In this work, the authors investigate the cuff-less estimation of continuous BP through pulse transit time (PTT) and heart rate (HR) using regression techniques, which is intended as a first step towards continuous BP estimation with a low error, according to AAMI guidelines. Hypertension (the ‘silent killer’) is one of the main risk factors for cardiovascular diseases (CVDs), which are the main cause of death worldwide. Its continuous monitoring can offer a valid tool for patient care, as blood pressure (BP) is a significant indicator of health and, using it together with other parameters, such as heart and breath rates, could strongly improve prevention of CVDs. The novelties introduced in this work are represented by the implementation of pre-processing and by the innovative method for features research and features processing to continuously monitor blood pressure in a non-invasive way. Currently, invasive methods are the only reliable methods for continuous monitoring, while non-invasive techniques measure the values every few minutes. The proposed approach can be considered the first step for the integration of these types of algorithms on wearable devices, in particular on those developed for the SINTEC project.
Background Inflammatory bowel disease (IBD) are complex chronic disabling disease with variable disease activity. Physicians’ and patients’ perception of disease burden may vary considerably. The use of eHealth tools is a useful technique to monitor disease burden, but physicians- and patients-reported disease measurement do not overlap completely. Aim of this study was to perspectively explore agreement for rating disease activity and impact between patients, senior (consultants) and junior (residents) physicians. Methods Using a tele-monitoring platform (IBD Tool), 508 consecutive IBD patients filled disease activity (Harvey Bradshaw Index, HBI, for Crohn’s and Patient Simple Clinical Colitis Activity Index, P-SCCAI, as appropriate) and disease impact (Pictorial Representation of Illness and Self-Measure, PRISM) validated questionnaires at the time of outpatient visits. At the same timepoint also senior and junior physicians filled the same activity (HBI and Clinician SCCA, C-SCCAI) and impact (PRISM) questionnaires. Agreement between patients’ and physicians’ scores was analysed with intraclass and concordance correlation coefficients and Spearman’s rank correlation coefficient. Results A total of, 629 filled questionnaires regarding, 508 patients was available for analysis. Crohn’s patients were, 52%, and females were, 50%, median age of patients was, 44 years, and their median age at diagnosis was, 28 years, while median disease duration was, 12 years; overall, 39% of patients underwent surgery before being enrolled. Agreement for different scores among patients, senior and junior physicians was always significant and details are reported in Table, 1. Table, 1. Agreement among patients, senior and junior physicians for HBI, SCCAI and PRISM. A closer inverse relationship between activity indices and PRISM was found in physicians’ scores, while it was looser in patients’ scores. Senior physicians’ agreement was -0.774 and -0.793 for HBI and C-SCCAI, respectively, to PRISM (p<0.0001); Junior physicians’ agreement was -0.745 and -0.753 for HBI and C-SCCAI, respectively, to PRISM (p<0.0001); patients’ agreement was -0.414 and -0.498 for HBI and C-SCCAI, respectively, to PRISM (p<0.0001). Conclusion Agreement of patients’ and physicians’ scoring of disease activity on a tele-monitoring platform is good and significant, and it is optimal between junior and senior doctors. According to published data, physicians’ and patients’ agreement regarding the perception of disease impact on patients’ lives (measured with PRIMS) is slightly worse, although still significant, while it is good comparing junior and senior physicians’ rates. When exploring relationships between PRISM and disease activity scores it is good for physicians, and only average for patients.
Background Tele-monitoring and eHealth tools are useful to monitor disease burden and activity in inflammatory bowel disease (IBD). We developed a web-based tele-monitoring platform (IBD Tool), in order to monitor granularly disease activity and impact on patients’ lives. Aim of this abstract is to report preliminary data on IBD Tool effectiveness. Methods Consecutive IBD patients were offered the access to the tele-monitoring platform (IBD Tool) as a part of an ongoing investigator-initiated observational study, overall 677 patients were enrolled between February and November 2021. Validated questionnaires administered on the platform captured disease activity [Harvey Bradshaw Index (HBI), Simple Clinical Colitis Activity Index (SCCAI), Monitor IBD At Home Questionnaire for Crohn’s disease (CD) or for ulcerative colitis (UC): MIAH-CD or MIAH-UC] and disease burden and quality of life. Patients were randomized 1:1 to standard of care (only activity questionnaires required every 3-months) and telemedicine (activity questionnaires required monthly, remaining questionnaires every 3-months). Results Out of 678 patients enrolled, 585 (87%) are active on the platform and filled overall 14,297 questionnaires during an average follow-up of 9.8 months, the mean number of questionnaires filled/patient was 24.9. Characteristics of the patient enrolled in the study are presented in Table 1. Table 1. Characteristics of patients enrolled on the IBD Tool tele-monitoring platform and questionnaires filled Among the 320 cases with 2 or more observations in the IBD Tool platform, it was possible to analyse disease activity variation (summarized as constant, amelioration, or worsening) according to SCCAI or HBI changes ±2 points, results are detailed in Table 2. Table 2. Charateristics of patients constant, ameliorating or worsening in time. Conclusion Patients’ persistence in the tele-monitoring system is adequate; the systems offer granular and precise multidimensional evaluation of IBD patients.
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