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Ahmad Hatib NA, Lee JH, Chong SL, Sng QW, Tan VSR, Ong GYK, Lim AM, Quek BH, How MS, Chan JMF, Saffari SE, Ng KC. A two-phased study on the use of remote photoplethysmography (rPPG) in paediatric care. ANNALS OF TRANSLATIONAL MEDICINE 2024; 12:46. [PMID: 38911566 PMCID: PMC11193567 DOI: 10.21037/atm-23-1896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/10/2024] [Indexed: 06/25/2024]
Abstract
Background Advancements in medical technologies have led to the development of contact-free methods of haemodynamic monitoring such as remote photoplethysmography (rPPG). rPPG uses video cameras to interpret variations in skin colour related to blood flow, which are analysed to generate vital signs readings. rPPG potentially ameliorates problems like fretfulness and fragile skin contact associated with conventional probes in children. While rPPG has been validated in adults, no prior validation has been performed in children. Methods A two-phased prospective cross-sectional single-centre study was conducted from January to April 2023 to evaluate the feasibility, acceptability, and accuracy of obtaining heart rate (HR), respiratory rate (RR) and oxygen saturation (SpO2) using rPPG in children, compared to the current standard of care. In Phase 1, we recruited patients ≤16 years from the neonatal and paediatric wards. We excluded preterm neonates with gestational age <35 weeks and newborns <24 hours old. The rPPG webcam was positioned 30 cm from the face. After 1 minute of facial scanning, readings generated were compared with pulse oximetry for HR and SpO2, and manual counting for RR. Correlation and Bland-Altman analyses were performed. In Phase 2, we focused on the population in whom there was potential correlation between rPPG and the actual vital signs. Results Ten neonates and 28 children aged 5 to 16 years were recruited for Phase 1 (765 datapoints). All patients were haemodynamically stable and normothermic. Patients and caregivers showed high acceptability to rPPG. rPPG values were clinically discrepant for children <10 years. For those ≥10 years, moderate correlation was observed for HR, with Spearman's correlation coefficient (Rs) of 0.50 [95% confidence intervals (CI): 0.42, 0.57]. We performed Phase 2 on 23 patients aged 12 to 16 years (559 datapoints). Strong correlation was observed for HR with Rs=0.82 (95% CI: 0.78, 0.85). There was weak correlation for SpO2 and RR (Rs=-0.25 and -0.02, respectively). Conclusions Our study showed that rPPG is acceptable and feasible for neonates and children aged 5 to 16 years, and HR values in older children aged 12 to 16 years correlated well with the current standard. The rPPG algorithms need to be further refined for younger children, and for obtaining RR and SpO2 in all children. If successful, rPPG will provide a viable contact-free alternative for assessing paediatric vital signs, with potential use in remote monitoring and telemedicine.
