Wearable knee health system employing novel physiological biomarkers

Knee injuries and chronic disorders, such as arthritis, affect millions of Americans, leading to missed workdays and reduced quality of life. Currently, after an initial diagnosis, there are few quantitative technologies available to provide sensitive subclinical feedback to patients regarding improvements or setbacks to their knee health status; instead, most assessments are qualitative, relying on patient-reported symptoms, performance during functional tests, and physical examinations. Recent advances have been made with wearable technologies for assessing the health status of the knee (and potentially other joints) with the goal of facilitating personalized rehabilitation of injuries and care for chronic conditions. This review describes our progress in developing wearable sensing technologies that enable quantitative physiological measurements and interpretation of knee health status. Our sensing system enables longitudinal quantitative measurements of knee sounds, swelling, and activity context during clinical and field situations. Importantly, we leverage machine-learning algorithms to fuse the low-level signal and feature data of the measured time series waveforms into higher level metrics of joint health. This paper summarizes the engineering validation, baseline physiological experiments, and human subject studies—both cross-sectional and longitudinal—that demonstrate the efficacy of using such systems for robust knee joint health assessment. We envision our sensor system complementing and advancing present-day practices to reduce joint reinjury risk, to optimize rehabilitation recovery time for a quicker return to activity, and to reduce health care costs.

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PROMIS Scales for Assessment of Persistent Post-COVID Symptoms: A Cross Sectional Study

Journal of Primary Care & Community Health ◽

10.1177/21501327211030413 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110304

Author(s):

Ravindra Ganesh ◽

Aditya K. Ghosh ◽

Mark A. Nyman ◽

Ivana T. Croghan ◽

Stephanie L. Grach ◽

...

Keyword(s):

Health Status ◽

Social Roles ◽

Disease Process ◽

Cross Sectional Study ◽

Large Sample Size ◽

Sectional Study ◽

Cross Sectional ◽

Data Set ◽

Patient Reported ◽

The Impact

Objective Persistent post-COVID symptoms are estimated to occur in up to 10% of patients who have had COVID-19. These lingering symptoms may persist for weeks to months after resolution of the acute illness. This study aimed to add insight into our understanding of certain post-acute conditions and clinical findings. The primary purpose was to determine the persistent post COVID impairments prevalence and characteristics by collecting post COVID illness data utilizing Patient-Reported Outcomes Measurement Information System (PROMIS®). The resulting measures were used to assess surveyed patients physical, mental, and social health status. Methods A cross-sectional study and 6-months Mayo Clinic COVID recovered registry data were used to evaluate continuing symptoms severity among the 817 positive tested patients surveyed between March and September 2020. The resulting PROMIS® data set was used to analyze patients post 30 days health status. The e-mailed questionnaires focused on fatigue, sleep, ability to participate in social roles, physical function, and pain. Results The large sample size (n = 817) represented post hospitalized and other managed outpatients. Persistent post COVID impairments prevalence and characteristics were determined to be demographically young (44 years), white (87%), and female (61%). Dysfunction as measured by the PROMIS® scales in patients recovered from acute COVID-19 was reported as significant in the following domains: ability to participate in social roles (43.2%), pain (17.8%), and fatigue (16.2%). Conclusion Patient response on the PROMIS® scales was similar to that seen in multiple other studies which used patient reported symptoms. As a result of this experience, we recommend utilizing standardized scales such as the PROMIS® to obtain comparable data across the patients’ clinical course and define the disease trajectory. This would further allow for effective comparison of data across studies to better define the disease process, risk factors, and assess the impact of future treatments.

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Knowledge, Attitude, and Practices of Mothers Related to their Oral Health Status of 6-12 Years Old Children in Bhilai City, Chhattisgarh, India

European Scientific Journal ESJ ◽

10.19044/esj.2018.v14n21p248 ◽

2018 ◽

Vol 14 (21) ◽

pp. 248

Author(s):

Pallavi Pawar ◽

Nilotpol Kashyap ◽

Rohit Anand

Keyword(s):

