scholarly journals Evaluating the Accuracy of an Integrated Vital Sign Measurement Wellness Device

Iproceedings ◽  
10.2196/15203 ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e15203
Author(s):  
Nicole Polanco ◽  
Sharon Odametey ◽  
Neda Derakhshani ◽  
Mark Khachaturian ◽  
Connor Devoe ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Linear Relationship ◽  
Health Care Providers ◽  
Vital Sign ◽  
Skin Color ◽  
Vital Signs ◽  
Mean Difference ◽  
Step Test ◽  
Sensitivity Analyses ◽  
Care Providers

Background Wellness devices for health tracking have gained popularity in recent years. Additionally, portable and readily accessible wellness devices have several advantages when compared to traditional medical devices found in clinical environments. Building tools for patients to manage their health independently may benefit their health in the long run by improving health care providers’ (HCPs) awareness of their patients’ health information outside of the clinic. Increased access to portable wellness devices that track vital signs may increase how patients and HCPs track and monitor chronic conditions which can improve health outcomes. The VitalWellness is a portable wellness device that can potentially aid vital sign measuring for those interested in tracking their health. Objective In this diagnostic accuracy study, we evaluated the clinical performance of the VitalWellness, a wireless, compact, non-invasive device that measures four vital signs using the index finger and forehead against reference vital signs devices used in the hospital setting. Methods Volunteers age ≥18 years were enrolled to provide blood pressure (BP), heart rate (HR), respiratory rate (RR), and body temperature. We recruited volunteers with vital signs that fell within and outside of the normal physiological range, depending on the measurements they consented to undergo. A subgroup of eligible volunteers were asked to undergo an exercise test, aerobic step test and/or a paced breathing test to analyze the VitalWellness device's performance on vital signs outside of the normal physiological ranges for HR and RR. Vital signs measurements were collected with the VitalWellness device and FDA-approved reference devices. Mean, standard deviation, mean difference, standard deviation of difference, standard error of mean difference, and correlation coefficients were calculated for measurements collected; these measurements were plotted on a scatter plot and a Bland-Altman plot. Sensitivity analyses were performed to evaluate the performance of the VitalWellness device by gender, skin color, finger size, and in the presence of artifacts. Results We enrolled 265 volunteers in the study and 2 withdrew before study completion. The majority of volunteers were female (62%), predominately white (63%), graduated from college or post college (67%), and employed (59%). There was a moderately strong linear relationship between VitalWellness BP and reference BP (r=0.7, P<.05) and bewteen VitalWellness RR and reference RR measurements (r=0.7, P<.05). The VitalWellness HR readings were significantly in line with the reference HR readings (r=0.9, P<.05). There was a weaker linear relationship between VitalWellness temperature and reference temperature (r=0.3, P<.05). There were no differences in performance of the VitalWellness device by gender, skin color or in the presence of artifacts. Finger size was associated with differential performance for RR. Conclusions Overall, the VitalWellness device performed well in taking BP, HR and RR when compared to FDA-approved reference devices and has potential serve as a wellness device. To test adaptability and acceptability, future research may evaluate user’s interactions and experiences with the VitalWellness device at home. In addition, the next phase of the study will evaluate transmitting vital sign information from the VitalWellness device to an online secured database where information can be shared with HCPs within seconds of measurement.

scholarly journals Evaluating the Accuracy of the VitalWellness Device

Iproceedings ◽  
10.2196/16250 ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e16250
Author(s):  
Nicole Polanco ◽  
Sharon Odametey ◽  
Neda Derakhshani ◽  
Mark Khachaturian ◽  
Connor Devoe ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Standard Deviation ◽  
Body Temperature ◽  
Respiratory Rate ◽  
Linear Relationship ◽  
Vital Sign ◽  
Skin Color ◽  
Vital Signs ◽  
Mean Difference

