| 1. |
- Herzog, Almut, 1969-, et al.
(författare)
-
Network solutions for home health care applications
- 2003
-
Ingår i: Technology and Health Care. - : IOS Press. - 0928-7329 .- 1878-7401. ; 11:2, s. 77-87
-
Tidskriftsartikel (refereegranskat)abstract
- The growing number of the elderly in industrialised countries is increasing the pressure on respective health care systems. This is one reason for recent trends in the development and expansion of home health care organisations. With Internet access available to everyone and the advent of wireless technologies, advanced telehomecare is a possibility for a large proportion of the population.In the near future, one of the authors plans to implement a home health care infrastructure for patients with congestive heart failure and patients with chronic obstructive pulmonary disease. The system is meant to support regular and ad-hoc measurements of medical parameters in patient homes and transmission of measurement data to the home health care provider.In this paper we look at network technologies that connect sensors and input devices in the patient home to a home health care provider. We consider wireless and Internet technologies from functional and security-related perspectives and arrive at a recommendation for our system.Security and usability aspects of the proposed network infrastructures are explored with special focus on their impact on the patient home.
|
|
| 2. |
- Jacobson, Petra, et al.
(författare)
-
Applying the Rome Proposal on Exacerbations of Chronic Obstructive Pulmonary Disease : Does Comorbid Chronic Heart Failure Matter?
- 2023
-
Ingår i: The International Journal of Chronic Obstructive Pulmonary Disease. - : Dove Medical Press Ltd. - 1176-9106 .- 1178-2005. ; 18, s. 2055-2064
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic heart failure (CHF) is a common comorbidity among patients with chronic obstructive pulmonary disease (COPD). Both exacerbations of COPD (ECOPDs) and exacerbations of CHF (ECHFs) display worsening of breathlessness at rest (BaR) and breathlessness at physical activity (BaPA). Comorbid CHF may have an impact on the vital signs assessed, when the Rome proposal (adopted by GOLD 2023) is applied on ECOPDs. Thus, the aim of the present study was to investigate the impact of comorbid CHF on ECOPDs severity, particularly focusing on the influence of comorbid CHF on BaR and BaPA. Methods: We analysed data on COPD symptoms collected from the telehealth study The eHealth Diary. Patients with COPD (n = 43) and patients with CHF (n = 41) were asked to daily monitor BaR and BaPA, employing a digital pen and scales for BaR and BaPA (from 0 to 10). Twenty-eight patients of the COPD patients presented with comorbid CHF. Totally, 125 exacerbations were analysed. Results: Exacerbations in the group with COPD patients and comorbid CHF were compared to the group with COPD patients without comorbid CHF and the group with CHF patients. Compared with GOLD 2022, the GOLD 2023 (the Rome proposal) significantly downgraded the ECOPD severity. Comorbid CHF did not interfere significantly on the observed difference. Comorbid CHF did not worsen BaR scores, assessed at inclusion and at the symptom peak of the exacerbations. Conclusion: In the present study, we find no evidence that comorbid CHF would interfere significantly with the parameters included in the Rome proposal (GOLD 2023). We conclude that the Rome proposal can be safely applied even on COPD patients with very advanced comorbid CHF.
|
|
| 3. |
- Jacobson, Petra, et al.
(författare)
-
The Exacerbation of Chronic Obstructive Pulmonary Disease : Which Symptom is Most Important to Monitor?
