Wireless Chest Wearable Vital Sign Monitoring Platform for Hypertension

Hypertension, a silent killer, is the biggest challenge of the 21 st century in public health agencies worldwide. World Health Organization (WHO) statistic shows that the mortality rate of hypertension is 9.4 million per year and causes 55.3% of total deaths in cardiovascular (CV) patients. Early detection and prevention of hypertension can significantly reduce the CV mortality. We are presenting a wireless chest wearable vital sign monitoring platform. It measures Electrocardiogram (ECG), Photoplethsmogram (PPG) and Ballistocardiogram (BCG) signals and sends data over Bluetooth low energy (BLE) to mobile phone-acts as a gateway. A custom android application relays the data to thingspeak server where MATLAB based offline analysis estimates the blood pressure. A server reacts on the health of subject to friends and family on the social media - twitter. The chest provides a natural position for the sensor to capture legitimate signals for hypertension condition. We have done a clinical technical evaluation of prototypes on 11 normotensive subjects, 9 males 2 females

Wearable devices for remote vital signs monitoring in the outpatient setting: an overview of the field

Early detection of physiological deterioration has been shown to improve patient outcomes. Due to recent improvements in technology, comprehensive outpatient vital signs monitoring is now possible. This is the first review to collate information on all wearable devices on the market for outpatient physiological monitoring. A scoping review was undertaken. The monitors reviewed were limited to those that can function in the outpatient setting with minimal restrictions on the patient’s normal lifestyle, while measuring any or all of the vital signs: heart rate, ECG, oxygen saturation, respiration rate, blood pressure and temperature. A total of 270 papers were included in the review. Thirty wearable monitors were examined: 6 patches, 3 clothing-based monitors, 4 chest straps, 2 upper arm bands and 15 wristbands. The monitoring of vital signs in the outpatient setting is a developing field with differing levels of evidence for each monitor. The most common clinical application was heart rate monitoring. Blood pressure and oxygen saturation measurements were the least common applications. There is a need for clinical validation studies in the outpatient setting to prove the potential of many of the monitors identified. Research in this area is in its infancy. Future research should look at aggregating the results of validity and reliability and patient outcome studies for each monitor and between different devices. This would provide a more holistic overview of the potential for the clinical use of each device

Wireless Wearable Photoplethysmography Sensors for Continuous Blood Pressure Monitoring

Blood Pressure (BP) is a crucial vital sign taken into consideration for the general assessment of patient’s condition: patients with hypertension or hypotension are advised to record their BP routinely. Particularly, hypertension is emphasized by stress, diabetic neuropathy and coronary heart diseases and could lead to stroke. Therefore, routine and long-term monitoring can enable early detection of symptoms and prevent life-threatening events. The gold standard method for measuring BP is the use of a stethoscope and sphygmomanometer to detect systolic and diastolic pressures. However, only discrete measurements are taken. To enable pervasive and continuous monitoring of BP, recent methods have been proposed: pulse arrival time (PAT) or PAT difference (PATD) between different body parts are based on the combination of electrocardiogram (ECG) and photoplethysmography (PPG) sensors. Nevertheless, this technique could be quite obtrusive as in addition to at least two contacts/electrodes to measure the differential voltage across the left arm/leg/chest and the right arm/leg/chest, ECG measurements are easily corrupted by motion artefacts. Although such devices are small, wearable and relatively convenient to use, most devices are not designed for continuous BP measurements. This paper introduces a novel PPG-based pervasive sensing platform for continuous measurements of BP. Based on the principle of using PAT to estimate BP, two PPG sensors are used to measure the PATD between the earlobe and the wrist to measure BP. The device is compared with a gold standard PPG sensor and validation of the concept is conducted with a preliminary study involving 9 healthy subjects. Results show that the mean BP and PATD are correlated with a 0.3 factor. This preliminary study shows the feasibility of continuous monitoring of BP using a pair of PPG placed on the ear lobe and wrist with PATD measurements is possible

The design and evaluation of discrete wearable medical devices for vital signs monitoring

The observation, recording and appraisal of an individual’s vital signs, namely temperature, heart rate, blood pressure, respiratory rate and blood oxygen saturation (SpO2), are key components in the assessment of their health and wellbeing. Measurements provide valuable diagnostic data, facilitating clinical diagnosis, management and monitoring. Respiratory rate sensing is perhaps the most under-utilised of all the vital signs, being routinely assessed by observation or estimated algorithmically from respiratory-induced beat-to-beat variation in heart rate. Moreover there is an unmet need for wearable devices that can measure all or most of the vital signs. This project therefore aims to a) develop a device that can measure respiratory rate and b) develop a wearable device that can measure all or most of the vital signs. An accelerometer-based clavicular respiratory motion sensor was developed and compared with a similar thoracic motion sensor and reference using exhalatory flow. Pilot study results established that the clavicle sensor accurately tracked the reference in monitoring respiratory rate and outperformed the thoracic device. An Ear-worn Patient Monitoring System (EPMS) was also developed, providing a discrete telemonitoring device capable of rapidly measuring tympanic temperature, heart rate, SpO2 and activity level. The results of a comparative pilot study against reference instruments revealed that heart rate matched the reference for accuracy, while temperature under read (< 1°C) and SpO2 was inconsistent with poor correlation. In conclusion, both of the prototype devices require further development. The respiratory sensor would benefit from product engineering and larger scale testing to fully exploit the technology, but could find use in both hospital and community-based The design and evaluation of discrete wearable medical devices for vital signs monitoring DG Pitts ii Cranfield University monitoring. The EPMS has potential for clinical and community use, having demonstrated its capability of rapidly capturing and wirelessly transmitting vital signs readings. Further development is nevertheless required to improve the thermometer probe and resolve outstanding issues with SpO2 readings