Background Wellness devices for health tracking have gained popularity in recent years. Additionally, portable and readily accessible wellness devices have several advantages when compared to traditional medical devices found in clinical environments The VitalWellness device is a portable wellness device that can potentially aide vital sign measuring for those interested in tracking their health. Objective In this diagnostic accuracy study, we evaluated the performance of the VitalWellness device, a wireless, compact, non-invasive device that measures four vital signs (blood pressure (BP), heart rate (HR), respiratory rate (RR), and body temperature using the index finger and forehead. Methods Volunteers age ≥18 years were enrolled to provide blood pressure (BP), heart rate (HR), respiratory rate (RR), and body temperature. We recruited participants with vital signs that fell within and outside of the normal physiological range. A sub-group of eligible participants were asked to undergo an exercise test, aerobic step test and/or a paced breathing test to analyze the VitalWellness device’s performance on vital signs outside of the normal physiological ranges for HR and RR. Vital signs measurements were collected with the VitalWellness device and FDA-approved reference devices. Mean, standard deviation, mean difference, standard deviation of difference, standard error of mean difference, and correlation coefficients were calculated for measurements collected; these measurements were plotted on a scatter plot and a Bland-Altman plot. Sensitivity analyses were performed to evaluate the performance of the VitalWellness device by gender, skin color, finger size, and in the presence of artifacts. Results 265 volunteers enrolled in the study and 2 withdrew before study completion. Majority of the volunteers were female (62%), predominately white (63%), graduated from college or post college (67%), and employed (59%). There was a moderately strong linear relationship between VitalWellness BP and reference BP (r=0.7, P<.05) and VitalWellness RR and reference RR measurements (r=0.7, P<.05). The VitalWellness HR readings were significantly in line with the reference HR readings (r=0.9, P<.05). There was a weaker linear relationship between VitalWellness temperature and reference temperature (r=0.3, P<.05). There were no differences in performance of the VitalWellness device by gender, skin color or in the presence of artifacts. Finger size was associated with differential performance for RR. Conclusions Overall, the VitalWellness device performed well in taking BP, HR, and RR when compared to FDA-approved reference devices and has potential serve as a wellness device. To test adaptability and acceptability, future research may evaluate user’s interactions and experiences with the VitalWellness device at home. In addition, the next phase of the study will evaluate transmitting vital sign information from the VitalWellness device to an online secured database where information can be shared with HCPs within seconds of measurement.

Using On-scene EMS Responders’ Assessment and Electronic Patient Care Records to Evaluate the Suitability of EMD-triaged, Low-acuity Calls for Secondary Nurse Triage in 911 Centers

2016 ◽  
Vol 31 (1) ◽  
pp. 46-57 ◽  
Author(s):  
Greg Scott ◽  
Jeff Clawson ◽  
Mark C. Fivaz ◽  
Jennie McQueen ◽  
Marie I. Gardett ◽  
...  
Keyword(s):  
Patient Care ◽  
Health Care Providers ◽  
Vital Sign ◽  
Clinical Status ◽  
Vital Signs ◽  
Care Providers ◽  
Emergency Medical Dispatch ◽  
Emergency Medical ◽  
Alpha Level ◽  
Nurse Triage

