Skip to main content
Erschienen in: Journal of Medical Systems 10/2015

01.10.2015 | Mobile Systems

Cloud-Based Smart Health Monitoring System for Automatic Cardiovascular and Fall Risk Assessment in Hypertensive Patients

verfasst von: P. Melillo, A. Orrico, P. Scala, F. Crispino, L. Pecchia

Erschienen in: Journal of Medical Systems | Ausgabe 10/2015

Einloggen, um Zugang zu erhalten

Abstract

The aim of this paper is to describe the design and the preliminary validation of a platform developed to collect and automatically analyze biomedical signals for risk assessment of vascular events and falls in hypertensive patients. This m-health platform, based on cloud computing, was designed to be flexible, extensible, and transparent, and to provide proactive remote monitoring via data-mining functionalities. A retrospective study was conducted to train and test the platform. The developed system was able to predict a future vascular event within the next 12 months with an accuracy rate of 84 % and to identify fallers with an accuracy rate of 72 %. In an ongoing prospective trial, almost all the recruited patients accepted favorably the system with a limited rate of inadherences causing data losses (<20 %). The developed platform supported clinical decision by processing tele-monitored data and providing quick and accurate risk assessment of vascular events and falls.
Literatur
1.
Zurück zum Zitat Fortino G, Pathan M, Di Fatta G, editors. BodyCloud: Integration of Cloud Computing and body sensor networks. Cloud Computing Technology and Science (CloudCom), 2012 I.E. 4th International Conference on; 2012 3–6 Dec. 2012. Fortino G, Pathan M, Di Fatta G, editors. BodyCloud: Integration of Cloud Computing and body sensor networks. Cloud Computing Technology and Science (CloudCom), 2012 I.E. 4th International Conference on; 2012 3–6 Dec. 2012.
3.
Zurück zum Zitat Pandey, S., Voorsluys, W., Niu, S., Khandoker, A., and Buyya, R., An autonomic cloud environment for hosting ECG data analysis services. Future Generation Computer Systems 28(1):147–54, 2012.CrossRef Pandey, S., Voorsluys, W., Niu, S., Khandoker, A., and Buyya, R., An autonomic cloud environment for hosting ECG data analysis services. Future Generation Computer Systems 28(1):147–54, 2012.CrossRef
4.
Zurück zum Zitat Baig, M. M., and Gholamhosseini, H., Smart health monitoring systems: an overview of design and modeling. J Med Syst 37(2):9898, 2013.CrossRefPubMed Baig, M. M., and Gholamhosseini, H., Smart health monitoring systems: an overview of design and modeling. J Med Syst 37(2):9898, 2013.CrossRefPubMed
5.
Zurück zum Zitat Malik, M., Bigger, J. T., Camm, A. J., Kleiger, R. E., Malliani, A., Moss, A. J., et al., Heart rate variability: Standards of measurement, physiological interpretation, and clinical use. Eur Heart J 17(3):354–81, 1996.CrossRef Malik, M., Bigger, J. T., Camm, A. J., Kleiger, R. E., Malliani, A., Moss, A. J., et al., Heart rate variability: Standards of measurement, physiological interpretation, and clinical use. Eur Heart J 17(3):354–81, 1996.CrossRef
6.
Zurück zum Zitat Guzzetti, S., Magatelli, R., Borroni, E., and Mezzetti, S., Heart rate variability in chronic heart failure. Autonomic Neuroscience-Basic & Clinical 90(1–2):102–5, 2001.CrossRef Guzzetti, S., Magatelli, R., Borroni, E., and Mezzetti, S., Heart rate variability in chronic heart failure. Autonomic Neuroscience-Basic & Clinical 90(1–2):102–5, 2001.CrossRef
7.
