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E-grāmata: Personalized Health Systems for Cardiovascular Disease

Edited by (Full Professor, Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy), Edited by , Edited by (Associate Professor, Center for Informatics and Systems of the University of Coimbra (CISUC), Department of Informatics )
  • Formāts: PDF+DRM
  • Izdošanas datums: 21-Jan-2022
  • Izdevniecība: Academic Press Inc
  • Valoda: eng
  • ISBN-13: 9780128190661
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  • Formāts: PDF+DRM
  • Izdošanas datums: 21-Jan-2022
  • Izdevniecība: Academic Press Inc
  • Valoda: eng
  • ISBN-13: 9780128190661
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Personalized Health Systems for Cardiovascular Disease is intended for researchers, developers, and designers in the field of p-health, with a specific focus on management of cardiovascular diseases. Biomedical engineers will benefit from coverage of sensors, data transmission, signal processing, data analysis, home and mobile applications, standards, and all other subject matters developed in this book in order to provide an integrated view of the different and multidisciplinary problems related to p-health systems. However, many chapters will also be interesting to physicians and other professionals who operate in the health domain. Students, MS and PhD level, mainly in technical universities, but also in medical schools, will find in this book a complete view of the manifold aspects of p-health, including technical problems related to sensors and software, to automatic evaluation and correct interpretation of the data, and also some legal and regulatory aspects. This book mainly focuses on the development of technology used by people and patients in the management of their own health.

New wearable and implantable devices allow a continuous monitoring of chronic patients, with a direct involvement of clinical centers and physicians. Also, healthy people are more and more interested in keeping their own wellness under control, by adopting healthy lifestyles and identifying any early sign of risk. This is leading to personalized solutions via systems which are tailored to a specific patient/person and her/ his needs. However, many problems are still open when it comes to p-health systems. Which sensors and parameters should be used? Which software and analysis? When and how? How do you design an effective management plan for chronic pathologies such as cardiovascular diseases? What is useful feedback for the patient or for the clinician? And finally, what are the limits of this approach? What is the view of physicians? The purpose of this book is to provide, from a technical point of view, a complete description of most of the elements which are part of such systems, including the sensors and the hardware, the signal processing and data management procedures, the classification and stratification models, the standards and the regulations, focusing on the state of the art and identifying the new directions for innovative solutions. In this book, readers will find the fundamental elements that must be taken into account when developing devices and systems in the field of p-health.
List of Contributors
xiii
About the editors xvii
Preface xix
Introduction xxiii
1 Telemonitoring applications in cardiology
1(10)
James Milner
Lino Goncalves
1.1 Background
1(1)
1.2 Telemonitoring applications in cardiology
2(4)
1.2.1 Remote Monitoring for CIED
2(2)
1.2.2 Remote monitoring for heart failure
4(2)
1.3 Challenges and future perspectives
6(5)
References
8(3)
2 Data and signals for the assessment of the cardiovascular system
11(40)
Francisco Castells
Raquel Cervigon
Jose Millet
2.1 Introduction
11(3)
2.2 The electrocardiogram
14(14)
2.2.1 The electrical nature of cardiac activation
14(3)
2.2.2 The ECG signal
17(2)
2.2.3 The ECG in p-health devices
19(4)
2.2.4 Potential of p-health devices
23(5)
2.3 RR series
28(6)
2.3.1 Heart rate variability
30(3)
2.3.2 Detection of atrial fibrillation
33(1)
2.4 Arterial blood pressure
34(5)
2.4.1 The arterial pulse wave
38(1)
2.5 Photoplethysmography
39(3)
2.5.1 Potential of PPG devices
40(2)
2.6 The phonocardiogram
42(2)
2.7 Benefits of massive screening of cardiovascular signals
44(7)
References
45(6)
3 Systems, sensors, and devices in personal healthcare applications
51(34)
Jens Muhlsteff
Warner ten Kate
Alberto Bonomi
Illapha Cuba Gyllensten
Paulo de Carvalho
Alexandru Pielmus
Reinhold Orglmeister
3.1 Patient monitoring in personal healthcare settings
51(1)
3.2 Application-driven sensor research and device development
52(8)
3.2.1 The requirements that personal healthcare applications place on devices and systems
52(4)
3.2.2 Core system components
56(1)
3.2.3 Cardiovascular parameter for personal healthcare applications
