Evaluating User Perceptions of a Vibrotactile Feedback System in Trunk Stabilization Exercises: A Feasibility Study.

Low back pain patients often have deficits in trunk stability. For this reason, many patients receive physiotherapy treatment, which represents an enormous socio-economic burden. Training at home could reduce these costs. The problem here is the lack of correction of the exercise execution. Therefore, this feasibility study investigates the applicability of a vibrotactile-controlled feedback system for trunk stabilisation exercises. A sample of 13 healthy adults performed three trunk stabilisation exercises. Exercise performance was corrected by physiotherapists using vibrotactile feedback. The NASA TLX questionnaire was used to assess the practicability of the vibrotactile feedback. The NASA TLX questionnaire shows a very low global workload 40.2 [29.3; 46.5]. The quality of feedback perception was perceived as good by the subjects, varying between 69.2% (anterior hip) and 92.3% (lower back). 80.8% rated the feedback as helpful for their training. On the expert side, the results show a high rating of movement quality. The positive evaluations of the physiotherapists and the participants on using the vibrotactile feedback system indicate that such a system can reduce the trainees fear of independent training and support the users in their training. This could increase training adherence and long-term success.

A Prospective Study on a Suture Force Feedback Device for Training and Evaluating Junior Surgeons in Anastomotic Surgical Closure.

BACKGROUND: Surgical reconstruction is a crucial stage in various surgeries, including pancreaticoduodenectomy, as it can significantly affect the surgical results. The objective was to design a suture force feedback (SFF) device that can precisely measure the suture force during surgical closures. Afterward, the device was used to train junior surgeons in surgical closure techniques. METHODS: The SFF was used to capture the suture force data of experienced surgeons. This data was utilized to train and assess junior surgeons. The SFF device had 2 tactile-based force sensors that measured the applied force. Whenever the applied force was not within the optimal force range, the device provided feedback to the surgeon. A workshop was conducted to train junior surgeons in surgical closure techniques to improve their suturing skills. RESULTS: Thirty-seven junior surgeons were enrolled in this training, of whom only 24 completed the 30-day training program. The pre-assessment results revealed that the force exerted by junior surgeons during suture knot-tying was uneven compared with that of the experienced surgeons, with a significant difference in the force exerted per knot throw (P = 0.005. Before the training program, junior surgeons applied a force of 3.89 ± 0.43 N, which was more than twice the force applied by experienced surgeons (1.75 ± 0.12 N). However, after completing the 30-day training program, their force improved to 2.35 ± 0.13 N. CONCLUSIONS: The SFF device was shown to be an encouraging training tool for improving the surgical closure dexterity and technique of the participating junior surgeons.

Dose-Response Effects of MittEcho, a Measurement Feedback System, in an Indicated Mental Health Intervention for Children in Municipal and School Services in Norway.

Including routine client feedback can increase the effectiveness of mental health interventions for children, especially when implemented as intended. Rate of implementation, or dose, of such feedback interventions has been shown to moderate results in some studies. Variation in implementation and use of client feedback may also contribute to the mixed results observed within the feedback literature. This study evaluates dose-response associations of client feedback using a novel Measurement Feedback System (MFS) within an indicated group intervention. The primary aim was to determine whether the rate of MFS implementation predicts symptom reduction in anxiety and depression among school-aged children. The secondary aim was to assess whether the rate of MFS implementation influences children's satisfaction with the group intervention or their dropout rates. Data were collected via a randomized factorial study (clinicaltrials.gov NCT04263558) across 58 primary schools in Norway. Children aged 8 to 12 years (N = 701) participated in a group-based, transdiagnostic intervention targeting elevated symptoms of anxiety or depression. Half of the child groups also received the feedback intervention using the MittEcho MFS. Group leaders (N = 83), recruited locally, facilitated the interventions. The MFS dose was measured using the Implementation Index, which combines the use of MFS by both children and providers (group leaders) into a single dose variable. Results showed no significant additional effect of dose of MFS on change in depression or anxiety scores, on user satisfaction with the intervention or on intervention dropout. The discussion addresses potential reasons for these non-significant findings and implications for MFS implementation in preventive, group-based interventions in school settings.

Recent Progress of Tactile and Force Sensors for Human-Machine Interaction.