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Affiliation(s)
- Nur Adila Ahmad Hatib
- General Paediatrics Service, KK Women’s and Children’s Hospital, Singapore, Singapore
- SingHealth Duke-NUS Paediatrics Academic Clinical Programme, Duke-NUS, Singapore, Singapore
| | - Jan Hau Lee
- SingHealth Duke-NUS Paediatrics Academic Clinical Programme, Duke-NUS, Singapore, Singapore
- Children’s Intensive Care Unit, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Shu-Ling Chong
- SingHealth Duke-NUS Paediatrics Academic Clinical Programme, Duke-NUS, Singapore, Singapore
- Department of Emergency Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Qian Wen Sng
- Department of Advancing Nursing and Education, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Victoria Shi Rui Tan
- SingHealth Duke-NUS Paediatrics Academic Clinical Programme, Duke-NUS, Singapore, Singapore
- Department of Emergency Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Gene Yong-Kwang Ong
- SingHealth Duke-NUS Paediatrics Academic Clinical Programme, Duke-NUS, Singapore, Singapore
- Department of Emergency Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Alicia May Lim
- SingHealth Duke-NUS Paediatrics Academic Clinical Programme, Duke-NUS, Singapore, Singapore
- Department of Neonatology, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Bin Huey Quek
- SingHealth Duke-NUS Paediatrics Academic Clinical Programme, Duke-NUS, Singapore, Singapore
- Department of Neonatology, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Mee See How
- Special Care Nursery, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Joel Meng Fai Chan
- General Paediatrics Service, KK Women’s and Children’s Hospital, Singapore, Singapore
- SingHealth Duke-NUS Paediatrics Academic Clinical Programme, Duke-NUS, Singapore, Singapore
| | - Seyed Ehsan Saffari
- Centre for Quantitative Medicine, Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Kee Chong Ng
- SingHealth Duke-NUS Paediatrics Academic Clinical Programme, Duke-NUS, Singapore, Singapore
- Chief Executive Officer, Changi General Hospital, Singapore, Singapore
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Pham C, Poorzargar K, Panesar D, Lee K, Wong J, Parotto M, Chung F. Video plethysmography for contactless blood pressure and heart rate measurement in perioperative care. J Clin Monit Comput 2024; 38:121-130. [PMID: 37715858 DOI: 10.1007/s10877-023-01074-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/30/2023] [Indexed: 09/18/2023]
Abstract
The purpose of this study was to evaluate the feasibility and accuracy of remote Video Plethysmography (VPPG) for contactless measurements of blood pressure (BP) and heart rate (HR) in adult surgical patients in a hospital setting. An iPad Pro was used to record a 1.5-minute facial video of the participant's face and VPPG was used to extract vital signs measurements. A standard medical device (Welch Allyn) was used for comparison to measure BP and HR. Trial registration: NCT05165381. Two-hundred-sixteen participants consented and completed the contactless BP and HR monitoring (mean age 54.1 ± 16.8 years, 58% male). The consent rate was 75% and VPPG was 99% successful in capturing BP and HR. VPPG predicted SBP, DBP, and HR with a measurement bias ± SD, -8.18 ± 16.44 mmHg, - 6.65 ± 9.59 mmHg, 0.09 ± 6.47 beats/min respectively. Pearson's correlation for all measurements between VPPG and standard medical device was significant. Correlation for SBP was moderate (0.48), DBP was weak (0.29), and HR was strong (0.85). Most patients were satisfied with the non-contact technology with an average rating of 8.7/10 and would recommend it for clinical use. VPPG was highly accurate in measuring HR, and is currently not accurate in measuring BP in surgical patients. The VPPG BP algorithm showed limitations in capturing individual variations in blood pressure, highlighting the need for further improvements to render it clinically effective across all ranges. Contactless vital signs monitoring was well-received and earned a high satisfaction score.
