Blood pressure self-measurement (BPSM) requires patients to follow a range of recommendations in order to be considered reliable for diagnostic use. We investigated currently used BPSM interventions at four medical clinics combined with an online questionnaire targeting BPSM users. We found that the participating healthcare personnel perceived BPSM as a relevant and useful intervention method providing that the recommendations are followed. A total of six challenges were identified: (1) existing devices do not guarantee that the recommendations are followed, (2) healthcare providers cannot verify whether self-monitoring patients follow the recommendations, (3) patients are not aware of all recommendations and the need to follow them, (4) risk of patient induced reporting bias, (5) risk of healthcare provider induced data-transfer bias, and (6) risk of data being registered as belonging to the wrong patient. We conclude that existing BPSM interventions could be significantly affected by user-induced bias resulting in an indeterminable quality of the measurement data. Therefore, we suggest applying context-aware technological support tools to better detect and quantify user errors. This may allow us to develop solutions that could overcome or compensate for such errors in the future.
Results indicate that context-aware technology may be useful for accurately modeling aspects of nonadherent patient behavior. This may be used to inform staff of the validity of the measurement and pinpoint patients in need of additional training or to design better aids to assist the patients. The developed system is generally applicable to other self-measurement environments, including the home setting and remote outpatient clinics, as it is built using telemedicine technology and thus well suited for remote monitoring and diagnosis.
Abstract. Positioning using GPS receivers is a primary sensing modality in many areas of pervasive computing. However, previous work has not considered how people's body impacts the availability and accuracy of GPS positioning and for means to sense such impacts. We present results that the GPS performance degradation on modern smart phones for different hand grip styles and body placements can cause signal strength drops as high as 10-16 dB and double the positioning error. Furthermore, existing phone applications designed to help users identify sources of GPS performance impairment are restricted to show raw signal statistics. To help both users as well as application systems in understanding and mitigating body and environment-induced effects, we propose a method for sensing the current sources of GPS reception impairment in terms of body, urban and indoor conditions. We present results that show that the proposed autonomous method can identify and differentiate such sources, and thus also user environments and phone postures, with reasonable accuracy, while relying solely on GPS receiver data as it is available on most modern smart phones.
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