Human-Machine Interface (HMI) plays a key role in the interaction between people and machines, which allows people to easily and intuitively control the machine and immersively experience the virtual world of the meta-universe by virtual reality/augmented reality (VR/AR) technology. Currently, wearable skin-integrated tactile and force sensors are widely used in immersive human-machine interactions due to their ultra-thin, ultra-soft, conformal characteristics. In this paper, the recent progress of tactile and force sensors used in HMI are reviewed, including piezoresistive, capacitive, piezoelectric, triboelectric, and other sensors. Then, this paper discusses how to improve the performance of tactile and force sensors for HMI. Next, this paper summarizes the HMI for dexterous robotic manipulation and VR/AR applications. Finally, this paper summarizes and proposes the future development trend of HMI.

Full-hand electrotactile feedback using electronic skin and matrix electrodes for high-bandwidth human-machine interfacing.

Tactile feedback is relevant in a broad range of human-machine interaction systems (e.g. teleoperation, virtual reality and prosthetics). The available tactile feedback interfaces comprise few sensing and stimulation units, which limits the amount of information conveyed to the user. The present study describes a novel technology that relies on distributed sensing and stimulation to convey comprehensive tactile feedback to the user of a robotic end effector. The system comprises six flexible sensing arrays (57 sensors) integrated on the fingers and palm of a robotic hand, embedded electronics (64 recording channels), a multichannel stimulator and seven flexible electrodes (64 stimulation pads) placed on the volar side of the subject's hand. The system was tested in seven subjects asked to recognize contact positions and identify contact sliding on the electronic skin, using distributed anode configuration (DAC) and single dedicated anode configuration. The experiments demonstrated that DAC resulted in substantially better performance. Using DAC, the system successfully translated the contact patterns into electrotactile profiles that the subjects could recognize with satisfactory accuracy ([Formula: see text] for static and [Formula: see text] for dynamic patterns). The proposed system is an important step towards the development of a high-density human-machine interfacing between the user and a robotic hand. This article is part of the theme issue 'Advanced neurotechnologies: translating innovation for health and well-being'.

Optimal Underwater Acoustic Warfare Strategy Based on a Three-Layer GA-BP Neural Network.

A defense platform is usually based on two methods to make underwater acoustic warfare strategy decisions. One is through Monte-Carlo method online simulation, which is slow. The other is by typical empirical (database) and typical back-propagation (BP) neural network algorithms based on genetic algorithm (GA) optimization, which is less accurate and less robust. Therefore, this paper proposes a method to build an optimal underwater acoustic warfare feedback system using a three-layer GA-BP neural network and dropout processing of the neural network to prevent overfitting, so that the three-layer GA-BP neural network has adequate memory capability while still having suitable generalization capability. This method improves the accuracy and stability of the defense platform in making underwater acoustic warfare strategy decisions, thus increasing the survival probability of the defense platform in the face of incoming torpedoes. This paper uses the optimal underwater acoustic warfare strategies corresponding to incoming torpedoes with different postures as the sample set. Additionally, it uses a three-layer GA-BP neural network with an overfitting treatment for training. The prediction results have less error than the typical single-layer GA-BP neural network, and the survival probability of the defense platform improves by 6.15%. This defense platform underwater acoustic warfare strategy prediction method addresses the impact on the survival probability of the defense platform due to the decision speed and accuracy.

Frequency-Modulated Signal Measurement Using Closed-Loop Methodology.

Frequency-modulated (FM) signals are widely used in sensing, measurement, and signal detection due to their strong anti-interference and easy transmission characteristics. Although the high-precision measurement methods for static signals are quite complete, the high-precision measurement methods for dynamic FM signals still need to be studied, and the measurement accuracy in the high-sampling system still has room for improvement. Traditionally, the equal-precision measurement method is widely applied in most scenarios. However, its accuracy is limited by the quantization error of ±1 word and the sampling gate time, making it difficult to improve the frequency measurement accuracy while ensuring a high sampling rate at the same time. In this paper, a high-precision feedback frequency measurement system with the capability to eliminate the quantization error of ±1 word is proposed. The proposed system consists of two stages, the rough measurement stage based on the equal-precision measurement method and the precise measurement stage based on the negative feedback tracking architecture using the phase-frequency detector (PFD) and direct digital synthesizer (DDS). The effectiveness and feasibility of the system are verified by both simulation and experiment. At the sampling rate of 2 kHz, the frequency measurement accuracy is improved by more than 30 dB.

Measurement Feedback System for Intensive Neurorehabilitation after Severe Acquired Brain Injury.

