Dataset Information

Smartphone app for neonatal heart rate assessment: an observational study.

ABSTRACT: Background:Heart rate (HR) assessment is crucial in neonatal resuscitation, but pulse oximetry (PO) and electrocardiography (ECG) are rarely accessible in low-resource to middle-resource settings. This study evaluated a free-of-charge smartphone application, NeoTap, which records HR with a screen-tapping method bypassing mental arithmetic calculations. Methods:This observational study was carried out during three time periods between May 2015 and January 2019 in Uganda in three phases. In phase 1, a metronome rate (n=180) was recorded by low-end users (midwives) using NeoTap. In phase 2, HR (n=69) in breathing neonates was recorded by high-end users (paediatricians) using NeoTap versus PO. In phase 3, HR (n=235) in non-breathing neonates was recorded by low-end users using NeoTap versus ECG. Results:In high-end users the mean difference was 3 beats per minute (bpm) higher with NeoTap versus PO (95% agreement limits -14 to 19 bpm), with acquisition time of 5?seconds. In low-end users, the mean difference was 6 bpm lower with NeoTap versus metronome (95% agreement limits -26 to 14 bpm) and 3 bpm higher with NeoTap versus ECG in non-breathing neonates (95% agreement limits -48 to 53 bpm), with acquisition time of 2.7?seconds. The agreement between NeoTap and ECG was good in the HR categories of 60-99 bpm and ?100?bpm; HR <60 bpm had few measurements (kappa index 0.71, 95%?CI 0.63 to 0.79). Conclusion:HR could be accurately and rapidly assessed using a smartphone application in breathing neonates in a low-resource setting. Clinical assessment by low-end users was less accurate with wider CI but still adds clinically important information in non-breathing neonates. The authors suggest low-end users may benefit from auscultation-focused training. More research is needed to evaluate its feasibility in clinical use.

SUBMITTER: Myrnerts Hook S

PROVIDER: S-EPMC7381998 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Smartphone app for neonatal heart rate assessment: an observational study.

Myrnerts Höök Susanna S Pejovic Nicolas J NJ Cavallin Francesco F Lubulwa Clare C Byamugisha Josaphat J Nankunda Jolly J Tylleskär Thorkild T Alfven Tobias T

BMJ paediatrics open 20200722 1

<h4>Background</h4>Heart rate (HR) assessment is crucial in neonatal resuscitation, but pulse oximetry (PO) and electrocardiography (ECG) are rarely accessible in low-resource to middle-resource settings. This study evaluated a free-of-charge smartphone application, NeoTap, which records HR with a screen-tapping method bypassing mental arithmetic calculations.<h4>Methods</h4>This observational study was carried out during three time periods between May 2015 and January 2019 in Uganda in three ph ...[more]

PMID: 32760813

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Project description:BACKGROUND:Smartphone apps for heart rate variability (HRV) measurement have been extensively developed in the last decade. However, ultra-short-term HRV recordings taken by wearable devices have not been examined. OBJECTIVE:The aims of this study were the following: (1) to compare the validity and reliability of ultra-short-term and short-term HRV time-domain and frequency-domain variables in a novel smartphone app, Pulse Express Pro (PEP), and (2) to determine the agreement of HRV assessments between an electrocardiogram (ECG) and PEP. METHODS:In total, 60 healthy adults were recruited to participate in this study (mean age 22.3 years [SD 3.0 years], mean height 168.4 cm [SD 8.0 cm], mean body weight 64.2 kg [SD 11.5 kg]). A 5-minute resting HRV measurement was recorded via ECG and PEP in a sitting position. Standard deviation of normal R-R interval (SDNN), root mean square of successive R-R interval (RMSSD), proportion of NN50 divided by the total number of RR intervals (pNN50), normalized very-low-frequency power (nVLF), normalized low-frequency power (nLF), and normalized high-frequency power (nHF) were analyzed within 9 time segments of HRV recordings: 0-1 minute, 1-2 minutes, 2-3 minutes, 3-4 minutes, 4-5 minutes, 0-2 minutes, 0-3 minutes, 0-4 minutes, and 0-5 minutes (standard). Standardized differences (ES), intraclass correlation coefficients (ICC), and the Spearman product-moment correlation were used to compare the validity and reliability of each time segment to the standard measurement (0-5 minutes). Limits of agreement were assessed by using Bland-Altman plot analysis. RESULTS:Compared to standard measures in both ECG and PEP, pNN50, SDNN, and RMSSD variables showed trivial ES (<0.2) and very large to nearly perfect ICC and Spearman correlation coefficient values in all time segments (>0.8). The nVLF, nLF, and nHF demonstrated a variation of ES (from trivial to small effects, 0.01-0.40), ICC (from moderate to nearly perfect, 0.39-0.96), and Spearman correlation coefficient values (from moderate to nearly perfect, 0.40-0.96). Furthermore, the Bland-Altman plots showed relatively narrow values of mean difference between the ECG and PEP after consecutive 1-minute recordings for SDNN, RMSSD, and pNN50. Acceptable limits of agreement were found after consecutive 3-minute recordings for nLF and nHF. CONCLUSIONS:Using the PEP app to facilitate a 1-minute ultra-short-term recording is suggested for time-domain HRV indices (SDNN, RMSSD, and pNN50) to interpret autonomic functions during stabilization. When using frequency-domain HRV indices (nLF and nHF) via the PEP app, a recording of at least 3 minutes is needed for accurate measurement.