Health Status ◽

Oral Health ◽

Health Assessment ◽

Cross Sectional Study ◽

Oral Health Status ◽

P Value ◽

Cross Sectional ◽

Health Related ◽

High Level ◽

Children’S Oral Health

Aim and Objectives: The aim of the study was to assess the oral health status of 6-12 year old children and their mother’s knowledge, attitude, and practices in Bhilai city. Moreover, this study was also carried out to determine whether mother’s oral health related knowledge, attitude, and practices have a significant influence on the oral health of their children. Materials and Methods: A cross- sectional study was conducted among children (n=600) aged between 6-12 years, attending both government and private schools accompanied with their mothers in Bhilai city. The oral health status of the children was evaluated by using WHO Oral Health Assessment Form (2013). The parents were then asked to fill 25 item based on selfadministered questionnaire. Mother’s knowledge, attitude, and practices were assessed by direct contact with mothers using close ended questionnaire. Statistical Analysis: The data was then entered and analysed using SPSS (Statistical Package for Social Sciences, SPSS Inc., Chicago, IL, USA). Also, p value≤ 0.05 was considered to be statistically significant. Results: The result of the study showed that 90% of mothers had good knowledge, 75% mothers had average attitude, and 51% mothers had high level practices related to oral health. An inverse relationship was found between children’s oral health status and their mother’s knowledge, attitude, and practices about oral health. Thus, the findings were highly significant. Conclusion: Results showed that mother’s oral health related to knowledge, attitude, and practices had a significant impact on oral health status of their children.

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What Factors Influence the Health Status of Patients with Rheumatoid Arthritis Measured by the SF-12v2 Health Survey and the Health Assessment Questionnaire?

The Journal of Rheumatology ◽

10.3899/jrheum.090134 ◽

2009 ◽

Vol 36 (10) ◽

pp. 2183-2189 ◽

Cited By ~ 30

Author(s):

LOUISE LINDE ◽

JAN SØRENSEN ◽

MIKKEL ØSTERGAARD ◽

KIM HØRSLEV-PETERSEN ◽

CLAUS RASMUSSEN ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Health Status ◽

Health Survey ◽

Health Assessment Questionnaire ◽

Health Assessment ◽

Physical Component Score ◽

Related Factors ◽

Component Score ◽

Patient Reported ◽

Assessment Questionnaire

Objective.The Health Assessment Questionnaire Disability Index (HAQ) is a widely used outcome measure in rheumatoid arthritis (RA), whereas the SF-12v2 Health Survey (SF-12) was introduced recently. We investigated how the HAQ and SF-12 were associated with socio-demographic, lifestyle, and disease- and treatment-related factors in patients with RA.Methods.In RA patients from 11 Danish centers, clinical and patient-reported data, including the HAQ and SF-12, were collected. Three multiple linear regression models were estimated, with the HAQ, SF-12 physical component score (PCS), and SF-12 mental component score (MCS) as outcome and sociodemographic, lifestyle, and RA-related treatment and comorbidity characteristics as explanatory variables.Results.In total, 3156 (85%) of 3704 invited patients participated — 75% women, 76% rheumatoid factor-positive, median age 61 years (range 15–93 yrs), disease duration 7 years (range 0–68 yrs), Disease Activity Score on 28 joints (DAS28) 2.97 (range 0.96–8.61), HAQ score 0.63 (range 0–3), SF-12 PCS 56 (range 6–99), and SF-12 MCS 57 (range 16–99). Variation in HAQ was associated with 12 of 15 possible variables (R2 0.41), in PCS and MCS with 6 of 15 variables (R2 0.02 and 0.05). Patients with moderate to high DAS28 and ≥ 3 comorbid conditions had consistently worse HAQ and SF-12 scores compared to the reference groups, while weekly exercise was associated with better scores compared to no exercise.Conclusion.The HAQ was more sensitive to differences in demographic, lifestyle, and disease- and treatment-related factors than the SF-12. The established clinical value and feasibility of the HAQ highlights its advantages over the SF-12 in describing health status in RA.

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Impaired Health Status and the Effect of Pain and Fatigue on Functioning in Clinical Trial Patients with Systemic Lupus Erythematosus

The Journal of Rheumatology ◽

10.3899/jrheum.130046 ◽

2013 ◽

Vol 40 (11) ◽

pp. 1865-1874 ◽

Cited By ~ 12

Author(s):

Michelle Petri ◽

Ariane K. Kawata ◽

Ancilla W. Fernandes ◽

Kavita Gajria ◽

Warren Greth ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Clinical Trial ◽

