A Telemedicine Approach for Monitoring COPD: A Prospective Feasibility and Acceptability Cohort Study.

BACKGROUND: Telemedicine may help the detection of symptom worsening in patients with chronic obstructive pulmonary disease (COPD), potentially resulting in improved outcomes. This study aimed to determine the feasibility and acceptability of telemedicine among patients with COPD and physicians and facility staff in Japan. METHODS: This was a 52-week multicenter, prospective, single-arm, feasibility and acceptability cohort study of Japanese patients ≥40 years of age with COPD or asthma-COPD overlap. Participants underwent training to use YaDoc, a telemedicine smartphone App, which included seven daily symptom questions and weekly COPD Assessment Test (CAT) questions. The primary endpoint was participant compliance for required question completion. The secondary endpoint was participant and physician/facility staff acceptability of YaDoc based on questionnaires completed at Week 52. The impact of the Japanese COVID-19 pandemic state of emergency on results was also assessed. RESULTS: Of the 84 participants enrolled (mean age: 68.7 years, 88% male), 72 participants completed the study. Completion was high in the first six months but fell after that. Median (interquartile range [IQR]) compliance for daily questionnaire entry was 66.6% (31.0-91.8) and 81.0% (45.3-94.3) for weekly CAT entry. Positive participant responses to the exit questionnaire were highest regarding YaDoc ease of use (83.8%), positive impact on managing health (58.8%), and overall satisfaction (53.8%). Of the 26 physicians and facility staff enrolled, 24 completed the study. Of these, the majority (66.7%) responded positively regarding app facilitation of communication between physicians and participants to manage disease. Compliance was similar before and after the first COVID-19 state of emergency in Japan. CONCLUSION: Daily telemedicine monitoring is potentially feasible and acceptable to both patients and physicians in the management of COPD. These results may inform potential use of telemedicine in clinical practice and design of future studies. CLINICAL TRIAL REGISTRATION: JapicCTI-194916

Conservation Laws and Lumped System Dynamics

Physical systems modeling, aimed at network modeling of complex multi-physics systems, has especially flourished in the fifties and sixties of the 20-th century, see e.g. [11, 12] and references provided therein. With the reinforcement of the ’systems’ legacy in Systems & Control, the growing recognition that ’control’ is not confined to developing algorithms for processing the measurements of the system into control signals (but instead is concerned with the design of the total controlled system), and facing the complexity of modern technological and natural systems, systematic methods for physical systems modeling of large-scale lumpedand distributed-parameter systems capturing their basic physical characteristics are needed more than ever