An Advanced Bolus Calculator for Type 1 Diabetes: System Architecture and Usability Results
An Advanced Bolus Calculator for Type 1 Diabetes: System Architecture and Usability Results
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DOI：
10.1109/jbhi.2015.2464088
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发表时间：
2016-01-01
影响因子：
7.7
通讯作者：
Georgiou, Pantelis
中科院分区：
文献类型：
--
作者：
Pesl, Peter;Herrero, Pau;Georgiou, Pantelis
本文介绍了一个先进的糖尿病胰岛素推注计算器(ABC4D)的体系结构和初步使用结果，该计算器通过区分不同的糖尿病情景并随着时间的推移自动调整其参数，为糖尿病患者提供个性化的胰岛素推荐。拟议的平台包括两个主要组成部分：一个基于智能手机的患者平台，允许手动输入血糖和影响血糖水平的变量(如膳食碳水化合物含量和锻炼)，并提供实时的胰岛素推注建议；以及一个临床修订平台，用于监督推注计算器参数的自动调整。该系统实现了基于案例推理的先前在Silico中验证的推注计算器算法，该算法使用来自相似过去事件(即，案例)的信息来建议改进的个性化胰岛素推注推荐，并自动从新事件中学习。在为期六周的试点研究(n=10)结束时，通过分析系统使用情况来评估ABC4D的可用性。在研究结束时，通过可用性问卷从每个参与者那里获得了关于ABC4D使用的进一步反馈。平均每个参与者请求115+/-21个胰岛素推荐，其中103+/-28个(90%)被接受。临床修订软件总共提出了754个病例修订，其中723个(96%)经临床专家批准并在患者平台上更新。
This paper presents the architecture and initial usability results of an advanced insulin bolus calculator for diabetes (ABC4D), which provides personalized insulin recommendations for people with diabetes by differentiating between various diabetes scenarios and automatically adjusting its parameters over time. The proposed platform comprises two main components: a smartphone-based patient platform allowing manual input of glucose and variables affecting blood glucose levels (e.g., meal carbohydrate content and exercise) and providing real-time insulin bolus recommendations; and a clinical revision platform to supervise the automatic adaptations of the bolus calculator parameters. The system implements a previously in silico validated bolus calculator algorithm based on case-based reasoning, which uses information from similar past events (i.e., cases) to suggest improved personalized insulin bolus recommendations and automatically learns from new events. Usability of ABC4D was assessed by analyzing the system usage at the end of a six-week pilot study (n = 10). Further feedback on the use of ABC4D has been obtained from each participant at the end of the study from a usability questionnaire. On average, each participant requested 115 +/- 21 insulin recommendations, of which 103 +/- 28 (90%) were accepted. The clinical revision software proposed a total of 754 case revisions, where 723 (96%) adaptations were approved by a clinical expert and updated in the patient platform.