Use of nonintrusive sensor-based information and communication technology for real-world evidence for clinical trials in dementia

Cognitive function is an important end point of treatments in dementia clinical trials. Measuring cognitive function by standardized tests, however, is biased toward highly constrained environments (such as hospitals) in selected samples. Patient-powered real-world evidence using information and communication technology devices, including environmental and wearable sensors, may help to overcome these limitations. This position paper describes current and novel information and communication technology devices and algorithms to monitor behavior and function in people with prodromal and manifest stages of dementia continuously, and discusses clinical, technological, ethical, regulatory, and user-centered requirements for collecting real-world evidence in future randomized controlled trials. Challenges of data safety, quality, and privacy and regulatory requirements need to be addressed by future smart sensor technologies. When these requirements are satisfied, these technologies will provide access to truly user relevant outcomes and broader cohorts of participants than currently sampled in clinical trials

A Mobile Healthcare Solution for Ambient Assisted Living Environments

Elderly people need regular healthcare services and, several times, are dependent of physicians’ personal attendance. This dependence raises several issues to elders, such as, the need to travel and mobility support. Ambient Assisted Living (AAL) and Mobile Health (m-Health) services and applications offer good healthcare solutions that can be used both on indoor and in mobility environments. This dissertation presents an ambient assisted living (AAL) solution for mobile environments. It includes elderly biofeedback monitoring using body sensors for data collection offering support for remote monitoring. The used sensors are attached to the human body (such as the electrocardiogram, blood pressure, and temperature). They collect data providing comfort, mobility, and guaranteeing efficiency and data confidentiality. Periodic collection of patients’ data is important to gather more accurate measurements and to avoid common risky situations, like a physical fall may be considered something natural in life span and it is more dangerous for senior people. One fall can out a life in extreme cases or cause fractures, injuries, but when it is early detected through an accelerometer, for example, it can avoid a tragic outcome. The presented proposal monitors elderly people, storing collected data in a personal computer, tablet, or smartphone through Bluetooth. This application allows an analysis of possible health condition warnings based on the input of supporting charts, and real-time bio-signals monitoring and is able to warn users and the caretakers. These mobile devices are also used to collect data, which allow data storage and its possible consultation in the future. The proposed system is evaluated, demonstrated and validated through a prototype and it is ready for use. The watch Texas ez430-Chronos, which is capable to store information for later analysis and the sensors Shimmer who allow the creation of a personalized application that it is capable of measuring biosignals of the patient in real time is described throughout this dissertation

Challenges and Opportunities of Internet of Things in Healthcare

The Internet of  Things (IoT) relies on physical objects interconnected between each other’s, creating a mesh of devices producing information and services. In this context, sensors and actuators are being continuously embedded in everyday objects (e.g., cars, home appliances, and smartphones) thus pervading our living environment. Among the plethora of application contexts, smart Healthcare is gaining momentum. Indeed IoT can revolutionize the healthcare industry by improving operational efficiency and clinical trials’ quality of monitoring, and by optimizing healthcare costs. This paper provides an overview of IoT, its applicability in healthcare, some insights about current trends and an outlook on future developments of healthcare systems.

Medical data processing and analysis for remote health and activities monitoring

Recent developments in sensor technology, wearable computing, Internet of Things (IoT), and wireless communication have given rise to research in ubiquitous healthcare and remote monitoring of human\u2019s health and activities. Health monitoring systems involve processing and analysis of data retrieved from smartphones, smart watches, smart bracelets, as well as various sensors and wearable devices. Such systems enable continuous monitoring of patients psychological and health conditions by sensing and transmitting measurements such as heart rate, electrocardiogram, body temperature, respiratory rate, chest sounds, or blood pressure. Pervasive healthcare, as a relevant application domain in this context, aims at revolutionizing the delivery of medical services through a medical assistive environment and facilitates the independent living of patients. In this chapter, we discuss (1) data collection, fusion, ownership and privacy issues; (2) models, technologies and solutions for medical data processing and analysis; (3) big medical data analytics for remote health monitoring; (4) research challenges and opportunities in medical data analytics; (5) examples of case studies and practical solutions

