The development of an automated device for asthma monitoring for adolescents: methodologic approach and user acceptability.
The development of an automated device for asthma monitoring for adolescents: methodologic approach and user acceptability.
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DOI：
10.2196/mhealth.3118
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发表时间：
2014-06-19
影响因子：
5
通讯作者：
Fairbanks E
中科院分区：
文献类型：
--
作者：
Rhee H;Miner S;Sterling M;Halterman JS;Fairbanks E
许多青少年患有严重的哮喘相关疾病，可以通过适当的自我管理来预防。患者准确的症状监测是有效哮喘管理的最基本前提。然而，由于个体易犯的症状感知、不良的依从性和不充分的技术，目前症状自我监测方法的充分性和有效性受到了挑战。认识到这些局限性导致了一种创新设备的开发，该设备可以促进对哮喘症状的连续和准确监测，同时最大限度地减少对日常生活的干扰，从而提高青少年的可接受性。本研究的目的是：（1）描述青少年（青少年）新型症状监测设备的开发，（2）评估他们对设备可用性和可接受性的看法。患有和不患有哮喘的青少年（13-17岁）参与了哮喘监测自动化设备（ADAM）的演变，该演变包括三个阶段，包括开发（第1阶段，n=37），验证/用户可接受性（第2阶段，n=84）和事后验证（第3阶段，n=10）。在第1阶段，根据原始症状声音的声学分析识别症状算法，并将其编程到流行的移动的系统iPod中。第2阶段包括为期7天的ADAM体内试验，以及使用接受度调查和个人访谈评估用户接受度。ADAM在第3阶段中得到进一步修改和增强。通过ADAM，输入的音频数据被数字化，并在两个步骤中进行处理，包括提取一系列描述性特征向量，并通过基于隐马尔可夫模型的维特比解码器处理这些序列，以区分症状声音和背景噪声。检测到的症状的数量和次数被存储并显示在设备中。更新的咳嗽算法的灵敏度（真阳性）为70%（21/30），平均每小时2次咳嗽被识别为假阳性。ADAM还使用移动的系统的内置加速计功能跟踪他们全天的活动水平。总体而言，该设备受到了参与者的好评，他们认为它具有吸引力，方便和有用。参与者认识到该设备在哮喘护理中的潜在益处，并渴望将其用于哮喘管理。ADAM可以潜在地以最小的侵入性和最大的客观性自动化日常症状监测。基于其公认的便利性、用户友好性和在提高症状意识方面的有用性，用户对该设备的接受强调了ADAM克服症状监测问题的潜力，包括青少年的依从性差、技术不足和症状感知差。需要进一步改进算法，以提高设备的准确性。未来的研究还需要评估该设备在促进自我管理和哮喘结局方面的有效性。
Many adolescents suffer serious asthma related morbidity that can be prevented by adequate self-management of the disease. The accurate symptom monitoring by patients is the most fundamental antecedent to effective asthma management. Nonetheless, the adequacy and effectiveness of current methods of symptom self-monitoring have been challenged due to the individuals’ fallible symptom perception, poor adherence, and inadequate technique. Recognition of these limitations led to the development of an innovative device that can facilitate continuous and accurate monitoring of asthma symptoms with minimal disruption of daily routines, thus increasing acceptability to adolescents. The objectives of this study were to: (1) describe the development of a novel symptom monitoring device for teenagers (teens), and (2) assess their perspectives on the usability and acceptability of the device. Adolescents (13-17 years old) with and without asthma participated in the evolution of an automated device for asthma monitoring (ADAM), which comprised three phases, including development (Phase 1, n=37), validation/user acceptability (Phase 2, n=84), and post hoc validation (Phase 3, n=10). In Phase 1, symptom algorithms were identified based on the acoustic analysis of raw symptom sounds and programmed into a popular mobile system, the iPod. Phase 2 involved a 7 day trial of ADAM in vivo, and the evaluation of user acceptance using an acceptance survey and individual interviews. ADAM was further modified and enhanced in Phase 3. Through ADAM, incoming audio data were digitized and processed in two steps involving the extraction of a sequence of descriptive feature vectors, and the processing of these sequences by a hidden Markov model-based Viterbi decoder to differentiate symptom sounds from background noise. The number and times of detected symptoms were stored and displayed in the device. The sensitivity (true positive) of the updated cough algorithm was 70% (21/30), and, on average, 2 coughs per hour were identified as false positive. ADAM also kept track of the their activity level throughout the day using the mobile system’s built in accelerometer function. Overall, the device was well received by participants who perceived it as attractive, convenient, and helpful. The participants recognized the potential benefits of the device in asthma care, and were eager to use it for their asthma management. ADAM can potentially automate daily symptom monitoring with minimal intrusiveness and maximal objectivity. The users’ acceptance of the device based on its recognized convenience, user-friendliness, and usefulness in increasing symptom awareness underscores ADAM’s potential to overcome the issues of symptom monitoring including poor adherence, inadequate technique, and poor symptom perception in adolescents. Further refinement of the algorithm is warranted to improve the accuracy of the device. Future study is also needed to assess the efficacy of the device in promoting self-management and asthma outcomes.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
DOI：
10.1046/j.1440-1843.2001.00350.x
发表时间：
2001-12-01
期刊：
Respirology (Carlton, Vic.)
影响因子：
--
作者：
Adams, R J;Boath, K;Ruffin, R E
通讯作者：
Ruffin, R E
影响因子：
8
作者：
Calmes, D;Leake, BD;Carlisle, DM
通讯作者：
Carlisle, DM
影响因子：
5.2
作者：
Halterman, J. S.;Yoos, H. L.;McMullen, A.
通讯作者：
McMullen, A.
影响因子：
8
作者：
Akinbami, Lara J.;Moorman, Jeanne E.;Sondik, Edward J.
通讯作者：
Sondik, Edward J.