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Abstract-In this paper first we present an overview of the state-of-the-art remote patient monitoring systems in the backdrop of real clinical needs. The paper establishes a clear guideline in terms of clinical expectations from such a system from the viewpoint of practicing clinicians. It provides in-depth analysis of the shortcomings of the existing architectures and paves a way towards developing a practical "patient-centric" architecture that could be useful in the day-to-day clinical practice for providing "continuum of care". Subsequently, the restrictions imposed by the resource constrained nature of such a system on development of appropriate hardware for supporting information processing on the data acquired by body-worn sensors are analyzed.

This paper addresses patient-reported outcomes (PROs) and telemonitoring in congestive heart failure (CHF), both increasingly important topics. The interest in CHF trials is shifting from hard end-points such as hospitalization and mortality, to softer end-points such health-related quality of life. However, the relation of these softer end-points to objective parameters is not well studied. Telemonitoring is suitable for collecting both patient-reported outcomes and objective parameters. Most telemonitoring studies, however, do not take full advantage of the available sensor technology and intelligent data analysis. The Chiron clinical observational study was performed among 24 CHF patients (17 men and 7 women, age 62.9 ± 9.4 years, 15 NYHA class II and 9 class III, 10 of ishaemic, aetiology, 6 dilated, 2 valvular, and 6 of multiple aetiologies or cardiomyopathy) in Italy and UK. A large number of physiological and ambient parameters were collected by wearable and other devices, together with PROs describing how well the patients felt, over 1,086 days of observation. The resulting data were mined for relations between the objective parameters and the PROs. The objective parameters (humidity, ambient temperature, blood pressure, SpO2, and sweeting intensity) could predict the PROs with accuracies up to 86% and AUC up to 0.83, making this the first report providing evidence for ambient and physiological parameters to be objectively related to PROs in CHF patients. We also analyzed the relations in the predictive models, gaining some insights into what affects the feeling of health, which was also generally not attempted in previous investigations. The paper strongly points to the possibility of using PROs as primary end-points in future trials.

BackgroundTo meet the required hours of intensive intervention for treating children with autism spectrum disorder (ASD), we developed an automated serious gaming platform (11 games) to deliver intervention at home (GOLIAH) by mapping the imitation and joint attention (JA) subset of age-adapted stimuli from the Early Start Denver Model (ESDM) intervention. Here, we report the results of a 6-month matched controlled exploratory study.MethodsFrom two specialized clinics, we included 14 children (age range 5–8 years) with ASD and 10 controls matched for gender, age, sites, and treatment as usual (TAU). Participants from the experimental group received in addition to TAU four 30-min sessions with GOLIAH per week at home and one at hospital for 6 months. Statistics were performed using Linear Mixed Models.ResultsChildren and parents participated in 40% of the planned sessions. They were able to use the 11 games, and participants trained with GOLIAH improved time to perform the task in most JA games and imitation scores in most imitation games. GOLIAH intervention did not affect Parental Stress Index scores. At end-point, we found in both groups a significant improvement for Autism Diagnostic Observation Schedule scores, Vineland socialization score, Parental Stress Index total score, and Child Behavior Checklist internalizing, externalizing and total problems. However, we found no significant change for by time × group interaction.ConclusionsDespite the lack of superiority of TAU + GOLIAH versus TAU, the results are interesting both in terms of changes by using the gaming platform and lack of parental stress increase. A large randomized controlled trial with younger participants (who are the core target of ESDM model) is now discussed. This should be facilitated by computing GOLIAH for a web platform. Trial registration Clinicaltrials.gov NCT02560415

The Nostalgia Bits (NoBits) project aims at fostering interaction between elderly and children through collecting memories. A web-based platform will be developed to allow tangible artefacts of an elderly person's life experience to become a resource to other generations and to connect the elderly users with members of their own generation. Here, we describe the results of a user needs analysis conducted by focus groups and questionnaires with end-users. The sample comprised 23 elderly (M = 65.83 SD = 6.32) and 310 children (M = 11.29 SD = 2.28). The findings were expanded through other two focus groups-one with ten elderly (M = 67.30 SD = 4.30) and one with 11 children (M = 12.45 SD = 1.21)-to obtain specific data for the development of a website based upon the suggestions collected through this user needs analysis. Results showed that both samples accepted the NoBits concept and that supporting collaborative reminiscing with social media is a promising approach to increase cross-generational interactions and mentoring.