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1.
Neuroimage ; 256: 119216, 2022 08 01.
Article in English | MEDLINE | ID: mdl-35452803

ABSTRACT

Currently, there is great interest in making neuroimaging widely accessible and thus expanding the sampling population for better understanding and preventing diseases. The use of wearable health devices has skyrocketed in recent years, allowing continuous assessment of physiological parameters in patients and research cohorts. While most health wearables monitor the heart, lungs and skeletal muscles, devices targeting the brain are currently lacking. To promote brain health in the general population, we developed a novel, low-cost wireless cerebral oximeter called FlexNIRS. The device has 4 LEDs and 3 photodiode detectors arranged in a symmetric geometry, which allows for a self-calibrated multi-distance method to recover cerebral hemoglobin oxygenation (SO2) at a rate of 100 Hz. The device is powered by a rechargeable battery and uses Bluetooth Low Energy (BLE) for wireless communication. We developed an Android application for portable data collection and real-time analysis and display. Characterization tests in phantoms and human participants show very low noise (noise-equivalent power <70 fW/√Hz) and robustness of SO2 quantification in vivo. The estimated cost is on the order of $50/unit for 1000 units, and our goal is to share the device with the research community following an open-source model. The low cost, ease-of-use, smart-phone readiness, accurate SO2 quantification, real time data quality feedback, and long battery life make prolonged monitoring feasible in low resource settings, including typically medically underserved communities, and enable new community and telehealth applications.


Subject(s)
Brain/physiology , Oximetry/methods , Wearable Electronic Devices , Wireless Technology , Head , Hemoglobins/analysis , Humans , Oximetry/economics , Oximetry/instrumentation , Phantoms, Imaging , Wearable Electronic Devices/economics , Wireless Technology/economics
2.
PLoS One ; 15(8): e0235953, 2020.
Article in English | MEDLINE | ID: mdl-32841253

ABSTRACT

The most crucial challenge in the functioning of the wireless networks is the efficient utilization of radio resources. A significant element of resource handling is power regulation. With increasing requirement of wireless data transmission services, it is essential to devise energy harvesting techniques for mobile devices. In this research, a new methodology has been proposed for distributed power regulation in cognitive radio, networks of CR are grounded on non-cooperation game phenomenon and pricing technique. QoS (Quality of service) of the user of CR is anticipated as a beneficial activity through pricing as well as dissemination of energy generating as an unbeneficial game wherein the consumers increase their overall efficacy. The price is defined as an actual function of transmission power to upraise the pricing of the most distant consumers. The proposed mathematical model shows that the proposed game model has a Nash equilibrium and is also unique. Furthermore, in order to make the proposed algorithm valid for green communication within the wireless network, the best response technique was proposed. Finally, simulation results showed that the proposed energy harvesting technique, grounded on a unique function of the utilization, reduces the consumption of transmission power and greatly improves the convergence speed; which are suitable for the vision of the 5G networks.


Subject(s)
Costs and Cost Analysis/methods , Game Theory , Models, Economic , Radio Waves , Wireless Technology/economics , Algorithms , Computer Simulation
3.
PLoS One ; 14(12): e0226499, 2019.
Article in English | MEDLINE | ID: mdl-31841536

ABSTRACT

Researchers are increasingly showing interest in the application of a Butler matrix for fifth-generation (5G) base station antennas. However, the design of the Butler matrix is challenging at millimeter wave because of the very small wavelength. The literature has reported issues of high insertion losses and incorrect output phases at the output ports of the Butler matrix, which affects the radiation characteristics. To overcome these issues, the circuit elements of the Butler matrix such as the crossover, the quadrature hybrid and the phase shifter must be designed using highly accurate dimensions. This paper presents a low-loss and compact single-layer 8 × 8 Butler matrix operating at 28 GHz. The optimum design of each circuit element is also demonstrated in detail. The designed Butler matrix was fabricated to validate the simulated results. The measured results showed return losses of less than -10 dB at 28 GHz. The proposed Butler matrix achieved a low insertion loss and a low phase error of ± 2 dB and ± 10°, respectively. In sum, this work obtained a good agreement between the simulated and measured results.


