Background and Objective: The early identification of malignant pulmonary nodules is critical for a better lung cancer prognosis and a less invasive chemo or radio therapies. Nodule malignancy assessment done by radiologists is extremely useful for planning a preventive intervention but is, unfortunately, a complex, time-consuming and error-prone task. This explains the lack of large datasets containing radiologists malignancy characterization of nodules; Methods: In this article, we propose to assess nodule malignancy through 3D convolutional neural networks and to integrate it in an automated end-to-end existing pipeline of lung cancer detection. For training and testing purposes we used independent subsets of the LIDC dataset; Results: Adding the probabilities of nodules malignity in a baseline lung cancer pipeline improved its F1-weighted score by 14.7 %, whereas integrating the malignancy model itself using transfer learning outperformed the baseline prediction by 11.8 % of F1-weighted score;Conclusions: Despite the limited size of the lung cancer datasets, integrating predictive models of nodule malignancy improves prediction of lung cancer.

Current brain-computer interface (BCIs) software is often tailored to the needs of scientists and technicians and therefore complex to allow for versatile use. To facilitate home use of BCIs a multifunctional P300 BCI with a graphical user interface intended for non-expert set-up and control was designed and implemented. The system includes applications for spelling, web access, entertainment, artistic expression and environmental control. In addition to new software, it also includes new hardware for the recording of electroencephalogram (EEG) signals. The EEG system consists of a small and wireless amplifier attached to a cap that can be equipped with gel-based or dry contact electrodes. The system was systematically evaluated with a healthy sample, and targeted end users of BCI technology, i.e., people with a varying degree of motor impairment tested the BCI in a series of individual case studies. Usability was assessed in terms of effectiveness, efficiency and satisfaction. Feedback of users was gathered with structured questionnaires. Two groups of healthy participants completed an experimental protocol with the gel-based and the dry contact electrodes (N = 10 each). The results demonstrated that all healthy participants gained control over the system and achieved satisfactory to high accuracies with both gel-based and dry electrodes (average error rates of 6 and 13%). Average satisfaction ratings were high, but certain aspects of the system such as the wearing comfort of the dry electrodes and design of the cap, and speed (in both groups) were criticized by some participants. Six potential end users tested the system during supervised sessions. The achieved accuracies varied greatly from no control to high control with accuracies comparable to that of healthy volunteers. Satisfaction ratings of the two end-users that gained control of the system were lower as compared to healthy participants. The advantages and disadvantages of the BCI and its applications are discussed and suggestions are presented for improvements to pave the way for user friendly BCIs intended to be used as assistive technology by persons with severe paralysis.

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Abstract. This paper proposed an approach of intelligent healthcare services to support health monitoring of old people through the project named SAAPHO. Here, definition and architecture of the proposed healthcare services are presented considering six different health parameters such as: 1) physical activity, 2) blood pressure, 3) glucose, 4) medication compliance, 5) pulse monitoring and 6) weight monitoring. The outcome of the proposed services is evaluated in a case study where total 201 subjects from Spain and Slovenia are involved for user requirements analysis considering 1) end users, 2) clinicians, and 3) field study analysis perspectives. The result shows the potentiality and competence of the proposed healthcare services for the users.