Outcome of acquired brain injury (ABI) and the potential for neurorehabilitation are subject to distinct heterogeneity between patients. Limited knowledge of the complex constellation of determinants at play interferes with the possibility to deploy precision medicine in neurorehabilitation. Measurement Feedback Systems (MFS) structure clinical data collection and deliver the measurement results as feedback to clinicians, thereby facilitating progress monitoring, promoting balanced patient-centered discussion and shared decision making. Accumulation of clinical data in the MFS also enables data-driven precision rehabilitation medicine. This article describes the development and implementation of a MFS for neurorehabilitation after ABI. The MFS consists of specialized measurement tracks which are developed together with representatives of each discipline in the multidisciplinary team. The MFS is built into a digital platform that automatically distributes measurements among clinicians, at predetermined time points during the inpatient treatment, outpatient treatment and follow-up. The results of all measurements are visualized in individual patient dashboards that are accessible for all clinicians involved in treatment. Since step-wise implementation, 124 patients have been registered on the MFS platform so far, providing an average of more than 200 new measurements per week. Currently, more than 15,000 clinical measurements are captured in the MFS. The current overall completion rate of measurements is 86,4%. This study shows that structured clinical assessment and feedback is feasible in the context of neurorehabilitation after severe ABI. The future directions are discussed for MFS data in our Health Intelligence Program, which aims at periodic care evaluation and the transition of neurorehabilitation care towards precision medicine.

Clinician perceptions of nomothetic and individualized patient-reported outcome measures in measurement-based care.

Objective: Measurement-based care (MBC), which encompasses routine outcome monitoring (ROM) and measurement feedback systems (MFSs), is an evidence-based practice (EBP) supporting treatment personalization and clinical responsiveness. Despite MBC's effectiveness, clinicians report reservations regarding its utility, which may be a function of overreliance on nomothetic (i.e., standardized) measures. Although research suggests that individualized (i.e., idiographic) patient-reported outcome measures (I-PROMs) may have the potential to overcome these obstacles, little is known regarding clinicians' perceptions of different measurement approaches to MBC. Methods: This study examined clinicians' perceptions of the clinical utility, relevance to treatment planning, and practicality of nomothetic, individualized, and combined clinical feedback provided by a simulated MFS. Three hundred and twenty-nine clinicians were randomized to one of three conditions that presented a clinical vignette comprising: (a) nomothetic, (b) individualized, or (c) combined clinical feedback. Results: Participants' perceptions of the clinical feedback were not affected by the measurement approach. However, cognitive behavioral participants reported more positive perceptions of all aspects associated with the clinical feedback. Conclusion: These results were consistent with previous findings, suggesting that clinicians' theoretical orientation may have a significant impact on their perceptions of MBC, and should be considered when designing and implementing these systems.

Self-Regulating Colloidal Co-Assemblies That Accelerate Their Own Destruction via Chemo-Structural Feedback.

Biological self-assemblies self- and cross-regulate each other via chemical reaction networks (CRNs) and feedback. Although artificial transient self-assemblies have been realized via activation/deactivation CRNs, the transient structures themselves do mostly not engage in the CRN. We introduce a rational design approach for chemo-structural feedback, and present a transient colloidal co-assembly system, where the formed co-assemblies accelerate their destruction autonomously. We achieve this by immobilizing enzymes of a deactivating acid-producing enzymatic cascade on pH-switchable microgels that can form co-assemblies at high pH. Since the enzyme partners are immobilized on individual microgels, the co-assembled state brings them close enough for enhanced acid generation. The amplified deactivator production (acid) leads to an almost two-fold reduction in the lifetime of the transiently formed pH-state. Our study thus introduces versatile mechanisms for chemo-structural feedback.

Continuous quality improvement in measure development: Lessons from building a novel clinical feedback system.

PURPOSE: While the use of clinical feedback systems has become commonplace in psychological treatment, many of the most common instruments used for this purpose have not changed in decades. This paper describes the first four cycles of a measure development method designed to embrace continuous quality improvement. METHODS: Using techniques and philosophies developed in business management and academia-lean continuous quality improvement, action research, and practice research networks-we iterated through multiple cycles of development with the goal of creating an optimal clinical feedback system. These cycles emphasize building capacity to receive and implement feedback from a variety of stakeholders, especially patients and providers of behavioral health services, while also being responsive to quantitative findings from measure development. RESULTS: Iterating measure development with stakeholder feedback over the course of 5 years has resulted in a novel measurement system with 19 subscales administered via branching logic, and a supporting practice research network to sustain development. CONCLUSION: In developing a new clinical feedback system, the less-frequently-discussed practical aspects of measure development require close attention. Specifically, being willing to embrace change, planning for iteration, and systematically seeking stakeholder feedback are identified as central methods for improving clinical feedback systems.