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Affiliation(s)
- Chi Pham
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Khashayar Poorzargar
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Darshan Panesar
- Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Kang Lee
- Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Jean Wong
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Matteo Parotto
- Department of Anesthesia and Pain Medicine, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Frances Chung
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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Burgos LM, Ballari F, Massa M, Talavera ML, Benzadón M, Díez M. Evaluation of vital signs through a mobile application in patients with heart failure: a opportunity for remote titration? ARCHIVOS DE CARDIOLOGIA DE MEXICO 2024; 94:86-94. [PMID: 38507315 PMCID: PMC11160516 DOI: 10.24875/acm.22000221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 06/01/2023] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Virtual consultations have increased exponentially, but a limitation is the inability to assess vital signs (VS). This is particularly useful in patients with heart failure (HF) for titrating prognosis-modifying medication. This issue could potentially be addressed by a tool capable of measuring blood pressure (BP) and heart rate (HR) accurately, remotely, and conveniently. Mobile phones equipped with transdermal optical imaging technology could meet these requirements. OBJECTIVE To evaluate the accuracy of a transdermal optical imaging-based app for estimating VS compared to clinical assessment in patients with HF. METHODS A prospective cohort study included patients evaluated in an HF outpatient unit between February and April 2022. BP and HR were simultaneously assessed using the app and clinical examination (BP with an automated sphygmomanometer and HR by brachial palpation). Three measurements were taken by both the app and clinic for each patient, by two independent blinded physicians. RESULTS Thirty patients were included, with 540 measurements of BP and HR. The mean age was 66 (± 13) years, 53.3% were male. The mean left ventricular ejection fraction was 37 ± 15, with 63.3% having previous hospitalizations for HF, and 63.4% in NYHA class II-III. The mean difference between the app measurement and its clinical reference measurement was 3.6 ± 0.5 mmHg for systolic BP (SBP), 0.9 ± -0.2 mmHg for diastolic BP (DBP), and 0.2 ± 0.4 bpm for HR. When averaging the paired mean differences for each patient, the mean across the 30 patients was 2 ± 6 mmHg for SBP, -0.14 ± 4.6 mmHg for DBP, and 0.23 ± 4 bpm for HR. CONCLUSION The estimation of BP and HR by an app with transdermal optical imaging technology was comparable to non-invasive measurement in patients with HF and met the precision criteria for BP measurement in this preliminary study. The use of this new transdermal optical imaging technology provides promising data, which should be corroborated in larger cohorts.
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Affiliation(s)
- Lucrecia M. Burgos
- Servicio de Insuficiencia Cardiaca, Hipertensión Pulmonar y Trasplante Cardiaco
| | | | | | - María L. Talavera
- Servicio de Insuficiencia Cardiaca, Hipertensión Pulmonar y Trasplante Cardiaco
| | - Mariano Benzadón
- Departamento de Innovación. Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - Mirta Díez
- Servicio de Insuficiencia Cardiaca, Hipertensión Pulmonar y Trasplante Cardiaco
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Arrow C, Ward M, Eshraghian J, Dwivedi G. Capturing the pulse: a state-of-the-art review on camera-based jugular vein assessment. BIOMEDICAL OPTICS EXPRESS 2023; 14:6470-6492. [PMID: 38420308 PMCID: PMC10898581 DOI: 10.1364/boe.507418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/02/2023] [Accepted: 11/05/2023] [Indexed: 03/02/2024]
Abstract
Heart failure is associated with a rehospitalisation rate of up to 50% within six months. Elevated central venous pressure may serve as an early warning sign. While invasive procedures are used to measure central venous pressure for guiding treatment in hospital, this becomes impractical upon discharge. A non-invasive estimation technique exists, where the clinician visually inspects the pulsation of the jugular veins in the neck, but it is less reliable due to human limitations. Video and signal processing technologies may offer a high-fidelity alternative. This state-of-the-art review analyses existing literature on camera-based methods for jugular vein assessment. We summarize key design considerations and suggest avenues for future research. Our review highlights the neck as a rich imaging target beyond the jugular veins, capturing comprehensive cardiac signals, and outlines factors affecting signal quality and measurement accuracy. Addressing an often quoted limitation in the field, we also propose minimum reporting standards for future studies.