AbstractIntroductionUsing the Medical Priority Dispatch System (MPDS) – a systematic 911 triage process – to identify a large subset of low-acuity patients for secondary nurse triage in the 911 center is a largely unstudied practice in North America. This study examines the ALPHA-level subset of low-acuity patients in the MPDS to determine the suitability of these patients for secondary triage by evaluating vital signs and necessity of lights-and-siren transport, as determined by attending Emergency Medical Services (EMS) ambulance crews.ObjectivesThe primary objective of this study was to determine the clinical status of MPDS ALPHA-level (low-acuity) patients, as determined by on-scene EMS crews’ patient care records, in two US agencies. A secondary objective was to determine which ALPHA-level codes are suitable candidates for secondary triage by a trained Emergency Communication Nurse (ECN).MethodsIn this retrospective study, one full year (2013) of both dispatch data and EMS patient records data, associated with all calls coded at the ALPHA-level (low-acuity) in the dispatch protocol, were collected. The primary outcome measure was the number and percentage of ALPHA-level codes categorized as low-acuity, moderate-acuity, high-acuity, and critical using four common vital signs to assign these categories: systolic blood pressure (SBP), pulse rate (PR), oxygen saturation (SpO2), and Glasgow Coma Score (GCS). Vital sign data were obtained from ambulance crew electronic patient care records (ePCRs). The secondary endpoint was the number and percentage of ALPHA-level codes that received a “hot” (lights-and-siren) transport.ResultsOut of 19,300 cases, 16,763 (86.9%) were included in the final analysis, after excluding cases from health care providers and those with missing data. Of those, 89% of all cases did not have even one vital sign indicator of unstable patient status (high or critical vital sign). Of all cases, only 1.1% were transported lights-and-siren.ConclusionWith the exception of the low-acuity, ALPHA-level seizure cases, the ALPHA-level patients are suitable to transfer for secondary triage in a best-practices, accredited, emergency medical dispatch center that utilizes the MPDS at very high compliance rates. The secondary nurse triage process should identify the few at-risk patients that exist in the low-acuity calls.ScottG, ClawsonJ, FivazMC, McQueenJ, GardettMI, SchultzB, YoungquistS, OlolaCHO. Using on-scene EMS responders’ assessment and electronic patient care records to evaluate the suitability of EMD-triaged, low-acuity calls for secondary nurse triage in 911 centers. Prehosp Disaster Med. 2016;31(1):46–57.

Patients’ Perceptions of Integrated Care Among Medicare Beneficiaries by Level of Need for Health Services

2022 ◽  
pp. 107755872110678
Author(s):  
Nancy Song ◽  
Molly Frean ◽  
Christian T. Covington ◽  
Maike Tietschert ◽  
Emilia Ling ◽  
...  
Keyword(s):  
Integrated Care ◽  
Health Care Providers ◽  
Chronic Conditions ◽  
Health Management ◽  
Least Square ◽  
Sensitivity Analyses ◽  
Medicare Beneficiaries ◽  
Care Providers ◽  
Factors Affecting ◽  
Ordinary Least Square Regression

Requirements for integrating care across providers, settings, and over time increase with patients’ needs. Health care providers’ ability to offer care that patients experience as integrated may vary among patients with different levels of need. We explore the variation in patients’ perceptions of integrated care among Medicare beneficiaries based on the beneficiary’s level of need using ordinary least square regression for each of four high-need groups: beneficiaries (a) with complex chronic conditions, (b) with frailties, (c) below 65 with disability, and (d) with any (of the first three) high needs. We control for beneficiary demographics and other factors affecting integrated care, and we conduct sensitivity analyses controlling for multiple individual chronic conditions. We find significant positive associations with level of need for provider support for self-directed care and medication and home health management. Controlling for multiple individual chronic conditions reduces effect sizes and number of significant relationships.

A Psychosocial Study of Albinism in a Predominately Mulatto Caribbean Community

1993 ◽  
Vol 73 (3_part_1) ◽  
pp. 1007-1010
Author(s):  
Wayne Westhoff
Keyword(s):  
Health Care Providers ◽  
Skin Color ◽  
Skin Pigmentation ◽  
Psychosocial Problems ◽  
Special Populations ◽  
Care Providers ◽  
Social Characteristic ◽  
White Skin ◽  
Caribbean Community ◽  
Sensitive Issues

Psychosocial data collected from 12 albinos in rural and isolated parts of the Dominican Republic suggest a stigma is associated with the absence of skin color. The general population living in the area has a skin pigmentation of dark brown. The purpose of the investigation was to assess whether there were psychosocial problems for albinos with white skin and hair. Prior studies imply albinism is a negative social characteristic associated with prejudice and apartheid in a predominately mulatto community. This researcher recommends that psychologists and health-care providers be familiar with similar sensitive issues among special populations.

scholarly journals Knowledge on Post Exposure Prophylaxis of HIV among Nurses in a Hospital of Pokhara

