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International Journal of Telemedicine and Applications focuses on the applications of medical practice and care at a distance and their supporting technologies such as, computing, communications, and networking technologies.
International Journal of Telemedicine and Applications maintains an Editorial Board of practicing researchers from around the world, to ensure manuscripts are handled by editors who are experts in the field of study.
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False Alarm Reduction in Self-Care by Personalized Automatic Detection of ECG Electrode Cable Interchanges
Introduction. False alarm reduction is an important challenge in self-care, whereas one of the most important false alarm causes in the cardiology domain is electrodes misplacements in ECG recordings, the main investigations to perform for early and pervasive detection of cardiovascular diseases. In this context, we present and assess a new method for electrode reversals identification for Mason-Likar based 3D ECG recording systems which are especially convenient to use in self-care and allow to achieve, as previously reported, high computerized ischemia detection accuracy. Methods. We mathematically simulate the effect of the six pairwise reversals of the LA, RA, LL, and C2 electrodes on the three ECG leads I, II, and V2. Our approach then consists in performing serial comparisons of the newly recorded 3D ECG and of the six derived ECGs simulating an electrode reversal with a standard, 12-lead reference ECG by means of the CAVIAR software. We further use a scoring method to compare these analysis results and then apply a decision tree model to extract the most relevant measurements in a learning set of 121 patients recorded in ICU. Results. The comparison of the seven sets of serial analysis results from the learning set resulted in the determination of a composite criteria involving four measurements of spatial orientation changes of QRS and T and providing a reversal identification accuracy of 100%. Almost the same results, with 99.99% of sensitivity and 100% of specificity, were obtained in two test sets from 90 patients, composed of 2098 and 2036 representative ECG beats respectively recorded during PTCA balloon inflation, a procedure which mimics ischemia, and before PTCA for control. Conclusion. Personalized automatic detection of ECG electrode cable interchanges can reach almost the maximal accuracy of 100% in self-care, and can be performed in almost real time.
Influence of Generational Cohorts on the Preferences for Information and Communication Technologies in Latin American Patients with Obstructive Lung Diseases
Background. Advances in information and communication technologies (ICTs) represent a growing platform for the expansion of healthcare related services, but there is little information on how generational differences might account for distinct patterns of use and interest for ICTs. Our study aims to achieve a better understanding on how generational cohorts might influence the use and preferences for ICTs among patients with obstructive lung diseases in Latin America. Materials and Methods. We conducted an anonymous cross-sectional survey-based study, involving 968 patients with obstructive lung diseases (OLD) in Latin America. Patients rated their frequency of use and preferences of ICTs through a modified version of the Michigan Questionnaire. Chi-square test for association and adjusted regression analyses were performed. Results. Of all, 63.6% of participants had Internet access. Younger generations, in particular Generation Z and Millennials, had the highest rate of Internet access and smartphone ownership, as well as of overall frequency of ICT use. Web-based Internet was found to be the main source to seek information about the disease (36.9%) across all generational cohorts. Generation Z and Millennials presented the highest odds to be interested in using Twitter (OR 31.79 and 8.86) for receiving health-related information, and email (OR 4.87 and 4.86) as the preferred way to ask physicians information related to their disease through ICTs. Conclusion. Generational cohorts influence the use and preferences for ICTs among patients with obstructive lung diseases. Younger generational cohorts were associated with higher access to the Internet and smartphone ownership, as well as higher interest for using ICTs to receive and ask for health-related information.
Wearable Measurement of ECG Signals Based on Smart Clothing
Smart clothing that can measure electrocardiogram (ECG) signals and monitor the health status of people meets the needs of our increasingly aging society. However, the conventional measurement of ECG signals is complicated and its electrodes can cause irritation to the skin, which makes the conventional measurement method unsuitable for applications in smart clothing. In this paper, a novel wearable measurement of ECG signals is proposed. There are only three ECG textile electrodes knitted into the fabric of smart clothing. The acquired ECG signals can be transmitted to a smartphone via Bluetooth, and they can also be sent out to a PC terminal by a smartphone via WiFi or Internet. To get more significant ECG signals, the ECG differential signal between two electrodes is calculated based on a spherical volume conductor model, and the best positions on the surface of a human body for two textile electrodes to measure ECG signals are simulated by using the body-surface potential mapping (BSPM) data. The results show that position 12 in the lower right and position 11 in the upper left of the human body are the best for the two electrodes to measure ECG signals, and the presented wearable measurement can obtain good performance when one person is under the conditions of sleeping and jogging.