Health Status ◽

General Population ◽

Lupus Erythematosus ◽

Health Assessment ◽

Systemic Lupus ◽

Patient Reported ◽

The Us ◽

Impaired Health

Objective.Our study evaluated the impaired health status of clinical trial patients with systemic lupus erythematosus (SLE) and explored the relationship between changes in fatigue and pain and their effect on overall health status.Methods.Pooled treatment and placebo data from a phase Ib clinical trial of adults with moderate/severe SLE were analyzed. Measures included patient-reported Medical Outcome Study Short Form-36 Survey, Version 2 (SF-36v2), Fatigue Severity Scale, and numeric rating scales (NRS) for pain and global health assessment and clinician-reported global assessment of disease activity (MDGA). Disease burden was compared to the US general population. Health status of responders and nonresponders on pain or fatigue were compared.Results.The sample included 161 patients with SLE, predominantly female (96%) and white (72%), with average age of 43 ± 11 years. Mean SF-36v2 component summary scores reflected overall problems with physical [physical component summary (PCS); 35.2 ± 9.7] and mental health (mental component summary; 40.9 ± 12.9). Patients with SLE had worse health status on all SF-36v2 subscales than the US general population and comparable age and sex norms (effect size −0.51 to −2.15). Pain and fatigue responders had greater improvements on SF-36v2 scores (bodily pain, physical functioning, social functioning, PCS), patient global health assessment NRS, and MDGA than nonresponders. There was moderate agreement in responder status, based on global assessments by patients and clinicians (68.1%), with some discrepancy between patients who were MDGA responders but patient assessment nonresponders (27.7%).Conclusion.Improvements in patient-reported pain or fatigue correlated with improvements in overall health. Patient assessments offer a unique perspective on treatment outcomes. Patient-reported outcomes add value in understanding clinical trial treatment benefits.

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Clinico-demographic Profile of Undifferentiated Inflammatory Arthritis Patients

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v18i2.2739 ◽

2020 ◽

Vol 18 (2) ◽

pp. 288-292

Author(s):

Binit Vaidya ◽

Manisha Bhochhibhoya ◽

Rakshya Joshi ◽

Bhoj raj Adhikari ◽

Shweta Nakarmi

Keyword(s):

Inflammatory Arthritis ◽

Smoking Status ◽

Health Assessment ◽

Patient Reported Outcome Measures ◽

Cross Sectional Study ◽

Patient Reported Outcome ◽

Tender Joint ◽

Cross Sectional ◽

Markers Of Inflammation ◽

Patient Reported

Background: Undifferentiated inflammatory arthritis is a group of inflammatory joint diseases that do not fulfil the classification criteria for any other rheumatic or connective tissue disorders. This study aims to describe the clinical, demographic and serological features of undifferentiated inflammatory arthritis cases presenting at a tertiary level rheumatology centre from Nepal.Methods: A descriptive cross-sectional study conducted at National Centre for Rheumatic Diseases, Kathmandu, Nepal which represents a midterm analysis of the undifferentiated inflammatory arthritis registry maintained at the centre. Patients more than 18 years of age, who consented for the study having least one swollen or tender joint were enrolled. Ethical approval was obtained from Nepal Health Research Council.Results: A total of 1120 patients were enrolled in the study out of which 941 (84%) were females. The mean age at diagnosis was 46.0±12.8 years and most of them were in overweight range (mean BMI: 27.0±5.8) with 818 (73%) patients having BMI more than 24.0. Patients mostly had low disease activity at presentation (DAS 28 score of 2.5±0.8). Other markers of inflammation and patient reported outcome measures (health assessment questionnaire, patient global assessment and visual analogue scale) were also in the moderate range. Seropositivity for anti-citrullinated peptides and anti-nuclear antibodies was seen in 5 (0.45%) and 43 (3.8%) patients respectively. Majority of patients were non-smokers (77%). Inflammatory arthritis on musculoskeletal ultrasonography was seen in 638 (57%).Conclusions: Undifferentiated inflammatory arthritis was more common in overweight females. Serological markers and smoking status are not common features in these patients. Keywords: Early arthritis; Nepal; undifferentiated arthritis.

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Healthcare utilization and costs among prolactinoma patients: a cross-sectional study and analysis of determinants

Pituitary ◽

10.1007/s11102-020-01089-1 ◽

2020 ◽

Author(s):

Merel van der Meulen ◽

Amir H. Zamanipoor Najafabadi ◽

Daniel J. Lobatto ◽

Wilbert B. van den Hout ◽

Cornelie D. Andela ◽

...

