Smartphone tools for anaphylaxis management

Anaphylaxis is a severe life-threatening allergic condition which is increasing in prevalence and now affects more than 2% of UK children. Anaphylaxis management requires the avoidance of allergen triggers and preparation in readiness for an anaphylactic reaction. People with anaphylaxis and their carers carry Adrenaline Auto-Injectors which need to be administered immediately in the event of an anaphylactic reaction. But, unfortunately, many people often do not know how to use the injectors and fail to use them or fail to use them correctly. This is due in part to deficiencies in training and also to a lack of a system encouraging continuous practice and providing feedback on that practice. Pervasive healthcare research has demonstrated potential in supporting the management of chronic conditions such as diabetes. However, research into assistive technologies for the support of anaphylaxis management has been significantly neglected. Thesis results provide evidence of the potential that smartphone tools have to significantly improve adrenaline injection training skills and a positive influence on self-efficacy. In addition, the results provide insights into possible self-efficacy failings in traditional training and benefits of embedding self-efficacy theory into the design process. The thesis also shows that clinical staff expressed positive feedback after they were provided the technology for one week

Evaluation of AllergiSense smartphone tools for adrenaline injection training

© 2015 IEEE. Anaphylaxis is an increasingly prevalent life-threatening allergic condition that requires people with anaphylaxis and their caregivers to be trained in the avoidance of allergen triggers and in the administration of adrenaline auto-injectors. The prompt and correct administration of auto-injectors in the event of an anaphylactic reaction is a significant challenge in the management of anaphylaxis. Unfortunately, many people do not know how to use auto-injectors and either fail to use them or fail to use them correctly. This is due in part to deficiencies in training and also to the lack of a system encouraging continuous practice with feedback. Assistive smartphone healthcare technologies have demonstrated potential to support the management of chronic conditions such as diabetes and cardiovascular disease, but there have been deficiencies in their evaluation and there has been a lack of application to anaphylaxis. This paper describes AllergiSense, a smartphone app and sensing system for anaphylaxis management, and presents the results of a randomized, controlled, pre-post evaluation of AllergiSense injection training and feedback tools with healthy participants. Participants whose training was supplemented with AllergiSense injection feedback achieved significantly better practiced injections with 90.5% performing correct injections compared to only 28.6% in the paper-only control group. In addition, the results provide insights into possible self-efficacy failings in traditional training and the benefits of embedding self-efficacy theory into the technology design process

Diagnosing, managing and preventing anaphylaxis:Systematic review

Background This systematic review used the GRADE approach to compile evidence to inform the European Academy of Allergy and Clinical Immunology's (EAACI) anaphylaxis guideline. Methods We searched five bibliographic databases from 1946 to 20 April 2020 for studies about the diagnosis, management and prevention of anaphylaxis. We included 50 studies with 18 449 participants: 29 randomized controlled trials, seven controlled clinical trials, seven consecutive case series and seven case-control studies. Findings were summarized narratively because studies were too heterogeneous to conduct meta-analysis. Results It is unclear whether the NIAID/FAAN criteria or Brighton case definition are valid for immediately diagnosing anaphylaxis due to the very low certainty of evidence. There was also insufficient evidence about the impact of most anaphylaxis management and prevention strategies. Adrenaline is regularly used for first-line emergency management of anaphylaxis but little robust research has assessed its effectiveness. Newer models of adrenaline autoinjectors may slightly increase the proportion of people correctly using the devices and reduce time to administration. Face-to-face training for laypeople may slightly improve anaphylaxis knowledge and competence in using autoinjectors. We searched for but found little or no comparative effectiveness evidence about strategies such as fluid replacement, oxygen, glucocorticosteroids, methylxanthines, bronchodilators, management plans, food labels, drug labels and similar. Conclusions Anaphylaxis is a potentially life-threatening condition but, due to practical and ethical challenges, there is a paucity of robust evidence about how to diagnose and manage it

Wearable Patient and Health Worker Monitoring: Opportunities for Improved Outcomes and Open Source Sensing

Wearable multi-modal monitoring systems, capable of robust real-world recording during the activities of daily life, have the potential to provide rich objective experiential and well-being accounts. Sensing systems have wide clinical application in rehabilitation, pre- and post-surgical assessment, monitoring of the acute medical patient [1] and management of chronic conditions [2] [3], among others. They also provide new opportunities for insights into the workplace activities, processes and stressors of clinical staff and health workers [4] [5]. In prior work [6] of The Quantified Outpatient Project (http://quantifiedoutpatient.com), a prototype 24-hour wearable and ambient monitoring system was developed, and opportunities and challenges identified. A new and evolved “Sense247” design is now presented that addresses data and usability challenges identified in interview feedback and participant assessments. The underpinning vision is for a generic and expandable “core” sensing system to provide objective sensed recordings that supplement, not supplant, subjective reports. To this end, continuously-sensed physiological, environmental and actigraphy recordings are combined with quantified subjective reports

The Role of Mobile Health Technologies in Allergy Care:an EAACI Position Paper

Mobile health (mHealth) uses mobile communication devices such as smartphones and tablet computers to support and improve health-related services, data and information flow, patient self-management, surveillance, and disease management from the moment of first diagnosis to an optimized treatment. The European Academy of Allergy and Clinical Immunology created a task force to assess the state of the art and future potential of mHealth in allergology. The task force endorsed the "Be He@lthy, Be Mobile" WHO initiative and debated the quality, usability, efficiency, advantages, limitations, and risks of mobile solutions for allergic diseases. The results are summarized in this position paper, analyzing also the regulatory background with regard to the "General Data Protection Regulation" and Medical Directives of the European Community. The task force assessed the design, user engagement, content, potential of inducing behavioral change, credibility/accountability, and privacy policies of mHealth products. The perspectives of healthcare professionals and allergic patients are discussed, underlining the need of thorough investigation for an effective design of mHealth technologies as auxiliary tools to improve quality of care. Within the context of precision medicine, these could facilitate the change in perspective from clinician- to patient-centered care. The current and future potential of mHealth is then examined for specific areas of allergology, including allergic rhinitis, aerobiology, allergen immunotherapy, asthma, dermatological diseases, food allergies, anaphylaxis, insect venom, and drug allergy. The impact of mobile technologies and associated big data sets are outlined. Facts and recommendations for future mHealth initiatives within EAACI are listed

A System for the Measurement of the Subjective Visual Vertical Using a Virtual Reality Device

The Subjective Visual Vertical (SVV) is a common test for evaluating the perception of verticality. Altered verticality has been connected with disorders in the otolithic, visual or proprioceptive systems, caused by stroke, Parkinson’s disease or multiple sclerosis, among others. Currently, this test is carried out using a variety of specific, mostly homemade apparatuses that include moving planes, buckets, hemispheric domes or a line projected in a screen. Our aim is to develop a flexible, inexpensive, user-friendly and easily extensible system based on virtual reality for the measurement of the SVV and several related visual diagnostic tests, and validate it through an experimental evaluation. Our evaluation showed that the proposed system is suitable for the measurement of SVV in healthy subjects. The next step is to perform a more elaborated experimentation on patients and compare the results with the measurements obtained from traditional methods