Subject(s)
Electromagnetic Radiation , Equipment Design , Wireless Technology/instrumentation , Algorithms , Computer Simulation , Electrodes , Equipment Design/economics , Software , Wireless Technology/economics
4.
Biosens Bioelectron ; 140: 111272, 2019 Sep 01.
Article in English | MEDLINE | ID: mdl-31170654

ABSTRACT

Monitoring of food quality, in particular, milk quality, is critical in order to maintain food safety and human health. To guarantee quality and safety of milk products and at the same time deliver those as soon as possible, rapid analysis methods as well as sensitive, reliable, cost-effective, easy-to-use devices and systems for process control and milk spoilage detection are needed. In this paper, we review different rapid methods, sensors and commercial systems for milk spoilage and microorganism detection. The main focus lies on chemical sensors and biosensors for detection/monitoring of the well-known indicators associated with bacterial growth and milk spoilage such as changes in pH value, conductivity/impedance, adenosine triphosphate level, concentration of dissolved oxygen and produced CO2. These sensors offer several advantages, like high sensitivity, fast response time, minimal sample preparation, miniaturization and ability for real-time monitoring of milk spoilage. In addition, electronic-nose- and electronic-tongue systems for the detection of characteristic volatile and non-volatile compounds related to microbial growth and milk spoilage are described. Finally, wireless sensors and color indicators for intelligent packaging are discussed.


Subject(s)
Biosensing Techniques/instrumentation , Food Analysis/instrumentation , Milk/chemistry , Animals , Biosensing Techniques/economics , Biosensing Techniques/methods , Electronic Nose/economics , Food Analysis/economics , Food Analysis/methods , Food Quality , Food Safety , Humans , Milk/microbiology , Time Factors , Wireless Technology/economics , Wireless Technology/instrumentation
5.
Rev Sci Instrum ; 90(4): 043113, 2019 Apr.
Article in English | MEDLINE | ID: mdl-31043035

ABSTRACT

In order to develop a low-cost wearable electromyography (EMG) sensor system that can be used at home, compacting the data size is studied first to extract potential features via frequency analysis. A low-cost wearable home-use EMG sensor is then developed. Results show the frequency band at 40-60 Hz of tibialis anterior offers significant differences to identify walking problems (p-value < 0.05), which can be used as a detection standard with a smaller data size. More significantly, data sizes are dramatically reduced by 95.06% compared to the original data size. This finding suggests a potential examining method for identifying pathological gait with the compacted data in satisfactory processing time that can be used at home.


Subject(s)
Electromyography/instrumentation , Gait Analysis/instrumentation , Self Care/instrumentation , Wearable Electronic Devices , Adult , Aged , Diagnosis, Computer-Assisted , Electromyography/economics , Equipment Design , Gait Analysis/methods , Humans , Leg/physiopathology , Muscle, Skeletal/physiopathology , Paraplegia/diagnosis , Paraplegia/physiopathology , Self Care/economics , Signal Processing, Computer-Assisted , Wearable Electronic Devices/economics , Wireless Technology/economics , Wireless Technology/instrumentation
7.
Behav Res Methods ; 51(6): 2559-2572, 2019 12.
Article in English | MEDLINE | ID: mdl-30187433