Zurück zum Zitat Aronson, D., Mittleman, M. A., and Burger, A. J., Measures of heart period variability as predictors of mortality in hospitalized patients with decompensated congestive heart failure. Am J Cardiol 93(1):59–63, 2004.CrossRefPubMed Aronson, D., Mittleman, M. A., and Burger, A. J., Measures of heart period variability as predictors of mortality in hospitalized patients with decompensated congestive heart failure. Am J Cardiol 93(1):59–63, 2004.CrossRefPubMed
8.
Zurück zum Zitat Hadase, M., Azuma, A., Zen, K., Asada, S., Kawasaki, T., Kamitani, T., et al., Very low frequency power of heart rate variability is a powerful predictor of clinical prognosis in patients with congestive heart failure. Circulation Journal 68(4):343–7, 2004.CrossRefPubMed Hadase, M., Azuma, A., Zen, K., Asada, S., Kawasaki, T., Kamitani, T., et al., Very low frequency power of heart rate variability is a powerful predictor of clinical prognosis in patients with congestive heart failure. Circulation Journal 68(4):343–7, 2004.CrossRefPubMed
9.
Zurück zum Zitat Smilde, T. D. J., van Veldhuisen, D. J., and van den Berg, M. P., Prognostic value of heart rate variability and ventricular arrhythmias during 13-year follow-up in patients with mild to moderate heart failure. Clinical Research in Cardiology 98(4):233–9, 2009.CrossRefPubMed Smilde, T. D. J., van Veldhuisen, D. J., and van den Berg, M. P., Prognostic value of heart rate variability and ventricular arrhythmias during 13-year follow-up in patients with mild to moderate heart failure. Clinical Research in Cardiology 98(4):233–9, 2009.CrossRefPubMed
10.
Zurück zum Zitat Melillo, P., Bracale, M., and Pecchia, L., Nonlinear Heart Rate Variability features for real-life stress detection. Case study: students under stress due to university examination. Biomed Eng Online 10(1):96, 2011.PubMedCentralCrossRefPubMed Melillo, P., Bracale, M., and Pecchia, L., Nonlinear Heart Rate Variability features for real-life stress detection. Case study: students under stress due to university examination. Biomed Eng Online 10(1):96, 2011.PubMedCentralCrossRefPubMed
11.
Zurück zum Zitat Melillo, P., De Luca, N., Bracale, M., and Pecchia, L., Classification Tree for Risk Assessment in Patients Suffering From Congestive Heart Failure via Long-Term Heart Rate Variability. IEEE J Biomed Health Inform 17(3):727–33, 2013.CrossRefPubMed Melillo, P., De Luca, N., Bracale, M., and Pecchia, L., Classification Tree for Risk Assessment in Patients Suffering From Congestive Heart Failure via Long-Term Heart Rate Variability. IEEE J Biomed Health Inform 17(3):727–33, 2013.CrossRefPubMed
12.
Zurück zum Zitat Melillo, P., Fusco, R., Sansone, M., Bracale, M., and Pecchia, L., Discrimination power of long-term heart rate variability measures for chronic heart failure detection. Med Biol Eng Comput 49(1):67–74, 2011.CrossRefPubMed Melillo, P., Fusco, R., Sansone, M., Bracale, M., and Pecchia, L., Discrimination power of long-term heart rate variability measures for chronic heart failure detection. Med Biol Eng Comput 49(1):67–74, 2011.CrossRefPubMed
13.
Zurück zum Zitat Pecchia, L., Melillo, P., and Bracale, M., Remote health monitoring of heart failure with data mining via CART method on HRV features. IEEE Trans Bio Med Eng 58(3):800–4, 2011.CrossRef Pecchia, L., Melillo, P., and Bracale, M., Remote health monitoring of heart failure with data mining via CART method on HRV features. IEEE Trans Bio Med Eng 58(3):800–4, 2011.CrossRef
14.
Zurück zum Zitat Pecchia, L., Melillo, P., Sansone, M., and Bracale, M., Discrimination power of short-term heart rate variability measures for CHF assessment. IEEE Trans Inf Technol Biomed 15(1):40–6, 2011.CrossRefPubMed Pecchia, L., Melillo, P., Sansone, M., and Bracale, M., Discrimination power of short-term heart rate variability measures for CHF assessment. IEEE Trans Inf Technol Biomed 15(1):40–6, 2011.CrossRefPubMed
15.
