Computational Approaches for Monitoring of Health Parameters and Their Evaluation for Application in Clinical Setting.

The algorithms and mathematical methods developed in this work focus on using computational approaches for low cost solution of health care problems for better patient outcome. Furthermore, evaluation of those approaches for clinical application considering the risk and benefit in a clinical setting is studied. Those risks and benefits are discussed in terms of sensitivity, specificity and area under the receiver operating characteristics curve. With a rising cost of health care and increasing number of aging population, there is a need for innovative and low cost solutions for health care problems. In this work, algorithms, mathematical techniques for the solutions of the problems related to physiological parameter monitoring have been explored and their evaluation approaches for application in a clinical setting have been studied. The physiological parameters include affective state, pain level, heart rate, oxygen saturation, hemoglobin level and blood pressure. For the mathematical basis development for different data intensive problems, eigenvalue based methods along with others have been used in designing innovative solutions for health care problems, developing new algorithms for smart monitoring of patients; from home monitoring to combat casualty situations. Eigenvalue based methods already have wide applications in many areas such as analysis of stability in control systems, search algorithms (Google Page Rank), Eigenface methods for face recognition, principal component analysis for data compression and pattern recognition. Here, the research work in 1) multi-parameter monitoring of affective state, 2) creating a smart phone based pain detection tool from facial images, 3) early detection of hemorrhage from arterial blood pressure data, 4) noninvasive measurement of physiological signals including hemoglobin level and 5) evaluation of the results for clinical application are presented

A Novel Real-Time Non-invasive Hemoglobin Level Detection Using Video Images from Smartphone Camera

Hemoglobin level detection is necessary for evaluating health condition in the human. In the laboratory setting, it is detected by shining light through a small volume of blood and using a colorimetric electronic particle counting algorithm. This invasive process requires time, blood specimens, laboratory equipment, and facilities. There are also many studies on non-invasive hemoglobin level detection. Existing solutions are expensive and require buying additional devices. In this paper, we present a smartphone-based non-invasive hemoglobin detection method. It uses the video images collected from the fingertip of a person. We hypothesized that there is a significant relation between the fingertip mini-video images and the hemoglobin level by laboratory gold standard. We also discussed other non-invasive methods and compared with our model. Finally, we described our findings and discussed future works

Big data in healthcare - the promises, challenges and opportunities from a research perspective: A case study with a model database

Recent advances in data collection during routine health care in the form of Electronic Health Records (EHR), medical device data (e.g., infusion pump informatics, physiological monitoring data, and insurance claims data, among others, as well as biological and experimental data, have created tremendous opportunities for biological discoveries for clinical application. However, even with all the advancement in technologies and their promises for discoveries, very few research findings have been translated to clinical knowledge, or more importantly, to clinical practice. In this paper, we identify and present the initial work addressing the relevant challenges in three broad categories: data, accessibility, and translation. These issues are discussed in the context of a widely used detailed database from an intensive care unit, Medical Information Mart for Intensive Care (MIMIC III) database

e-ESAS: Evolution of a Participatory Design-based Solution for Breast Cancer (BC) Patients in Rural Bangladesh

Healthcare facility is scarce for rural women in the developing world. The situation is worse for patients who are suffering from diseases that require long-term feedback-oriented monitoring such as breast cancer. Lack of motivation to go to the health centers on patients’ side due to sociocultural barriers, financial restrictions and transportation hazards results in inadequate data for proper assessment. Fortunately, mobile phones have penetrated the masses even in rural communities of the developing countries. In this scenario, a mobile phone-based remote symptom monitoring system (RSMS) with inspirational videos can serve the purpose of both patients and doctors. Here, we present the findings of our field study conducted on 39 breast cancer patients in rural Bangladesh. Based on the results of extensive field studies, we have categorized the challenges faced by patients in different phases of the treatment process. As a solution, we have designed, developed and deployed e-ESAS—the first mobile-based RSMS in rural context. Along with the detail need assessment of such a system, we describe the evolution of e-ESAS and the deployment results. We have included the unique and useful design lessons that we learned as e-ESAS evolved through participatory design process. The findings show how e-ESAS addresses several challenges faced by patients and doctors and positively impact their lives

Symptom Levels in Care-Seeking Bangladeshi and Nepalese Adults With Advanced Cancer

