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Islam T, Washington P. Non-Invasive Biosensing for Healthcare Using Artificial Intelligence: A Semi-Systematic Review. BIOSENSORS 2024; 14:183. [PMID: 38667177 PMCID: PMC11048540 DOI: 10.3390/bios14040183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/27/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024]
Abstract
The rapid development of biosensing technologies together with the advent of deep learning has marked an era in healthcare and biomedical research where widespread devices like smartphones, smartwatches, and health-specific technologies have the potential to facilitate remote and accessible diagnosis, monitoring, and adaptive therapy in a naturalistic environment. This systematic review focuses on the impact of combining multiple biosensing techniques with deep learning algorithms and the application of these models to healthcare. We explore the key areas that researchers and engineers must consider when developing a deep learning model for biosensing: the data modality, the model architecture, and the real-world use case for the model. We also discuss key ongoing challenges and potential future directions for research in this field. We aim to provide useful insights for researchers who seek to use intelligent biosensing to advance precision healthcare.
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Kottler J, Khosla S, Recio V, Chestek D, Shanks J, Larimer K, Hoek TV. Evaluating an Advanced Practice Provider-Managed Coronavirus Disease 2019 Deterioration Program. J Nurse Pract 2023; 19:104754. [PMID: 37693741 PMCID: PMC10486239 DOI: 10.1016/j.nurpra.2023.104754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Background COVID-19 changed how healthcare systems could provide quality healthcare to patients, safely. An urban healthcare system created an advanced practice provider (APP)-managed continuous remote patient monitoring (cRPM) program. Methods A mixed-method study design focusing on the usable and feasible nature of the cRPM program. Both APP-guided interviews and online questionnaires were analyzed. Results There was overwhelmingly positive APP feedback utilizing the remote monitoring solution including providing quality healthcare, detecting early clinical deterioration, and desiring to adapt the solution to other acute or chronic diseases. Implications Understanding the clinical users' feedback on usability and feasibility of cRPM highlights the significance of rapid clinical assessment, urgent care escalation and provider accessibility.
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Affiliation(s)
- Janey Kottler
- University of Illinois Hospital and Health Sciences, Emergency Department, 1740 W Taylor Street, Chicago, IL 60612
| | - Shaveta Khosla
- University of Illinois Hospital and Health Sciences, Emergency Department, 1740 W Taylor Street, Chicago, IL 60612
| | - Vicki Recio
- University of Illinois Hospital and Health Sciences, Emergency Department, 1740 W Taylor Street, Chicago, IL 60612
| | - David Chestek
- University of Illinois Hospital and Health Sciences, Emergency Department, 1740 W Taylor Street, Chicago, IL 60612
| | - Jacqueline Shanks
- University of Illinois Chicago College of Nursing, 845 S. Damen Avenue, Chicago, IL 60612
| | - Karen Larimer
- physIQ, Chicago, IL, 200 W Jackson Blvd, Suite 550, Chicago, IL 60606
| | - Terry Vanden Hoek
- University of Illinois Hospital and Health Sciences, Emergency Department, 1740 W Taylor Street, Chicago, IL 60612
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Goergen CJ, Tweardy MJ, Steinhubl SR, Wegerich SW, Singh K, Mieloszyk RJ, Dunn J. Detection and Monitoring of Viral Infections via Wearable Devices and Biometric Data. Annu Rev Biomed Eng 2022; 24:1-27. [PMID: 34932906 PMCID: PMC9218991 DOI: 10.1146/annurev-bioeng-103020-040136] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Mounting clinical evidence suggests that viral infections can lead to detectable changes in an individual's normal physiologic and behavioral metrics, including heart and respiration rates, heart rate variability, temperature, activity, and sleep prior to symptom onset, potentially even in asymptomatic individuals. While the ability of wearable devices to detect viral infections in a real-world setting has yet to be proven, multiple recent studies have established that individual, continuous data from a range of biometric monitoring technologies can be easily acquired and that through the use of machine learning techniques, physiological signals and warning signs can be identified. In this review, we highlight the existing knowledge base supporting the potential for widespread implementation of biometric data to address existing gaps in the diagnosis and treatment of viral illnesses, with a particular focus on the many important lessons learned from the coronavirus disease 2019 pandemic.
