An Ambulatory Blood Pressure Monitor Mobile Health System for Early Warning for Stroke Risk: Longitudinal Observational Study.

BACKGROUND: Stroke, as a leading cause of death around the globe, has become a heavy burden on our society. Studies show that stroke can be predicted and prevented if a person's blood pressure (BP) status is appropriately monitored via an ambulatory blood pressure monitor (ABPM) system. However, currently there exists no efficient and user-friendly ABPM system to provide early warning for stroke risk in real-time. Moreover, most existing ABPM devices measure BP during the deflation of the cuff, which fails to reflect blood pressure accurately. OBJECTIVE: In this study, we sought to develop a new ABPM mobile health (mHealth) system that was capable of monitoring blood pressure during inflation and could detect early stroke-risk signals in real-time. METHODS: We designed an ABPM mHealth system that is based on mobile network infrastructure and mobile apps. The proposed system contains two major parts: a new ABPM device in which an inflation-type BP measurement algorithm is embedded, and an abnormal blood pressure data analysis algorithm for stroke-risk prediction services at our health data service center. For evaluation, the ABPM device was first tested using simulated signals and compared with the gold standard of a mercury sphygmomanometer. Then, the performance of our proposed mHealth system was evaluated in an observational study. RESULTS: The results are presented in two main parts: the device test and the longitudinal observational studies of the presented system. The average measurement error of the new ABPM device with the inflation-type algorithm was less than 0.55 mmHg compared to a reference device using simulated signals. Moreover, the results of correlation coefficients and agreement analyses show that there is a strong linear correlation between our device and the standard mercury sphygmomanometer. In the case of the system observational study, we collected a data set with 88 features, including real-time data, user information, and user records. Our abnormal blood pressure data analysis algorithm achieved the best performance, with an area under the curve of 0.904 for the low risk level, 0.756 for the caution risk level, and 0.912 for the high-risk level. Our system enables a patient to be aware of their risk in real-time, which improves medication adherence with risk self-management. CONCLUSIONS: To our knowledge, this device is the first ABPM device that measures blood pressure during the inflation process and has obtained a government medical license. Device tests and longitudinal observational studies were conducted in Peking University hospitals, and they showed the device's high accuracy for BP measurements, its efficiency in detecting early signs of stroke, and its efficiency at providing an early warning for stroke risk.

Design and implementation of an intelligent belt system using accelerometer.

Activity monitor systems are increasing used recently. They are important for athletes and casual users to manage physical activity during daily exercises. In this paper, we use a triaxial accelerometer to design and implement an intelligent belt system, which can detect the user's step and flapping motion. In our system, a wearable intelligent belt is worn on the user's waist to collect activity acceleration signals. We present a step detection algorithm to detect real-time human step, which has high accuracy and low complexity. In our system, an Android App is developed to manage the intelligent belt. We also propose a protocol, which can guarantee data transmission between smartphones and wearable belt effectively and efficiently. In addition, when users flap the belt in emergency, the smartphone will receive alarm signal sending by the belt, and then notifies the emergency contact person, which can be really helpful for users in danger. Our experiment results show our system can detect physical activities with high accuracy (overall accuracy of our algorithm is above 95%) and has an effective alarm subsystem, which is significant for the practical use.

System light-loading technology for mHealth: Manifold-learning-based medical data cleansing and clinical trials in WE-CARE Project.

Cardiovascular disease (CVD) is a major issue to public health. It contributes 41% to the Chinese death rate each year. This huge loss encouraged us to develop a Wearable Efficient teleCARdiology systEm (WE-CARE) for early warning and prevention of CVD risks in real time. WE-CARE is expected to work 24/7 online for mobile health (mHealth) applications. Unfortunately, this purpose is often disrupted in system experiments and clinical trials, even if related enabling technologies work properly. This phenomenon is rooted in the overload issue of complex Electrocardiogram (ECG) data in terms of system integration. In this study, our main objective is to get a system light-loading technology to enable mHealth with a benchmarked ECG anomaly recognition rate. To achieve this objective, we propose an approach to purify clinical features from ECG raw data based on manifold learning, called the Manifold-based ECG-feature Purification algorithm. Our clinical trials verify that our proposal can detect anomalies with a recognition rate of up to 94% which is highly valuable in daily public health-risk alert applications based on clinical criteria. Most importantly, the experiment results demonstrate that the WE-CARE system enabled by our proposal can enhance system reliability by at least two times and reduce false negative rates to 0.76%, and extend the battery life by 40.54%, in the system integration level.

WE-CARE: an intelligent mobile telecardiology system to enable mHealth applications.

Recently, cardiovascular disease (CVD) has become one of the leading death causes worldwide, and it contributes to 41% of all deaths each year in China. This disease incurs a cost of more than 400 billion US dollars in China on the healthcare expenditures and lost productivity during the past ten years. It has been shown that the CVD can be effectively prevented by an interdisciplinary approach that leverages the technology development in both IT and electrocardiogram (ECG) fields. In this paper, we present WE-CARE , an intelligent telecardiology system using mobile 7-lead ECG devices. Because of its improved mobility result from wearable and mobile ECG devices, the WE-CARE system has a wider variety of applications than existing resting ECG systems that reside in hospitals. Meanwhile, it meets the requirement of dynamic ECG systems for mobile users in terms of the detection accuracy and latency. We carried out clinical trials by deploying the WE-CARE systems at Peking University Hospital. The clinical results clearly showed that our solution achieves a high detection rate of over 95% against common types of anomalies in ECG, while it only incurs a small detection latency around one second, both of which meet the criteria of real-time medical diagnosis. As demonstrated by the clinical results, the WE-CARE system is a useful and efficient mHealth (mobile health) tool for the cardiovascular disease diagnosis and treatment in medical platforms.

Design and tests of a smartphones-based multi-lead ECG monitoring system.

With the rapid development of wireless communications and sensor technologies, multi-lead electrocardiogram (ECG) monitoring systems can be implemented for real-time Cardiovascular Disease (CVD) tracking and prevention services by using mobile terminals. To meet this objective, we designed a 7-lead ECG monitoring system enabled by smartphones, which is a combination of user mobility requirement and clinical intelligent function. In the system, an application-layer protocol is conceived and tested for guaranteeing data transmission reliability between smartphones and portable sensors. In addition, the smartphone in the system can be customized as a personal health manager, which can control system function modes and device states, and also perform information management and deeper data analysis. Most significantly, we developed a health risk alarm algorithm to detect ECG signal abnormities, which could help professionals pick out the data with key clinical information. To test our system performance and validity, we carried out simulation tests and system experiments. The results show our system is helpful in CVD prevention services.