- 2023
-
Ingår i: The International Journal of Chronic Obstructive Pulmonary Disease. - : Dove Medical Press Ltd. - 1176-9106 .- 1178-2005. ; 18, s. 1533-1541
-
Tidskriftsartikel (refereegranskat)abstract
- Background: GOLD 2023 defines an exacerbation of COPD (ECOPD) by a deterioration of breathlessness at rest (BaR), mucus and cough. The severity of an ECOPD is determined by the degree of BaR, ranging from 0 to 10. However, it is not known which symptom is the most important one to detect early of an ECOPD, and which symptom that predicts future ECOPDs best. Thus, the purpose of the present study was to find out which symptom is the most important one to monitor. Methods: We analysed data on COPD symptoms from the telehealth study The eHealth Diary. Frequent exacerbators (n = 27) were asked to daily monitor BaR and breathlessness at physical activity (BaPA), mucus and cough, employing a digital pen and symptom scales (0–10). Twenty-seven patients with 105 ECOPDs were analysed. The association between symptom development and the occurrence of exacerbations was evaluated using the Andersen–Gill formulation of the Cox proportional hazards model for the analysis of recurrent time-to-event data with time-varying predictors. Results: According to the criteria proposed by GOLD 2023, 42% ECOPDs were mild, 48% were moderate and 5% were severe, while 6% were undefinable. Mucus and cough improved over study time, while BaR and BaPA deteriorated. Mucus appeared earliest, which was the most prominent feature of the average exacerbation, and worsening of mucus increased the risk for a future ECOPD. There was a 58% increase in the risk of exacerbation per unit increase in mucus score. Conclusion: This study suggests that mucus worsening is the most important COPD symptom to monitor to detect ECOPDs early and to predict future risk för ECOPDs. In the present study, we also noticed a pronounced difference between GOLD 2022 and 2023. Hence, GOLD 2023 defined the ECOPD severity much lower than GOLD 2022 did. © 2023 Jacobson et al.
|
|
| 4. |
- Jacobson, Petra, et al.
(författare)
-
Unleashing the Power of Very Small Data to Predict Acute Exacerbations of Chronic Obstructive Pulmonary Disease
- 2023
-
Ingår i: The International Journal of Chronic Obstructive Pulmonary Disease. - : Dove Medical Press Ltd. - 1176-9106 .- 1178-2005. ; 18, s. 1457-1473
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: In this article, we explore to what extent it is possible to leverage on very small data to build machine learning (ML) models that predict acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Methods: We build ML models using the small data collected during the eHealth Diary telemonitoring study between 2013 and 2017 in Sweden. This data refers to a group of multimorbid patients, namely 18 patients with chronic obstructive pulmonary disease (COPD) as the major reason behind previous hospitalisations. The telemonitoring was supervised by a specialised hospital-based home care (HBHC) unit, which also was responsible for the medical actions needed. Results: We implement two different ML approaches, one based on time-dependent covariates and the other one based on time-independent covariates. We compare the first approach with standard COX Proportional Hazards (CPH). For the second one, we use different proportions of synthetic data to build models and then evaluate the best model against authentic data. Discussion: To the best of our knowledge, the present ML study shows for the first time that the most important variable for an increased risk of future AECOPDs is “maintenance medication changes by HBHC”. This finding is clinically relevant since a sub-optimal maintenance treatment, requiring medication changes, puts the patient in risk for future AECOPDs. Conclusion: The experiments return useful insights about the use of small data for ML. © 2023 Jacobson et al.
|
|
| 5. |
- Karlsson, Daniel, et al.
(författare)
-
Archetype Representation of PROMs
- 2015
-
Ingår i: Digital Healthcare Empowering Europeans. - Amsterdam : IOS Press. - 9781614995111 - 9781614995128 ; , s. 980-980
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)
|
|
| 6. |
- Keskisärkkä, Robin, 1987-, et al.
(författare)
-
Capturing and Querying Uncertainty in RDF Stream Processing
- 2020
-
Ingår i: 22nd International Conference on Knowledge Engineering and Knowledge Management, EKAW 2020. - Cham : Springer Science and Business Media Deutschland GmbH. - 9783030612436 ; , s. 37-53
-
Konferensbidrag (refereegranskat)abstract
- RDF Stream Processing (RSP) has been proposed as a candidate for bringing together the Complex Event Processing (CEP) paradigm and the Semantic Web standards. In this paper, we investigate the impact of explicitly representing and processing uncertainty in RSP for the use in CEP. Additionally, we provide a representation for capturing the relevant notions of uncertainty in the RSP-QL data model and describe query functions that can operate on this representation. The impact evaluation is based on a use-case within electronic healthcare, where we compare the query execution overhead of different uncertainty options in a prototype implementation. The experiments show that the influence on query execution performance varies greatly, but that uncertainty can have noticeable impact on query execution performance. On the other hand, the overhead grows linearly with respect to the stream rate for all uncertainty options in the evaluation, and the observed performance is sufficient for many use-cases. Extending the representation and operations to support more uncertainty options and investigating different query optimization strategies to reduce the impact on execution performance remain important areas for future research.
|
|
| 7. |
- Keskisärkkä, Robin, 1987-, et al.