57(1)
3.2.4 Devices for personal healthcare: An overview
58(1)
3.2.5 Devices for spot checks of vital parameters
59(1)
3.3 Personal healthcare sensing technologies
60(7)
3.3.1 Overview of relevant sensing principles
60(7)
3.4 Implementation examples
67(12)
3.5 Conclusions
79(6)
References
79(6)
4 Signal processing for cardiovascular applications in p-health
85(34)
Anna Maria Bianchi
Stefania Coelli
Riccardo Lolatto
Pierluigi Reali
Giuseppe Baselli
4.1 Introduction
85(2)
4.2 Preprocessing
87(2)
4.2.1 Baseline and noise reduction
87(2)
4.2.2 Discarding corrupted frames
89(1)
4.3 Feature extraction
89(9)
4.3.1 Time domain
90(2)
4.3.2 Frequency domain
92(2)
4.3.3 Information domain
94(4)
4.4 Heart rate variability, a time series that is rich in information
98(14)
4.4.1 How sampling frequency affects extracted features
101(8)
4.4.2 Nonstationarity of the signals
109(3)
4.5 Conclusions
112(7)
References
113(6)
5 Models for risk assessment and stratification
119(32)
Teresa Rocha
Simao Paredes
Paulo de Carvalho
Jorge Henriques
5.1 Introduction
119(1)
5.2 Risk assessment and stratification
120(2)
5.3 Risk progression and prognosis
122(2)
5.4 Assessment of patients' Similarity
124(7)
5.4.1 Dimensionality reduction
124(3)
5.4.2 Clustering
127(4)
5.5 Risk assessment
131(9)
5.5.1 Personalization strategies
131(4)
5.5.2 Combination strategies
135(5)
5.5.3 Conclusion
140(1)
5.6 Risk progression
140(7)
5.6.1 Hypertension risk
140(1)
5.6.2 Trend progression
141(4)
5.6.3 Hypertension risk evaluation
145(2)
5.6.4 Conclusions
147(1)
5.7 Conclusions
147(4)
References
148(3)
6 Connected health technologies for knowledge extraction and knowledge-based medicine in cardiac care
151(26)
Ioanna Chouvarda
6.1 Introduction
151(2)
6.2 Enabling technologies and building blocks: The connected health technologies in cardiac care
153(10)
6.2.1 Connected health technologies and mobile health
153(1)
6.2.2 Point-of-care diagnostics and sensor systems
154(2)
6.2.3 Health behavior informatics
156(3)
6.2.4 Data management and analytics
159(4)
6.3 Knowledge-based cardiovascular disease medicine in the context of connected health technologies
163(5)
6.3.1 From enabling technologies and research to a next-generation cardiac care platform and back
165(1)
6.3.2 A cardiovascular disease personal health system as part of a learning health system
166(2)
6.4 Discussion
168(9)
References
170(7)
7 Increasing and standardizing quality of care using computerized guidelines for clinical decision support
177(28)
Fedor Lehocki
Erez Shalom
Silvia Putekova
Jozef Benacka
Alexandra Kristufkova
Timotej Matak
Marek Mydliar
7.1 Introduction
177(1)
7.2 Diagnosis and treatment of preeclampsia and heart failure
178(4)
7.2.1 Preeclampsia
178(2)
7.2.2 Congestive heart failure
180(2)
7.3 What are clinical guidelines?
182(15)
7.3.1 Automated support for clinical guideline application
182(2)
7.3.2 Clinical guideline application frameworks: A brief overview
184(1)
7.3.3 The digital electronic guideline library
185(1)
7.3.4 The life cycle of a computerized clinical guideline
186(11)
7.4 Computerized guidelines for decision support in heart failure
197(2)
7.5 Discussion: Benefits and contributions of using a guideline-based clinical decision support systems
199(1)
7.6 Conclusions
200(5)
Acknowledgments
201(1)
References
201(4)
8 Digital coaching for personalized healthcare of cardiovascular diseases
205(24)
Enrique Dorronzoro-Zubiete
Octavio Rivera-Romero
Francisco J. Nunez-Benjumea
Sergio Cervera-Torres
8.1 Introduction
205(2)
8.2 Needs, preferences, and attitudes
207(4)
8.2.1 Illness perceptions and health beliefs
207(2)
8.2.2 Relationship with technology
209(1)
8.2.3 Digital coaching features
209(2)
8.3 Study cases of coaching systems for cardiovascular diseases in the literature
211(8)
8.3.1 Description of study cases
211(3)
8.3.2 Theoretical foundations of study cases
214(2)
8.3.3 Personalization
216(1)
8.3.4 Gamification
216(3)
8.4 Matching users' needs and preferences with features implemented in study cases
219(3)
8.4.1 Illness perceptions and health beliefs
220(1)
8.4.2 Relationship with technology
220(1)
8.4.3 Digital coaching features
221(1)
8.4.4 Opportunity for social interaction
222(1)
8.5 Conclusions
222(7)
Acknowledgment
223(1)
References
223(6)
9 Methods for app development in p-health
229(20)
Antonio Martinez-Millana
Gunnar Hartvigsen
Vicente Traver Salcedo
9.1 Introduction
229(1)
9.2 Apps for p-health
230(7)
9.2.1 App markets
230(3)
9.2.2 Apps in p-health systems
233(2)
9.2.3 Architecture of an mHealth system
235(2)
9.3 Directive for p-health app development
237(2)
9.4 Interoperability for apps in p-health
239(3)
9.4.1 mFHAST
240(1)
9.4.2 MH2F
240(1)
9.4.3 HL7-FHIR
240(1)
9.4.4 Open mHealth
241(1)
9.4.5 SNOMEDCT
242(1)
9.5 Regulatory framework for health apps
242(3)
9.6 Conclusions
245(4)
References
246(3)
