Evaluation of Wearable Electronics for Epilepsy: A Systematic Review

Epilepsy is a neurological disorder that affects 50 million people worldwide. It is characterised by seizures that can vary in presentation, from short absences to protracted convulsions. Wearable electronic devices that detect seizures have the potential to hail timely assistance for individuals, inform their treatment, and assist care and self-management. This systematic review encompasses the literature relevant to the evaluation of wearable electronics for epilepsy. Devices and performance metrics are identified, and the evaluations, both quantitative and qualitative, are presented. Twelve primary studies comprising quantitative evaluations from 510 patients and participants were collated according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Two studies (with 104 patients/participants) comprised both qualitative and quantitative evaluation components. Despite many works in the literature proposing and evaluating novel and incremental approaches to seizure detection, there is a lack of studies evaluating the devices available to consumers and researchers, and there is much scope for more complete evaluation data in quantitative studies. There is also scope for further qualitative evaluations amongst individuals, carers, and healthcare professionals regarding their use, experiences, and opinions of these devices

Poster: Heart Rate Performance of a Medical-Grade Data Streaming Wearable Device

Wrist-worn devices afford convenient and unobtrusive heart rate sensing, however, motion artifacts can lead to unreliable data recordings. This paper evaluates heart rate estimates acquired during treadmill walking and 12 hours of everyday living from a medical-grade Empatica E4 data streaming wristband wearable compared to a Polar H10 chest strap ECG sensor. For treadmill walking, heart rate Mean Absolute Percentage Errors (MAPEs) were between 7.2\% and 29.2\%, and IntraClass Correlations (ICCs) between 0.6 and \nobreakdash-0.5, indicating moderate agreement and strong disagreement, respectively. During 12-hour everyday living acquisitions, heart rate estimate MAPEs were between 5.3\% and 13.5\% and ICCs between 0.7 and 0.1, indicating good to poor agreements

Automation transparency and the design of intelligent aircraft engine interfaces

© The Authors.In this article we report progress on a programme of research to implement intelligent engine systems in civil aircraft. Modern turbofan engines capture data about their performance and health during flight. Until now, this information has remained hidden from the flight deck. Our research will examine how best to communicate these new information sources to the flight deck to deliver intelligent assistance in understanding engine health and offering choices to minimise disruption should an engine develop a fault that affects performance. We have adopted automation transparency as a key design pillar to ensure that flight crew have an appropriate understanding of the reasoning of the intelligent system under different operating conditions. User-centred design will inform the degree to which the different interface elements are transparent, informing the balance between the provision of information necessary to ensure safe and efficient performance. Currently, there is significant uncertainty as to whether automation transparency can confer a performance advantage in all cases. Our research will empirically investigate different levels of automation transparency to validate performance

Evaluation of wearable epileptic seizure monitors

The research presented in this thesis contributes to the evaluation and future evolution of wearable epilepsy seizure monitoring devices with a systematic literature review and three research studies that include two device evaluation studies, and a survey of stakeholder opinions and experiences of wearable epilepsy monitoring devices. The thesis comprises background literature relevant to epilepsy, wearable technology, seizure monitoring and device evaluation. This review is followed by chapters for the systematic literature review and the three research studies. The systematic review is focused on evaluations of wearable epilepsy seizure monitors in the academic literature. It demonstrates that although there are over 3000 works in the literature proposing and evaluating novel and incremental approaches to epilepsy seizure detection, there are very few that report evaluations of available devices and, amongst studies that do report evaluations, there is a lack data for important metrics such as false alarm rates as well as other details that would support reproducibility. The first device evaluation study contributes an assessment of the ‘photoplethysmography’ optical heart rate performance of the medical-grade Empatica E4 data streaming wrist-worn wearable that is based on the Empatica Embrace epilepsy monitor. Heart rates were acquired from the E4 and a reference electrocardiogram (ECG) chest strap monitor for four participants during treadmill walking and 12 hours of free living. Mean Absolute Percentage Errors (MAPEs) and correlations are reported and demonstrate variable performance that includes negative correlation with the reference. This finding contributes insights into the poor seizure detection performance of studies that have relied on wrist-worn heart rate sensing during motor seizures. The second study reports device evaluation results for the Empatica Embrace wrist-worn seizure monitor. No other studies in the literature have evaluated the interfaces of wearable seizure monitors. Eight of the Embrace display indications were assessed for ‘guessabilty’ by fourteen computer science participants who also performed a heuristic evaluation of the interface. The guessability results demonstrate confusion between different interface indications. The heuristic evaluation identified i) concerns about accessibility and reliance on recall and ii) satisfaction in terms of the minimal aesthetic of a simple light pattern interface. The third and final study reports opinions and experiences of wearable epilepsy monitors reported by 61 respondents comprising 36 individuals with epilepsy, 14 carers, and 11 healthcare professionals. Overall, survey responses indicate that stakeholders have mixed opinions of wearable epilepsy seizure monitors and a degree of concern, particularly in terms of false alarms, missed seizures and other aspects of device reliability, as well as concerns about costs