Digital Tracking of Physical Activity, Heart Rate, and Inhalation Behavior in Patients With Pulmonary Arterial Hypertension Treated With Inhaled Iloprost: Observational Study (VENTASTEP)

Stollfuss, Barbara; Richter, Manuel J.; Drömann, Daniel; Klose, Hans; Schwaiblmair, Martin; Gruenig, Ekkehard; Ewert, Ralf; Kirchner, Martin C; Kleinjung, Frank; Irrgang, Valeska; Müeller, Christian

doi:10.2196/25163

Cited by 10 publications

(12 citation statements)

References 34 publications

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“…Most studies (n=26, 56.5%) originated from North America, including the United States (n=24) [ 16 - 39 ] and Canada (n=2) [ 40 , 41 ]. Twelve studies (26.1%) were conducted in European countries, such as France [ 42 , 43 ], Germany [ 44 , 45 ], Italy [ 46 , 47 ], Luxembourg [ 43 ], Spain [ 48 , 49 ], Switzerland [ 50 ], the Netherlands [ 48 , 49 ], and the United Kingdom [ 47 - 49 , 51 - 53 ]. Six studies (13%) originated from countries in the Western Pacific region, including Australia [ 54 , 55 ], Japan [ 56 , 57 ], and South Korea [ 58 , 59 ].…”

Section: Resultsmentioning

confidence: 99%

“…A total of 7 (15.2%) studies focused on cardiovascular diseases, which included hypertension [ 19 , 21 , 45 ], hypercholesterolemia [ 56 ], heart failure [ 24 ], and general cardiovascular health [ 32 , 47 ]. Five studies (10.9%) focused on cancer, including skin cancer [ 28 ], melanoma [ 34 , 35 ], breast cancer [ 55 ], and monitoring patients undergoing chemotherapy [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…Most (n=25, 54.3%) studies fell under the wearable device category [ 16 - 20 , 22 , 24 , 25 , 32 - 34 , 36 , 38 , 43 , 44 , 46 , 47 , 49 - 51 , 55 - 58 , 61 ]. Many (n=14, 30.4%) studies also collected data using a combination of wearable devices and a mobile app and thus fell under the wearable device + mobile app category [ 21 , 23 , 26 - 30 , 35 , 39 , 45 , 48 , 53 , 54 , 60 ]. Of the studies, 8.7% (n=4) fell under the mobile app category [ 31 , 37 , 40 , 59 ], 4.4% (n=2) under the wearable device + other category [ 41 , 52 ], and 2.2% (n=1) under the other category [ 42 ], which included data collection through web-based applications.…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the data analysis techniques, 22 (47.8%) studies used regression-based statistical methods [ 16 , 20 , 22 , 23 , 28 , 30 , 33 , 35 , 37 , 40 , 41 , 43 , 45 , 48 - 50 , 53 , 54 , 56 , 58 , 61 ], 2 (4.3%) used latent growth analysis [ 18 , 38 ], and 14 (30.4%) used other statistical analysis methods [ 21 , 24 - 26 , 29 , 31 , 32 , 34 , 42 , 44 , 46 , 47 , 52 , 55 ]. One (2.2%) study did not perform any statistical analyses because it was a case report [ 36 ].…”

Section: Resultsmentioning

confidence: 99%

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Digital Phenotyping in Health Using Machine Learning Approaches: Scoping Review

Dlima¹,

Shevade²,

Menezes³

et al. 2022

JMIR Bioinform Biotech

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Background Digital phenotyping is the real-time collection of individual-level active and passive data from users in naturalistic and free-living settings via personal digital devices, such as mobile phones and wearable devices. Given the novelty of research in this field, there is heterogeneity in the clinical use cases, types of data collected, modes of data collection, data analysis methods, and outcomes measured. Objective The primary aim of this scoping review was to map the published research on digital phenotyping and to outline study characteristics, data collection and analysis methods, machine learning approaches, and future implications. Methods We utilized an a priori approach for the literature search and data extraction and charting process, guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews). We identified relevant studies published in 2020, 2021, and 2022 on PubMed and Google Scholar using search terms related to digital phenotyping. The titles, abstracts, and keywords were screened during the first stage of the screening process, and the second stage involved screening the full texts of the shortlisted articles. We extracted and charted the descriptive characteristics of the final studies, which were countries of origin, study design, clinical areas, active and/or passive data collected, modes of data collection, data analysis approaches, and limitations. Results A total of 454 articles on PubMed and Google Scholar were identified through search terms associated with digital phenotyping, and 46 articles were deemed eligible for inclusion in this scoping review. Most studies evaluated wearable data and originated from North America. The most dominant study design was observational, followed by randomized trials, and most studies focused on psychiatric disorders, mental health disorders, and neurological diseases. A total of 7 studies used machine learning approaches for data analysis, with random forest, logistic regression, and support vector machines being the most common. Conclusions Our review provides foundational as well as application-oriented approaches toward digital phenotyping in health. Future work should focus on more prospective, longitudinal studies that include larger data sets from diverse populations, address privacy and ethical concerns around data collection from consumer technologies, and build “digital phenotypes” to personalize digital health interventions and treatment plans.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Digital Phenotyping in Health Using Machine Learning Approaches: Scoping Review