(författare)
-
RSP-QL⋆⋆: Enabling Statement-Level Annotations in RDF Streams
- 2019
-
Ingår i: Part of the Lecture Notes in Computer Science book series (LNCS, volume 11702). - Cham : Springer International Publishing. ; , s. 140-145, s. -55
-
Konferensbidrag (refereegranskat)abstract
- RSP-QL was developed by the W3C RDF Stream Processing (RSP) community group as a common way to express and query RDF streams. However, RSP-QL does not provide any way of annotating data on the statement level, for example, to express the uncertainty that is often associated with streaming information. Instead, the only way to provide such information has been to use RDF reification, which adds additional complexity to query processing, and is syntactically verbose. In this paper, we define an extension of RSP-QL, called RSP-QL⋆⋆, that provides an intuitive way for supporting statement-level annotations in RSP. The approach leverages the concepts previously described for RDF* and SPARQL*. We illustrate the proposed approach based on a scenario from a research project in e-health. An open-source implementation of the proposal is provided and compared to the baseline approach of using RDF reification. The results show that this way of dealing with statement-level annotations offers advantages with respect to both data transfer bandwidth and query execution performance.
|
|
| 8. |
- Lind, Leili, et al.
(författare)
-
A system for symptom assessment in advanced palliative home healthcare using digital pens
- 2004
-
Ingår i: Medical informatics and the Internet in medicine (Print). - : Informa UK Limited. - 1463-9238 .- 1464-5238. ; 29:3-4, s. 199-210
-
Tidskriftsartikel (refereegranskat)abstract
- Symptom control is one of the most important components of delivering effective palliative care, and adequate symptom assessment is a prerequisite for good symptom control. Patients receiving treatment in palliative home healthcare is geographically separated from the caregivers making symptom control a challenge, a challenge that could be met by the use of information and communication technology. Technologies of today offer different ways for patients to assess their symptoms at home and send the assessments to the healthcare provider. Examples are the use of a PC, a touch-tone telephone, and a digital pen, which require different kinds of infrastructure in the patient’s home, and which differ in strengths and weaknesses. As part of an ongoing quality assurance work within the hospital-based home care clinic at Linköping University Hospital, the project has designed, developed and implemented an IT-support system for pain assessments for patients at home using digital pen and mobile Internet technology. A questionnaire study indicated that pain assessment using digital pens was accepted by patients and that problems mainly arose from the use of the visual-analogue scale.
|
|
| 9. |
|
|
| 10. |
- Lind, Leili, 1954-, et al.
(författare)
-
COPD patients require more health care than heart failure patients
- 2018
-
Ingår i: ERS International Congress 2018.
-
Konferensbidrag (refereegranskat)abstract
- Background: Populations of elderly patients with advanced stages of chronic obstructive pulmonary disease (COPD) or heart failure (HF) are growing, urging the need for specialized health care in the patients’ home. A 4 year (2013-2017) telehealth intervention single-centre clinical study has been completed. We hypothesized that the two groups of patients, advanced COPD or HF, would exhibit differences regarding exacerbations and the need of health care.Objective: To study exacerbations of COPD or HF, and patients’ need of health care.Methods: A telemonitoring system, the Health Diary, which is based on digital pen technology, was employed. Patients with at least 2 hospital admissions the previous year were included. Responsible nurses and physicians at a specialized home care unit at a university hospital checked all daily patient reports. Physicians identified exacerbations using information provided through the telemonitoring system and patient contacts. Consumed health care was assessed as the number of patient contacts (home visits or telephone consultations).Results: Totally, 94 patients with advanced disease were enrolled (36 COPD and 58 HF patients) of which 53 patients (19 COPD and 34 HF patients) completed the 1-yr study period. The major reason for not completing the study was death (13 COPD, 15 HF patients). Average numbers of exacerbations were 3.1 and 0.8 and patient contacts were 94 and 67 per COPD and HF patient, respectively.Conclusions: Compared to HF patients, COPD patients exhibit exacerbations more frequently and demand much more home health care. This difference of health care consumption is mainly due to disease characteristics.
|
|