Zurück zum Zitat Melillo, P., Izzo, R., Luca, N., and Pecchia, L., Heart rate variability and target organ damage in hypertensive patients. BMC Cardiovasc Disord 12(1):105, 2012.PubMedCentralCrossRefPubMed Melillo, P., Izzo, R., Luca, N., and Pecchia, L., Heart rate variability and target organ damage in hypertensive patients. BMC Cardiovasc Disord 12(1):105, 2012.PubMedCentralCrossRefPubMed
16.
Zurück zum Zitat Ramirez-Villegas, J. F., Lam-Espinosa, E., Ramirez-Moreno, D. F., Calvo-Echeverry, P. C., and Agredo-Rodriguez, W., Heart rate variability dynamics for the prognosis of cardiovascular risk. PLoS One 6(2):e17060, 2011.PubMedCentralCrossRefPubMed Ramirez-Villegas, J. F., Lam-Espinosa, E., Ramirez-Moreno, D. F., Calvo-Echeverry, P. C., and Agredo-Rodriguez, W., Heart rate variability dynamics for the prognosis of cardiovascular risk. PLoS One 6(2):e17060, 2011.PubMedCentralCrossRefPubMed
17.
Zurück zum Zitat Singh A, Guttag JV, editors. A comparison of non-symmetric entropy-based classification trees and support vector machine for cardiovascular risk stratification. Engineering in Medicine and Biology Society,EMBC, 2011 Annual International Conference of the IEEE; 2011 Aug. 30 2011-Sept. 3 2011. Singh A, Guttag JV, editors. A comparison of non-symmetric entropy-based classification trees and support vector machine for cardiovascular risk stratification. Engineering in Medicine and Biology Society,EMBC, 2011 Annual International Conference of the IEEE; 2011 Aug. 30 2011-Sept. 3 2011.
18.
Zurück zum Zitat Song, T., Qu, X. F., Zhang, Y. T., Cao, W., Han, B. H., Li, Y., et al., Usefulness of the heart-rate variability complex for predicting cardiac mortality after acute myocardial infarction. BMC Cardiovasc Disord 14(1):59, 2014.PubMedCentralCrossRefPubMed Song, T., Qu, X. F., Zhang, Y. T., Cao, W., Han, B. H., Li, Y., et al., Usefulness of the heart-rate variability complex for predicting cardiac mortality after acute myocardial infarction. BMC Cardiovasc Disord 14(1):59, 2014.PubMedCentralCrossRefPubMed
19.
Zurück zum Zitat Ebrahimzadeh, E., Pooyan, M., and Bijar, A., A novel approach to predict sudden cardiac death (SCD) using nonlinear and time-frequency analyses from HRV signals. PLoS One 9(2), e81896, 2014.PubMedCentralCrossRefPubMed Ebrahimzadeh, E., Pooyan, M., and Bijar, A., A novel approach to predict sudden cardiac death (SCD) using nonlinear and time-frequency analyses from HRV signals. PLoS One 9(2), e81896, 2014.PubMedCentralCrossRefPubMed
20.
Zurück zum Zitat Isik, M., Cankurtaran, M., Yavuz, B. B., Deniz, A., Yavuz, B., Halil, M., et al., Blunted baroreflex sensitivity: An underestimated cause of falls in the elderly? European Geriatric Medicine 3(1):9–13, 2012.CrossRef Isik, M., Cankurtaran, M., Yavuz, B. B., Deniz, A., Yavuz, B., Halil, M., et al., Blunted baroreflex sensitivity: An underestimated cause of falls in the elderly? European Geriatric Medicine 3(1):9–13, 2012.CrossRef
21.
