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1.
J Med Internet Res ; 22(12): e19452, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33320101

RESUMO

BACKGROUND: Chronic kidney disease (CKD) is a global health burden. Self-management plays a key role in improving modifiable risk factors. OBJECTIVE: The aim of this study was to evaluate the effectiveness of wearable devices, a health management platform, and social media at improving the self-management of CKD, with the goal of establishing a new self-management intervention model. METHODS: In a 90-day prospective experimental study, a total of 60 people with CKD at stages 1-4 were enrolled in the intervention group (n=30) and control group (n=30). All participants were provided with wearable devices that collected exercise-related data. All participants maintained dietary diaries using a smartphone app. All dietary and exercise information was then uploaded to a health management platform. Suggestions about diet and exercise were provided to the intervention group only, and a social media group was created to inspire the participants in the intervention group. Participants' self-efficacy and self-management questionnaire scores, Kidney Disease Quality of Life scores, body composition, and laboratory examinations before and after the intervention were compared between the intervention and control groups. RESULTS: A total of 49 participants completed the study (25 in the intervention group and 24 in the control group); 74% of the participants were men and the mean age was 51.22 years. There were no differences in measured baseline characteristics between the groups except for educational background. After the intervention, the intervention group showed significantly higher scores for self-efficacy (mean 171.28, SD 22.92 vs mean 142.21, SD 26.36; P<.001) and self-management (mean 54.16, SD 6.71 vs mean 47.58, SD 6.42; P=.001). Kidney Disease Quality of Life scores were also higher in the intervention group (mean 293.16, SD 34.21 vs mean 276.37, SD 32.21; P=.02). The number of steps per day increased in the intervention group (9768.56 in week 1 and 11,389.12 in week 12). The estimated glomerular filtration rate (eGFR) of the intervention group was higher than that of the control group (mean 72.47, SD 24.28 vs mean 59.69, SD 22.25 mL/min/1.73m2; P=.03) and the decline in eGFR was significantly slower in the intervention group (-0.56 vs -4.58 mL/min/1.73m2). There were no differences in body composition between groups postintervention. CONCLUSIONS: The use of wearable devices, a health management platform, and social media support not only strengthened self-efficacy and self-management but also improved quality of life and a slower eGFR decline in people with CKD at stages 1-4. These results outline a new self-management model to promote healthy lifestyle behaviors for patients with CKD. TRIAL REGISTRATION: ClinicalTrials.gov NCT04617431; https://www.clinicaltrials.gov/ct2/show/NCT04617431.


Assuntos
Aplicativos Móveis/normas , Qualidade de Vida/psicologia , Insuficiência Renal Crônica/terapia , Autogestão/métodos , Mídias Sociais/tendências , Telemedicina/métodos , Dispositivos Eletrônicos Vestíveis/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Insuficiência Renal Crônica/psicologia
2.
JMIR Mhealth Uhealth ; 8(12): e25137, 2020 12 22.
Artigo em Inglês | MEDLINE | ID: mdl-33315580

RESUMO

Recently, companies such as Apple Inc, Fitbit Inc, and Garmin Ltd have released new wearable blood oxygenation measurement technologies. Although the release of these technologies has great potential for generating health-related information, it is important to acknowledge the repercussions of consumer-targeted biometric monitoring technologies (BioMeTs), which in practice, are often used for medical decision making. BioMeTs are bodily connected digital medicine products that process data captured by mobile sensors that use algorithms to generate measures of behavioral and physiological function. These BioMeTs span both general wellness products and medical devices, and consumer-targeted BioMeTs intended for general wellness purposes are not required to undergo a standardized and transparent evaluation process for ensuring their quality and accuracy. The combination of product functionality, marketing, and the circumstances of the global SARS-CoV-2 pandemic have inevitably led to the use of consumer-targeted BioMeTs for reporting health-related measurements to drive medical decision making. In this viewpoint, we urge consumer-targeted BioMeT manufacturers to go beyond the bare minimum requirements described in US Food and Drug Administration guidance when releasing information on wellness BioMeTs. We also explore new methods and incentive systems that may result in a clearer public understanding of the performance and intended use of consumer-targeted BioMeTs.


Assuntos
Monitores de Aptidão Física/tendências , Pandemias , Dispositivos Eletrônicos Vestíveis/normas , Humanos , Dispositivos Eletrônicos Vestíveis/efeitos adversos
3.
Intern Med J ; 50(12): 1578-1583, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33354885

RESUMO

The COVID-19 pandemic has led to many physicians working from home whenever possible. Although the concept of 'remote' patient care has been around for decades, present circumstances have provided a grand impetus in that direction with a view to protecting both patient and caregiver. In this article, we discuss some of the various challenges to moving forward with telemedicine, drawing in part on our own experiences in dealing with the COVID-19 pandemic. Clinical, technical, financial and cultural barriers to telemedicine are identified, along with a discussion concerning anticipated benefits. We conclude that the COVID-19 pandemic will likely forever change how healthcare is conducted as telemedicine figures increasingly prominently in the clinical landscape.