ABSTRACT

Training nonhuman primates (NHPs) to perform cognitive tasks is essential for many neuroscientific investigations, yet laboratory training is a time-consuming process with inherent limitations. Habituating NHPs to the laboratory staff and experimental equipment can take months before NHPs are ready to proceed to the primary tasks. Laboratory training also necessarily separates NHPs from their home-room social group and typically involves some form of restraint or limited mobility, and data collection is often limited to a few hours per day so that multiple NHPs can be trained on the same equipment. Consequently, it can often take a year to train NHPs on complex cognitive tasks. To overcome these issues, we developed a low-cost, open-source, wireless touchscreen training system that can be installed in the home-room environment. The automated device can run continuously all day, including over weekends, without experimenter intervention. The system utilizes real-time facial recognition to initiate subject-specific tasks and provide accurate data logging, without the need for implanted microchips or separation of the NHPs. The system allows NHPs to select their preferred reward on each trial and to work when and for as long as they desire, and it can analyze task performance in real time and adapt the task parameters in order to expedite training. We demonstrate that NHPs consistently use this system on a daily basis to quickly learn complex behavioral tasks. The system therefore addresses many of the welfare and experimental limitations of laboratory-based training of NHPs and provides a platform for wireless electrophysiological investigations in more naturalistic, freely moving environments.


Subject(s)
Automation/economics , Learning , Primates/physiology , Primates/psychology , User-Computer Interface , Wireless Technology/economics , Animals , Reward
8.
J Med Eng Technol ; 42(6): 420-425, 2018 Aug.
Article in English | MEDLINE | ID: mdl-30465704

ABSTRACT

In this study, a new electrooculography (EOG) based system that provides efficient communication for people suffered from motor neuron diseases is presented. The system consists of two distinct devices. The first device operates as a main unit that is activated by the subject's eye movements. This unit is capable of transmitting 10 different command/state messages. These messages enable subject to choose his/her situation such as "I'm fine", "I feel bad", "I'm hungry" and "I'm thirsty". Commands such as "Come", "Go". The number of messages can be increased. The main unit acquires the EOG signal from the subject. Newly developed analogue and digital signal conditioning interprets the eye movements as specific messages and transmits them to the second unit (receiver) using radio frequency transmitter. The messages related to the subject's demands and situation can be heard from both main and receiver unit speakers. The wireless receiver unit is capable of notifying the patient's command by auditory and visual indicators. The realised device was tested by 2 healthy and 2 ALS patients and confirmed to be successful with 100% performance for sending correct messages.


Subject(s)
Communication Aids for Disabled , Electrooculography/instrumentation , Motor Neuron Disease , Adult , Communication Aids for Disabled/economics , Cost-Benefit Analysis , Electrooculography/economics , Eye Movements , Humans , Male , Wireless Technology/economics
9.
Sensors (Basel) ; 18(9)2018 Aug 24.
Article in English | MEDLINE | ID: mdl-30149510

ABSTRACT

This paper reports the novel design of a touch mode capacitive pressure sensor (TMCPS) system with a wireless approach for a full-range continuous monitoring of ventricular pressure. The system consists of two modules: an implantable set and an external reading device. The implantable set, restricted to a 2 × 2 cm² area, consists of a TMCPS array connected with a dual-layer coil, for making a reliable resonant circuit for communication with the external device. The capacitive array is modelled considering the small deflection regime for achieving a dynamic and full 5⁻300 mmHg pressure range. In this design, the two inductive-coupled modules are calculated considering proper electromagnetic alignment, based on two planar coils and considering the following: 13.56 MHz frequency to avoid tissue damage and three types of biological tissue as core (skin, fat and muscle). The system was validated with the Comsol Multiphysics and CoventorWare softwares; showing a 90% power transmission efficiency at a 3.5 cm distance between coils. The implantable module includes aluminum- and polyimide-based devices, which allows ergonomic, robust, reproducible, and technologically feasible integrated sensors. In addition, the module shows a simplified and low cost design approach based on PolyMEMS INAOE® technology, featured by low-temperature processing.