Purpose Three-fourths of patients with advanced cancer are reported to suffer from pain. A primary barrier to provision of adequate symptom treatment is failure to appreciate the intensity of the symptoms patients are experiencing. Because data on Bangladeshi and Nepalese patients’ perceptions of their symptomatic status are limited, we sought such information using a cell phone questionnaire. Methods At tertiary care centers in Dhaka and Kathmandu, we recruited 640 and 383 adult patients, respectively, with incurable malignancy presenting for outpatient visits and instructed them for that single visit on one-time completion of a cell phone platform 15-item survey of questions about common cancer associated symptoms and their magnitudes using Likert scales of 0 to 10. The questions were taken from the Edmonton Symptom Assessment System and the Brief Pain Inventory instruments. Results All but two Bangladeshi patients recruited agreed to study participation. Two-thirds of Bangladeshi patients reported usual pain levels ≥ 5, and 50% of Nepalese patients reported usual pain levels ≤ 4 (population differences significant at P \u3c .001). Conclusion Bangladeshi and Nepalese adults with advanced cancer are comfortable with cell phone questionnaires about their symptoms and report high levels of pain. Greater attention to the suffering of these patients is warranted

The Mixing Rate of the Arterial Blood Pressure Waveform Markov Chain is Correlated with Shock Index during Hemorrhage in Anesthetized Swine

Identifying the need for interventions during hemorrhage is complicated due to physiological compensation mechanisms that can stabilize vital signs until a significant amount of blood loss. Physiological systems providing compensation during hemorrhage affect the arterial blood pressure waveform through changes in dynamics and waveform morphology. We investigated the use of Markov chain analysis of the arterial blood pressure waveform to monitor physiological systems changes during hemorrhage. Continuous arterial blood pressure recordings were made on anesthetized swine (N=7) during a 5 min baseline period and during a slow hemorrhage (10 ml/kg over 30 min). Markov chain analysis was applied to 20 sec arterial blood pressure waveform segments with a sliding window. 20 ranges of arterial blood pressure were defined as states and empirical transition probability matrices were determined for each 20 sec segment. The mixing rate (2nd largest eigenvalue of the transition probability matrix) was determined for all segments. A change in the mixing rate from baseline estimates was identified during hemorrhage for each animal (median time of 13 min, ~10% estimated blood volume, with minimum and maximum times of 2 and 33 min, respectively). The mixing rate was found to have an inverse correlation with shock index for all 7 animals (median correlation coefficient of -0.95 with minimum and maximum of -0.98 and -0.58, respectively). The Markov chain mixing rate of arterial blood pressure recordings is a novel potential biomarker for monitoring and understanding physiological systems during hemorrhage

Identifying and Analyzing Sepsis States: A Retrospective Study on Patients with Sepsis in ICUs

Sepsis accounts for more than 50% of hospital deaths, and the associated cost ranks the highest among hospital admissions in the US. Improved understanding of disease states, severity, and clinical markers has the potential to significantly improve patient outcomes and reduce cost. We develop a computational framework that identifies disease states in sepsis using clinical variables and samples in the MIMIC-III database. We identify six distinct patient states in sepsis, each associated with different manifestations of organ dysfunction. We find that patients in different sepsis states are statistically significantly composed of distinct populations with disparate demographic and comorbidity profiles. Collectively, our framework provides a holistic view of sepsis, and our findings provide the basis for future development of clinical trials and therapeutic strategies for sepsis

Towards unravelling the relationship between on-body, environmental and emotion data using sensor information fusion approach

Over the past few years, there has been a noticeable advancement in environmental models and information fusion systems taking advantage of the recent developments in sensor and mobile technologies. However, little attention has been paid so far to quantifying the relationship between environment changes and their impact on our bodies in real-life settings. In this paper, we identify a data driven approach based on direct and continuous sensor data to assess the impact of the surrounding environment and physiological changes and emotion. We aim at investigating the potential of fusing on-body physiological signals, environmental sensory data and on-line self-report emotion measures in order to achieve the following objectives: (1) model the short term impact of the ambient environment on human body, (2) predict emotions based on-body sensors and environmental data. To achieve this, we have conducted a real-world study ‘in the wild’ with on-body and mobile sensors. Data was collected from participants walking around Nottingham city centre, in order to develop analytical and predictive models. Multiple regression, after allowing for possible confounders, showed a noticeable correlation between noise exposure and heart rate. Similarly, UV and environmental noise have been shown to have a noticeable effect on changes in ElectroDermal Activity (EDA). Air pressure demonstrated the greatest contribution towards the detected changes in body temperature and motion. Also, significant correlation was found between air pressure and heart rate. Finally, decision fusion of the classification results from different modalities is performed. To the best of our knowledge this work presents the first attempt at fusing and modelling data from environmental and physiological sources collected from sensors in a real-world setting