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Affiliation(s)
- Coen Arrow
- School of Medicine, University of Western Australia, Perth, Australia
- Advanced Clinical and Translational Cardiovascular Imaging, Harry Perkins Institute of Medical Research, University of Western Australia, Perth, Australia
| | - Max Ward
- Department of Computer Science and Software Engineering, University of Western Australia, Perth, Australia
| | - Jason Eshraghian
- Department of Electrical and Computer Engineering, University of California (Santa Cruz), California, USA
| | - Girish Dwivedi
- School of Medicine, University of Western Australia, Perth, Australia
- Advanced Clinical and Translational Cardiovascular Imaging, Harry Perkins Institute of Medical Research, University of Western Australia, Perth, Australia
- Department of Cardiology, Fiona Stanley Hospital, Perth, Australia
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Covino M, Sandroni C, Della Polla D, De Matteis G, Piccioni A, De Vita A, Russo A, Salini S, Carbone L, Petrucci M, Pennisi M, Gasbarrini A, Franceschi F. Predicting ICU admission and death in the Emergency Department: A comparison of six early warning scores. Resuscitation 2023; 190:109876. [PMID: 37331563 DOI: 10.1016/j.resuscitation.2023.109876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/30/2023] [Accepted: 06/09/2023] [Indexed: 06/20/2023]
Abstract
AIM To compare the ability of the most used Early Warning Scores (EWS) to identify adult patients at risk of poor outcomes in the emergency department (ED). METHODS Single-center, retrospective observational study. We evaluated the digital records of consecutive ED admissions in patients ≥ 18 years from 2010 to 2019 and calculated NEWS, NEWS2, MEWS, RAPS, REMS, and SEWS based on parameters measured on ED arrival. We assessed the discrimination and calibration performance of each EWS in predicting death/ICU admission within 24 hours using ROC analysis and visual calibration. We also measured the relative weight of clinical and physiological derangements that identified patients missed by EWS risk stratification using neural network analysis. RESULTS Among 225,369 patients assessed in the ED during the study period, 1941 (0.9%) were admitted to ICU or died within 24 hours. NEWS was the most accurate predictor (area under the receiver operating characteristic [AUROC] curve 0.904 [95% CI 0.805-0.913]), followed by NEWS2 (AUROC 0.901). NEWS was also well calibrated. In patients judged at low risk (NEWS < 2), 359 events occurred (18.5% of the total). Neural network analysis revealed that age, systolic BP, and temperature had the highest relative weight for these NEWS-unpredicted events. CONCLUSIONS NEWS is the most accurate EWS for predicting the risk of death/ICU admission within 24 h from ED arrival. The score also had a fair calibration with few events occurring in patients classified at low risk. Neural network analysis suggests the need for further improvements by focusing on the prompt diagnosis of sepsis and the development of practical tools for the measurement of the respiratory rate.
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Affiliation(s)
- Marcello Covino
- Emergency Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy.
| | - Claudio Sandroni
- Università Cattolica del Sacro Cuore, Roma, Italy; Department of Anaesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Davide Della Polla
- Emergency Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Giuseppe De Matteis
- Department of Internal Medicina and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Andrea Piccioni
- Emergency Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Antonio De Vita
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Andrea Russo
- Department of Geriatrics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Sara Salini
- Department of Geriatrics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Luigi Carbone
- Emergency Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy; Department of Emergency Medicine, Ospedale Fatebenefratelli Isola Tiberina, Gemelli, Isola, Roma, Italy
| | - Martina Petrucci
- Emergency Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Mariano Pennisi
- Università Cattolica del Sacro Cuore, Roma, Italy; Department of Anaesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Antonio Gasbarrini
- Università Cattolica del Sacro Cuore, Roma, Italy; Department of Internal Medicina and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Francesco Franceschi
- Emergency Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy
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Bautista M, Cave D, Downey C, Bentham JR, Jayne D. Clinical applications of contactless photoplethysmography for vital signs monitoring in pediatrics: A systematic review and meta-analysis. J Clin Transl Sci 2023; 7:e144. [PMID: 37396820 PMCID: PMC10310860 DOI: 10.1017/cts.2023.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 05/11/2023] [Accepted: 05/11/2023] [Indexed: 07/04/2023] Open
Abstract
Background Contactless photoplethysmography (PPG) potentially affords the ability to obtain vital signs in pediatric populations without disturbing the child. Most validity studies have been conducted in laboratory settings or with healthy adult volunteers. This review aims to evaluate the current literature on contactless vital signs monitoring in pediatric populations and within a clinical setting. Methods OVID, Webofscience, Cochrane library, and clinicaltrials.org were systematically searched by two authors for research studies which used contactless PPG to assess vital signs in children and within a clinical setting. Results Fifteen studies were included with a total of 170 individuals. Ten studies were included in a meta-analysis for neonatal heart rate (HR), which demonstrated a pooled mean bias of -0.25 (95% limits of agreement (LOA), -1.83 to 1.32). Four studies assessed respiratory rate (RR) in neonates, and meta-analysis demonstrated a pooled mean bias of 0.65 (95% LOA, -3.08 to 4.37). All studies were small, and there were variations in the methods used and risk of bias. Conclusion Contactless PPG is a promising tool for vital signs monitoring in children and accurately measures neonatal HR and RR. Further research is needed to assess children of different age groups, the effects of skin type variation, and the addition of other vital signs.