Subject(s)
Electric Capacitance , Equipment Design , Monitoring, Physiologic/instrumentation , Prostheses and Implants , Ventricular Pressure , Wireless Technology , Adipose Tissue , Humans , Muscles , Prostheses and Implants/economics , Skin , Wireless Technology/economics
10.
Injury ; 49 Suppl 1: S102-S104, 2018 Jun.
Article in English | MEDLINE | ID: mdl-29929684

ABSTRACT

Over the past few decades, sensors have been gaining a lot of popularity in the medical field. These sensors have helped shift the paradigm in medicine from having things done manually to digitalizing them. In the medical field, sensors have been manufactured in different forms and shapes including wearable and implantable wireless devices. With the aid of these sensors, healthcare professionals hope to revolutionize the system in a cost-effective way. In fact, this is already evident in most healthcare systems with the use of sensors for blood pressure, oxygen saturation, and arrhythmias on a daily basis. Also, more sophisticated sensors have made way into the medical field with a feedback loop, such as insulin pumps. On the other hand, similar technologies have been introduced in the orthopaedics world in the past decade. In this paper we summarize some of the sensors used in the medical field in general, and in orthopaedics in particular.


Subject(s)
Monitoring, Physiologic/instrumentation , Orthopedic Procedures , Wearable Electronic Devices , Wireless Technology/trends , Cost-Benefit Analysis , Humans , Monitoring, Ambulatory , Monitoring, Physiologic/economics , Orthopedic Procedures/economics , Orthopedic Procedures/trends , Prostheses and Implants , Wearable Electronic Devices/economics , Wearable Electronic Devices/trends , Wireless Technology/economics
11.
Physiol Meas ; 39(3): 035008, 2018 03 29.
Article in English | MEDLINE | ID: mdl-29406314

ABSTRACT

OBJECTIVE: Multi-channel electrical recordings of physiologically generated signals are common to a wide range of biomedical fields. The aim of this work was to develop, validate, and demonstrate the practical utility of a high-quality, low-cost 32/64-channel bioamplifier system with real-time wireless data streaming capability. APPROACH: The new 'Intsy' system integrates three main off-the-shelf hardware components: (1) Intan RHD2132 bioamplifier; (2) Teensy 3.2 microcontroller; and (3) RN-42 Bluetooth 2.1 module with a custom LabView interface for real-time data streaming and visualization. Practical utility was validated by measuring serosal gastric slow waves and surface EMG on the forearm with various contraction force levels. Quantitative comparisons were made to a gold-standard commercial system (Biosemi ActiveTwo). MAIN RESULTS: Intsy signal quality was quantitatively comparable to that of the ActiveTwo. Recorded slow wave signals had high SNR (24 ± 2.7 dB) and wavefront propagation was accurately mapped. EMG spike bursts were characterized by high SNR (⩾10 dB) and activation timing was readily identified. Stable data streaming rates achieved were 3.5 kS s-1 for wireless and 64 kS s-1 for USB-wired transmission. SIGNIFICANCE: Intsy has the highest channel count of any existing open-source, wireless-enabled module. The flexibility, portability and low cost ($1300 for the 32-channel version, or $2500 for 64 channels) of this new hardware module reduce the entry barrier for a range of electrophysiological experiments, as are typical in the gastrointestinal (EGG), cardiac (ECG), neural (EEG), and neuromuscular (EMG) domains.


Subject(s)
Costs and Cost Analysis , Electrical Equipment and Supplies/economics , Wireless Technology/economics , Electromyography , Equipment Design , Signal-To-Noise Ratio , Stomach/physiology
12.
ACS Nano ; 11(9): 8830-8837, 2017 09 26.
Article in English | MEDLINE | ID: mdl-28806507

ABSTRACT

Heart-rate monitoring plays a critical role in personal healthcare management. A low-cost, noninvasive, and user-friendly heart-rate monitoring system is highly desirable. Here, a self-powered wireless body sensor network (BSN) system is developed for heart-rate monitoring via integration of a downy-structure-based triboelectric nanogenerator (D-TENG), a power management circuit, a heart-rate sensor, a signal processing unit, and Bluetooth module for wireless data transmission. By converting the inertia energy of human walking into electric power, a maximum power of 2.28 mW with total conversion efficiency of 57.9% was delivered at low operation frequency, which is capable of immediately and sustainably driving the highly integrated BSN system. The acquired heart-rate signal by the sensor would be processed in the signal process circuit, sent to an external device via the Bluetooth module, and displayed on a personal cell phone in a real-time manner. Moreover, by combining a TENG-based generator and a TENG-based sensor, an all-TENG-based wireless BSN system was developed, realizing continuous and self-powered heart-rate monitoring. This work presents a potential method for personal heart-rate monitoring, featured as being self-powered, cost-effective, noninvasive, and user-friendly.