Assuntos
/epidemiologia , Médicos/tendências , Telemedicina/métodos , Telemedicina/tendências , Humanos , Médicos/normas , Smartphone/normas , Smartphone/tendências , Telemedicina/normas , Dispositivos Eletrônicos Vestíveis/normas , Dispositivos Eletrônicos Vestíveis/tendências
4.
J Med Internet Res ; 22(4): e13810, 2020 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-32319961

RESUMO

BACKGROUND: Several studies have shown that facial attention differs in children with autism. Measuring eye gaze and emotion recognition in children with autism is challenging, as standard clinical assessments must be delivered in clinical settings by a trained clinician. Wearable technologies may be able to bring eye gaze and emotion recognition into natural social interactions and settings. OBJECTIVE: This study aimed to test: (1) the feasibility of tracking gaze using wearable smart glasses during a facial expression recognition task and (2) the ability of these gaze-tracking data, together with facial expression recognition responses, to distinguish children with autism from neurotypical controls (NCs). METHODS: We compared the eye gaze and emotion recognition patterns of 16 children with autism spectrum disorder (ASD) and 17 children without ASD via wearable smart glasses fitted with a custom eye tracker. Children identified static facial expressions of images presented on a computer screen along with nonsocial distractors while wearing Google Glass and the eye tracker. Faces were presented in three trials, during one of which children received feedback in the form of the correct classification. We employed hybrid human-labeling and computer vision-enabled methods for pupil tracking and world-gaze translation calibration. We analyzed the impact of gaze and emotion recognition features in a prediction task aiming to distinguish children with ASD from NC participants. RESULTS: Gaze and emotion recognition patterns enabled the training of a classifier that distinguished ASD and NC groups. However, it was unable to significantly outperform other classifiers that used only age and gender features, suggesting that further work is necessary to disentangle these effects. CONCLUSIONS: Although wearable smart glasses show promise in identifying subtle differences in gaze tracking and emotion recognition patterns in children with and without ASD, the present form factor and data do not allow for these differences to be reliably exploited by machine learning systems. Resolving these challenges will be an important step toward continuous tracking of the ASD phenotype.


Assuntos
Transtorno do Espectro Autista/terapia , Emoções/fisiologia , Óculos Inteligentes/normas , Dispositivos Eletrônicos Vestíveis/normas , Adolescente , Criança , Feminino , Humanos , Masculino , Fenótipo
5.
J Med Internet Res ; 22(5): e16443, 2020 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-32348254

RESUMO

BACKGROUND: Continuous photoplethysmography (PPG) monitoring with a wearable device may aid the early detection of atrial fibrillation (AF). OBJECTIVE: We aimed to evaluate the diagnostic performance of a ring-type wearable device (CardioTracker, CART), which can detect AF using deep learning analysis of PPG signals. METHODS: Patients with persistent AF who underwent cardioversion were recruited prospectively. We recorded PPG signals at the finger with CART and a conventional pulse oximeter before and after cardioversion over a period of 15 min (each instrument). Cardiologists validated the PPG rhythms with simultaneous single-lead electrocardiography. The PPG data were transmitted to a smartphone wirelessly and analyzed with a deep learning algorithm. We also validated the deep learning algorithm in 20 healthy subjects with sinus rhythm (SR). RESULTS: In 100 study participants, CART generated a total of 13,038 30-s PPG samples (5850 for SR and 7188 for AF). Using the deep learning algorithm, the diagnostic accuracy, sensitivity, specificity, positive-predictive value, and negative-predictive value were 96.9%, 99.0%, 94.3%, 95.6%, and 98.7%, respectively. Although the diagnostic accuracy decreased with shorter sample lengths, the accuracy was maintained at 94.7% with 10-s measurements. For SR, the specificity decreased with higher variability of peak-to-peak intervals. However, for AF, CART maintained consistent sensitivity regardless of variability. Pulse rates had a lower impact on sensitivity than on specificity. The performance of CART was comparable to that of the conventional device when using a proper threshold. External validation showed that 94.99% (16,529/17,400) of the PPG samples from the control group were correctly identified with SR. CONCLUSIONS: A ring-type wearable device with deep learning analysis of PPG signals could accurately diagnose AF without relying on electrocardiography. With this device, continuous monitoring for AF may be promising in high-risk populations. TRIAL REGISTRATION: ClinicalTrials.gov NCT04023188; https://clinicaltrials.gov/ct2/show/NCT04023188.