Project description:BACKGROUND:Although distress screening is crucial for cancer survivors, it is not easy for clinicians to recognize distress. Physical activity (PA) data collected by mobile devices such as smart bands and smartphone apps have the potential to be used to screen distress in breast cancer survivors. OBJECTIVE:The aim of this study was to assess data collection rates of smartphone apps and smart bands in terms of PA data, investigate the correlation between PA data from mobile devices and distress-related questionnaires from smartphone apps, and demonstrate factors associated with data collection with smart bands and smartphone apps in breast cancer survivors. METHODS:In this prospective observational study, patients who underwent surgery for breast cancer at Asan Medical Center, Seoul, Republic of Korea, between June 2017 and March 2018 were enrolled and asked to use both a smartphone app and smart band for 6 months. The overall compliance rates of the daily PA data collection via the smartphone walking apps and wearable smart bands were analyzed in a within-subject manner. The longitudinal daily collection rates were calculated to examine the dropout pattern. We also performed multivariate linear regression analysis to examine factors associated with compliance with daily collection. Finally, we tested the correlation between the count of daily average steps and distress level using Pearson correlation analysis. RESULTS:A total of 160 female patients who underwent breast cancer surgeries were enrolled. The overall compliance rates for using a smartphone app and smart bands were 88.0% (24,224/27,513) and 52.5% (14,431/27,513), respectively. The longitudinal compliance rate for smartphone apps was 77.8% at day 180, while the longitudinal compliance rate for smart bands rapidly decreased over time, reaching 17.5% at day 180. Subjects who were young, with other comorbidities, or receiving antihormonal therapy or targeted therapy showed significantly higher compliance rates to the smartphone app. However, no factor was associated with the compliance rate to the smart band. In terms of the correlation between the count of daily steps and distress level, step counts collected via smart band showed a significant correlation with distress level. CONCLUSIONS:Smartphone apps or smart bands are feasible tools to collect data on the physical activity of breast cancer survivors. PA data from mobile devices are correlated with participants' distress data, which suggests the potential role of mobile devices in the management of distress in breast cancer survivors. TRIAL REGISTRATION:ClinicalTrials.gov NCT03072966; https://clinicaltrials.gov/ct2/show/NCT03072966.

Project description:BackgroundBy enabling frequent, sensitive, and economic remote assessment, smartphones will facilitate the detection of early cognitive decline at scale. Previous studies have sustained participant engagement with remote cognitive assessment over a week; extending this to a period of 1 month clearly provides a greater opportunity for measurement. However, as study durations are increased, the need to understand how participant burden and scientific value might be optimally balanced also increases.ObjectiveThis study explored the little but often approach to assessment employed by the Mezurio app when prompting participants to interact every day for over a month. Specifically, this study aimed to understand whether this extended duration of remote study is feasible, and which factors promote sustained participant engagement over such periods.MethodsA total of 35 adults (aged 40-59 years) with no diagnosis of cognitive impairment were prompted to interact with the Mezurio smartphone app platform for up to 36 days, completing short, daily episodic memory tasks in addition to optional executive function and language tests. A subset (n=20) of participants completed semistructured interviews focused on their experience of using the app.ResultsParticipants complied with 80% of the daily learning tasks scheduled for subsequent tests of episodic memory, with 88% of participants still actively engaged by the final task. A thematic analysis of the participants' experiences highlighted schedule flexibility, a clear user interface, and performance feedback as important considerations for engagement with remote digital assessment.ConclusionsDespite the extended study duration, participants demonstrated high compliance with the schedule of daily learning tasks and were extremely positive about their experiences. Long durations of remote digital interaction are therefore definitely feasible but only when careful attention is paid to the design of the users' experience.