2018 ◽  
Vol 7 (1) ◽  
pp. 57-66
Author(s):  
Manu Thapa ◽  
Bishnu Gurung
Keyword(s):  
Nursing Education ◽  
Standard Deviation ◽  
Health Care Providers ◽  
Sampling Technique ◽  
Education Programme ◽  
Post Exposure Prophylaxis ◽  
Care Providers ◽  
Cross Sectional ◽  
Post Exposure ◽  
Exposure Prophylaxis

Health care providers are at risk of acquiring human immunodeficiency virus (HIV) infection from occupational exposure, with nurses being the most vulnerable. Post exposure prophylaxis (PEP) of HIV is the only way to reduce risk of HIV after potential exposure. A study was conducted on Nurses Knowledge on PEP of HIV at Gandaki Medical College (GMC), Pokhara to find out the knowledge on PEP of HIV among nurses. Descriptive cross sectional research design was used for the study. Probability stratified systematic random sampling technique was used for sampling and self administered questionnaires was used for data collection with sample size of 90 nurses working in GMC. The data was analyzed using Statistical Package for Social Science (SPSS) version 20 software programme and presented in terms of frequency distribution, percentage, mean and standard deviation. For inferential statistics, chi square test was used at 5% level of significance. The findings of the study revealed that mean age of the respondents was 24.57 with standard deviation 3.43. Out of 90 respondents majority (83.3%) of the respondents were PCL passed and 47.8% of the respondents had adequate knowledge regarding PEP of HIV. The study found no significant association between demographic variables and knowledge level. It can be concluded that the nurses need to improve their level of knowledge on PEP of HIV by participating in different training programs. Health institution should also conduct continue nursing education programme to improve and update knowledge among the employees.

What Is the Price and Claimed Efficacy of Platelet-Rich Plasma Injections for the Treatment of Knee Osteoarthritis in the United States?

2018 ◽  
Vol 32 (09) ◽  
pp. 879-885 ◽  
Author(s):  
Nicolas S. Piuzzi ◽  
Mitchell Ng ◽  
Ariel Kantor ◽  
Kenneth Ng ◽  
Stephanie Kha ◽  
...  
Keyword(s):  
United States ◽  
Standard Deviation ◽  
Knee Osteoarthritis ◽  
Clinical Efficacy ◽  
Health Care Providers ◽  
Platelet Rich Plasma ◽  
The United States ◽  
Care Providers ◽  
Knee Oa ◽  
The Mean

AbstractPlatelet-rich plasma (PRP) injections are often used for the treatment of knee osteoarthritis (OA), despite clinical value and cost-effectiveness not being definitely established. PRP injections are considered as a potential means of reducing pain and improving function in patients with knee OA, in the hope of delaying or avoiding the need for surgical intervention. Centers that offer PRP injections usually charge patients out of pocket and directly market services. Therefore, the purpose of this study was to quantify the current (1) prices and (2) marketed clinical efficacy of autologous PRP injections for knee OA. A prospective cross-sectional study was performed based on 286 centers identified in the United States offering PRP injections for knee OA. A total of 179 (73.4%) centers were successfully contacted via e-mail or phone, using a simulated 52-year-old male patient with knee OA. Scripted questions were asked by the simulated patient to determine the current marketed prices and clinical efficacy, either reported as “good results” or “symptomatic improvement,” claimed by each treating center. The mean price for a single unilateral knee same-day PRP injection was $714 with a standard deviation of $144 (95% confidence interval [CI]: $691–737, n = 153). The mean claim of clinical efficacy was 76% with a standard deviation of 11% (95% CI: 73.5–78.3%, n = 84). Out of the 84 clinics, 10 claimed “90 to 100% efficacy,” 27 claimed “80 to 90%,” 29 claimed “70 to 80%,” 9 claimed “60 to 70%,” 8 claimed “50 to 60%,” and 1 claimed “40 to 60%.” These findings provide a unique perspective on the PRP market for the treatment of knee OA that is valuable to physicians and health care providers in providing better education to patients on the associated costs and purported clinical benefits of PRP injections.

scholarly journals Physical assessment in pharmacy practice: Perspectives from pharmacists, nonpharmacist health care providers and the public