Subject(s)
Biosensing Techniques/instrumentation , Electric Power Supplies , Heart Rate , Monitoring, Physiologic/instrumentation , Nanotechnology/instrumentation , Wireless Technology/instrumentation , Biosensing Techniques/economics , Electric Power Supplies/economics , Equipment Design , Humans , Monitoring, Physiologic/economics , Nanotechnology/economics , Wireless Technology/economics
13.
PLoS One ; 12(4): e0175358, 2017.
Article in English | MEDLINE | ID: mdl-28403167

ABSTRACT

Rural areas have very low revenue potential. The major issue in providing low-cost broadband to rural areas is to provide reliable backhaul connections that spread over tens or even hundreds of miles, connecting villages to the nearest service provider. Along with aerial networks of Google and Facebook, there has been a considerable amount of research toward long-distance terrestrial WiFi links. As a comparison, WiFi routers are easier to be deployed and maintained by non-technical people from the local communities, whereas the aerial networks require professional support to operate. Moreover, they are still in the experimentation phase. However, the long distance WiFi links require high-gain directional antennas and very expensive tall towers for high data rates. On the other hand, multihop paths with stronger links may provide better data rates without the need of tall towers. In this paper, we evaluated the concept of using such multihop WiFi links for long backhaul connections. Our simulation results show that these networks can possibly be a cost-effective and practical solution for rural connectivity. These initial results can serve as a first step to understand the comprehensive feasibility of using multihop WiFi networks for backhaul connections in rural area.


Subject(s)
Computer Communication Networks/instrumentation , Wireless Technology/instrumentation , Algorithms , Computer Communication Networks/economics , Computer Simulation , Humans , Rural Population , Wireless Technology/economics
14.
Telemed J E Health ; 23(9): 753-762, 2017 09.
Article in English | MEDLINE | ID: mdl-28304241

ABSTRACT

INTRODUCTION: This article proposes a novel, cost-effective, flexible, and easy-to-deploy wireless teleophthalmology network architecture and performance evaluation for its potential use in remote areas. This study has used practical telecommunication standards, which is widely deployed throughout India. METHODS: In the proposed scenario, patient's eye images are obtained using a specified imaging modality, and then sent to a server at the primary eye care centre (PECC) using ZigBee a short-range wireless network. It is linked to the main server at the base eye hospital (BEH) through a GSM/UMTS (3G)/WiMAX (Worldwide Interoperability for Microwave Access) network. After diagnostic evaluation of the eye image using various automated diagnostic software, data are sent to a physician in an urban center for further validation, which is connected through GSM/UMTS (3G)/WiMAX network. Performance evaluation of these wireless networks is carried out for their use in teleophthalmology application based on network parameters, namely throughput, average end-to-end delay, and average jitter. It is found that end-to-end delay is the most critical network parameter affecting overall quality of service (QoS) of the proposed teleophthalmology network. RESULTS AND CONCLUSIONS: The results demonstrate that WiMAX is the most suitable network among the considered networks for connecting PECC nodes with BEH main server, and further connecting main server with a doctor on the move. It is also deduced that for a given set of QoS parameters, WiMAX supports a load capacity of 22,000 packets at center nodes and the main server and it performs well even when the mobility speed of doctor exceeds 200 KPH.