Keyword(s):

Health Status ◽

Healthcare Utilization ◽

Short Form ◽

Cross Sectional Study ◽

Sectional Study ◽

Specialist Care ◽

Cross Sectional ◽

Tertiary Referral Center ◽

Patient Reported ◽

Self Reported Health Status

Abstract Purpose Prolactinomas are the most prevalent functioning pituitary adenomas. They affect gonadal function as well as health-related quality of life (HRQoL). This study aimed to report healthcare utilization and costs, including their determinants, for prolactinoma patients. Methods Cross-sectional study of 116 adult prolactinoma patients in chronic care in a Dutch tertiary referral center. Patients completed four validated questionnaires, assessing healthcare utilization and costs over the previous 12 months (Medical Consumption Questionnaire), disease bother and needs (Leiden Bother and Needs Questionnaire Pituitary), HRQoL (Short Form-36), and self-reported health status (EuroQol 5D). Regression analyses were used to assess associations between disease-related characteristics and healthcare utilization and costs. Results Mean age was 52.0 years (SD 13.7) and median follow-up was 15.0 years (IQR 7.6–26.1). Patients visited the endocrinologist (86.2%), general practitioner (37.9%), and ophthalmologist (25.0%) most frequently. Psychological care was used by 12.9% of patients and 5% were admitted to hospital. Mean annual healthcare costs were €1928 (SD 3319), mainly for pituitary-specific medication (37.6% of total costs), hospitalization (19.4%) and specialist care (16.1%). Determinants for higher healthcare utilization and costs were greater disease bother and needs for support, lower HRQoL, elevated prolactin, and longer disease duration, while tumor size, hypopituitarism and adrenal insufficiency were not significantly associated with healthcare utilization and costs. Conclusion Healthcare utilization and costs of prolactinoma patients are related to patient-reported HRQoL, bother by disease and needs for support. Therefore, addressing patients’ HRQoL and needs is a way forward to improve efficiency of care and patients’ health status.

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Clinical significance of self-reported cough intensity and frequency in patients with interstitial lung disease: a cross-sectional study

BMC Pulmonary Medicine ◽

10.1186/s12890-019-1012-6 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Ryuhei Sato ◽

Tomohiro Handa ◽

Hisako Matsumoto ◽

Takeshi Kubo ◽

Toyohiro Hirai

Keyword(s):

Health Status ◽

Interstitial Lung Disease ◽

Lung Disease ◽

Multiple Logistic Regression Analysis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Cough Frequency ◽

Patient Reported ◽

Clinical Indices

Abstract Background The intensity and frequency of cough remain unclear in interstitial lung disease (ILD). The aim of this study was to evaluate the intensity and frequency of cough in idiopathic interstitial pneumonias (IIPs), connective tissue disease-associated interstitial lung disease (CTD-ILD), and chronic hypersensitivity pneumonia (CHP), and examine their associations with clinical indices. Methods In this cross-sectional study, the intensity and frequency of cough were evaluated using a 100-mm visual analogue scale. Scores on the Leicester Cough Questionnaire, chronic dyspnoea scale, and a frequency scale for symptoms of gastro-oesophageal reflux disease (FSSG) were collected. The correlations of cough intensity and frequency with potential predictor variables were tested using bivariate and multiple logistic regression analysis. Results The study included 70 patients with IIPs, 49 with CTD-ILD, and 10 with CHP. Patients with IIPs had the most severe cough intensity among the three patient groups. In patients with IIPs, both the intensity and frequency of cough were negatively associated with the diffusing capacity of the lung for carbon monoxide and positively with the Composite Physiologic Index (CPI). In CTD-ILD, both the intensity and frequency of cough were correlated with a higher FSSG score. In multivariate analysis of patients with ILD, IIPs and the FSSG score were independently associated with both components of cough, and CPI tended to be independently associated with cough frequency. Finally, we examined the features of the differences between cough intensity and frequency in all patients with ILD. Patients in whom cough frequency was predominant had a greater impairment of health status relative to other patients. Conclusions Cough intensity was greater in IIPs than in other ILDs. Different clinical indices were associated with patient-reported cough intensity and frequency according to the subtype of ILD. Cough frequency was more strongly associated with health status than was cough intensity. These findings suggest that medical staff could manage patients with ILD by considering cough-related factors when assessing the intensity and frequency of cough.

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Developing Children’s Oral Health Assessment Toolkits Using Machine Learning Algorithm

JDR Clinical & Translational Research ◽

10.1177/2380084419885612 ◽

2019 ◽

Vol 5 (3) ◽

pp. 233-243 ◽

Cited By ~ 1

Author(s):

Y. Wang ◽

R.D. Hays ◽

M. Marcus ◽

C.A. Maida ◽

J. Shen ◽

...