State of the art of audio- and video based solutions for AAL

Working Group 3. Audio- and Video-based AAL ApplicationsIt is a matter of fact that Europe is facing more and more crucial challenges regarding health and social care due to the demographic change and the current economic context. The recent COVID-19 pandemic has stressed this situation even further, thus highlighting the need for taking action. Active and Assisted Living (AAL) technologies come as a viable approach to help facing these challenges, thanks to the high potential they have in enabling remote care and support. Broadly speaking, AAL can be referred to as the use of innovative and advanced Information and Communication Technologies to create supportive, inclusive and empowering applications and environments that enable older, impaired or frail people to live independently and stay active longer in society. AAL capitalizes on the growing pervasiveness and effectiveness of sensing and computing facilities to supply the persons in need with smart assistance, by responding to their necessities of autonomy, independence, comfort, security and safety. The application scenarios addressed by AAL are complex, due to the inherent heterogeneity of the end-user population, their living arrangements, and their physical conditions or impairment. Despite aiming at diverse goals, AAL systems should share some common characteristics. They are designed to provide support in daily life in an invisible, unobtrusive and user-friendly manner. Moreover, they are conceived to be intelligent, to be able to learn and adapt to the requirements and requests of the assisted people, and to synchronise with their specific needs. Nevertheless, to ensure the uptake of AAL in society, potential users must be willing to use AAL applications and to integrate them in their daily environments and lives. In this respect, video- and audio-based AAL applications have several advantages, in terms of unobtrusiveness and information richness. Indeed, cameras and microphones are far less obtrusive with respect to the hindrance other wearable sensors may cause to one’s activities. In addition, a single camera placed in a room can record most of the activities performed in the room, thus replacing many other non-visual sensors. Currently, video-based applications are effective in recognising and monitoring the activities, the movements, and the overall conditions of the assisted individuals as well as to assess their vital parameters (e.g., heart rate, respiratory rate). Similarly, audio sensors have the potential to become one of the most important modalities for interaction with AAL systems, as they can have a large range of sensing, do not require physical presence at a particular location and are physically intangible. Moreover, relevant information about individuals’ activities and health status can derive from processing audio signals (e.g., speech recordings). Nevertheless, as the other side of the coin, cameras and microphones are often perceived as the most intrusive technologies from the viewpoint of the privacy of the monitored individuals. This is due to the richness of the information these technologies convey and the intimate setting where they may be deployed. Solutions able to ensure privacy preservation by context and by design, as well as to ensure high legal and ethical standards are in high demand. After the review of the current state of play and the discussion in GoodBrother, we may claim that the first solutions in this direction are starting to appear in the literature. A multidisciplinary 4 debate among experts and stakeholders is paving the way towards AAL ensuring ergonomics, usability, acceptance and privacy preservation. The DIANA, PAAL, and VisuAAL projects are examples of this fresh approach. This report provides the reader with a review of the most recent advances in audio- and video-based monitoring technologies for AAL. It has been drafted as a collective effort of WG3 to supply an introduction to AAL, its evolution over time and its main functional and technological underpinnings. In this respect, the report contributes to the field with the outline of a new generation of ethical-aware AAL technologies and a proposal for a novel comprehensive taxonomy of AAL systems and applications. Moreover, the report allows non-technical readers to gather an overview of the main components of an AAL system and how these function and interact with the end-users. The report illustrates the state of the art of the most successful AAL applications and functions based on audio and video data, namely (i) lifelogging and self-monitoring, (ii) remote monitoring of vital signs, (iii) emotional state recognition, (iv) food intake monitoring, activity and behaviour recognition, (v) activity and personal assistance, (vi) gesture recognition, (vii) fall detection and prevention, (viii) mobility assessment and frailty recognition, and (ix) cognitive and motor rehabilitation. For these application scenarios, the report illustrates the state of play in terms of scientific advances, available products and research project. The open challenges are also highlighted. The report ends with an overview of the challenges, the hindrances and the opportunities posed by the uptake in real world settings of AAL technologies. In this respect, the report illustrates the current procedural and technological approaches to cope with acceptability, usability and trust in the AAL technology, by surveying strategies and approaches to co-design, to privacy preservation in video and audio data, to transparency and explainability in data processing, and to data transmission and communication. User acceptance and ethical considerations are also debated. Finally, the potentials coming from the silver economy are overviewed.publishedVersio