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Affiliation(s)
- Melissa Bautista
- University of Leeds, Leeds, West Yorkshire, UK
- General Surgery Department, St James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, UK
| | - Daniel Cave
- University of Leeds, Leeds, West Yorkshire, UK
- Leeds Children’s Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, UK
| | - Candice Downey
- University of Leeds, Leeds, West Yorkshire, UK
- General Surgery Department, St James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, UK
| | - James R. Bentham
- University of Leeds, Leeds, West Yorkshire, UK
- Leeds Children’s Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, UK
| | - David Jayne
- University of Leeds, Leeds, West Yorkshire, UK
- General Surgery Department, St James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, UK
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Bautista MJ, Kowal M, Cave DGW, Downey C, Jayne DG. Clinical applications of contactless photoplethysmography for monitoring in adults: A systematic review and meta-analysis. J Clin Transl Sci 2023; 7:e129. [PMID: 37313385 PMCID: PMC10260340 DOI: 10.1017/cts.2023.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/24/2023] [Accepted: 05/05/2023] [Indexed: 06/15/2023] Open
Abstract
Contactless photoplethysmography (cPPG) is a method of physiological monitoring. It differs from conventional monitoring methods (e.g., saturation probe) by ensuring no contact with the subject by use of a camera. The majority of research on cPPG is conducted in a laboratory setting or in healthy populations. This review aims to evaluate the current literature on monitoring using cPPG in adults within a clinical setting. Adhering to the Preferred Items for Systematic Reviews and Meta-analysis (PRISMA, 2020) guidelines, OVID, Webofscience, Cochrane library, and clinicaltrials.org were systematically searched by two researchers. Research articles using cPPG for monitoring purposes in adults within a clinical setting were selected. Twelve studies with a total of 654 individuals were included. Heart rate (HR) was the most investigated vital sign (n = 8) followed by respiratory rate ((n = 2), Sp02 (n = 2), and HR variability (n = 2). Four studies were included in a meta-analysis of HR compared to ECG data which demonstrated a mean bias of -0.13 (95% CI, -1.22-0.96). This study demonstrates cPPG can be a useful tool in the remote monitoring of patients and has demonstrated accuracy for HR. However, further research is needed into the clinical applications of this method.
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Accurate and Reliable Assessment of Heart Rate in Real-Life Clinical Settings Using an Imaging Photoplethysmography. J Clin Med 2022; 11:jcm11206101. [PMID: 36294422 PMCID: PMC9604655 DOI: 10.3390/jcm11206101] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/28/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022] Open
Abstract
Remote photoplethysmography imaging (rPPGc) is a new method measuring essential parameters, such as heart rate (HR), which uses a video camera during teleconsultation. Our work aimed to evaluate the accuracy of such remote measurements compared with existing contact point measurement methods in real-life clinical settings. The prospective hospital-based study recruited 1045 patients who required a pulmonary function test. For each patient, measurements of HR using a standard electrocardiogram acquisition system (gold standard) were carried out concomitantly with the measurements made by the rPPGc system (Caducy v1.0.0) taken within a 60 s timeframe. Age, gender, and skin phototype were collected. We performed an intraclass coefficient correlation (ICC) and Bland–Altman plotting to determine the accuracy and precision of the rPPGc algorithm readings. We achieved measurement of HR using the two methods in 963 patients. The ICC measured at a 60 s timeframe, and when we compared the rPPGc with the gold standard, it had a 95% confidence interval (CI95) value of 0.886 [0.871:0.899]. In all, 94.6% (n = 911) patients showed promising results with a CI95 in Bland–Altman plotting. Fifty-two measurements were discordant, and further analysis established the method’s accuracy at 96.2%. Our results described a good accuracy and correlation between the rPPGc system and the gold standard, thus paving the way for more precise care via telemedicine.
