Biometric Monitoring Devices Research Articles

Biometric Monitoring, Service Delivery and Misreporting: Evidence from Healthcare in India

Abstract We examine the impact of biometric monitoring devices placed in tuberculosis treatment centers in Indian slums. The devices record health worker attendance and patient visits. Combining survey data, random center visits, and hospital registers, we find that patients at biometric-equipped centers are 25 percent less likely to interrupt treatment, reflecting increased efforts by health workers and greater daily adherence by patients. The technology also improves the quality of public data by reducing overreported patient numbers and underreported treatment interruptions. Overall, our results suggest that real-time monitoring of service delivery can strengthen the state's capacity to serve poor and marginalized populations.

Remote monitoring following adult cardiac surgery: A paradigm shift?

BackgroundThe Perfect Care (PC) initiative engages, educates, and enrolls adult cardiac surgery patients into a transformational program that includes an app for appointment scheduling, tracking biometric data and patient-reported outcomes, audiovisual visits, and messaging, paired with a digital health kit (consisting of a fitness tracker, scale, and sphygmomanometer). PC aims to reduce postoperative length of stay (LOS) as well as 30-day readmission and mortality. MethodsThis was a retrospective review of patients who underwent coronary artery bypass (CAB), valve, or combined CAB and valve procedures at either of the 2 participating hospitals between April 2018 and March 2022. Patients who participated in the PC quality improvement initiative were compared to propensity-matched controls (1:1 matching). The evaluation focused on postoperative LOS and a novel composite measure comprising 30-day readmission and mortality. ResultsRemote monitoring (PC) was associated with a shorter postoperative LOS, lower combined rate of 30-day readmission and mortality, and less variation compared to matched non-PC controls. ConclusionsIntegrated improvements in postoperative remote monitoring of adult cardiac surgery patients may reduce time in the hospital and post-acute care facilities. Future prioritized efforts include the development of additional, personalized biometric monitoring devices, use of biometric data to augment risk assessment, and investigation of the value of remote monitoring on various patient risk profiles to address potential disparities in care.

Mobile Postoperative Symptom Intervention Tool and Biometric Monitoring After Radical Cystectomy: Pilot Study Evaluating Feasibility, Usability, and Potential Utility.

Mobile health technology and integration of patient-reported outcome measures into clinical interventions have the potential to transform patient care. Though patient-reported outcome measure management has been shown to improve outcomes in ambulatory care settings, few studies have examined remote patient-reported outcome measure assessment after major cancer surgery. A multiphased feasibility and usability study was designed. A mobile app-based postoperative symptom intervention tool was developed and evaluated by a focus group of bladder cancer patients and caregivers. Patients were prospectively accrued prior to cystectomy and asked to complete the daily mobile postoperative symptom intervention tool and wear biometric monitoring devices for 30 days post discharge. Retention, postoperative symptom intervention tool completion, and usability were assessed. Exploratory analysis of daily symptoms and patient-generated health information correlated signals with postsurgical complications and hospital readmission. Fifteen patients with a median age of 72 years completed 78% of daily surveys over the 30-day recovery period. Average time to complete the postoperative symptom intervention tool was 152 seconds. All patients agreed that the daily survey was easy to use, and most reported it would be a better way to communicate with the care team about symptoms than calling the clinic. Frequency and severity of patient-reported symptoms appeared to cluster prior to or at the time of complication or unplanned health care encounters on visual-analogue mapping. Using smartphone and wearable technology to capture patient-reported symptoms and biometric data is feasible and rated as highly usable by bladder cancer patients after cystectomy. Symptom scores may signal developing complications and help clinicians identify postsurgical patients who may benefit from intervention.