Assuntos
Fibrilação Atrial/diagnóstico , Aprendizado Profundo/normas , Fotopletismografia/métodos , Dispositivos Eletrônicos Vestíveis/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudo de Prova de Conceito , Estudos Prospectivos
6.
Talanta ; 211: 120734, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32070599

RESUMO

The real-time detection and monitoring of chloride ion concentrations play important roles in broad industrial applications, including wearable health care device, environmental pollutant control and infrastructure corrosion monitoring. The development of all-solid-state micro-fabricated electrochemical sensors has enabled the miniaturisation of these testing devices. This study reviewed the micro-fabricated electrochemical chloride sensors developed since 1970s, together with a brief summary regarding the progression of miniaturised electrochemical sensors in the past half century. Three major types of electrochemical chloride sensors with specific ion-selectivity have been discussed, the potentiometric sensors (including both ion-selective electrodes and chemical FETs), the chronopotentiometric sensors and the voltammetric sensors. In addition, colorimetric sensors, an emerging low-cost, portable, fast diagnose sensor technique has been included in this review. Four critical sensor performances have been reviewed and compared systematically, the sensibility (chloride concentration range), selectivity, lifetime and applicable pH ranges. The future perspectives for engineering applications proposed in this review will benefit the further development of integrated multi-functional sensors, as well as new instrumental testing methods.


Assuntos
Técnicas Biossensoriais/métodos , Cloretos/análise , Técnicas Eletroquímicas/métodos , Eletrodos , Dispositivos Eletrônicos Vestíveis/normas , Humanos , Potenciometria
7.
Curr Sports Med Rep ; 19(2): 45-49, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32028347

RESUMO

The recent explosion of wearable technology and the associated concerns prompted the International Federation of Sports Medicine (FIMS) to create a quality assurance standard for wearable devices, which provides commissioned testing of marketing claims and endorsement of commercial wearables that test favorably. An open forum as announced in the conference advertising was held at the Annual Meeting of the New England Regional Chapter of the American College of Sports Medicine (NEACSM) November 7 to 8, 2019, in Providence, Rhode Island, USA for attending NEACSM members to voice their input on the process. Herein, we report the proceedings. The round table participants perceived the quality assurance standard to be important, but identified some practical process challenges that included the broad scope and complexity of the device universe, the need for a multiphase testing pathway, and the associated fees for product evaluation. The participants also supported the evaluation of device data analysis, behavioral influences, and user experience in the overall evaluation. Looking forward, the FIMS quality assurance standard faces the challenge of balancing these broader perspectives with practical constraints of budget, facilities, time, and human resources.


Assuntos
Monitores de Aptidão Física/normas , Medicina Esportiva/normas , Esportes/normas , Dispositivos Eletrônicos Vestíveis/normas , Humanos , New England
8.
J Med Internet Res ; 22(1): e15981, 2020 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-31913131

RESUMO

BACKGROUND: With advances in technology, the adoption of wearable devices has become a viable adjunct in poststroke rehabilitation. Upper limb (UL) impairment affects up to 77% of stroke survivors impacting on their ability to carry out everyday activities. However, despite an increase in research exploring these devices for UL rehabilitation, little is known of their effectiveness. OBJECTIVE: This review aimed to assess the effectiveness of UL wearable technology for improving activity and participation in adult stroke survivors. METHODS: Randomized controlled trials (RCTs) and randomized comparable trials of UL wearable technology for poststroke rehabilitation were included. Primary outcome measures were validated measures of activity and participation as defined by the International Classification of Functioning, Disability, and Health. Databases searched were MEDLINE, Web of Science (Core collection), CINAHL, and the Cochrane Library. The Cochrane Risk of Bias Tool was used to assess the methodological quality of the RCTs and the Downs and Black Instrument for the quality of non RCTs. RESULTS: In the review, we included 11 studies with collectively 354 participants at baseline and 323 participants at final follow-up including control groups and participants poststroke. Participants' stroke type and severity varied. Only 1 study found significant between-group differences for systems functioning and activity (P≤.02). The 11 included studies in this review had small sample sizes ranging from 5 to 99 participants at an average (mean) age of 57 years. CONCLUSIONS: This review has highlighted a number of reasons for insignificant findings in this area including low sample sizes and the appropriateness of the methodology for complex interventions. However, technology has the potential to measure outcomes, provide feedback, and engage users outside of clinical sessions. This could provide a platform for motivating stroke survivors to carry out more rehabilitation in the absence of a therapist, which could maximize recovery. TRIAL REGISTRATION: PROSPERO CRD42017057715; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=57715.


