Multicentre evaluation of a rule-based data filter for home monitoring of implanted cardioverter defibrillators

Sinha, Anil‐Martin; Koos, Ralf; Markus, Kai U.; Diem, Bjoern Henrik; Urbaszek, A.; Hanrath, Peter; Stellbrink, Christoph

doi:10.1258/135763306776084347

Cited by 7 publications

(7 citation statements)

References 8 publications

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“…Only two systems have implanted devices, i.e. a cardiac pacemaker with a monitoring function [ 58 ] and an implantable haemodynamic monitoring system [ 59 ].…”

Section: Resultsmentioning

confidence: 99%

Towards pervasive computing in health care – A literature review

Orwat

Graefe

Faulwasser

2008

BMC Med Inform Decis Mak

192

124

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Background: The evolving concepts of pervasive computing, ubiquitous computing and ambient intelligence are increasingly influencing health care and medicine. Summarizing published research, this literature review provides an overview of recent developments and implementations of pervasive computing systems in health care. It also highlights some of the experiences reported in deployment processes. Methods:There is no clear definition of pervasive computing in the current literature. Thus specific inclusion criteria for selecting articles about relevant systems were developed. Searches were conducted in four scientific databases alongside manual journal searches for the period of 2002 to 2006. Articles included present prototypes, case studies and pilot studies, clinical trials and systems that are already in routine use. Results:The searches identified 69 articles describing 67 different systems. In a quantitative analysis, these systems were categorized into project status, health care settings, user groups, improvement aims, and systems features (i.e., component types, data gathering, data transmission, systems functions). The focus is on the types of systems implemented, their frequency of occurrence and their characteristics. Qualitative analyses were performed of deployment issues, such as organizational and personnel issues, privacy and security issues, and financial issues. This paper provides a comprehensive access to the literature of the emerging field by addressing specific topics of application settings, systems features, and deployment experiences. Conclusion:Both an overview and an analysis of the literature on a broad and heterogeneous range of systems are provided. Most systems are described in their prototype stages. Deployment issues, such as implications on organization or personnel, privacy concerns, or financial issues are mentioned rarely, though their solution is regarded as decisive in transferring promising systems to a stage of regular operation. There is a need for further research on the deployment of pervasive computing systems, including clinical studies, economic and social analyses, user studies, etc.

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“…Only two systems have implanted devices, i.e. a cardiac pacemaker with a monitoring function [ 58 ] and an implantable haemodynamic monitoring system [ 59 ].…”

Section: Resultsmentioning

confidence: 99%

Towards pervasive computing in health care – A literature review

Orwat

Graefe

Faulwasser

2008

BMC Med Inform Decis Mak

192

124

View full text Add to dashboard Cite

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“…From the complexity of use perspective, since for the moment we do not consider the use of sensors, we have a single component system. From this review, the works [1,35] are the most related to ours.…”

Section: Related Workmentioning

confidence: 90%

“…In [35] a rule based solution is applied to data coming from automatic-defibrillators in home care settings. As for our case, the solution demonstrated users' satisfaction for the automatic interpretation of data and the ease of use.…”

Section: Related Workmentioning

confidence: 99%

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An expert Personal Health System to monitor patients affected by Gestational Diabetes Mellitus: A feasibility study

Bromuri

Puricel

Schumann

et al. 2016

AIS

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Purpose: Gestational Diabetes Mellitus (GDM) is a condition affecting 3-4% of pregnant women due to increased resistance to insulin caused by the growth of the fetus. Such a condition disappears just after delivery, but it is an indicator of the insurgence of diabetes type 2 (DT2) later in life: about 40% of the women affected by GDM also develop DT2 [22]. GDM brings several complications during pregnancy to both the mother and the fetus. We aim here at presenting our Personal Health System for monitoring GDM and we also present the results of outpatient monitoring and management by utilizing a personal health system (PHS) for GDM. Methods: The Personal Health System (PHS) was deployed in a feasibility study, modelled as a single-center, parallel group, open randomized controlled trial conducted in Lausanne University Hospital. Patients (n=24) were assigned to 2 different groups: standard protocol group (SP) and telemedicine group (TM). SP patients were managed by regular clinic visits. TM patients were managed with our EPHS system. The targeted feasibility outcome was whole trial feasibility, functioning of the PHS and its appropriateness for patient use. Results: Mean age was 32±5 years and patients were pregnant for 29.1±1.9 weeks at study inclusion. Patients came from 16 different countries. The follow-up rate was 100%. Acceptability in the TM-group was high, as 100% were satisfied with the care provided and equally 100% were at ease with the technology. Overall median[IQR] glucose control was 5.4 mmol/l [4.7-6.4] in the TM-group and 5.7mmol/l [4.9-6.7] in the SP-group (p<0.001). Four out of 6 daily plasma glucose values were significantly better controlled with telemedicine compared to standard care. Conclusion: The feasibility study that we conducted shows that PHSs have a great potential to improve the life of the patient by allowing a better communication of their physiological values to the caregivers. With respect to the particular case of GDM, the study suggests that use of PHS technology may improve glycaemic control in GDM, but to confirm this trend, a main trial is needed.

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“…A rule-based data filter was generally well accepted and found to be accurate in a multicenter study. 14 Automatic clinician alert triggers used with remote follow-up reduce time needed to action: the CONNECT trial (Medtronic) randomized 1997 patients and followed them at 1, 3, 6, 9, 12, and 15 months (patients in the remote arm had only remote follow-up at months 3, 6, 9, and 12). The median time to clinical decision after a detected event was reduced from 22 days in the in-office arm to 4.6 days in the remote arm, and the mean length of stay per cardiovascular hospitalization visit decreased from 4.0 days in the in-office arm to 3.3 days.…”

Section: Feasibility and Patient Safety With Remote Monitoringmentioning

confidence: 99%

Remote Monitoring of Cardiac Implantable Electronic Devices

Róka¹,

Schoenfeld²

2011

J Innov Cardiac Rhythm Manage

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Follow-up of implantable cardiac devices Patients require follow-up after implantation of a pacemaker (PM), implantable cardioverter-defibrillator (ICD), or cardiac resynchronization therapy device (CRT) to assess and adjust diagnostic, pacing, and antitachycardia functions. The frequency of follow-up is determined by multiple factors, including patient comorbidities, geographic accessibility to medical care and type of the implanted device. 1 Current guidelines recommend in person follow-up within 72 h after implantation of any device, with the next visit at 2-12 weeks. Thereafter, in person or remote follow-up is recommended every 3-12 months for pacemakers, and every 3-6 months for ICDs or CRT-defibrillators (CRT-D). Once every year, in person follow-up is required for any device, even if more frequent remote follow-up is performed. At signs of battery depletion, in person or remote follow-up every 1-3 months is needed. 2 In practice, office follow-up visits are frequently uneventful, revealing no relevant changes related to the implanted device or the patient's condition. There were an estimated 1.6 million PM and 2.1 million ICD follow-up encounters in 2007 in the USA alone, causing a significant burden on the cardiovascular workforce and contributing to increasing health-care costs. Remote monitoring systems The importance of pacemaker follow-up was recognized soon after these devices were introduced half a century

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Multicentre evaluation of a rule-based data filter for home monitoring of implanted cardioverter defibrillators

Cited by 7 publications

References 8 publications

Towards pervasive computing in health care – A literature review

Towards pervasive computing in health care – A literature review

An expert Personal Health System to monitor patients affected by Gestational Diabetes Mellitus: A feasibility study

Remote Monitoring of Cardiac Implantable Electronic Devices

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