MP03-16 FEASIBILITY, USABILITY AND UTILITY OF A REMOTE SYMPTOM ASSESSMENT TOOL AFTER RADICAL CYSTECTOMY

You have accessJournal of UrologyCME1 May 2022MP03-16 FEASIBILITY, USABILITY AND UTILITY OF A REMOTE SYMPTOM ASSESSMENT TOOL AFTER RADICAL CYSTECTOMY Heather Huelster, Logan Zemp, Brian Gonzalez, Heather Jim, Michael Poch, L Robert Gore, and Scott Gilbert Heather HuelsterHeather Huelster More articles by this author , Logan ZempLogan Zemp More articles by this author , Brian GonzalezBrian Gonzalez More articles by this author , Heather JimHeather Jim More articles by this author , Michael PochMichael Poch More articles by this author , L Robert GoreL Robert Gore More articles by this author , and Scott GilbertScott Gilbert More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002515.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Mobile health technology and integration of patient-reported outcomes (PROs) into clinical care has potential to transform how patients communicate with care teams. Though PRO symptom assessment and management has been shown to improve outcomes in ambulatory care settings, few studies have examined PROs from remote symptom assessment after major cancer surgery. METHODS: Relevant items from the NCI’s PRO version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) were adapted to capture common symptoms after radical cystectomy. Items were reviewed and vetted with nurses, surgeons, and NCI stakeholders. An app-based mobile symptom assessment tool (SAT) was developed and usability reviewed by patient and caregiver focus groups (N=10).Feasibility and usability was tested in prospectively accrued cystectomy patients (N=15) who completed daily SATs on an electronic tablet (Figure 1a) and wore Garmin biometric monitoring devices while recovering after hospital discharge. Retention, SAT completion, and usability was assessed. Clinical utility was explored by correlating daily PRO symptoms and biometric data to postoperative complications and readmission. RESULTS: Fifteen patients with a median age of 72 years completed the study during recovery from cystectomy. Eight (53.3%) patients experienced a complication, 11 (73.3%) had an unexpected healthcare encounter, and 2 (13.3%) required readmission. Patients completed a mean 78.2% daily surveys and the mean time required to complete each questionnaire was 152 seconds. All patients responded that they agreed/strongly agreed that the SAT was easy to use, and 9 (60%) stated that they thought it was a better way to communicate with the care team about symptoms. Heatmaps of daily SAT responses were clustered by outcomes and visually correlated with adverse recovery events (Figure 1b-d). A wearable Garmin monitor collected patient-generated health data including heart rate, activity, sleep, and stress metrics for a mean of 22.8 days per patient during the 30-day home recovery phase after cystectomy. CONCLUSIONS: Remote symptom assessment is feasible after cystectomy and rated as highly usable by patients. PRO-CTCAE scores and biometric data may signal developing complications and help clinicians identify patients who may benefit from intervention. Source of Funding: NA © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e26 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Heather Huelster More articles by this author Logan Zemp More articles by this author Brian Gonzalez More articles by this author Heather Jim More articles by this author Michael Poch More articles by this author L Robert Gore More articles by this author Scott Gilbert More articles by this author Expand All Advertisement PDF DownloadLoading ...

Active surveillance of chemotherapy-related symptom burden in ambulatory cancer patients via the implementation of electronic patient-reported outcomes and sensor-enabled vital signs capture: protocol for a decentralised feasibility pilot study

IntroductionRemote patient monitoring (RPM) has emerged as a potential avenue for optimising the management of symptoms in patients undergoing chemotherapy. However, RPM is a complex, multilevel intervention with technology, workflow,...

Lifestyle Modification Using a Wearable Biometric Ring and Guided Feedback Improve Sleep and Exercise Behaviors: A 12-Month Randomized, Placebo-Controlled Study.