Zurück zum Zitat Melillo P, Jovic A, De Luca N, Morgan SP, Pecchia L, editors. Automatic Prediction of Falls via Heart Rate Variability and Data Mining in Hypertensive Patients: The SHARE Project Experience. 6th European Conference of the International Federation for Medical and Biological Engineering; 2015: Springer. Melillo P, Jovic A, De Luca N, Morgan SP, Pecchia L, editors. Automatic Prediction of Falls via Heart Rate Variability and Data Mining in Hypertensive Patients: The SHARE Project Experience. 6th European Conference of the International Federation for Medical and Biological Engineering; 2015: Springer.
22.
Zurück zum Zitat Melillo P, Scala P, De Luca N, Pecchia L, editors. Automatic Prediction of Vascular Events by Heart Rate Variability Analysis in Hypertensive Patients. 6th European Conference of the International Federation for Medical and Biological Engineering; 2015: Springer. Melillo P, Scala P, De Luca N, Pecchia L, editors. Automatic Prediction of Vascular Events by Heart Rate Variability Analysis in Hypertensive Patients. 6th European Conference of the International Federation for Medical and Biological Engineering; 2015: Springer.
23.
Zurück zum Zitat Sannino G, Melillo P, De Pietro G, Stranges S, Pecchia L. To What Extent It Is Possible to Predict Falls due to Standing Hypotension by Using HRV and Wearable Devices? Study Design and Preliminary Results from a Proof-of-Concept Study. Ambient Assisted Living and Daily Activities. Springer; 2014. p. 167–70. Sannino G, Melillo P, De Pietro G, Stranges S, Pecchia L. To What Extent It Is Possible to Predict Falls due to Standing Hypotension by Using HRV and Wearable Devices? Study Design and Preliminary Results from a Proof-of-Concept Study. Ambient Assisted Living and Daily Activities. Springer; 2014. p. 167–70.
24.
Zurück zum Zitat Sannino G, Melillo P, De Pietro G, Stranges S, Pecchia L. Blood pressure drop prediction by using HRV measurements in orthostatic hypotension. J Med Syst. 2015 Sannino G, Melillo P, De Pietro G, Stranges S, Pecchia L. Blood pressure drop prediction by using HRV measurements in orthostatic hypotension. J Med Syst. 2015
25.
Zurück zum Zitat Sannino G, Melillo P, De Pietro G, Stranges S, Pecchia L. Short term heart rate variability to predict blood pressure drops due to standing: a pilot study. BMC Med. Inform. Decis. Mak. 2015. 15(Suppl 3):S2 doi:10.1186/1472-6947-15-S3-S2. Sannino G, Melillo P, De Pietro G, Stranges S, Pecchia L. Short term heart rate variability to predict blood pressure drops due to standing: a pilot study. BMC Med. Inform. Decis. Mak. 2015. 15(Suppl 3):S2 doi:10.​1186/​1472-6947-15-S3-S2.
26.
Zurück zum Zitat Rubenstein, L. Z., Falls in older people: epidemiology, risk factors and strategies for prevention. Age and ageing 35(Suppl 2):ii37–ii41, 2006.PubMed Rubenstein, L. Z., Falls in older people: epidemiology, risk factors and strategies for prevention. Age and ageing 35(Suppl 2):ii37–ii41, 2006.PubMed
27.
Zurück zum Zitat Siracuse, J. J., Odell, D. D., Gondek, S. P., Odom, S. R., Kasper, E. M., Hauser, C. J., et al., Health care and socioeconomic impact of falls in the elderly. American journal of surgery 203(3):335–8, 2012.CrossRefPubMed Siracuse, J. J., Odell, D. D., Gondek, S. P., Odom, S. R., Kasper, E. M., Hauser, C. J., et al., Health care and socioeconomic impact of falls in the elderly. American journal of surgery 203(3):335–8, 2012.CrossRefPubMed
28.