App-Based Tele Ophthalmology: A Novel Method of Rural Eye Care Delivery Connecting Tertiary Eye Care Center and Vision Centers in India
Purpose. The study aims to describe a novel method of utilization of the eyeSmart EMR (electronic medical record) app. It describes the demographic distribution, clinical presentation, query requested by the vision technician, and management advised to the patients by using “eyeSmart EMR” app from the vision centers located across a three-tier eye care network in India. Methods. This is a retrospective review of all patients who required a tele-ophthalmology consultation from January 2017 to August 2018. The demographic, clinical details, and the impact of teleophthalmology using eyeSmart app, in the vision centers of a three-tier eye care network, was analyzed in detail. Results. A total of 15,001 tele-ophthalmology consults were included which is from January 2017 to August 2018. The mean age was 38 ± 19 years and male to female ratio was 1 : 2. Video calls were performed for 6191 (41.27%) consults and the impact was measured. Additional clinical information was received in 65.61% consults through video call. Medical management was advised in 47.07% of patients and 30.30% were referred to higher centers for medical intervention and 0.59% were referred for surgical intervention, 16.23% were prescribed glasses. No intervention required for 0.69% of cases. Hence nil intervention was advised. Conclusion. The combination of using tablet and video calls with the help of eyeSmart EMR app is a novel method in teleophthalmology. It helps in connecting the patients at rural areas and the ophthalmologists in higher centers. The use of technology plays a vital role in the appropriate medical management of the patient.
Physicians’ Attitude towards The Use of Social Media for Professional Purposes in Saudi Arabia
Purpose. In relation to this research, only a few studies have been carried out around the world. However, in Saudi Arabia, there have been no investigations into this subject. In this sense, the objective of this study was to investigate the physicians’ attitudes towards the use of social media for professional purposes in Saudi Arabia. Methods. A cross-sectional study was conducted among 235 physicians from different regions of Saudi Arabia. The data were collected by means of a survey. The survey questionnaire was distributed using the WhatsApp application. Descriptive statistics were used to analyze the results. Results. The most common social media used by the respondents was Facebook, and the majority of the participants agreed that social media improved their knowledge and skills. However, most of the participants did not interact with patients using these tools, did not feel comfortable conducting an online consultation, and believed that social media affected the choice of the healthcare provider. Similarly, 30.6% of the respondents opined that it is not appropriate to search online information about patients, and 44.3% of them considered that patients would not trust the medical advice if a physician obtained the information from a website. Conclusion. The results showed that the majority of the respondents considered that social media improved the knowledge and abilities of physicians. In addition, the respondents reflected that there were ethical issues that must be taken into account when using social media and more than half of them did not interact with their patients employing these tools. The outcomes of this research will help to develop programs directed at the physicians in Saudi Arabia to enhance their knowledge, professional skills, medicine practice, patient-doctor interaction, and handle the risks involved in the use of social media.
Multi-Sensor-Fusion Approach for a Data-Science-Oriented Preventive Health Management System: Concept and Development of a Decentralized Data Collection Approach for Heterogeneous Data Sources
Investigations in preventive and occupational medicine are often based on the acquisition of data in the customer’s daily routine. This requires convenient measurement solutions including physiological, psychological, physical, and sometimes emotional parameters. In this paper, the introduction of a decentralized multi-sensor-fusion approach for a preventive health-management system is described. The aim is the provision of a flexible mobile data-collection platform, which can be used in many different health-care related applications. Different heterogeneous data sources can be integrated and measured data are prepared and transferred to a superordinated data-science-oriented cloud-solution. The presented novel approach focuses on the integration and fusion of different mobile data sources on a mobile data collection system (mDCS). This includes directly coupled wireless sensor devices, indirectly coupled devices offering the datasets via vendor-specific cloud solutions (as e.g., Fitbit, San Francisco, USA and Nokia, Espoo, Finland) and questionnaires to acquire subjective and objective parameters. The mDCS functions as a user-specific interface adapter and data concentrator decentralized from a data-science-oriented processing cloud. A low-level data fusion in the mDCS includes the synchronization of the data sources, the individual selection of required data sets and the execution of pre-processing procedures. Thus, the mDCS increases the availability of the processing cloud and in consequence also of the higher level data-fusion procedures. The developed system can be easily adapted to changing health-care applications by using different sensor combinations. The complex processing for data analysis can be supported and intervention measures can be provided.