Purpose: Wearable biometric monitoring devices (WBMD) show promise as a cutting edge means to improve health and prevent disease through increasing accountability. By regularly providing real-time quantitative data regarding activity, sleep quality, and recovery, users may become more aware of the impact that their lifestyle has on their health. The purpose of this study was to examine the efficacy of a biometric tracking ring on improving sleep quality and increasing physical fitness over a one-year period.Methods: Fifty-six participants received a biometric tracking ring and were placed in one of two groups. One group received a 3-month interactive behavioral modification intervention (INT) that was delivered virtually via a smartphone app with guided text message feedback (GTF). The other received a 3-month non-directive wellness education control (CON). After three months, the INT group was divided into a long-term feedback group (LT-GTF) that continued to receive GTF for another nine months or short-term feedback group (ST-GTF) that stopped receiving GTF. Weight, body composition, and VO2max were assessed at baseline, 3months, and 12months for all participants and additionally at 6 and 9months for the ST-GTF and LT-GTF groups. To establish baseline measurements, sleep and physical activity data were collected daily over a 30-day period. Daily measurements were also conducted throughout the 12-month duration of the study.Results: Over the first 3months, the INT group had significant (p<0.001) improvements in sleep onset latency, daily step count, % time jogging, VO2max, body fat percentage, and heart rate variability (rMSSD HRV) compared to the CON group. Over the next 9months, the LT-GTF group continued to improve significantly (p<0.001) in sleep onset latency, daily step count, % time jogging, VO2max, and rMSSD HRV. The ST-GTF group neither improved nor regressed over the latter 9months except for a small increase in sleep latency.Conclusion: Using a WBMD concomitantly with personalized education, encouragement, and feedback, elicits greater change than using a WBMD alone. Additionally, the improvements achieved from a short duration of personalized coaching are largely maintained with the continued use of a WBMD.

Biometric Monitoring Devices: Modern Solutions to Protecting Athletes’ Data Privacy

Smartwatches like Fitbits provide users with easy access to quantifiable health data. In the sports industry, tracking this biometric information may be particularly beneficial to athletes, whose livelihoods revolve around their health and fitness. Nonetheless, under the current regime, professional and collegiate athletes’ biometric health data are inadequately protected. Data privacy law is still in its infancy, but in the meantime, athletes must consider that motivations to sell or misuse players’ biometric information may outpace legal developments. This Paper will analyze the promise and risk of collecting professional and collegiate athletes’ health and biometric data, particularly through fitness wearables. It will provide a closer look at wearables in professional sports and consider the increased risk posed to college athletes. Finally, this Paper will consider possible solutions to maximize the benefits of newfound technology while simultaneously minimizing risks to players’ health information, privacy, and personal data ownership.

Virtual Care for Indigenous Populations in Canada, the United States, Australia, and New Zealand: Protocol for a Scoping Review.

BackgroundIndigenous people in Canada, the United States, Australia, and New Zealand experience an increased burden of chronic diseases compared to non-Indigenous people in these countries. Lack of necessary services and culturally relevant care for Indigenous people contributes to this burden. Many Indigenous communities have implemented systems, such as virtual care, to improve chronic disease management. Virtual care has extended beyond videoconferencing to include more advanced technologies, such as remote biometric monitoring devices. However, given the historical and ongoing Western intrusion into Indigenous day to day life, these technologies may seem more invasive and thus require additional research on their acceptability and utility within Indigenous populations.ObjectiveThe objective of this paper is to present the protocol for a scoping review, which aims to map existing evidence. This study is based on the following guiding research question: What are the characteristics of virtual care use by Indigenous adult populations in Canada, the United States, Australia, and New Zealand? The subquestions are related to the technology used, health conditions and nature of the virtual care, cultural safety, and key concepts for effective use.MethodsThis scoping review protocol is informed by the methodology described by the Joanna Briggs Institute and is supplemented by the frameworks proposed by Arksey and O’Malley and Levac et al. A search for published and gray literature, written in English, and published between 2000 and present will be completed utilizing electronic databases and search engines, including MEDLINE, CINAHL, Embase, Indigenous Peoples of North America, Australian Indigenous HealthInfoNet, Informit, and Native Health Database. Search results will be uploaded to the review software, Covidence, for title and abstract screening before full-text screening begins. This process will be repeated for gray literature. Upon completion, a data abstraction tool will organize the relevant information into categorical formations.ResultsThe search strategy has been confirmed, and the screening of titles and abstracts is underway. As of October 2020, we have identified over 300 articles for full-text screening.ConclusionsPrevious reviews have addressed virtual care within Indigenous communities. However, new virtual care technologies have since emerged; subsequently, additional literature has been published. Mapping and synthesizing this literature will inform new directions for research and discussion.International Registered Report Identifier (IRRID)PRR1-10.2196/21860

Use of wearable biometric monitoring devices to measure outcomes in randomized clinical trials: a methodological systematic review