2021 ◽  
pp. 171516352110049
Author(s):  
Christine Leong ◽  
Leila Soufi
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Online Survey ◽  
Vital Signs ◽  
Pharmacy Practice ◽  
Care Providers ◽  
Cross Sectional ◽  
Physical Assessment ◽  
The Public ◽  
The Future

Background: Physical assessment in pharmacy practice is not a new concept, yet the idea is still unfamiliar to many people. Canadian pharmacy graduates are expected to be trained in physical examination as it relates to drug therapy. However, standard delivery of course content in this area has not been clearly established, and previous publications have reported low uptake of this practice despite formal training. To aid the future development of a physical assessment course for pharmacists that is relevant to practice and will contribute to patient care, it is important to gather insight from practising pharmacists, health care providers and the public. Objective: To determine the type of physical assessment skills that would be of value to pharmacy practice and the benefits and barriers of these skills in practice from the perspectives of pharmacists, health care providers and the public. Methods: This was a cross-sectional online survey of pharmacists, nonpharmacist health care providers and the public. Descriptive statistics and thematic analysis were used to describe data. Results: A total of 348 respondents (98 pharmacists, 154 nonpharmacist health care providers, 96 public) completed the survey. Most (64%) nonpharmacist providers were physiotherapists or occupational therapists (only 6.5% physicians). Most respondents felt that performing basic vital signs was relevant to pharmacy practice (79% pharmacists, 69% other providers, 79% public) and felt confident and comfortable about pharmacists using these skills. Palpation, percussion and auscultation were rated less favourably (<50% for most respondents). Nonpharmacist providers tended to be less favourable than pharmacist and public respondents. Seven themes related to benefits and 13 themes related to disadvantages of pharmacists performing physical assessment were identified. Conclusion: These findings provide insight into opinions about the value of pharmacists performing physical assessments. Consensus recommendations on performance expectations to improve recognition of pharmacists in this area is needed in the future. Can Pharm J (Ott) 2021;154:xx-xx.

Randomized Comparison of Every-2-Week Darbepoetin Alfa and Weekly Epoetin Alfa for the Treatment of Chemotherapy-Induced Anemia: The 20030125 Study Group Trial

2006 ◽  
Vol 24 (15) ◽  
pp. 2290-2297 ◽  
Author(s):  
John Glaspy ◽  
Saroj Vadhan-Raj ◽  
Ravi Patel ◽  
Linda Bosserman ◽  
Eddie Hu ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Darbepoetin Alfa ◽  
Study Drug ◽  
The United States ◽  
Phase Iii ◽  
Sensitivity Analyses ◽  
Comparable Efficacy ◽  
Care Providers ◽  
Epoetin Alfa ◽  
Noninferiority Margin

Purpose Chemotherapy-induced anemia is widely treated in the United States with darbepoetin alfa (DA) or epoetin alfa (EA). This noninferiority study systematically compares efficacy and safety of DA and EA using common doses and schedules used in clinical practice. Methods Patients had a diagnosis of nonmyeloid malignancy with ≥ 8 weeks of planned chemotherapy, age ≥ 18 years, and anemia (hemoglobin ≤ 11 g/dL). Patients were randomly assigned 1:1 to DA 200 μg every two weeks (Q2W) or EA 40,000 units every week (QW) for up to 16 weeks with identical dose adjustment rules. Efficacy was assessed by the incidence of RBC transfusion (Kaplan-Meier estimate). The definition of noninferiority was that the upper 95% CI limit of the observed difference in RBC transfusions between groups was less than 11.5%; this noninferiority margin was based on the treatment effect observed in placebo-controlled EA studies. Results Of 1,220 patients randomly assigned, 1,209 received ≥ one dose of the study drug. Common tumor types were lung (26%), breast (21%), and gastrointestinal (18%). Transfusion incidence from week 5 to the end of the treatment phase (the primary end point) was 21% in the DA group and 16% in the EA group; noninferiority was concluded because the upper 95% CI limit of the difference between groups (10.8%) was below the prespecified noninferiority margin. Sensitivity analyses using alternate statistical methods and analysis sets yielded similar results. Hemoglobin, quality of life, and safety end points further support equivalency of the erythropoietic therapies. Conclusion This large, phase III study demonstrates comparable efficacy of DA Q2W and EA QW. Less frequent dosing offers potential benefits for patients, caregivers and health care providers.