Subject(s)
Ophthalmology/organization & administration , Rural Health Services/organization & administration , Telemedicine/organization & administration , Wireless Technology/organization & administration , Cost-Benefit Analysis , Humans , India , Ophthalmology/economics , Rural Health Services/economics , Telemedicine/economics , Wireless Technology/economics
15.
PLoS One ; 12(1): e0170273, 2017.
Article in English | MEDLINE | ID: mdl-28121992

ABSTRACT

Due to the lack of dependency for routing initiation and an inadequate allocated sextant on responding messages, the secure geographic routing protocols for Wireless Sensor Networks (WSNs) have attracted considerable attention. However, the existing protocols are more likely to drop packets when legitimate nodes fail to respond to the routing initiation messages while attackers in the allocated sextant manage to respond. Furthermore, these protocols are designed with inefficient collection window and inadequate verification criteria which may lead to a high number of attacker selections. To prevent the failure to find an appropriate relay node and undesirable packet retransmission, this paper presents Secure Region-Based Geographic Routing Protocol (SRBGR) to increase the probability of selecting the appropriate relay node. By extending the allocated sextant and applying different message contention priorities more legitimate nodes can be admitted in the routing process. Moreover, the paper also proposed the bound collection window for a sufficient collection time and verification cost for both attacker identification and isolation. Extensive simulation experiments have been performed to evaluate the performance of the proposed protocol in comparison with other existing protocols. The results demonstrate that SRBGR increases network performance in terms of the packet delivery ratio and isolates attacks such as Sybil and Black hole.


Subject(s)
Algorithms , Computer Communication Networks , Computer Security , Wireless Technology , Aggression , Computer Communication Networks/economics , Computer Communication Networks/organization & administration , Computer Security/economics , Computer Simulation , Geographic Information Systems/economics , Software , Wireless Technology/economics , Wireless Technology/organization & administration
16.
J Neurosci Methods ; 276: 79-83, 2017 01 30.
Article in English | MEDLINE | ID: mdl-27899319

ABSTRACT

BACKGROUND: Automation of animal experimentation improves consistency, reduces potential for error while decreasing animal stress and increasing well-being. Radio frequency identification (RFID) tagging can identify individual mice in group housing environments enabling animal-specific tracking of physiological parameters. NEW METHOD: We describe a simple protocol to radio frequency identification (RFID) tag and detect mice. RFID tags were injected sub-cutaneously after brief isoflurane anesthesia and do not require surgical steps such as suturing or incisions. We employ glass-encapsulated 125kHz tags that can be read within 30.2±2.4mm of the antenna. A raspberry pi single board computer and tag reader enable automated logging and cross platform support is possible through Python. RESULTS: We provide sample software written in Python to provide a flexible and cost effective system for logging the weights of multiple mice in relation to pre-defined targets. COMPARISON WITH EXISTING METHODS: The sample software can serve as the basis of any behavioral or physiological task where users will need to identify and track specific animals. Recently, we have applied this system of tagging to automated mouse brain imaging within home-cages. CONCLUSIONS: We provide a cost effective solution employing open source software to facilitate adoption in applications such as automated imaging or tracking individual animal weights during tasks where food or water restriction is employed as motivation for a specific behavior.


Subject(s)
Automation, Laboratory/instrumentation , Radio Frequency Identification Device , Animals , Automation, Laboratory/economics , Automation, Laboratory/methods , Behavior, Animal , Body Weight , Computers , Injections, Subcutaneous , Mice, Inbred C57BL , Mice, Transgenic , Radio Frequency Identification Device/economics , Radio Frequency Identification Device/methods , Software , Wireless Technology/economics , Wireless Technology/instrumentation
17.
PLoS One ; 11(8): e0161213, 2016.
Article in English | MEDLINE | ID: mdl-27529783

ABSTRACT

Smartphones have become the major communication and portable computing devices that access the Internet through Wi-Fi or mobile networks. Unfortunately, users without a mobile data subscription can only access the Internet at limited locations, such as hotspots. In this paper, we propose a collaborative bandwidth sharing protocol (CBSP) built on top of MultiPath TCP (MPTCP). CBSP enables users to buy bandwidth on demand from neighbors (called Helpers) and uses virtual interfaces to bind the subflows of MPTCP to avoid modifying the implementation of MPTCP. However, although MPTCP provides the required multi-homing functionality for bandwidth sharing, the current packet scheduling in collaborative MPTCP (e.g., Co-MPTCP) leads to the so-called biased-feeding problem. In this problem, the fastest link might always be selected to send packets whenever it has available cwnd, which results in other links not being fully utilized. In this work, we set out to design an algorithm, called Scheduled Window-based Transmission Control (SWTC), to improve the performance of packet scheduling in MPTCP, and we perform extensive simulations to evaluate its performance.


