Towards an Architecture to Guarantee Both Data Privacy and Utility in the First Phases of Digital Clinical Trials

Secure Biomedical Document Protection Framework to Ensure Privacy Through Blockchain

In the recent health care era, biomedical documents play a crucial role, and they contain much evidence-based documentation associated with many stakeholders data. Protecting those confidential research documents is more difficult and effective, and a significant process in the medical-based research domain. Those bio-documentation related to health care and other relevant community-valued data are suggested by medical professionals and processed. Many traditional security mechanisms such as akteonline and Health Insurance Portability and Accountability Act (HIPAA) are used to protect the biomedical documents as they consider the problem of non-repudiation and data integrity related to the retrieval and storage of documents. Thus, there is a need for a comprehensive framework that improves protection in terms of cost and response time related to biomedical documents. In this research work, blockchain-based biomedical document protection framework (BBDPF) is proposed, which includes blockchain-based biomedical data protection (BBDP) and blockchain-based biomedical data retrieval (BBDR) algorithms. BBDP and BBDR algorithms provide consistency on the data to prevent data modification and interception of confidential data with proper data validation. Both the algorithms have strong cryptographic mechanisms to withstand post-quantum security risks, ensuring the integrity of biomedical document retrieval and non-deny of data retrieval transactions. In the performance analysis, Ethereum blockchain infrastructure is deployed BBDPF and smart contracts using Solidity language. In the performance analysis, request time and searching time are determined based on the number of request to ensure data integrity, non-repudiation, and smart contracts for the proposed hybrid model as it gets increased gradually. A modified prototype is built with a web-based interface to prove the concept and evaluate the proposed framework. The experimental results revealed that the proposed framework renders data integrity, non-repudiation, and support for smart contracts with Query Notary Service, MedRec, MedShare, and Medlock.

An empirical investigation into the altering health perspectives in the internet of health things

Healthcare is on top of the agenda of all governments in the world as it is related to the well-being of the people. Naturally, this domain has attracted the attention of many researchers globally, who have studied the development of its different phases, including E-Health and the Internet of Health Things (IoHT). In this paper, the difference between the recent concepts of healthcare (E-health, M-Health, S-Health, I-Health, U-Health, and IoHT/IoMT) is analyzed based on the main services, applications, and technologies in each concept. The paper has also studied the latest developments in IoHT, which are linked to existing phases of development. A classification of groups of services and constituents of IoHT, linked to the latest technologies, is also provided. In addition, challenges, and future scope of research in this domain concerning the wellbeing of the people in the face of ongoing COVID-19 and future pandemics are explored.

METORY: Development of a Demand-Driven Blockchain-Based Dynamic Consent Platform Tailored for Clinical Trials

The recent advent of the dynamic consent concept intensified the data integrity issue in clinical trials. Incorporating blockchain technology into a dynamic consent platform can be a feasible solution. Due to various clinical trial settings, a demand-driven development strategy is required. We developed a blockchain-based dynamic consent platform named METORY tailored for clinical trials. The platform consisted of three parts: web and mobile application user interface, study management platform, and blockchain platform. Hyperledger Fabric, an enterprise-grade private blockchain framework, was used to integrate blockchain into the study consent platform. We conducted user acceptance tests and applied feedback to the improvement of the platform. Identity and role-based access control was constructed by combining mobile-application-based certificate system and access control functionalities in Hyperledger fabric. Data were encrypted using SHA-256 prior to transmission to blockchain server and TLS protocol was used for in-transit encryption. File-system level encryption was separated implemented within the security measures from Amazon RDS. Users' experience in the clinical trial was acceptable in the ease and usefulness of the platform.

Development of Novel, Value-Based, Digital Endpoints for Clinical Trials: A Structured Approach Toward Fit-for-Purpose Validation

Novel digital endpoints gathered via wearables, small devices, or algorithms hold great promise for clinical trials. However, implementation has been slow because of a lack of guidelines regarding the validation process of these new measurements. In this paper, we propose a pragmatic approach toward selection and fit-for-purpose validation of digital endpoints. Measurements should be value-based, meaning the measurements should directly measure or be associated with meaningful outcomes for patients. Devices should be assessed regarding technological validity. Most importantly, a rigorous clinical validation process should appraise the tolerability, difference between patients and controls, repeatability, detection of clinical events, and correlation with traditional endpoints. When technically and clinically fit-for-purpose, case building in interventional clinical trials starts to generate evidence regarding the response to new or existing health-care interventions. This process may lead to the digital endpoint replacing traditional endpoints, such as clinical rating scales or questionnaires in clinical trials. We recommend initiating more data-sharing collaborations to prevent unnecessary duplication of research and integration of value-based measurements in clinical care to enhance acceptance by health-care professionals. Finally, we invite researchers and regulators to adopt this approach to ensure a timely implementation of digital measurements and value-based thinking in clinical trial design and health care. SIGNIFICANCE STATEMENT: Novel digital endpoints are often cited as promising for the clinical trial of the future. However, clear validation guidelines are lacking in the literature. This paper contains pragmatic criteria for the selection, technical validation, and clinical validation of novel digital endpoints and provides recommendations for future work and collaboration.

Fog-Computing-Based Heartbeat Detection and Arrhythmia Classification Using Machine Learning

Designing advanced health monitoring systems is still an active research topic. Wearable and remote monitoring devices enable monitoring of physiological and clinical parameters (heart rate, respiration rate, temperature, etc.) and analysis using cloud-centric machine-learning applications and decision-support systems to predict critical clinical states. This paper moves from a totally cloud-centric concept to a more distributed one, by transferring sensor data processing and analysis tasks to the edges of the network. The resulting solution enables the analysis and interpretation of sensor-data traces within the wearable device to provide actionable alerts without any dependence on cloud services. In this paper, we use a supervised-learning approach to detect heartbeats and classify arrhythmias. The system uses a window-based feature definition that is suitable for execution within an asymmetric multicore embedded processor that provides a dedicated core for hardware assisted pattern matching. We evaluate the performance of the system in comparison with various existing approaches, in terms of achieved accuracy in the detection of abnormal events. The results show that the proposed embedded system achieves a high detection rate that in some cases matches the accuracy of the state-of-the-art algorithms executed in standard processors.