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Smartphone-Based Geofencing to Ascertain Hospitalizations.

ABSTRACT: BACKGROUND:Ascertainment of hospitalizations is critical to assess quality of care and the effectiveness and adverse effects of various therapies. Smartphones, mobile geolocators that are ubiquitous, have not been leveraged to ascertain hospitalizations. Therefore, we evaluated the use of smartphone-based geofencing to track hospitalizations. METHODS AND RESULTS:Participants aged ?18 years installed a mobile application programmed to geofence all hospitals using global positioning systems and cell phone tower triangulation and to trigger a smartphone-based questionnaire when located in a hospital for ?4 hours. An in-person study included consecutive consenting patients scheduled for electrophysiology and cardiac catheterization procedures. A remote arm invited Health eHeart Study participants who consented and engaged with the study via the internet only. The accuracy of application-detected hospitalizations was confirmed by medical record review as the reference standard. Of 22 eligible in-person patients, 17 hospitalizations were detected (sensitivity 77%; 95% confidence interval, 55%-92%). The length of stay according to the application was positively correlated with the length of stay ascertained via the electronic medical record (r=0.53; P=0.03). In the remote arm, the application was downloaded by 3443 participants residing in all 50 US states; 243 hospital visits at 119 different hospitals were detected through the application. The positive predictive value for an application-reported hospitalization was 65% (95% confidence interval, 57%-72%). CONCLUSIONS:Mobile application-based ascertainment of hospitalizations can be achieved with modest accuracy. This first proof of concept may ultimately be applicable to geofencing other types of prespecified locations to facilitate healthcare research and patient care.

SUBMITTER: Nguyen KT

PROVIDER: S-EPMC5363280 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

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Smartphone-Based Geofencing to Ascertain Hospitalizations.

Nguyen Kaylin T KT Olgin Jeffrey E JE Pletcher Mark J MJ Ng Madelena M Kaye Leanne L Moturu Sai S Gladstone Rachel A RA Malladi Chaitanya C Fann Amy H AH Maguire Carol C Bettencourt Laura L Christensen Matthew A MA Marcus Gregory M GM

Circulation. Cardiovascular quality and outcomes 20170301 3

<h4>Background</h4>Ascertainment of hospitalizations is critical to assess quality of care and the effectiveness and adverse effects of various therapies. Smartphones, mobile geolocators that are ubiquitous, have not been leveraged to ascertain hospitalizations. Therefore, we evaluated the use of smartphone-based geofencing to track hospitalizations.<h4>Methods and results</h4>Participants aged ≥18 years installed a mobile application programmed to geofence all hospitals using global positioning ...[more]

PMID: 28325751

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Project description:Water quality is undergoing significant deterioration due to bacteria, pollutants and other harmful particles, damaging aquatic life and lowering the quality of drinking water. It is, therefore, important to be able to rapidly and accurately measure water quality in a cost-effective manner using e.g., a turbidimeter. Turbidimeters typically use different illumination angles to measure the scattering and transmittance of light through a sample and translate these readings into a measurement based on the standard nephelometric turbidity unit (NTU). Traditional turbidimeters have high sensitivity and specificity, but they are not field-portable and require electricity to operate in field settings. Here we present a field-portable and cost effective turbidimeter that is based on a smartphone. This mobile turbidimeter contains an opto-mechanical attachment coupled to the rear camera of the smartphone, which contains two white light-emitting-diodes to illuminate the water sample, optical fibers to transmit the light collected from the sample to the camera, an external lens for image formation, and diffusers for uniform illumination of the sample. Including the smartphone, this cost-effective device weighs only ~350 g. In our mobile turbidimeter design, we combined two illumination approaches: transmittance, in which the optical fibers were placed directly below the sample cuvette at 180° with respect to the light source, and nephelometry in which the optical fibers were placed on the sides of the sample cuvette at a 90° angle with respect to the to the light source. Images of the end facets of these fiber optic cables were captured using the smart phone and processed using a custom written image processing algorithm to automatically quantify the turbidity of each sample. Using transmittance and nephelometric readings, our mobile turbidimeter achieved accurate measurements over a large dynamic range, from 0.3 NTU to 2000 NTU. The accurate performance of our smartphone-based turbidimeter was also confirmed with various water samples collected in Los Angeles (USA), bacteria spiked water samples, as well as diesel fuel contaminated water samples. Having a detection limit of ~0.3 NTU, this cost-effective smartphone-based turbidimeter can be a useful analytical tool for screening of water quality in resource limited settings.

Project description:BackgroundThe success rate of correct endotracheal tube (ETT) placement for junior medical staff is less than 50% and accidental oesophageal intubation is common. Rapid confirmation of correct tube placement is important because tube malposition is associated with serious adverse outcomes including hypoxaemia, death, pneumothorax and right upper lobe collapse.ETT position can be confirmed using chest radiography, but this is often delayed; hence, a number of rapid point-of-care methods to confirm correct tube placement have been developed. Current neonatal resuscitation guidelines advise that correct ETT placement should be confirmed by the observation of clinical signs and the detection of exhaled carbon dioxide (CO2). Even though these devices are frequently used in the delivery room to assess tube placement, they can display false-negative results. Recently, newer techniques to assess correct tube placement have emerged (e.g. respiratory function monitor), which have been claimed to be superior in the assessment of tube placement.ObjectivesTo assess various techniques for the identification of correct ETT placement after oral or nasal intubation in newborn infants in either the delivery room or neonatal intensive care unit compared with chest radiography.Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL,The Cochrane Library 2012, Issue 4), MEDLINE (January 1996 to June 2014), EMBASE (January 1980 to Juen 2014) and CINAHL (January 1982 to June 2014). We searched clinical trials registers and the abstracts of the Society for Pediatric Research and the European Society for Pediatric Research from 2004 to 2014. We did not apply any language restrictions.Selection criteriaWe planned to include randomised and quasi-randomised controlled trials and cluster trials that compared chest radiography with clinical signs, respiratory function monitors, exhaled CO2 detectors or ultrasound for the assessment of correct ETT placement either in the delivery room or the neonatal intensive care unit.Data collection and analysisTwo review authors independently evaluated the search results against the selection criteria. We did not perform data extraction and 'Risk of bias' assessments because we identified no studies that met our inclusion criteria.Main resultsWe did not identify any studies meeting the criteria for inclusion in this review.Authors' conclusionsThere is insufficient evidence to determine the most effective technique for the assessment of correct ETT placement either in the delivery room or the neonatal intensive care unit. Randomised clinical trials comparing either of these techniques with chest radiography are warranted.

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Smartphone-Based Geofencing to Ascertain Hospitalizations.

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Smartphone-Based Geofencing to Ascertain Hospitalizations.

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