Dlima¹,

Shevade²,

Menezes³

et al. 2022

JMIR Bioinform Biotech

View full text Add to dashboard Cite

show abstract

“…Remotely assessing 6-min walk distance, a cornerstone metric in evaluating PAH severity and response to therapy, has been a common goal. Trials using monitoring of physical activity via commercially available smartwatch and smartphone platforms have demonstrated feasibility in PAH patients and showed moderate to good correlation between traditional and digital 6-min walk distances (Glinskii et al, 2021;Stollfuss et al, 2021). Invasive monitoring systems such as the CardioMEMS sensor can assess pulmonary arterial pressures to allow real-time hemodynamics to guide heart failure therapy and have been explored primarily in left-sided heart failure.…”

Section: Right Atrial Pacing and Cardiac Synchronization Therapymentioning

confidence: 99%

Novel and emerging therapies in pulmonary arterial hypertension

Cassady

Soldin²,

Ramani³

2022

Front. Drug. Discov.

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Pulmonary arterial hypertension (PAH), defined as a mean pulmonary artery pressure exceeding 20 mmHg with a pulmonary vascular resistance of 3 or more Wood units, is an incurable and progressive condition. The cornerstone of PAH treatment is pulmonary vasodilators, which act on the pulmonary vasculature to reduce pulmonary pressures and pulmonary vascular resistance and prevent progression to right heart failure. The number of available pulmonary vasodilator therapies has grown markedly in the last 10 years, alongside a rapidly expanding body of literature establishing strategies for their use. Up-front combination therapy, typically with two pulmonary vasodilator medications, has become the standard of care based on landmark trials showing superior outcomes over single therapies alone. Complex risk stratification matrices have begun to see widespread use as tools with which to guide changes in PAH therapies for individual patients. Strategies for using the pulmonary vasodilators in common use continue to be evaluated in trials exploring concepts such as up-front triple combination therapy and substitution of vasodilators for patients not meeting therapeutic goals. Alongside established pulmonary vasodilator therapies for PAH, there is a broad spectrum of experimental therapies that are being studied for the disease. These include both more conventional medications that act on pathways targeted by existing vasodilator therapies as well as non-vasodilator treatments with novel methods of action, that may act both to vasodilate and to address the detrimental changes of pulmonary arterial and right ventricular remodeling. Many of these emerging medications are the focus of active phase 2 and 3 trials. Finally, there has been significant interest in therapeutic pathways that are well established in left heart failure, with the hope of adapting strategies that may be efficacious in PAH and right heart failure as well. These include explorations of pathways treated by goal-directed medical therapy as well as device therapies such as pacing, resynchronization therapy, and cardiac monitoring devices. Many of these options show promise and may represent a complementary approach to treatment of PAH, allowing for multimodal therapy alongside pulmonary vasodilators to improve patient outcomes.

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Peak steps: Capacity for activity improves after adding approved therapy in pulmonary arterial hypertension

Lachant,

Light,

Lachant

et al. 2023

Pulm. circ.

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Pulmonary arterial hypertension (PAH) patients have low activity. Activity intensity or duration could be a measure of clinical status or improvement. We aimed to determine whether standard or novel actigraphy measures could detect increases in activity after adding therapy. This was a prospective, single‐center observational study evaluating activity after adding therapy in Group 1 PAH; we also report a validation cohort. For our study, two different accelerometers were used, a wrist (ActiGraph) and chest (MC10) device. Patients were analyzed in two groups, Treatment Intensification (TI, adding therapy) or Stable. Both groups had baseline monitoring periods of 7 days; the TI group had follow‐up at 3 months, while Stables had follow‐up within 4 weeks to assess stability. Activity time and steps were reported from both devices' proprietary algorithms. In ActiGraph only, steps in 1‐min intervals throughout the day were ranked (not necessarily contiguous). Average values for each week were calculated and compared using nonparametric testing. Thirty patients had paired data (11 Stable and 19 TI). There was no between‐group difference at baseline; we did not observe therapy‐associated changes on average daily steps or activity time/intensity. The top 5 min of steps (capacity) increased after adding therapy; there was no difference in the stable group. This key finding was validated in a previously reported randomized trial studying a behavioral intervention to increase exercise. Total daily activity metrics are influenced by both disease and non‐disease factors, making therapy‐associated change difficult to detect. Peak minute steps were a treatment‐responsive marker in both a pharmacologic and training intervention.

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Digital Tracking of Physical Activity, Heart Rate, and Inhalation Behavior in Patients With Pulmonary Arterial Hypertension Treated With Inhaled Iloprost: Observational Study (VENTASTEP)

Cited by 10 publications

References 34 publications

Digital Phenotyping in Health Using Machine Learning Approaches: Scoping Review

Digital Phenotyping in Health Using Machine Learning Approaches: Scoping Review

Novel and emerging therapies in pulmonary arterial hypertension

Peak steps: Capacity for activity improves after adding approved therapy in pulmonary arterial hypertension

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