Assuntos
Reabilitação do Acidente Vascular Cerebral/métodos , Extremidade Superior/patologia , Dispositivos Eletrônicos Vestíveis/normas , Humanos , Pessoa de Meia-Idade , Sobreviventes
9.
J Cancer Surviv ; 14(3): 386-392, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31933148

RESUMO

PURPOSE: A growing amount of research has successfully incorporated Fitbit devices and other wearable activity trackers into technology-oriented lifestyle interventions to increase physical activity among cancer survivors. METHODS: The present review of this literature is based upon bibliographic searches in PubMed and CINAHL and relevant search terms. Articles published in English from January 1, 2009, through October 16, 2019, were considered. RESULTS: A total of 1726 article citations were identified in PubMed and non-duplicates in CINAHL. After screening the abstracts or full texts of these articles and reviewing the references of previous review articles, we found 13 studies that met the eligibility criteria. Of these, 8 were randomized controlled trials, one was a pre-post-test trial, and 4 were qualitative studies (focus groups, in-depth interviews). The studies focused on breast cancer (n = 8), prostate cancer (n = 2), and colorectal cancer (n = 1), and the remainder focused on more than one cancer site. CONCLUSIONS: Additional research is needed to examine the efficacy of consumer wearable devices in promoting physical activity and weight management among cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: Cancer survivors show an increase in physical activity when using consumer wearable activity trackers. Increased physical activity plays an important role in alleviating many adverse effects of breast cancer therapy as well as improving morbidity and mortality. Additional research such as clinical trials focused on the development of successful interventions utilizing these devices is warranted.


Assuntos
Neoplasias da Mama/terapia , Sobreviventes de Câncer/estatística & dados numéricos , Neoplasias Colorretais/terapia , Exercício Físico/fisiologia , Monitores de Aptidão Física/normas , Neoplasias da Próstata/terapia , Dispositivos Eletrônicos Vestíveis/normas , Sobreviventes de Câncer/psicologia , Feminino , Humanos , Masculino
10.
Artigo em Inglês | MEDLINE | ID: mdl-31936245

RESUMO

Everyday life of the elderly and impaired population living in smart homes is challenging because of possible accidents that may occur due to daily activities. In such activities, persons often lean over (to reach something) and, if they not cautious, are prone to falling. To identify fall incidents, which could stochastically cause serious injuries or even death, we propose specific temporal inference models; namely, CM-I and CM-II. These models can infer a fall incident based on classification methods by exploiting wearable Internet of Things (IoT) altimeter sensors adopted by seniors. We analyzed real and synthetic data of fall and lean over incidents to test the proposed models. The results are promising for incorporating such inference models to assist healthcare for fall verification of seniors in smart homes. Specifically, the CM-II model achieved a prediction accuracy of 0.98, which is the highest accuracy when compared to other models in the literature under the McNemar's test criterion. These models could be incorporated in wearable IoT devices to provide early warning and prediction of fall incidents to clinical doctors.


Assuntos
Assistência à Saúde/métodos , Habitação , Internet das Coisas , Modelos Teóricos , Dispositivos Eletrônicos Vestíveis , Idoso , Marcha , Habitação/normas , Humanos , Dispositivos Eletrônicos Vestíveis/normas
11.
Int J Cardiol ; 300: 161-164, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31787389

RESUMO

BACKGROUND: Wrist-worn heart rate (HR) monitors are increasingly popular. A paucity of data exists on their accuracy in atrial fibrillation (AF) in ambulatory patients. We sought to assess the HR accuracy of two commercially available smart watches [SW] (Fitbit Charge HR [FB] and Apple Watch Series 3 [AW]) compared with Holter monitoring in an ambulant patient cohort. METHODS: Thirty-two participants ≥18 years referred for 24-hour Holter monitoring were prospectively recruited. Each participant was randomly allocated to wear either a FB or AW along with their Holter monitor. RESULTS: Across all devices, 53,288 heart rate values were analysed from 32 participants. Twenty wore the AW (17 had persistent AF and 3 had sinus rhythm [SR]) while 12 participants wore the FB (9 in persistent AF and 3 in SR). Participants in SR demonstrated strong agreement compared to Holter monitoring (bias <1 beat, limits of agreement [LoA] -11 to 11 beats). In AF, both devices underestimated HR measurements (bias -9 beats, LoA -41 to 23). The degree of underestimation was more pronounced when HR > 100 bpm (bias of -28 beats for HR range 100-120 bpm, -48 for 120-140 bpm, and -69 for >140 bpm) compared to a slower HR (bias of -6 for HR range 80-100 bpm, <1 for 60-80 bpm, and -1 for <60 bpm). CONCLUSION: In ambulatory patients, smartwatches underestimated HR in AF particularly at HR ranges >100 bpm. Further improvements in device technology are needed before integrating them into the clinical management of rate control in AF.