Abstract P207: Food Insecurity, Anxiety And Depression In An Underserved Heart Failure Population

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Erin B Clarkson ◽  
Stephen Clarkson ◽  
Reid Eagleson ◽  
Connie White-Williams
Keyword(s):  
Heart Failure ◽  
African American ◽  
Food Insecurity ◽  
Health Care Providers ◽  
Clinical Characteristics ◽  
Underserved Populations ◽  
Vital Signs ◽  
Social Determinant ◽  
Depression And Anxiety ◽  
Care Providers

Objective: The HRTSA (HeaRt -Failure Transitional Services for Adults) Clinic at the University of Alabama at Birmingham Hospital serves underinsured individuals with heart failure (HF). We examined the differences in sociodemographic, clinical characteristics, and depression and anxiety among food secure and insecure patients who established care in clinic. Methods: Between May 2018 and December 2019, 291 patients established care in the HRTSA Clinic post-hospitalization. Patients were adults ≥18 years of age with heart failure. At the first clinic visit, baseline sociodemographic and medical history were obtained. Additionally, each patient was screened for depression using the Patient Health Questionaire-9 (PHQ-9) and anxiety using the General Anxiety Disorder-7 (GAD-7) questionnaire. Patients were also screened for food insecurity (FI) using the Hunger Vital Signs screener, a validated 2-item tool created for clinical settings to rapidly identify FI. Using descriptive statistics and t-tests, we compared demographic and clinical characteristics of FI and FS clinic patients. Results: Of the 291 newly referred patients seen in the HRTSA Clinic and screened for food insecurity, the mean age was 50 years, 58% were African American and 29% were female. A total of 80 patients (27%) screened positive for food insecurity. FI patients tended to be female (37% vs 27%, p=0.108) and African American (68% vs. 58%, p=0.142), although not statistically significant. FI patients had statistically significant higher depression scores and had anxiety scores that trended to higher values. Conclusions: Food insecurity, an important social determinant of health, is associated with more depression and anxiety. Depression and anxiety are important contributors to patient-centered outcomes for heart failure patients, specifically in underserved populations. This has implications for health care providers to implement screening interventions to improve mental health in underserved populations.

scholarly journals Foudroyant Course of an ExtensiveClostridium septicumGas Gangrene in a Diabetic Patient with Occult Carcinoma of the Colon

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Maximilian Hartel ◽  
Asad Kutup ◽  
Axel Gehl ◽  
Jozef Zustin ◽  
Lars G. Grossterlinden ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Health Care Providers ◽  
Vital Signs ◽  
Underlying Disease ◽  
Multiple Organ ◽  
Care Providers ◽  
Laboratory Findings ◽  
Carcinoma Of The Colon ◽  
Surgical Measures

Background. Spontaneous gas gangrene is a rare disease in whichClostridium septicumfrequently can be detected. After an incubation period of 5–48 hours, a very painful swelling is accompanied by a rapidly spreading toxic-infectious clinical picture ultimately leading to septic shock and multiple organ failure. We present a case of a completely documented rare infectious disease with triage findings including initial vital signs, initial medical findings, and the emergency lab., radiological, intraoperative, histopathological, microbiological, and postmortem results. After initial diagnosis of the underlying disease, the patient has been immediately transferred to the operating theatre. The laboratory findings reflect the devastating effect of toxinαwhich is a toxin typically produced byC. septicum.The patient presented both an anaemia and a manifest coagulopathy as well as an onset of multiple organ failure. Despite the aggressive medical and surgical measures that have been taken, this patient could not be saved.Discussion. The case presented vividly emphasises the difficulty to identify these cases early enough to save a patient. This documentation may help health care providers to identify this life threatening disease as early as possible in future cases.

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