Improving measurement feedback systems for measurement-based care.

AbstractObjectives: Measurement feedback systems (MFS) are a class of health information technologies developed to facilitate measurement-based care. The individual clinical decision support features within MFS are diverse and their influence on clinicians is largely unknown. This study tested the impact of MFS features on clinicians' progress assessments and treatment decisions in different scenarios. Method: Clinicians (n = 299) were randomly assigned to view one of six combinations of the following MFS features: graph, expected change trajectory line, alert, and treatment suggestions. The assigned feature combination was paired with three vignettes and clinical data representing three clinical scenarios: patient deterioration, no progress, and approaching remission. Clinicians answered questions after each vignette, and at the conclusion. Results: MFS features differentially impacted clinicians' progress assessment accuracy, their likelihood of making a treatment change, and their treatment choices. Which feature was most impactful varied depending on the clinical scenario. Clinicians reported graphs influenced their assessments and choices significantly more than the other features, and the majority stated they would prefer to use all of the features. Conclusions: Specific MFS features impact clinicians' assessments and choices to greater degrees, and the impact of those features can be influenced by the clinical state of the patient.

Introducing a Measurement Feedback System for Youth Mental Health: Predictors and Impact of Implementation in a Community Agency.

Measurement feedback systems (MFSs) that routinely collect and report client progress to mental health therapists have demonstrated beneficial impact on outcomes in numerous studies, with evidence that there is a dose-response relationship related to the implementation of the MFS. The current study examined the impact of MFS implementation (Implementation Index) on youth symptom outcomes separately by caregiver and youth self-report. Additionally, we tested the extent to which Implementation Index rates varied by individual therapists and clients, and whether therapist and client characteristics predicted MFS implementation. Methods: Administrative data (client charts, youth- and caregiver-reported Youth Outcome Questionnaires) for 229 youth (52.83% Latinx, 42.79% girls, M age = 10.33) treated during a 1-year period at a community mental health organization in Central Texas were analyzed using multi-level modeling. Caregiver-reported symptoms decreased faster for those with a higher MFS Implementation Index. Between-group differences among therapists accounted for a significant proportion of variance in the Implementation Index for caregiver report, whereas client differences accounted for most of the variance in the Implementation Index for youth self-report. Therapist trainee status predicted a significant increase in the Implementation Index for caregiver-report data. Youth symptom improvement as reported by caregivers varied with the extent of MFS implementation fidelity, and MFS implementation fidelity was higher for clients treated by trainees relative to staff therapists for caregiver report of symptoms.

Feedback and Communication in Active Hydrogel Spheres with pH Fronts: Facile Approaches to Grow Soft Hydrogel Structures.

Compartmentalized reaction networks regulating signal processing, communication and pattern formation are central to living systems. Towards achieving life-like materials, we compartmentalized urea-urease and more complex urea-urease/ester-esterase pH-feedback reaction networks into hydrogel spheres and investigate how fuel-driven pH fronts can be sent out from these spheres and regulated by internal reaction networks. Membrane characteristics are installed by covering urease spheres with responsive hydrogel shells. We then encapsulate the two networks (urea-urease and ester-esterase) separately into different hydrogel spheres to devise communication, pattern formation and attraction. Moreover, these pH fronts and patterns can be used for self-growing hydrogels, and for developing complex geometries from non-injectable hydrogels without 3D printing tools. This study opens possibilities for compartmentalized feedback reactions and their use in next generation materials fabrication.

Presynaptic glutamatergic transmission and feedback system of oxytocinergic neurons in the hypothalamus of a rat model of adjuvant arthritis.