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Do W, Russell R, Wheeler C, Lockwood M, De Vos M, Pavord I, Bafadhel M. Performance of Contactless Respiratory Rate Monitoring by Albus Home TM, an Automated System for Nocturnal Monitoring at Home: A Validation Study. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22197142. [PMID: 36236241 PMCID: PMC9573065 DOI: 10.3390/s22197142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/01/2022] [Accepted: 09/16/2022] [Indexed: 06/12/2023]
Abstract
Respiratory rate (RR) is a clinically important predictor of cardio-respiratory deteriorations. The mainstay of clinical measurement comprises the manual counting of chest movements, which is variable between clinicians and limited to sporadic readings. Emerging solutions are limited by poor adherence and acceptability or are not clinically validated. Albus HomeTM is a contactless and automated bedside system for nocturnal respiratory monitoring that overcomes these limitations. This study aimed to validate the accuracy of Albus Home compared to gold standards in real-world sleeping environments. Participants undertook overnight monitoring simultaneously using Albus Home and gold-standard polygraphy with thoraco-abdominal respiratory effort belts (SomnomedicsEU). Reference RR readings were obtained by clinician-count of polygraphy data. For both the Albus system and reference, RRs were measured in 30-s segments, reported as breaths/minute, and compared. Accuracy was defined as the percentage of RRs from the Albus system within ±2 breaths/minute of reference counts. Across a diverse validation set of 32 participants, the mean accuracy exceeded 98% and was maintained across different participant characteristics. In a Bland-Altman analysis, Albus RRs had strong agreement with reference mean differences and the limits of agreement of -0.4 and ±1.2 breaths/minute, respectively. Albus Home is a contactless yet accurate system for automated respiratory monitoring. Validated against gold -standard methods, it enables long-term, reliable nocturnal monitoring without patient burden.
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Affiliation(s)
| | - Richard Russell
- Respiratory Medicine Unit, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7FZ, UK
| | | | | | - Maarten De Vos
- Department of Electrical Engineering and Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
| | - Ian Pavord
- Respiratory Medicine Unit, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7FZ, UK
| | - Mona Bafadhel
- King’s Centre for Lung Health, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King’s College London, London SE1 1UL, UK
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Algoritmically improved microwave radar monitors breathing more acurrate than sensorized belt. Sci Rep 2022; 12:14412. [PMID: 36002632 PMCID: PMC9400007 DOI: 10.1038/s41598-022-18808-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 08/19/2022] [Indexed: 11/12/2022] Open
Abstract
This paper describes a novel way to measure, process, analyze, and compare respiratory signals acquired by two types of devices: a wearable sensorized belt and a microwave radar-based sensor. Both devices provide breathing rate readouts. First, the background research is presented. Then, the underlying principles and working parameters of the microwave radar-based sensor, a contactless device for monitoring breathing, are described. The breathing rate measurement protocol is then presented, and the proposed algorithm for octave error elimination is introduced. Details are provided about the data processing phase; specifically, the management of signals acquired from two devices with different working principles and how they are resampled with a common processing sample rate. This is followed by an analysis of respiratory signals experimentally acquired by the belt and microwave radar-based sensors. The analysis outcomes were checked using Levene’s test, the Kruskal–Wallis test, and Dunn’s post hoc test. The findings show that the proposed assessment method is statistically stable. The source of variability lies in the person-triggered breathing patterns rather than the working principles of the devices used. Finally, conclusions are derived, and future work is outlined.