Ear-Lead Multiple Smart Bio Sensor System in M-health

In this paper, we present a multi-parameter wearable sensor system within a smartphone to enable a real-time unobtrusive monitoring of core body temperature, electrocardiogram (ear-lead ECG), and blood oxygen saturation (SpO2) on ambulatory patients. Clinical researches illustrating that continuing accurate measurements of core body temperature are crucial to investigate human thermoregulation in ambulatory environment and during activity. On the other part, ECG remains the mainstay test for primary diagnosis and survival analysis of the heart diseases. We implement a wireless multisensory system that measures both the tympanic temperature inside the ear and ECG data from an ear and an arm. The behind-the-Ear device makes desirable to measure ECG data without any chest belt and allow patient move around freely. The proposed Bluetooth device has similarity the form factor of a hearing aid and is wirelessly connected to a smartphone for data transmission and displaying. This device not only gives the doctors access to the core temperature and ECG data in real time, but the device can be controlled – removed and reapplied – by the patient at any time, thus increasing the performance of personal health applications

Wearable continuous vital sign monitoring for deterioration detection and clinical outcomes in hospitalised patients

 Current practice uses physiological early warning scoring (EWS) systems to monitor “standard” vital signs, including heart rate (HR), respiratory rate (RR), blood pressure (BP), oxygen saturations (SpO2) and temperature, coupled with a graded response such as referral for a senior review or increasing monitoring frequency. Early detection of the deteriorating patient is a known challenge within hospital environments, as EWS is dependent on correct frequency of physiological observations tailored to specific patient needs, that can be time consuming for healthcare professionals, resulting in missed or incomplete observations. Wearable monitoring systems (WMS) may bring the potential to fill the gap in vital sign monitoring between traditional intermittent manual measurements and continuous automatic monitoring. However, evidence on the feasibility and impact of WMS implementation remains scarce. The virtual High Dependency Unit (vHDU) project was designed to develop and test the feasibility of deploying a WMS system in the hospital ward environment. This doctoral work aims to critically analyse the roadmap work of the vHDU project, containing ten publications distributed throughout 7 chapters. Chapter 1 (with 3 publications) includes a systematic review and meta-analysis identifying the lack of statistical evidence of the impact of WMS in early deterioration detection and associated clinical outcomes, highlighting the need for high-quality randomised controlled trials (RCTs). It also supports the use of WMS as a complement, and not a substitute, for standard and direct care. Chapter 2 explores clinical staff and patient perceptions of current vital sign monitoring practices, as well as their early thoughts on the use of WMS in the hospital environment through a qualitative interview study. WMS were seen positively by both clinical and patient groups as a potential tool to bridge the gap between manual observations and the traditional wired continuous automatic systems, as long as it does not add more noise to the wards nor replaces direct contact from the clinical staff. In chapter 3, the wearability of 7 commercially available wearables (monitoring HR, RR and SpO2) was assessed, advocating for the use of pulse oximeters without a fingertip probe and a small chest patch to improve worn times from the patients. Out of these, five devices were submitted to measurement accuracy testing (chapter 4, with 3 publications) under movement and controlled hypoxaemia, resulting in the validation of a chest patch (monitoring HR and RR) and proving the diagnostic accuracy of 3 pulse oximeters (monitoring pulse rate, PR and SpO2) under test. These results were timely for the final selection of the devices to be integrated in our WMS, namely vHDU system, explored in chapter 5, outlining the process for its development and rapid deployment in COVID-19 isolation wards in our local hospital during the pandemic. This work is now converging in the design of a feasibility RCT to test the impact of the vHDU system (now augmented with blood pressure and temperature monitoring, completing all 5 vital signs) versus standard care in an unbiased environment (chapter 6). This will also ascertain the feasibility for a multicentre RCT, that may in the future, contribute with the much-needed statistical evidence to my systematic review and meta-analysis research question, highlighted in chapter 1. Finally, chapter 7 includes a critical reflection of the vHDU project and overall doctoral work, as well as its contributions to the field of wearable monitoring.<p class="MsoNormal"/

Sleep apnea syndrome sensing at C-Band

A non-intrusive sleep apnea detection system using a C-Band channel sensing technique is proposed to monitor sleep apnea syndrome in real time. The system utilizes perturbations of RF signals to differentiate between patient's breathing under normal and sleep apnea conditions. The peak distance calculation is used to obtain the respiratory rates. A comparison of the datasets generated by the proposed method and a wearable sensor is made using a concordance correlation coefficient to establish its accuracy. The results show that the proposed sensing technique exhibits high accuracy and robustness, with more than 80% concordance with the wearable breathing sensor. This method is, therefore, a good candidate for the real-time wireless detection of sleep apnea

Ambient Intelligence in Healthcare: A State-of-the-Art

Information technology advancement leads to an innovative paradigm called Ambient Intelligence (AmI). A digital environment is employed along with AmI to enable individuals to be aware to their behaviors, needs, emotions and gestures. Several applications of the AmI systems in healthcare environment attract several researchers. AmI is considered one of the recent technologies that support hospitals, patients, and specialists for personal healthcare with the aid of artificial intelligence techniques and wireless sensor networks. The improvement in the wearable devices, mobile devices, embedded software and wireless technologies open the doors to advanced applications in the AmI paradigm. The WSN and the BAN collect medical data to be used for the progress of the intelligent systems adapted inevitably. The current study outlines the AmI role in healthcare concerning with its relational and technological nature. Health