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I. INTRODUCTION
With the rising cost of healthcare and an aging worldwide
population, there is an increasing need for effective methods
of reducing hospital readmissions, home-based screening
tests, and technologies that allow for aging-in-place. Remote monitoring technologies have the potential to provide
near real-time health information and may also facilitate a
means to observe important cardiopulmonary and activity
information in patients and aging adults in the comfort of
their own homes. The reduction in size of digital processors,
accelerometers and components for electrocardiographic
(ECG) monitoring has allowed such technologies to become
increasingly unobtrusive. Furthermore, the widespread use
of smartphones and wireless connectivity make real-time
monitoring in ambulatory conditions possible.
The ability to monitor ECG and heart rate can provide
important information for patients with cardiovascular diseases such as supraventricular tachycardia (SVT) or congestive heart failure (CHF). Furthermore, rapid detection
of acute events like myocardial infarctions (MI) or atrial
fibrillation (AF) is possible. Monitoring of breathing rate
is also important for the screening of abnormal respiration
that may occur in obstructive sleep apneas or CHF. Activity
monitoring can be highly useful for providing a snapshot
of the total daily activity in patients who require moderate
exercise, for detecting and providing notifications of falls in
Authors are with Vital Connect Inc., Campbell, CA 95008, USA. (*corresponding authors e-mail: rnarasimhan@vitalconnect.com)
Fig. 1.
module
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nasal canula
(to capnography
monitor)
Actiheart electrode
patch sensor
1
2
3
pedometers
(FitBit & Omron)
Fig. 2.
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98
96
5
Posture Accuracy (%)
100
overall
sitting
ADLs
94
92
90
88
86
84
1
82
1
2
patch location
80
Fig. 4.
2
patch location
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TABLE I
H EART RATE AND HEART RATE VARIABILITY ERRORS GIVEN AS MEAN STANDARD ERROR
HR - ADLs (bpm)
MAE
RMSE
2.70.3
4.30.6
2.60.4
3.80.6
2.70.2
4.20.5
HR - sitting (bpm)
MAE
RMSE
1.10.1
1.70.2
1.20.1
1.90.2
1.10.1
1.80.2
loc.
1
2
3
10
9
8
7
6
5
4
3
2
1
0
MeanNN (ms)
MAE
RMSE
6.81.6
7.51.7
7.51.6
8.31.8
5.51.3
6.21.6
RMSSD (ms)
MAE
RMSE
12.13.0
14.63.6
11.72.9
13.83.4
11.32.7
13.53.3
Triang8
MAE
RMSE
1.00.2 1.20.3
0.90.2 1.00.2
1.00.2 1.20.3
0.35
0.3
IV. CONCLUSIONS
0.4
0.25
0.2
0.15
0.1
0.05
0
2
3
patch location
2
3
patch location
Fall Type
Forward (legs straight)
Backwards (legs straight)
Left (legs straight)
Right (legs straight)
Forward (knees bent)
Backwards (knees bent)
Left (knees bent)
Right (knees bent)
Tripping
Rolling out of bed
Missing a chair
avg
SDNN (ms)
MAE
RMSE
9.12.4
11.53.2
8.72.5
11.43.6
8.82.9
10.83.6
1
100
100
90.0
100
90.0
100
100
100
96.7
96.2
80.0
95.7
Location
2
96.7
100
100
100
86.7
100
100
100
100
91.3
73.3
95.3
3
100
100
93.3
100
93.3
100
96.6
92.3
89.7
100
76.7
94.7
avg
98.9
100
94.3
100
90.0
100
98.9
97.6
95.5
96.2
76.7
95.2
D. Fall Detection
To estimate the sensitivity of the fall detection algorithm,
the simulated falls performed by the young subjects were
used. In total, 330 physical falls were performed among the
10 subjects, resulting in 990 captured fall data (each fall
captured by three patches). Data from 23 falls were excluded
from analysis due to loss of data from the patch during the
fall. The overall sensitivity of the detection algorithm was
95.2%. A detailed breakdown of sensitivities between patch
locations and fall types is shown in Table II.
Specificity was estimated using the ADLs from the elderly
subjects. Each ADL that could possibly result in a fall (e.g.
sitting in a chair, lying on a bed, reclining) was counted as
one possible false fall event. A total of 27 ADLs that could
be construed as a fall were present for each elderly subject,
resulting in a total of 405 events that could have triggered a
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