10 Devices for p-health: Which regulations in Europe?
249(14)
Dario Pirovano
10.1 Introduction
249(1)
10.2 Principles of the regulations
250(11)
10.3 Conclusions
261(2)
11 Remote management of heart failure patients: A p-health example
263(12)
Anna Maria Bianchi
Jorge Henriques
Vicente Traver Salcedo
11.1 Introduction
263(1)
11.2 Heart failure and management strategies
263(3)
11.3 Success and potential of home monitoring and self-care in heart failure
266(2)
11.4 Steps toward personalized solutions
268(6)
11.4.1 When discharged from the hospital
269(1)
11.4.2 While at home
270(2)
11.4.3 P-health: An integrated care system centered on the patient
272(2)
11.5 Conclusions
274(1)
References 275(4)
Index 279
Anna Maria Bianchi is a Full Professor in Biomedical Engineering, with teaching responsibility in Biomedical Signal Processing and Medical Informatics, in BS, MS, and PhD Bioengineering programs. Her research interests are mainly related to the processing of biomedical signals and images and to the development of innovative methodologies for feature extraction, information enhancement, and model development. Applications are both in physiological studies and in clinics through design of interpretative and diagnostic models. In recent years, applications have been in the field of medical informatics and artificial intelligence. Prof. Bianchi is the scientific coordinator of the Medical Informatics Lab at DEIB and is a member of the management committee of two interdepartmental labs at Politecnico di Milano (i.e., the BrainLab@Polimi and PHEEL). She has authored 20 book chapters and more than 110 peer-reviewed papers in ISI international journals. She has been a fellow of EAMBES (European Alliance for Medical and Biological Engineering and Science) since 2012. Dr. Bianchi serves as a scientific expert in the EMBS Technical Committee on Neuroengineering and the Technical Committee on Cardiopulmonary Systems. She is Associate Editor of 'IEEE Transactions on Neural System and Rehabilitation Engineering' and a member of the editorial board of the 'Journal of Biomedical Signals Processing and Control' and of 'ElectronicsOpen Access Journal'. She has participated in many EU-funded (from VI framework program to H2020) and Italian-funded research projects with scientific responsibility and has active collaborations with companies operating in the field of biomedical instrumentation and systems. Jorge Henriques is an Associate Professor, with teaching responsibility in Informatics Engineering and Biomedical Engineering in BS, MS, and PhD programs. His main research interests are computational intelligence methodologies with application to modeling, prediction, diagnosis, and decision making, in particular in the clinical context. He has been particularly active in the development of innovative solutions in p-health scenarios, with particular application to situations in preventive medicine and chronic diseases management, namely in the research and implementation of advanced algorithms for biosignals' analysis and processing (in particular, electrocardiogram, photoplethysmogram, heart sounds, and blood pressure). He is a senior researcher in the Adaptive Computation Group at the Center for Informatics and Systems of the University of Coimbra (CISUC). His publications include seven book chapters and over 200 papers in refereed international journals and conferences. He is a reviewer for many biomedical engineering journals and has been involved in numerous program committees of major international conferences. He has coordinated and participated in several projects at national and international levels (European FP6, FP7, and H2020). He is a licensed professional engineer, was the executive coordinator of the Informatics Laboratory of Instituto Pedro Nunes, and has provided consulting services to various companies and national institutions in the clinical informatics and e-health areas. Vicente Traver Salcedo has a bachelors degree (1998) and a PhD (2004) in Telecommunications Engineering from the Universitat Politčcnica de Valčncia. He is a member of the academic board for the interuniversity master's degree in Biomedical Engineering at the Universitat Politčcnica de Valčncia. He is also the coordinator of the 'Healthy Living' cluster, which combines six different R&D university groups working in the field. Since 1998, his research focus has been on telemedicine, e-health, and e-inclusion, especially on the provision of home healthcare services through telematic media and the concepts of patient empowerment and the citizen as a health co-producer. He has participated in more than 50 EU-funded projects (from IV framework program to H2020) and Spanish-funded projects, and has taken part in multiple research agreements with companies in healthcare and social services that make use of information communication technologies. He has published more than 120 technical papers in national and international journals and has participated in several seminars and conferences as invited speaker. He is a member of international scientific congresses committees and a member of the editorial board of 'IET Networks'. He was the keynote lecturer at BIOSTEC 2010. He was the chairman and organizer of pHealth 2008 and the four editions of the International Workshop on Technology for Healthcare and Healthy Lifestyle (2008, 2010, 2011, 2012). He was conference co-chair of IEEE Biomedical Health Informatics 2014. He is cofounder of two SME IT health-related companies, currently employing more than 40 people. A full list of his publications is available at goo.gl/Wg2JZR.