patterns in smartphone trace data, from time spent on social network, messenger, video, and game applications to smartphone-tracked sleep proxies, are related to well-being in individuals. The strength and nature of this relation depends on the individual and app usage pattern under consideration. The relation between smartphone app use patterns and well-being is limited in most individuals, but relatively strong in a minority. Whereas some individuals might benefit from using specific app types, others might experience decreases in well-being when spending more time on these apps. With respect to the question whether we might use smartphone trace data to monitor well-being in individuals (RQ2), we found that smartphone trace data might be useful for this purpose in some individuals and to some extent. They appear most relevant in the context of sleep monitoring (Chapter 3) and have the potential to be included as one of several data sources for monitoring momentary procrastination (Chapter 2), stress (Chapter 4), and fatigue (Chapter 5) in daily life. Outlook Future interdisciplinary research is needed to investigate whether the relationship between smartphone use and well-being depends on the nature of the activities performed on these devices, the content they present, and the context in which they are used. Answering these questions is essential to unravel the complex puzzle of developing technologies for monitoring well-being in daily life.<br/

Advances in transfer learning methods based on computational intelligence

Traditional machine learning and data mining have made tremendous progress in many knowledge-based areas, such as clustering, classification, and regression. However, the primary assumption in all of these areas is that the training and testing data should be in the same domain and have the same distribution. This assumption is difficult to achieve in real-world applications due to the limited availability of labeled data. Associated data in different domains can be used to expand the availability of prior knowledge about future target data. In recent years, transfer learning has been used to address such cross-domain learning problems by using information from data in a related domain and transferring that data to the target task. The transfer learning methodology is utilized in this work with unsupervised and supervised learning methods. For unsupervised learning, a novel transfer-learning possibilistic c-means (TLPCM) algorithm is proposed to handle the PCM clustering problem in a domain that has insufficient data. Moreover, TLPCM overcomes the problem of differing numbers of clusters between the source and target domains. The proposed algorithm employs the historical cluster centers of the source data as a reference to guide the clustering of the target data. The experimental studies presented here were thoroughly evaluated, and they demonstrate the advantages of TLPCM in both synthetic and real-world transfer datasets. For supervised learning, a transfer learning (TL) technique is used to pre-train a CNN model on posture data and then fine-tune it on the sleep stage data. We used a ballistocardiography (BCG) bed sensor to collect both posture and sleep stage data to provide a non-invasive, in-home monitoring system that tracks changes in the subjects' health over time. The quality of sleep has a significant impact on health and life. This study adopts a hierarchical and none-hierarchical classification structure to develop an automatic sleep stage classification system using ballistocardiogram (BCG) signals. A leave-one-subject-out cross-validation (LOSO-CV) procedure is used for testing classification performance in most of the experiments. Convolutional Neural Networks (CNNs), Long Short-Term Memory (LSTM), and Deep Neural Networks DNNs are complementary in their modeling capabilities, while CNNs have the advantage of reducing frequency variations, LSTMs are good at temporal modeling. Polysomnography (PSG) data from a sleep lab was used as the ground truth for sleep stages, with the emphasis on three sleep stages, specifically, awake, rapid eye movement (REM), and non-REM sleep (NREM). Moreover, a transfer learning approach is employed with supervised learning to address the cross-resident training problem to predict early illness. We validate our method by conducting a retrospective study on three residents from TigerPlace, a retirement community in Columbia, MO, where apartments are fitted with wireless networks of motion and bed sensors. Predicting the early signs of illness in older adults by using a continuous, unobtrusive nursing home monitoring system has been shown to increase the quality of life and decrease care costs. Illness prediction is based on sensor data and uses algorithms such as support vector machine (SVM) and k-nearest neighbors (kNN). One of the most significant challenges related to the development of prediction algorithms for sensor networks is the use of knowledge from previous residents to predict new ones' behaviors. Each day, the presence or absence of illness was manually evaluated using nursing visit reports from a homegrown electronic medical record (EMR) system. In this work, the transfer learning SVM approach outperformed three other methods, i.e., regular SVM, one-class SVM, and one-class kNN.Includes bibliographical references (pages 114-127)