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Allado E, Poussel M, Renno J, Moussu A, Hily O, Temperelli M, Albuisson E, Chenuel B. Remote Photoplethysmography Is an Accurate Method to Remotely Measure Respiratory Rate: A Hospital-Based Trial. J Clin Med 2022; 11:3647. [PMID: 35806932 PMCID: PMC9267568 DOI: 10.3390/jcm11133647] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/14/2022] [Accepted: 06/21/2022] [Indexed: 02/04/2023] Open
Abstract
Remote photoplethysmography imaging (rPPG) is a new solution proposed to measure vital signs, such as respiratory rate (RR) in teleconsultation, by using a webcam. The results, presented here, aim at evaluating the accuracy of such remote measurement methods, compared with existing measurement methods, in a real-life clinical setting. For each patient, measurement of RR, using the standard system (control), has been carried out concomitantly with the experimental system. A 60-s time frame was used for the measurements made by our rPPG system. Age, gender, BMI, and skin phototype were collected. We performed the intraclass correlation coefficient and Bland-Altman plot to analyze the accuracy and precision of the rPPG algorithm readings. Measurements of RR, using the two methods, have been realized on 963 patients. Comparison of the two techniques showed excellent agreement (96.0%), with most of the patients (n = 924-standard patients) being in the confidence interval of 95% in Bland-Altman plotting. There were no significant differences between standard patients and outlier patients for demographic and clinical characteristics. This study indicates a good agreement between the rPPG system and the control, thus allowing clinical use of this remote assessment of the respiratory rate.
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Affiliation(s)
- Edem Allado
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F-54000 Nancy, France; (M.P.); (A.M.); (O.H.); (M.T.); (B.C.)
- DevAH, Université de Lorraine, F-54000 Nancy, France
- OMEOS, F-54000 Nancy, France;
| | - Mathias Poussel
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F-54000 Nancy, France; (M.P.); (A.M.); (O.H.); (M.T.); (B.C.)
- DevAH, Université de Lorraine, F-54000 Nancy, France
| | | | - Anthony Moussu
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F-54000 Nancy, France; (M.P.); (A.M.); (O.H.); (M.T.); (B.C.)
- OMEOS, F-54000 Nancy, France;
| | - Oriane Hily
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F-54000 Nancy, France; (M.P.); (A.M.); (O.H.); (M.T.); (B.C.)
| | - Margaux Temperelli
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F-54000 Nancy, France; (M.P.); (A.M.); (O.H.); (M.T.); (B.C.)
| | - Eliane Albuisson
- CHRU-Nancy, Direction de la Recherche Clinique et de l’Innovation, F-54000 Nancy, France;
- CNRS, IECL, Université de Lorraine, F-54000 Nancy, France
- Département du Grand Est de Recherche en Soins Primaires (DEGERESP), Université de Lorraine, F-54000 Nancy, France
| | - Bruno Chenuel
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F-54000 Nancy, France; (M.P.); (A.M.); (O.H.); (M.T.); (B.C.)
- DevAH, Université de Lorraine, F-54000 Nancy, France
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Video-based physiologic monitoring: promising applications for the ICU and beyond. NPJ Digit Med 2022; 5:26. [PMID: 35256730 PMCID: PMC8901769 DOI: 10.1038/s41746-022-00575-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/11/2022] [Indexed: 01/25/2023] Open
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One small wearable, one giant leap for patient safety? J Clin Monit Comput 2021; 36:1-4. [PMID: 34665392 PMCID: PMC8525066 DOI: 10.1007/s10877-021-00767-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 10/12/2021] [Indexed: 01/15/2023]
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