The neurohypophysial hormone oxytocin (OXT) is synthesized in the hypothalamic paraventricular and supraoptic nuclei. Recently, some studies have considered OXT to be important in sensory modulation and that the OXT protein is upregulated by acute and chronic nociception. However, the mechanism by which OXT is upregulated in neurons is unknown. In this study, we examined the resting membrane potentials and excitatory postsynaptic currents in OXT-ergic neurons in the paraventricular nucleus in adjuvant arthritis rat model, a model of chronic inflammation, using whole-cell patch-clamping. Transgenic rats expressing OXT and monomeric red fluorescent protein 1 (mRFP1) fusion protein to visualize the OXT-ergic neurons were used, and the OXT-mRFP1 transgenic rat model of adjuvant arthritis was developed by injection of heat-killed Mycobacterium butyricum. Furthermore, the feedback system of synthesized OXT was also examined using the OXT receptor antagonist L-368,899. We found that the resting membrane potentials and frequency of miniature excitatory postsynaptic currents and spontaneous excitatory postsynaptic currents in OXT-monomeric red fluorescent protein 1 neurons in the paraventricular nucleus were significantly increased in adjuvant arthritis rats. Furthermore, L-368,899 dose-dependently increased the frequency of miniature excitatory postsynaptic currents and spontaneous excitatory postsynaptic currents in OXT-ergic neurons. Following bath application of the GABAA receptor antagonist picrotoxin and the cannabinoid receptor 1 antagonist AM 251, L-368,899 still increased the frequency of miniature excitatory postsynaptic currents. However, following bath application of the nitric oxide synthase inhibitor Nω-Nitro-L-arginine methyl ester hydrochloride, L-368,899 did not alter the miniature excitatory postsynaptic current frequency. Thus, it is suggested that OXT-ergic neuron activity is upregulated via an increase in glutamate release, and that the upregulated OXT neurons have a feedback system with released endogenous OXT. It is possible that nitric oxide, but not GABA, may contribute to the feedback system of OXT neurons in chronic inflammation.

A new model of patient-reported outcome monitoring with a clinical feedback system in ostomy care: rationale, description and evaluation protocol.

BACKGROUND: Living with an ostomy can be challenging and adapting to life with an ostomy can be particularly complex, with regard to both the physical and psychosocial aspects. Follow-up with a stoma care nurse (SCN) is usually performed after surgery to support the adaptation process. In the present paper, we describe a new model of ostomy care, where a clinical feedback system (CFS) is implemented in order to improve the adaption process of patients with an ostomy. We also present a plan for evaluating patients experience with the CFS and their clinical outcomes. METHODS: In this study, we include patients who had recently performed colostomy, ileostomy, or urostomy surgery. The intervention includes self-reported measures for adaptation to life with an ostomy and health-related quality of life (HRQoL), as well as patient experiences and satisfaction recorded by the clinical feedback system. The measures are electronically assessed before each clinical consultation at 3, 6, and 12 months after surgery. The scores are instantly analysed and graphically presented for use during the consultation and the patient and the SCN can discuss the findings. Patient experiences and satisfaction with care will be measured with the Generic Short Patient Experiences Questionnaire. Adaptation to the life with ostomy will be measured with the Ostomy Adjustment Scale, and HRQoL with the Short Form 36. DISCUSSION: This study presents a novel approach that could lead to improved consultation, more patient involvement, and better adaptation to life with an ostomy. TRIAL REGISTER: ClinicalTrials.gov Registration Number: NCT03841071. Date 18. February 2019 retrospectively registered.

Closed-Loop Temperature Control Based on Fiber Bragg Grating Sensors for Laser Ablation of Hepatic Tissue.

Laser ablation (LA) of cancer is a minimally invasive technique based on targeted heat release. Controlling tissue temperature during LA is crucial to achieve the desired therapeutic effect in the organs while preserving the healthy tissue around. Here, we report the design and implementation of a real-time monitoring system performing closed-loop temperature control, based on fiber Bragg grating (FBG) spatial measurements. Highly dense FBG arrays (1.19 mm length, 0.01 mm edge-to-edge distance) were inscribed in polyimide-coated fibers using the femtosecond point-by-point writing technology to obtain the spatial resolution needed for accurate reconstruction of high-gradient temperature profiles during LA. The zone control strategy was implemented such that the temperature in the laser-irradiated area was maintained at specific set values (43 and 55 °C), in correspondence to specific radii (2 and 6 mm) of the targeted zone. The developed control system was assessed in terms of measured temperature maps during an ex vivo liver LA. Results suggest that the temperature-feedback system provides several advantages, including controlling the margins of the ablated zone and keeping the maximum temperature below the critical values. Our strategy and resulting analysis go beyond the state-of-the-art LA regulation techniques, encouraging further investigation in the identification of the optimal control-loop.