Project description:BACKGROUND:Adoption of healthy lifestyle and compliance with cholesterol-lowering medication reduces the risk of cardiovascular disease (CVD). The use of digital tools and mobile technology may be important for sustaining positive behavioral change. OBJECTIVE:The primary objective of this study is to evaluate the feasibility and acceptability of administering the Cholesterol CarePlan Web app developed by the American Heart Association aimed at improving lifestyle and medication adherence among patients prescribed cholesterol-lowering medication. The secondary objective is to assess the Web app's efficacy. METHODS:A prospective, observational feasibility study will be conducted to demonstrate whether the Web app may be successfully taken up by patients and will be associated with improved clinical and behavioral outcomes. The study will aim to recruit 180 study participants being prescribed cholesterol-lowering medication for at least 30 days across 14 general practices in London, England. Potentially eligible patients will be invited to use the Web app on a smartphone and visit general practice for three 20-minute clinical assessments of blood pressure, height, weight, smoking, and nonfasting cholesterol over 24 weeks. The feasibility of administering the Web app will be judged by recruitment and dropout statistics and the sociodemographic and comorbidity profile of consenting study participants, consenting nonparticipants, and all potentially eligible patients. Acceptability will be assessed using patients' readiness to embrace new technologies, the usability of the Web app, and patient satisfaction. The efficacy of the Web app will be assessed by changes in medication adherence and clinical risk factors by levels of the Web app compliance. RESULTS:This study is currently funded by the American Heart Association. Initial study recruitment will take place between February and July 2018 followed by patient follow-up. Patient level data will be obtained in January 2019. Data analysis will be completed by February 2019. Results will be submitted for publication in March 2019. CONCLUSIONS:The potential of an app to improve patients' lifestyle and management of cholesterol may inform the design of a randomized controlled trial and the delivery of more effective CVD prevention programs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):PRR1-10.2196/9017.

Project description:BackgroundPatient self-assessment via a mobile app detects actionable symptoms and has been shown to detect lung cancer relapses early, thereby lengthening survival.ObjectiveThe purpose of this study was to assess the incidence of chief symptoms associated with the main tobacco-induced pathologies in both current and ex-smokers through a self-assessment smartphone app and to evaluate the app's capacity to encourage users to quit smoking or reduce consumption, as well as its impact on early lung cancer stages at the time of diagnosis.MethodsCurrent and ex-smokers were recruited through an advertising campaign in Sarthe county (France) proposing the free download of a smartphone app. App users were asked to answer 13 questions related to symptoms associated with tobacco-induced diseases (chronic obstructive pulmonary disease [COPD], cardiovascular diseases, cancer). In the event of any positive answer, a message was displayed recommending the user to consult a physician. In addition, they were asked about smoking cessation intention before and after answering these 13 questions. Finally, incidence of stage 1 or 2 lung cancers diagnosed during the launch period of our application was evaluated by comparing data from various sources to those from the same period during the previous year.ResultsOf the 5671 users who were eligible for evaluation, an alert was sent to the majority (4118/5671, 72.6%), with a higher incidence for current smokers (2833/3679, 77.0% vs 1298/1992, 65.2%; P<.001). The most frequent symptoms triggering the notifications were fatigue (2023/5671, 35.7%), cough (1658/5671, 29.2%), dyspnea (1502/5671, 26.5%), and persistent chest pain (1286/5671, 22.7%). Of the current smokers, 14.0% (515/3679) showed symptoms suggesting COPD, 15.5% (571/3679) showed symptoms suggesting stable angina, 12.4% (455/3679) probably had lower extremity artery disease, and 6.8% (249/3679) had possible cancer. Of the users, 36.5% (1343/3679) claimed that they thought about quitting smoking, and 48.7% (1795/3679) had thought about reducing their consumption. Surgery-eligible stage 1 and 2 lung cancer incidence was 24% (14/58) during the study period versus 9% (5/54) during the previous year in Sarthe county (P=.04), whereas it remained unchanged in the neighboring county of Maine-et-Loire.ConclusionsA majority of current and ex-smokers showed worrying symptoms, and the use of a self-assessment smartphone app may drive a majority of smokers toward the intention of smoking cessation or decreasing consumption. A randomized study should be performed to confirm this intention and to support the potential increase of symptomatic lung cancer detection at early, surgery-accessible stages.Trial registrationClinicalTrials.gov NCT04048954; https://www.clinicaltrials.gov/ct2/show/NCT04048954.

Dataset Information

Smartphone app for neonatal heart rate assessment: an observational study.

Publications

Smartphone app for neonatal heart rate assessment: an observational study.

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