BackgroundWearable biometric monitoring devices (BMDs) have the potential to transform the conduct of randomized controlled trials (RCTs) by shifting the collection of outcome data from single measurements at predefined time points to dense continuous measurements.MethodsMethodological systematic review to understand how recent RCTs used BMDs to measure outcomes and to describe the reporting of these RCTs. Electronic search was performed in the Cochrane Central Register of Controlled Trials, PubMed, and EMBASE and completed a page-by-page hand search in five leading medical journals between January 1, 2018, and December 31, 2018. Three reviewers independently extracted all primary and secondary outcomes collected using BMDs, and assessed (1) the definitions used to summarize BMD outcome data; (2) whether the validity, reliability, and responsiveness of sensors was reported; (3) the discrepancy with outcomes prespecified in public clinical trial registries; and (4) the methods used to manage missing and incomplete BMD outcome data.ResultsOf the 4562 records screened, 75 RCTs were eligible. Among them, 24% tested a pharmacological intervention and 57% used an inertial measurement sensor to measure physical activity. Included trials involved 464 outcomes (average of 6 [SD = 8] outcomes per trial). In total, 35 trials used a BMD to measure a primary outcome. Several issues affected the value and transparency of trials using BMDs to measure outcomes. First, the definition of outcomes used in the trials was highly heterogeneous (e.g., 21 diabetes trials had 266 outcomes and 153 had different unique definitions to measure diabetes control), which limited the combination and comparison of results. Second, information on the validity, reliability, and responsiveness of sensors used was lacking in 74% of trials. Third, half (53%) of the outcomes measured with BMDs had not been prespecified, with a high risk of outcome reporting bias. Finally, reporting on the management of incomplete outcome data (e.g., due to suboptimal compliance with the BMD) was absent in 68% of RCTs.ConclusionsUse of BMDs to measure outcomes is becoming the norm rather than the exception in many fields. Yet, trialists need to account for several methodological issues when specifying and conducting RCTs using these novel tools.

Identification of Patient Perceptions That Can Affect the Uptake of Interventions Using Biometric Monitoring Devices: Systematic Review of Randomized Controlled Trials.

BackgroundBiometric monitoring devices (BMDs) are wearable or environmental trackers and devices with embedded sensors that can remotely collect high-frequency objective data on patients’ physiological, biological, behavioral, and environmental contexts (for example, fitness trackers with accelerometer). The real-world effectiveness of interventions using biometric monitoring devices depends on patients’ perceptions of these interventions.ObjectiveWe aimed to systematically review whether and how recent randomized controlled trials (RCTs) evaluating interventions using BMDs assessed patients’ perceptions toward the intervention.MethodsWe systematically searched PubMed (MEDLINE) from January 1, 2017, to December 31, 2018, for RCTs evaluating interventions using BMDs. Two independent investigators extracted the following information: (1) whether the RCT collected information on patient perceptions toward the intervention using BMDs and (2) if so, what precisely was collected, based on items from questionnaires used and/or themes and subthemes identified from qualitative assessments. The two investigators then synthesized their findings in a schema of patient perceptions of interventions using BMDs.ResultsA total of 58 RCTs including 10,071 participants were included in the review (the median number of randomized participants was 60, IQR 37-133). BMDs used in interventions were accelerometers/pedometers (n=35, 60%), electrochemical biosensors (eg, continuous glucose monitoring; n=18, 31%), or ecological momentary assessment devices (eg, carbon monoxide monitors for smoking cessation; n=5, 9%). Overall, 26 (45%) trials collected information on patient perceptions toward the intervention using BMDs and allowed the identification of 76 unique aspects of patient perceptions that could affect the uptake of these interventions (eg, relevance of the information provided, alarm burden, privacy and data handling, impact on health outcomes, independence, interference with daily life). Patient perceptions were unevenly collected in trials. For example, only 5% (n=3) of trials assessed how patients felt about privacy and data handling aspects of the intervention using BMDs.ConclusionsOur review showed that less than half of RCTs evaluating interventions using BMDs assessed patients’ perceptions toward interventions using BMDs. Trials that did assess perceptions often only assessed a fraction of them. This limits the extrapolation of the results of these RCTs to the real world. We thus provide a comprehensive schema of aspects of patient perceptions that may affect the uptake of interventions using BMDs and which should be considered in future trials.Trial RegistrationPROSPERO CRD42018115522; https://tinyurl.com/y5h8fjgx