Zurück zum Zitat Wild, D., Nayak, U., and Isaacs, B., How dangerous are falls in old people at home? British medical journal (Clinical research ed) 282(6260):266, 1981.CrossRef Wild, D., Nayak, U., and Isaacs, B., How dangerous are falls in old people at home? British medical journal (Clinical research ed) 282(6260):266, 1981.CrossRef
29.
Zurück zum Zitat Melillo, P., Izzo, R., Orrico, A., Scala, P., Attanasio, M., Mirra, M., et al., Automatic Prediction of Cardiovascular and Cerebrovascular Events Using Heart Rate Variability Analysis. PLoS ONE 10(3):e0118504, 2015.PubMedCentralCrossRefPubMed Melillo, P., Izzo, R., Orrico, A., Scala, P., Attanasio, M., Mirra, M., et al., Automatic Prediction of Cardiovascular and Cerebrovascular Events Using Heart Rate Variability Analysis. PLoS ONE 10(3):e0118504, 2015.PubMedCentralCrossRefPubMed
30.
Zurück zum Zitat Tseng, K. C., Hsu, C. L., and Chuang, Y. H., Designing an intelligent health monitoring system and exploring user acceptance for the elderly. J Med Syst 37(6):9967, 2013.CrossRefPubMed Tseng, K. C., Hsu, C. L., and Chuang, Y. H., Designing an intelligent health monitoring system and exploring user acceptance for the elderly. J Med Syst 37(6):9967, 2013.CrossRefPubMed
31.
Zurück zum Zitat Ramshur J. Design, Evaluation and application of Heart rate variability software. 2010. Ramshur J. Design, Evaluation and application of Heart rate variability software. 2010.
32.
Zurück zum Zitat Niskanen, J.-P., Tarvainen, M. P., Ranta-aho, P. O., and Karjalainen, P. A., Software for advanced HRV analysis. Computer Methods and Programs in Biomedicine 76(1):73–81, 2004.CrossRefPubMed Niskanen, J.-P., Tarvainen, M. P., Ranta-aho, P. O., and Karjalainen, P. A., Software for advanced HRV analysis. Computer Methods and Programs in Biomedicine 76(1):73–81, 2004.CrossRefPubMed
33.
Zurück zum Zitat Brennan, M., Palaniswami, M., and Kamen, P., Do existing measures of Poincare plot geometry reflect nonlinear features of heart rate variability? IEEE Trans Bio Med Eng 48(11):1342–7, 2001.CrossRef Brennan, M., Palaniswami, M., and Kamen, P., Do existing measures of Poincare plot geometry reflect nonlinear features of heart rate variability? IEEE Trans Bio Med Eng 48(11):1342–7, 2001.CrossRef
34.
Zurück zum Zitat Richman, J. S., and Moorman, J. R., Physiological time-series analysis using approximate entropy and sample entropy. American Journal of Physiology-Heart and Circulatory Physiology 278(6):H2039–H49, 2000.PubMed Richman, J. S., and Moorman, J. R., Physiological time-series analysis using approximate entropy and sample entropy. American Journal of Physiology-Heart and Circulatory Physiology 278(6):H2039–H49, 2000.PubMed
35.
Zurück zum Zitat Carvajal, R., Wessel, N., Vallverdú, M., Caminal, P., and Voss, A., Correlation dimension analysis of heart rate variability in patients with dilated cardiomyopathy. Computer Methods and Programs in Biomedicine 78(2):133–40, 2005.CrossRefPubMed Carvajal, R., Wessel, N., Vallverdú, M., Caminal, P., and Voss, A., Correlation dimension analysis of heart rate variability in patients with dilated cardiomyopathy. Computer Methods and Programs in Biomedicine 78(2):133–40, 2005.CrossRefPubMed
36.
Zurück zum Zitat Penzel, T., Kantelhardt, J. W., Grote, L., Peter, J. H., and Bunde, A., Comparison of detrended fluctuation analysis and spectral analysis for heart rate variability in sleep and sleep apnea. IEEE Trans Bio Med Eng 50(10):1143–51, 2003.CrossRef Penzel, T., Kantelhardt, J. W., Grote, L., Peter, J. H., and Bunde, A., Comparison of detrended fluctuation analysis and spectral analysis for heart rate variability in sleep and sleep apnea. IEEE Trans Bio Med Eng 50(10):1143–51, 2003.CrossRef
37.