Subject(s)
Computer Communication Networks/statistics & numerical data , Internet/statistics & numerical data , Internet/economics , Wireless Technology/economics , Wireless Technology/statistics & numerical data
19.
J Med Syst ; 40(1): 27, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26547847

ABSTRACT

Brain Computer Interface (BCI) based environment control systems could facilitate life of people with neuromuscular diseases, reduces dependence on their caregivers, and improves their quality of life. As well as easy usage, low-cost, and robust system performance, mobility is an important functionality expected from a practical BCI system in real life. In this study, in order to enhance users' mobility, we propose internet based wireless communication between BCI system and home environment. We designed and implemented a prototype of an embedded low-cost, low power, easy to use web server which is employed in internet based wireless control of a BCI based home environment. The embedded web server provides remote access to the environmental control module through BCI and web interfaces. While the proposed system offers to BCI users enhanced mobility, it also provides remote control of the home environment by caregivers as well as the individuals in initial stages of neuromuscular disease. The input of BCI system is P300 potentials. We used Region Based Paradigm (RBP) as stimulus interface. Performance of the BCI system is evaluated on data recorded from 8 non-disabled subjects. The experimental results indicate that the proposed web server enables internet based wireless control of electrical home appliances successfully through BCIs.


Subject(s)
Brain-Computer Interfaces , Home Care Services , Internet , Signal Processing, Computer-Assisted/instrumentation , Wireless Technology/instrumentation , Humans , Wireless Technology/economics
20.
Surg Endosc ; 30(8): 3454-60, 2016 08.
Article in English | MEDLINE | ID: mdl-26537906

ABSTRACT

INTRODUCTION: Early referral for catheter-based esophageal pH monitoring is more cost-effective than empiric proton-pump inhibitor (PPI) therapy to diagnose gastroesophageal reflux disease (GERD). We hypothesize that BRAVO wireless pH monitoring will also demonstrate substantial cost-savings compared to empiric PPI therapy, given its superior sensitivity and comfort. METHODS: We reviewed 100 consecutive patients who underwent wireless pH monitoring for suspected GERD at our institution. A cost model and a cost equivalence calculation were generated. Cost-saving analyses were performed for both esophageal and extraesophageal symptoms. RESULTS: Eighty-seven patients were available for analysis. Median PPI use prior to referral was 215 weeks (range 0-520). Forty-three patients (49 %) had BRAVO results diagnosing GERD; 98 % of these had esophageal symptoms. Patients with negative BRAVO studies had a median of 113 (0-520) weeks of unnecessary PPI therapy. Cost-savings ranged from $1048 to $15,853 per patient, depending on sensitivity (75-95 %), PPI dosage, and brand. Maximum cost-savings occurred in patients with extraesophageal symptoms ($2948-$31,389 per patient). The PPI cost equivalence of BRAVO placement was 36 and 6 weeks for low- and high-dose therapy, respectively. CONCLUSIONS: BRAVO wireless pH testing is more cost-effective than prolonged empiric medical management for GERD and should be incorporated early in the treatment algorithm.


Subject(s)
Esophageal pH Monitoring/economics , Esophageal pH Monitoring/methods , Gastroesophageal Reflux/diagnosis , Telemetry/economics , Wireless Technology/economics , Adult , Aged , Cost Savings , Cost-Benefit Analysis , Female , Humans , Male , Middle Aged , Models, Economic , Young Adult
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