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Affiliation(s)
- Craig J Goergen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA;
| | | | - Steven R Steinhubl
- physIQ Inc., Chicago, Illinois, USA
- Scripps Research Translational Institute, La Jolla, California, USA
| | | | - Karnika Singh
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | | | - Jessilyn Dunn
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
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Reamer C, Chi WN, Gordon R, Sarswat N, Gupta C, Gaznabi S, White VanGompel E, Szum I, Morton-Jost M, Vaughn J, Larimer K, Victorson D, Erwin J, Halasyamani L, Solomonides A, Padman R, Shah NS. Continuous remote patient monitoring in heart failure patients (CASCADE study): mixed methods feasibility protocol (Preprint). JMIR Res Protoc 2022; 11:e36741. [PMID: 36006689 PMCID: PMC9459840 DOI: 10.2196/36741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 05/24/2022] [Accepted: 06/16/2022] [Indexed: 11/29/2022] Open
Abstract
Background Heart failure (HF) is a prevalent chronic disease and is associated with increases in mortality and morbidity. HF is a leading cause of hospitalizations and readmissions in the United States. A potentially promising area for preventing HF readmissions is continuous remote patient monitoring (CRPM). Objective The primary aim of this study is to determine the feasibility and preliminary efficacy of a CRPM solution in patients with HF at NorthShore University HealthSystem. Methods This study is a feasibility study and uses a wearable biosensor to continuously remotely monitor patients with HF for 30 days after discharge. Eligible patients admitted with an HF exacerbation at NorthShore University HealthSystem are being recruited, and the wearable biosensor is placed before discharge. The biosensor collects physiological ambulatory data, which are analyzed for signs of patient deterioration. Participants are also completing a daily survey through a dedicated study smartphone. If prespecified criteria from the physiological data and survey results are met, a notification is triggered, and a predetermined electronic health record–based pathway of telephonic management is completed. In phase 1, which has already been completed, 5 patients were enrolled and monitored for 30 days after discharge. The results of phase 1 were analyzed, and modifications to the program were made to optimize it. After analysis of the phase 1 results, 15 patients are being enrolled for phase 2, which is a calibration and testing period to enable further adjustments to be made. After phase 2, we will enroll 45 patients for phase 3. The combined results of phases 1, 2, and 3 will be analyzed to determine the feasibility of a CRPM program in patients with HF. Semistructured interviews are being conducted with key stakeholders, including patients, and these results will be analyzed using the affective adaptation of the technology acceptance model. Results During phase 1, of the 5 patients, 2 (40%) were readmitted during the study period. The study completion rate for phase 1 was 80% (4/5), and the study attrition rate was 20% (1/5). There were 57 protocol deviations out of 150 patient days in phase 1 of the study. The results of phase 1 were analyzed, and the study protocol was adjusted to optimize it for phases 2 and 3. Phase 2 and phase 3 results will be available by the end of 2022. Conclusions A CRPM program may offer a low-risk solution to improve care of patients with HF after hospital discharge and may help to decrease readmission of patients with HF to the hospital. This protocol may also lay the groundwork for the use of CRPM solutions in other groups of patients considered to be at high risk. International Registered Report Identifier (IRRID) DERR1-10.2196/36741
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Affiliation(s)
- Courtney Reamer
- Department of Medicine, NorthShore University HealthSystem, Evanston, IL, United States
| | - Wei Ning Chi
- Outcomes Research Network, NorthShore University HealthSystem, Evanston, IL, United States
| | - Robert Gordon
- Department of Medicine, NorthShore University HealthSystem, Evanston, IL, United States
| | - Nitasha Sarswat
- Department of Medicine, NorthShore University HealthSystem, Evanston, IL, United States
- Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, IL, United States
| | - Charu Gupta
- Department of Medicine, NorthShore University HealthSystem, Evanston, IL, United States
| | - Safwan Gaznabi
- Department of Medicine, NorthShore University HealthSystem, Evanston, IL, United States
| | - Emily White VanGompel
- Department of Family Medicine, NorthShore University HealthSystem, Evanston, IL, United States
| | - Izabella Szum
- Home and Hospice Services, NorthShore University HealthSystem, Evanston, IL, United States
| | - Melissa Morton-Jost
- Home and Hospice Services, NorthShore University HealthSystem, Evanston, IL, United States
| | | | | | - David Victorson
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, United States
| | - John Erwin
- Department of Medicine, NorthShore University HealthSystem, Evanston, IL, United States
- Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, IL, United States
| | - Lakshmi Halasyamani
- Department of Medicine, NorthShore University HealthSystem, Evanston, IL, United States
- Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, IL, United States
| | - Anthony Solomonides
- Outcomes Research Network, NorthShore University HealthSystem, Evanston, IL, United States
| | - Rema Padman
- Heinz College of Information Systems and Public Policy, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Nirav S Shah
- Department of Medicine, NorthShore University HealthSystem, Evanston, IL, United States
- Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, IL, United States
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Wearable sensor derived decompensation index for continuous remote monitoring of COVID-19 diagnosed patients. NPJ Digit Med 2021; 4:155. [PMID: 34750499 PMCID: PMC8576003 DOI: 10.1038/s41746-021-00527-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 10/07/2021] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic has accelerated the adoption of innovative healthcare methods, including remote patient monitoring. In the setting of limited healthcare resources, outpatient management of individuals newly diagnosed with COVID-19 was commonly implemented, some taking advantage of various personal health technologies, but only rarely using a multi-parameter chest-patch for continuous monitoring. Here we describe the development and validation of a COVID-19 decompensation index (CDI) model based on chest patch-derived continuous sensor data to predict COVID-19 hospitalizations in outpatient-managed COVID-19 positive individuals, achieving an overall AUC of the ROC Curve of 0.84 on 308 event negative participants, and 22 event positive participants, out of an overall study cohort of 400 participants. We retrospectively compare the performance of CDI to standard of care modalities, finding that the machine learning model outperforms the standard of care modalities in terms of both numbers of events identified and with a lower false alarm rate. While only a pilot phase study, the CDI represents a promising application of machine learning within a continuous remote patient monitoring system.
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