Assuntos
Fibrilação Atrial/diagnóstico , Fibrilação Atrial/fisiopatologia , Eletrocardiografia Ambulatorial/normas , Frequência Cardíaca/fisiologia , Dispositivos Eletrônicos Vestíveis/normas , Idoso , Idoso de 80 Anos ou mais , Eletrocardiografia Ambulatorial/instrumentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
14.
Epilepsy Behav ; 103(Pt A): 106507, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31645318

RESUMO

Electroencephalography (EEG) is a core element in the diagnosis of epilepsy syndromes and can help to monitor antiseizure treatment. Mobile EEG (mEEG) devices are increasingly available on the consumer market and may offer easier access to EEG recordings especially in rural or resource-poor areas. The usefulness of consumer-grade devices for clinical purposes is still underinvestigated. Here, we compared EEG traces of a commercially available mEEG device (Emotiv EPOC) to a simultaneously recorded clinical video EEG (vEEG). Twenty-two adult patients (11 female, mean age 40.2 years) undergoing noninvasive vEEG monitoring for clinical purposes were prospectively enrolled. The EEG recordings were evaluated by 10 independent raters with unmodifiable view settings. The individual evaluations were compared with respect to the presence of abnormal EEG findings (regional slowing, epileptiform potentials, seizure pattern). Video EEG yielded a sensitivity of 56% and specificity of 88% for abnormal EEG findings, whereas mEEG reached 39% and 85%, respectively. Interrater reliability coefficients were better in vEEG as compared to mEEG (ϰ = 0.50 vs. 0.30), corresponding to a moderate and fair agreement. Intrarater reliability between mEEG and vEEG evaluations of simultaneous recordings of a given participant was moderate (ϰ = 0.48). Given the limitations of our exploratory pilot study, our results suggest that vEEG is superior to mEEG, but that mEEG can be helpful for diagnostic purposes. We present the first quantitative comparison of simultaneously acquired clinical and mobile consumer-grade EEG for a clinical use-case.


Assuntos
Eletroencefalografia , Síndromes Epilépticas/diagnóstico , Monitorização Ambulatorial , Convulsões/diagnóstico , Dispositivos Eletrônicos Vestíveis , Adulto , Eletroencefalografia/instrumentação , Eletroencefalografia/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Ambulatorial/instrumentação , Monitorização Ambulatorial/normas , Projetos Piloto , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Dispositivos Eletrônicos Vestíveis/normas
15.
Adv Wound Care (New Rochelle) ; 9(1): 28-33, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31871828

RESUMO

Objective: The objective of this prospective clinical study was to validate two prototype pressure ulcer monitoring platform (PUMP) devices, (PUMP1 and PUMP2), to promote optimal bed repositioning of hospitalized patients to prevent pressure ulcers (PUs). Approach: PUMP1 was a wearable electronic device attached to the patient gown with no skin contact. PUMP2 was a set of four identical electronic devices placed under the patient's bed wheels. A video camera recorded events in the patient room while measurements from the PUMP devices were correlated with true patient repositioning activity. The performance of these PUMP devices developed by our research team were evaluated and compared by both clinicians and engineers. Results: Ten mobility-restricted patients were enrolled into the study. Repositioning movement was recorded by both PUMP devices for 10 ± 2 h and corroborated with video capture. One hundred thirty-seven movements in total were detected by both PUMP1 and PUMP2 over 105 h of capture. Two false positives were detected by the sensors and 11 movements were missed by the sensors. PUMP1 and PUMP2 never conflicted in data collection. Innovation: The presented study evaluated two different sensors' abilities to capture accurate patient repositioning to eventually prevent PU formation. Importantly, detection of patient motion was completed without contact to patient skin. Conclusion: The clinical study demonstrated successful capture of patient repositioning movement by both PUMP1 and PUMP2 devices with 85% reliability, 2 false positives, and 11 missed movements. In future studies, the PUMP devices will be combined with a SMS-based mobile phone alert system to improve caregiver repositioning behavior.