Keyword(s):

Machine Learning ◽

Health Status ◽

Oral Health ◽

Program Implementation ◽

Health Assessment ◽

Care Program ◽

Oral Health Status ◽

Machine Learning Algorithms ◽

Treatment Needs ◽

Children’S Oral Health

Objectives: Evaluating children’s oral health status and treatment needs is challenging. We aim to build oral health assessment toolkits to predict Children’s Oral Health Status Index (COHSI) score and referral for treatment needs (RFTN) of oral health. Parent and Child toolkits consist of short-form survey items (12 for children and 8 for parents) with and without children’s demographic information (7 questions) to predict the child’s oral health status and need for treatment. Methods: Data were collected from 12 dental practices in Los Angeles County from 2015 to 2016. We predicted COHSI score and RFTN using random Bootstrap samples with manually introduced Gaussian noise together with machine learning algorithms, such as Extreme Gradient Boosting and Naive Bayesian algorithms (using R). The toolkits predicted the probability of treatment needs and the COHSI score with percentile (ranking). The performance of the toolkits was evaluated internally and externally by residual mean square error (RMSE), correlation, sensitivity and specificity. Results: The toolkits were developed based on survey responses from 545 families with children aged 2 to 17 y. The sensitivity and specificity for predicting RFTN were 93% and 49% respectively with the external data. The correlation(s) between predicted and clinically determined COHSI was 0.88 (and 0.91 for its percentile). The RMSEs of the COHSI toolkit were 4.2 for COHSI (and 1.3 for its percentile). Conclusions: Survey responses from children and their parents/guardians are predictive for clinical outcomes. The toolkits can be used by oral health programs at baseline among school populations. The toolkits can also be used to quantify differences between pre- and post-dental care program implementation. The toolkits’ predicted oral health scores can be used to stratify samples in oral health research. Knowledge Transfer Statement: This study creates the oral health toolkits that combine self- and proxy- reported short forms with children’s demographic characteristics to predict children’s oral health and treatment needs using Machine Learning algorithms. The toolkits can be used by oral health programs at baseline among school populations to quantify differences between pre and post dental care program implementation. The toolkits can also be used to stratify samples according to the treatment needs and oral health status.

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MO883FATIGUE IS THE PREDOMINANT PATIENT-REPORTED OUTCOME MEASURE IN HEMODIALYSIS PATIENTS: RESULTS OF A MULTICENTER CROSS-SECTIONAL EPROMS STUDY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab100.008 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Abdallah Guerraoui ◽

Anne Kolko-Labadens ◽

Mathilde Prezelin-Reydit ◽

Philippe Chauveau ◽

Catherine Lasseur ◽

...

Keyword(s):

Health Status ◽

Recovery Time ◽

Patient Characteristics ◽

Clinical Results ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Dialysis Session ◽

Cross Sectional ◽

Dialysis Unit ◽

Patient Reported

Abstract Background and Aims End Stage renal disease (ESRD) and hemodialysis are associated with a decrease in quality of life (QOL). Self-reported QOL symptoms are not always prioritized by the medical team, potentially leading to conflicting priorities with patients. Electronic patient-reported outcome measures (ePROMs) allow physicians to better describe these symptoms. The objective was to describe the prevalence of symptoms self-reported by HD patients. Method A multicenter cross-sectional study was conducted in three HD centers. Patients were included if they were 18 years old or over and treated with HD for at least three months in a center. Data were collected by the patient via a self-administered ePROMs questionnaire. Data included patient characteristics, post-dialysis fatigue and intensity, recovery time after a session, perceived stress, impaired sleep the day before the dialysis session, current state of health, and the one-year change. Results In total, we included 173 patients with a mean age of 66.2 years, a mean ± SD hemodialysis duration of 48.9 ± 58.02 months, mainly treated in self-dialysis unit (67%) and having at least one comorbidity (72.5%). The prevalence of fatigue was 72.1% [IC 95% 64.7% to 78.7%] with a mean severity score of 5.84± 2.12. 66.4% had a high level of stress (level B or C). Recovery time was more than 6 hours for 24.9% of patients and 78 % declared they had a better or unchanged health status than the previous year. The self-perceived health status of patients was 6.2± 2.12 and 77.5% [IC 95% 70.5% to 83.5%] of patients stated that they had not a worsened health status than the year before. No statistical differences were observed between centers for the PROMS. Despite significant differences in patient characteristics from the three centers including age, comorbidities or type of dialysis, no differences were found on the prevalence of the various PROMs, in favor of internally Conclusion Fatigue and stress were the main symptoms reported by HD patients. There was no association between symptoms reported and comorbidities clinical results of patients. The patient’s care teams should better consider these symptoms.

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