Middle and High School Student Perspectives on Digitally-Delivered Mental Health Assessments and Measurement Feedback Systems.

Implementation of measurement-based care (MBC) by child-serving community mental health providers, particularly school-based providers, is low. To inform user-centered design of measurement feedback systems (MFSs) and MBC implementation more broadly, semi-structured interviews were conducted with 61 middle and high school students. Interviews explored student preferences for and perceived helpfulness of different assessment methods and use of MFS in counseling. Results indicate that student preference for digitally-administered assessment is equivocal, with preferences being influenced by student perceptions of the ease of use, impersonalization, and confidentiality. Students with exposure to the MFS found it helpful when used by their provider to share assessment feedback.

Estimation of the baroreflex total loop gain by the power spectral analysis of continuous arterial pressure recordings.

Baroreflex dysfunction contributes to the pathogenesis of cardiovascular diseases. The baroreflex comprises a negative feedback loop to stabilize arterial pressure (AP); its pressure-stabilizing capacity is defined as the gain ( G) of the transfer function ( H) of the baroreflex total loop. However, no method exists to evaluate G in a clinical setting. A feedback system with H attenuates pressure disturbance (PD) to PD/(1 + H). We hypothesized that the baroreflex attenuates the power spectrum density (PSD) of AP in the baroreflex functioning frequency range. We created graded baroreflex dysfunction in rats using a modified sinoaortic denervation (SAD) method [SAD; control (no SAD): n = 9; partial SAD (SAD in the right carotid sinus): n = 6, and total SAD (SAD in the bilateral carotid sinuses): n = 6] and evaluated the PSD of 12-h telemetric AP recordings in the light phase. Using the ratio of PSD at 0.01-0.1 Hz (PSD slope), we normalized them with the PSD in rats with complete baroreflex failure and derived the baroreflex index (BRI), which directly reflects G. We compared BRI and G obtained from a baroreflex open-loop experiment (reference G). The PSD slope became steeper with progression of baroreflex dysfunction. BRI (control: 2.00 ± 0.31, partial SAD: 1.28 ± 0.30, and total SAD: 0.06 ± 0.10, P < 0.05) was linearly correlated with reference G ( R2 = 0.91, P < 0.01). BRI accurately estimated G of the baroreflex and may serve as a novel tool for estimating the pressure-stabilizing capacity of the baroreflex in clinical settings. NEW & NOTEWORTHY This study proposed a novel method to estimate the gain of the baroreflex total loop, the so-called "baroreflex index" (BRI). BRI focuses on action potential variability in the frequency domain, considering baroreflex low-pass filter characteristics within 0.01-0.1 Hz. We demonstrated that BRI was linearly correlated with the reference gain of baroreflex in rats. Thus, BRI may contribute greatly to the development of a clinical tool for estimating baroreflex pressure-stabilizing capacity.

Output-driven feedback system control platform optimizes combinatorial therapy of tuberculosis using a macrophage cell culture model.

Tuberculosis (TB) remains a major global public health problem, and improved treatments are needed to shorten duration of therapy, decrease disease burden, improve compliance, and combat emergence of drug resistance. Ideally, the most effective regimen would be identified by a systematic and comprehensive combinatorial search of large numbers of TB drugs. However, optimization of regimens by standard methods is challenging, especially as the number of drugs increases, because of the extremely large number of drug-dose combinations requiring testing. Herein, we used an optimization platform, feedback system control (FSC) methodology, to identify improved drug-dose combinations for TB treatment using a fluorescence-based human macrophage cell culture model of TB, in which macrophages are infected with isopropyl ß-D-1-thiogalactopyranoside (IPTG)-inducible green fluorescent protein (GFP)-expressing Mycobacterium tuberculosis (Mtb). On the basis of only a single screening test and three iterations, we identified highly efficacious three- and four-drug combinations. To verify the efficacy of these combinations, we further evaluated them using a methodologically independent assay for intramacrophage killing of Mtb; the optimized combinations showed greater efficacy than the current standard TB drug regimen. Surprisingly, all top three- and four-drug optimized regimens included the third-line drug clofazimine, and none included the first-line drugs isoniazid and rifampin, which had insignificant or antagonistic impacts on efficacy. Because top regimens also did not include a fluoroquinolone or aminoglycoside, they are potentially of use for treating many cases of multidrug- and extensively drug-resistant TB. Our study shows the power of an FSC platform to identify promising previously unidentified drug-dose combinations for treatment of TB.