Assuntos
Monitorização Fisiológica/instrumentação , Movimentação e Reposicionamento de Pacientes/métodos , Posicionamento do Paciente/instrumentação , Lesão por Pressão/prevenção & controle , Adulto , Idoso , Ensaios Clínicos como Assunto , Desenho de Equipamento/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Movimento/fisiologia , Estudos Prospectivos , Reprodutibilidade dos Testes , Dispositivos Eletrônicos Vestíveis/normas
16.
J Med Internet Res ; 21(12): e14909, 2019 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-31793887

RESUMO

BACKGROUND: Atrial fibrillation is the most common recurrent arrhythmia in clinical practice, with most clinical events occurring outside the hospital. Low detection and nonadherence to guidelines are the primary obstacles to atrial fibrillation management. Photoplethysmography is a novel technology developed for atrial fibrillation screening. However, there has been limited validation of photoplethysmography-based smart devices for the detection of atrial fibrillation and its underlying clinical factors impacting detection. OBJECTIVE: This study aimed to explore the feasibility of photoplethysmography-based smart devices for the detection of atrial fibrillation in real-world settings. METHODS: Subjects aged ≥18 years (n=361) were recruited from September 14 to October 16, 2018, for screening of atrial fibrillation with active measurement, initiated by the users, using photoplethysmography-based smart wearable devices (ie, a smart band or smart watches). Of these, 200 subjects were also automatically and periodically monitored for 14 days with a smart band. The baseline diagnosis of "suspected" atrial fibrillation was confirmed by electrocardiogram and physical examination. The sensitivity and accuracy of photoplethysmography-based smart devices for monitoring atrial fibrillation were evaluated. RESULTS: A total of 2353 active measurement signals and 23,864 periodic measurement signals were recorded. Eleven subjects were confirmed to have persistent atrial fibrillation, and 20 were confirmed to have paroxysmal atrial fibrillation. Smart devices demonstrated >91% predictive ability for atrial fibrillation. The sensitivity and specificity of devices in detecting atrial fibrillation among active recording of the 361 subjects were 100% and about 99%, respectively. For subjects with persistent atrial fibrillation, 127 (97.0%) active measurements and 2240 (99.2%) periodic measurements were identified as atrial fibrillation by the algorithm. For subjects with paroxysmal atrial fibrillation, 36 (17%) active measurements and 717 (19.8%) periodic measurements were identified as atrial fibrillation by the algorithm. All persistent atrial fibrillation cases could be detected as "atrial fibrillation episodes" by the photoplethysmography algorithm on the first monitoring day, while 14 (70%) patients with paroxysmal atrial fibrillation demonstrated "atrial fibrillation episodes" within the first 6 days. The average time to detect paroxysmal atrial fibrillation was 2 days (interquartile range: 1.25-5.75) by active measurement and 1 day (interquartile range: 1.00-2.00) by periodic measurement (P=.10). The first detection time of atrial fibrillation burden of <50% per 24 hours was 4 days by active measurement and 2 days by periodic measurementThe first detection time of atrial fibrillation burden of >50% per 24 hours was 1 day for both active and periodic measurements (active measurement: P=.02, periodic measurement: P=.03). CONCLUSIONS: Photoplethysmography-based smart devices demonstrated good atrial fibrillation predictive ability in both active and periodic measurements. However, atrial fibrillation type could impact detection, resulting in increased monitoring time. TRIAL REGISTRATION: Chinese Clinical Trial Registry of the International Clinical Trials Registry Platform of the World Health Organization ChiCTR-OOC-17014138; http://www.chictr.org.cn/showprojen.aspx?proj=24191.


Assuntos
Fibrilação Atrial/diagnóstico , Fotopletismografia/normas , Adulto , Fibrilação Atrial/fisiopatologia , Estudos de Coortes , Eletrocardiografia , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Aplicativos Móveis/normas , Monitorização Fisiológica , Projetos Piloto , Sensibilidade e Especificidade , Dispositivos Eletrônicos Vestíveis/normas
17.
JMIR Mhealth Uhealth ; 7(11): e13858, 2019 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-31682585