Radar and RGB-depth sensors for fall detection: a review

This paper reviews recent works in the literature on the use of systems based on radar and RGB-Depth (RGB-D) sensors for fall detection, and discusses outstanding research challenges and trends related to this research field. Systems to detect reliably fall events and promptly alert carers and first responders have gained significant interest in the past few years in order to address the societal issue of an increasing number of elderly people living alone, with the associated risk of them falling and the consequences in terms of health treatments, reduced well-being, and costs. The interest in radar and RGB-D sensors is related to their capability to enable contactless and non-intrusive monitoring, which is an advantage for practical deployment and users’ acceptance and compliance, compared with other sensor technologies, such as video-cameras, or wearables. Furthermore, the possibility of combining and fusing information from The heterogeneous types of sensors is expected to improve the overall performance of practical fall detection systems. Researchers from different fields can benefit from multidisciplinary knowledge and awareness of the latest developments in radar and RGB-D sensors that this paper is discussing

Unobtrusive Health Monitoring in Private Spaces: The Smart Home

With the advances in sensor technology, big data, and artificial intelligence, unobtrusive in-home health monitoring has been a research focus for decades. Following up our research on smart vehicles, within the framework of unobtrusive health monitoring in private spaces, this work attempts to provide a guide to current sensor technology for unobtrusive in-home monitoring by a literature review of the state of the art and to answer, in particular, the questions: (1) What types of sensors can be used for unobtrusive in-home health data acquisition? (2) Where should the sensors be placed? (3) What data can be monitored in a smart home? (4) How can the obtained data support the monitoring functions? We conducted a retrospective literature review and summarized the state-of-the-art research on leveraging sensor technology for unobtrusive in-home health monitoring. For structured analysis, we developed a four-category terminology (location, unobtrusive sensor, data, and monitoring functions). We acquired 912 unique articles from four relevant databases (ACM Digital Lib, IEEE Xplore, PubMed, and Scopus) and screened them for relevance, resulting in n=55 papers analyzed in a structured manner using the terminology. The results delivered 25 types of sensors (motion sensor, contact sensor, pressure sensor, electrical current sensor, etc.) that can be deployed within rooms, static facilities, or electric appliances in an ambient way. While behavioral data (e.g., presence (n=38), time spent on activities (n=18)) can be acquired effortlessly, physiological parameters (e.g., heart rate, respiratory rate) are measurable on a limited scale (n=5). Behavioral data contribute to functional monitoring. Emergency monitoring can be built up on behavioral and environmental data. Acquired physiological parameters allow reasonable monitoring of physiological functions to a limited extent. Environmental data and behavioral data also detect safety and security abnormalities. Social interaction monitoring relies mainly on direct monitoring of tools of communication (smartphone; computer). In summary, convincing proof of a clear effect of these monitoring functions on clinical outcome with a large sample size and long-term monitoring is still lacking

Individual Behavior Modeling with Sensors Using Process Mining

[EN] Understanding human behavior can assist in the adoption of satisfactory health interventions and improved care. One of the main problems relies on the definition of human behaviors, as human activities depend on multiple variables and are of dynamic nature. Although smart homes have advanced in the latest years and contributed to unobtrusive human behavior tracking, artificial intelligence has not coped yet with the problem of variability and dynamism of these behaviors. Process mining is an emerging discipline capable of adapting to the nature of high-variate data and extract knowledge to define behavior patterns. In this study, we analyze data from 25 in-house residents acquired with indoor location sensors by means of process mining clustering techniques, which allows obtaining workflows of the human behavior inside the house. Data are clustered by adjusting two variables: the similarity index and the Euclidean distance between workflows. Thereafter, two main models are created: (1) a workflow view to analyze the characteristics of the discovered clusters and the information they reveal about human behavior and (2) a calendar view, in which common behaviors are rendered in the way of a calendar allowing to detect relevant patterns depending on the day of the week and the season of the year. Three representative patients who performed three different behaviors: stable, unstable, and complex behaviors according to the proposed approach are investigated. 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