Zurück zum Zitat Zbilut, J. P., Thomasson, N., and Webber, C. L., Recurrence quantification analysis as a tool for nonlinear exploration of nonstationary cardiac signals. Medical Engineering & Physics 24(1):53–60, 2002.CrossRef Zbilut, J. P., Thomasson, N., and Webber, C. L., Recurrence quantification analysis as a tool for nonlinear exploration of nonstationary cardiac signals. Medical Engineering & Physics 24(1):53–60, 2002.CrossRef
38.
Zurück zum Zitat Kuncheva LI, Rodríguez JJ. An experimental study on rotation forest ensembles. Multiple Classifier Systems. Springer; 2007. p. 459–68. Kuncheva LI, Rodríguez JJ. An experimental study on rotation forest ensembles. Multiple Classifier Systems. Springer; 2007. p. 459–68.
39.
Zurück zum Zitat Garcia, J., Martinez, I., Sornmo, L., Olmos, S., Mur, A., and Laguna, P., Remote processing server for ECG-based clinical diagnosis support. IEEE Trans Inf Technol Biomed 6(4):277–84, 2002.CrossRefPubMed Garcia, J., Martinez, I., Sornmo, L., Olmos, S., Mur, A., and Laguna, P., Remote processing server for ECG-based clinical diagnosis support. IEEE Trans Inf Technol Biomed 6(4):277–84, 2002.CrossRefPubMed
40.
Zurück zum Zitat Melillo P, Jovic A, Luca ND, Pecchia L. Automatic classifier based on heart rate variability to identify fallers among hypertensive subjects. Healthcare Technology Letters 2015. doi:10.1049/htl.2015.0012. Melillo P, Jovic A, Luca ND, Pecchia L. Automatic classifier based on heart rate variability to identify fallers among hypertensive subjects. Healthcare Technology Letters 2015. doi:10.​1049/​htl.​2015.​0012.
41.
Zurück zum Zitat Pecchia L, Melillo P, Stranges S, De Pietro G, G S, inventors; Autonomous Nervous System status detection to predict falls including Heart Rate Variability (HRV) assessment 2014. Pecchia L, Melillo P, Stranges S, De Pietro G, G S, inventors; Autonomous Nervous System status detection to predict falls including Heart Rate Variability (HRV) assessment 2014.
42.
Zurück zum Zitat Melillo P, Orrico A, Attanasio M, Rossi S, Pecchia L, Chirico F et al. A pilot study for development of a novel tool for clinical decision making to identify fallers among ophthalmic patients. BMC Med. Inform. Decis. Mak. 15(Suppl 3):S6, 2015. doi:10.1186/1472-6947-15-S3-S6. Melillo P, Orrico A, Attanasio M, Rossi S, Pecchia L, Chirico F et al. A pilot study for development of a novel tool for clinical decision making to identify fallers among ophthalmic patients. BMC Med. Inform. Decis. Mak. 15(Suppl 3):S6, 2015. doi:10.​1186/​1472-6947-15-S3-S6.
Metadaten
Titel
Cloud-Based Smart Health Monitoring System for Automatic Cardiovascular and Fall Risk Assessment in Hypertensive Patients
verfasst von
P. Melillo
A. Orrico
P. Scala
F. Crispino
L. Pecchia
Publikationsdatum
01.10.2015
Verlag
Springer US
Erschienen in
Journal of Medical Systems / Ausgabe 10/2015
Print ISSN: 0148-5598
Elektronische ISSN: 1573-689X
DOI
https://doi.org/10.1007/s10916-015-0294-3

Weitere Artikel der Ausgabe 10/2015

Journal of Medical Systems 10/2015 Zur Ausgabe