RESUMO

BACKGROUND: There is increasing availability of, and interest in, wearable activity trackers for children younger than 13 years. However, little is known about how children and parents use these activity trackers or perceive their acceptability. OBJECTIVE: This study primarily aimed to ascertain parental perspectives on the acceptability and usability of wearables designed to monitor children's physical activity levels. Secondary aims were to (1) identify practical considerations for future use in physical activity interventions and promotion initiatives; (2) determine use of different features and functions incorporated into the accompanying app; and (3) identify parents' awareness of their child's current physical activity levels. METHODS: In total, 36 children (18 boys and 18 girls) aged 7-12 years were asked to wear a wrist-worn activity tracker (KidFit) for 4 consecutive weeks and to use the accompanying app with parental assistance and guidance. Each week, one parent from each family (n=25; 21 mothers and 4 fathers) completed a Web-based survey to record their child's activity tracker use, app interaction, and overall experiences. At the end of the 4-week period, a subsample of 10 parents (all mothers) participated in face-to-face interviews exploring perceptions of the acceptability and usability of wearable activity trackers and accompanying apps. Quantitative and qualitative data were analyzed descriptively and thematically, respectively. Thematic data are presented using pen profiles, which were constructed from verbatim transcripts. RESULTS: Parents reported that they and their children typically found the associated app easy to use for activity tracking, though only step or distance information was generally accessed and some difficulties interpreting the data were reported. Children were frustrated with not being able to access real-time feedback, as the features and functions were only available through the app, which was typically accessed by, or in the presence of, parents. Parents identified that children wanted additional functions including a visual display to track and self-monitor activity, access to the app for goal setting, and the option of undertaking challenges against schools or significant others. Other barriers to the use of wearable activity trackers included discomfort of wearing the monitor because of the design and the inability to wear for water- or contact-based sports. CONCLUSIONS: Most parents reported that the wearable activity tracker was easy for their child or children to use and a useful tool for tracking their children's daily activity. However, several barriers were identified, which may impact sustained use over time; both the functionality and wearability of the activity tracker should therefore be considered. Overall, wearable activity trackers for children have the potential to be integrated into targeted physical activity promotion initiatives.


Assuntos
Ergonomia/normas , Monitores de Aptidão Física/normas , Pais/psicologia , Dispositivos Eletrônicos Vestíveis/normas , Criança , Ergonomia/estatística & dados numéricos , Feminino , Monitores de Aptidão Física/estatística & dados numéricos , Humanos , Masculino , Monitorização Fisiológica/instrumentação , Inquéritos e Questionários , Dispositivos Eletrônicos Vestíveis/psicologia , Dispositivos Eletrônicos Vestíveis/estatística & dados numéricos
18.
Circulation ; 140(25): e944-e963, 2019 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-31694402

RESUMO

The widespread use of cardiac implantable electronic devices and wearable monitors has led to the detection of subclinical atrial fibrillation in a substantial proportion of patients. There is evidence that these asymptomatic arrhythmias are associated with increased risk of stroke. Thus, detection of subclinical atrial fibrillation may offer an opportunity to reduce stroke risk by initiating anticoagulation. However, it is unknown whether long-term anticoagulation is warranted and in what populations. This scientific statement explores the existing data on the prevalence, clinical significance, and management of subclinical atrial fibrillation and identifies current gaps in knowledge and areas of controversy and consensus.


Assuntos
American Heart Association , Fibrilação Atrial/diagnóstico , Desfibriladores Implantáveis/normas , Conhecimentos, Atitudes e Prática em Saúde , Marca-Passo Artificial/normas , Dispositivos Eletrônicos Vestíveis/normas , Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/terapia , Desfibriladores Implantáveis/tendências , Humanos , Marca-Passo Artificial/tendências , Fatores de Risco , Estados Unidos/epidemiologia , Dispositivos Eletrônicos Vestíveis/tendências
19.
JMIR Mhealth Uhealth ; 7(10): e14534, 2019 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-31579020

RESUMO

BACKGROUND: Sport watches and fitness trackers provide a feasible way of obtaining energy expenditure (EE) estimations in daily life as well as during exercise. However, today's popular wrist-worn technologies show only poor-to-moderate EE accuracy. Recently, the invention of optical heart rate measurement and the further development of accelerometers in wrist units have opened up the possibility of measuring EE. OBJECTIVE: This study aimed to validate the new multisensory wristwatch Polar Vantage and its EE estimation in healthy individuals during low-to-high-intensity activities against indirect calorimetry. METHODS: Overall, 30 volunteers (15 females; mean age 29.5 [SD 5.1] years; mean height 1.7 [SD 0.8] m; mean weight 67.5 [SD 8.7] kg; mean maximal oxygen uptake 53.4 [SD 6.8] mL/min·kg) performed 7 activities-ranging in intensity from sitting to playing floorball-in a semistructured indoor environment for 10 min each, with 2-min breaks in between. These activities were performed while wearing the Polar Vantage M wristwatch and the MetaMax 3B spirometer. RESULTS: After EE estimation, a mean (SD) of 69.1 (42.7) kcal and 71.4 (37.8) kcal per 10-min activity were reported for the MetaMax 3B and the Polar Vantage, respectively, with a strong correlation of r=0.892 (P<.001). The systematic bias was 2.3 kcal (3.3%), with 37.8 kcal limits of agreement. The lowest mean absolute percentage errors were reported during the sitting and reading activities (9.1%), and the highest error rates during household chores (31.4%). On average, 59.5% of the mean EE values obtained by the Polar Vantage were within ±20% of accuracy when compared with the MetaMax 3B. The activity intensity quantified by perceived exertion (odds ratio [OR] 2.028; P<.001) and wrist circumference (OR -1.533; P=.03) predicted 29% of the error rates within the Polar Vantage. CONCLUSIONS: The Polar Vantage has a statistically moderate-to-good accuracy in EE estimation that is activity dependent. During sitting and reading activities, the EE estimation is very good, whereas during nonsteady activities that require wrist and arm movement, the EE accuracy is only moderate. However, compared with other available wrist-worn EE monitors, the Polar Vantage can be recommended, as it performs among the best.