Background Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnea (OSA), but treatment compliance is often unsatisfactory. Objective The aim of this study was to assess the effectiveness and cost-effectiveness of an intelligent monitoring system for improving CPAP compliance. Methods This is a prospective, open label, parallel, randomized controlled trial including 60 newly diagnosed patients with OSA requiring CPAP (Apnea–Hypopnea Index [AHI] >15) from Lleida, Spain. Participants were randomized (1:1) to standard management or the MiSAOS intelligent monitoring system, involving (1) early compliance detection, thus providing measures of patient’s CPAP compliance from the very first days of usage; (2) machine learning–based prediction of midterm future CPAP compliance; and (3) rule-based recommendations for the patient (app) and care team. Clinical and anthropometric variables, daytime sleepiness, and quality of life were recorded at baseline and after 6 months, together with patient’s compliance, satisfaction, and health care costs. Results Randomized patients had a mean age of 57 (SD 11) years, mean AHI of 50 (SD 27), and 13% (8/60) were women. Patients in the intervention arm had a mean (95% CI) of 1.14 (0.04-2.23) hours/day higher adjusted CPAP compliance than controls (P=.047). Patients’ satisfaction was excellent in both arms, and up to 88% (15/17) of intervention patients reported willingness to keep using the MiSAOS app in the future. No significant differences were found in costs (control: mean €90.2 (SD 53.14) (US $105.76 [SD 62.31]); intervention: mean €96.2 (SD 62.13) (US $112.70 [SD 72.85]); P=.70; €1=US $1.17 was considered throughout). Overall costs combined with results on compliance demonstrated cost-effectiveness in a bootstrap-based simulation analysis. Conclusions A machine learning–based intelligent monitoring system increased daily compliance, reported excellent patient satisfaction similar to that reported in usual care, and did not incur in a substantial increase in costs, thus proving cost-effectiveness. This study supports the implementation of intelligent eHealth frameworks for the management of patients with CPAP-treated OSA and confirms the value of patients’ empowerment in the management of chronic diseases. Trial Registration ClinicalTrials.gov NCT03116958; https://clinicaltrials.gov/ct2/show/NCT03116958

Today, the healthcare monitoring is not limited to take place in primary care facilities simply due to deployment of ICT. However, to support an ICT-based health monitoring, proper health parameters, sensor devices, data communications, approaches, methods and their combination are still open challenges. This paper presents a self-serve ICT-based health monitoring system to support active ageing by assisting seniors to participate in regular monitoring of elderly's health condition. Here, the main objective is to facilitate a number of healthcare services to enable good health outcomes of healthy active living. Therefore, the proposed approach is identified and constructed three different kinds of healthcare services: 1) real time feedback generation service, 2) historical summary calculation service and 3) recommendation generation service. These services are implemented considering a number of health parameters, such as, 1) blood pressure, 2) blood glucose, 3) medication compliance, 4) weight monitoring, 5) physical activity, 6) pulse monitoring etc. The services are evaluated in Spain and Slovenia through 2 prototypical systems, i.e. year2prototype (Y2P) and year3prototype (Y3P) by 46 subjects (40 for Y2P and 6 for Y3P). The evaluation results show the necessity and competence of the proposed healthcare services. In addition, the prototypical system (i.e. Y3P) is found very much accepted and useful by most of the users.

BackgroundPatients suffering obstructive sleep apnea are mainly treated with continuous positive airway pressure (CPAP). Although it is a highly effective treatment, compliance with this therapy is problematic to achieve with serious consequences for the patients’ health. Unfortunately, there is a clear lack of clinical analytical tools to support the early prediction of compliant patients.MethodsThis work intends to take a further step in this direction by building compliance classifiers with CPAP therapy at three different moments of the patient follow-up, before the therapy starts (baseline) and at months 1 and 3 after the baseline.ResultsResults of the clinical trial shows that month 3 was the time-point with the most accurate classifier reaching an f1-score of 87% and 84% in cross-validation and test. At month 1, performances were almost as high as in month 3 with 82% and 84% of f1-score. At baseline, where no information of patients’ CPAP use was given yet, the best classifier achieved 73% and 76% of f1-score in cross-validation and test set respectively. Subsequent analyzes carried out with the best classifiers of each time point revealed baseline factors (i.e. headaches, psychological symptoms, arterial hypertension and EuroQol visual analog scale) closely related to the prediction of compliance independently of the time-point. In addition, among the variables taken only during the follow-up of the patients, Epworth and the average nighttime hours were the most important to predict compliance with CPAP.ConclusionsBest classifiers reported high performances after one month of treatment, being the third month when significant differences were achieved with respect to the baseline. Four baseline variables were reported relevant for the prediction of compliance with CPAP at each time-point. Two characteristics more were also highlighted for the prediction of compliance at months 1 and 3.Trial registrationClinicalTrials.gov Identifier, NCT03116958. Retrospectively registered on 17 April 2017.Electronic supplementary materialThe online version of this article (10.1186/s12911-018-0657-z) contains supplementary material, which is available to authorized users.