Patients\u2019 views of wearable devices and AI in healthcare: findings from the ComPaRe e-cohort

Wearable biometric monitoring devices (BMDs) and artificial intelligence (AI) enable the remote measurement and analysis of patient data in real time. These technologies have generated a lot of “hype,” but their real-world effectiveness will depend on patients’ uptake. Our objective was to describe patients’ perceptions of the use of BMDs and AI in healthcare. We recruited adult patients with chronic conditions in France from the “Community of Patients for Research” (ComPaRe). Participants (1) answered quantitative and open-ended questions about the potential benefits and dangers of using of these new technologies and (2) participated in a case-vignette experiment to assess their readiness for using BMDs and AI in healthcare. Vignettes covered the use of AI to screen for skin cancer, remote monitoring of chronic conditions to predict exacerbations, smart clothes to guide physical therapy, and AI chatbots to answer emergency calls. A total of 1183 patients (51% response rate) were enrolled between May and June 2018. Overall, 20% considered that the benefits of technology (e.g., improving the reactivity in care and reducing the burden of treatment) greatly outweighed the dangers. Only 3% of participants felt that negative aspects (inadequate replacement of human intelligence, risks of hacking and misuse of private patient data) greatly outweighed potential benefits. We found that 35% of patients would refuse to integrate at least one existing or soon-to-be available intervention using BMDs and AI-based tools in their care. Accounting for patients’ perspectives will help make the most of technology without impairing the human aspects of care, generating a burden or intruding on patients’ lives.

Biometric monitoring devices for assessing end points in clinical trials: developing an ecosystem.

Biometric monitoring devices for assessing end points in clinical trials: developing an ecosystem

LANDSCAPE ANALYSIS OF BIOMETRIC MONITORING DEVICES (BMDS) UTILIZED IN ASSESSING COGNITION, SLEEP AND MOBILITY IN ALZHEIMER’S DISEASE AND OTHER AGE-RELATED NEUROLOGICAL DISEASES

The general public and collective biomedical research enterprise are increasingly embracing local and remote monitoring technologies, mobile smartphone apps, and portable/wearable devices into their activities of daily living. Many view these devices as future path to provide a deeper understanding of disease processes, patients’ cognitive and functional status, and quality-of-life assessments. Biometric Monitoring Devices (BMDs) refer to the use of a biosensor(s) to continuously collect objective data on a biological recognition element (glucose, hormone levels, etc.), or integrated physiological parameters (blood pressure, mobility/motor, memory/processing, speech/sleep patterns, social engagement, etc.). BMDs utilize algorithms to transform data into a format that is interpretable as a specific measure, or, an aggregate functional outcome. Health platforms using BMDs are providing clinicians real-time evidence that allows efficient and continuous collection of data and assessments to monitor clinically meaningful parameters. The Coalition Against Major Diseases (CAMD), a nonprofit organization that aims to convene diverse stakeholders (academia, advocacy groups, industry, regulators) to create new Drug Development Tools (DDTs) that can accelerate the drug development process, conducted a landscape analysis of BMDs utilized in assessing sleep, cognition, and mobility in Alzheimer's disease (AD) and other age-related neurological diseases. CAMD convened workshops to gather and unify the research community, subject-matter experts, device developers, standard development organizations, and regulators around the identification of existing gaps and challenges, a common lexicon, assessments of existing devices in use, and use-cases for potential integration into clinical trial tools across neurological diseases. Because BMDs represent a paradigm shift in developing evidence of biomarker changes or clinical endpoints for clinical trials, they will require an innovative approach to data standardization, data integration and data analytics. This presentation aims to summarize the workshop results, share lessons-learned, and provide recommendations for validation approaches. The volume and quality of studies of BMD data generation/validation/interpretation, the comparability among studies, and the pathway to overcome the challenges confronting the successful use and acceptance of BMDs for clinical research in CNS diseases must be improved. BMD's are promising, but as yet unproven, DDTs to advance innovative treatments for various stages of AD and other neurodegenerative diseases.