Assuntos
Calorimetria Indireta/normas , Metabolismo Energético/fisiologia , Monitores de Aptidão Física/normas , Acelerometria/instrumentação , Acelerometria/métodos , Acelerometria/estatística & dados numéricos , Adulto , Calorimetria Indireta/métodos , Calorimetria Indireta/estatística & dados numéricos , Feminino , Monitores de Aptidão Física/estatística & dados numéricos , Humanos , Masculino , Estudos de Validação como Assunto , Dispositivos Eletrônicos Vestíveis/normas , Dispositivos Eletrônicos Vestíveis/estatística & dados numéricos
20.
JMIR Mhealth Uhealth ; 7(10): e14149, 2019 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-31621642

RESUMO

BACKGROUND: Although geriatric depression is prevalent, diagnosis using self-reporting instruments has limitations when measuring the depressed mood of older adults in a community setting. Ecological momentary assessment (EMA) by using wearable devices could be used to collect data to classify older adults into depression groups. OBJECTIVE: The objective of this study was to develop a machine learning algorithm to predict the classification of depression groups among older adults living alone. We focused on utilizing diverse data collected through a survey, an Actiwatch, and an EMA report related to depression. METHODS: The prediction model using machine learning was developed in 4 steps: (1) data collection, (2) data processing and representation, (3) data modeling (feature engineering and selection), and (4) training and validation to test the prediction model. Older adults (N=47), living alone in community settings, completed an EMA to report depressed moods 4 times a day for 2 weeks between May 2017 and January 2018. Participants wore an Actiwatch that measured their activity and ambient light exposure every 30 seconds for 2 weeks. At baseline and the end of the 2-week observation, depressive symptoms were assessed using the Korean versions of the Short Geriatric Depression Scale (SGDS-K) and the Hamilton Depression Rating Scale (K-HDRS). Conventional classification based on binary logistic regression was built and compared with 4 machine learning models (the logit, decision tree, boosted trees, and random forest models). RESULTS: On the basis of the SGDS-K and K-HDRS, 38% (18/47) of the participants were classified into the probable depression group. They reported significantly lower scores of normal mood and physical activity and higher levels of white and red, green, and blue (RGB) light exposures at different degrees of various 4-hour time frames (all P<.05). Sleep efficiency was chosen for modeling through feature selection. Comparing diverse combinations of the selected variables, daily mean EMA score, daily mean activity level, white and RGB light at 4:00 pm to 8:00 pm exposure, and daily sleep efficiency were selected for modeling. Conventional classification based on binary logistic regression had a good model fit (accuracy: 0.705; precision: 0.770; specificity: 0.859; and area under receiver operating characteristic curve or AUC: 0.754). Among the 4 machine learning models, the logit model had the best fit compared with the others (accuracy: 0.910; precision: 0.929; specificity: 0.940; and AUC: 0.960). CONCLUSIONS: This study provides preliminary evidence for developing a machine learning program to predict the classification of depression groups in older adults living alone. Clinicians should consider using this method to identify underdiagnosed subgroups and monitor daily progression regarding treatment or therapeutic intervention in the community setting. Furthermore, more efforts are needed for researchers and clinicians to diversify data collection methods by using a survey, EMA, and a sensor.


Assuntos
Depressão/diagnóstico , Aprendizado de Máquina/normas , Dispositivos Eletrônicos Vestíveis/normas , Idoso , Idoso de 80 Anos ou mais , Depressão/psicologia , Avaliação Momentânea Ecológica , Feminino , Humanos , Modelos Logísticos , Aprendizado de Máquina/estatística & dados numéricos , Masculino , República da Coreia , Características de Residência/classificação , Características de Residência/estatística & dados numéricos , Inquéritos e Questionários , Dispositivos Eletrônicos Vestíveis/psicologia , Dispositivos Eletrônicos Vestíveis/estatística & dados numéricos
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