NeuroVision™: A Smartphone Application for Neurology and Telemedicine

医疗保健向家庭远程医疗服务的变革性转变预计将带来长期好处 超越COVID大流行的人群，以及那些因与专科隔离而得不到充分服务的人群 护理中心。然而，对于神经科医生来说，从面对面护理的转变已经扰乱了 利用当前的远程医疗技术执行全面的运动评估。虽然视频会议 平台已经实现了对言语、面部和上半身症状的一些神经学评估，大多数 帕金森氏病(PD)等神经系统疾病需要对不同的 运动任务和运动症状都太容易被狭窄的视野和 标准远程医疗视频会议交互的受限2D可视显示。要克服这些障碍 我们的计算机视觉专家团队正在与领先的 神经科医生将开发一种远程记录和量化处方神经运动评估的方法 使用智能手机(3D)深度传感摄像头通知后续远程医疗访问的家中任务 视频样本和相应的数字结果指标。虽然我们团队和其他人的发展 在计算机视觉领域，使用了全身姿势估计算法和固定3D摄像机来 测量关节力学，我们的试点工作证明了一种新的方法来推导神经学的可行性 直接从深度数据记录的步态、转移和精细运动评估任务的结果 非固定(手持)智能手机。在第一阶段，我们将在这项工作的基础上同时开发 目标1中的定位和标测算法以从n=10获得运动障碍的结果测量 患有PD的参与者在黄金标准运动捕捉方面达到+/-5%的误差。AIM 2将添加 向软件提供指导性说明、合规性反馈和摘要报告。由此产生的神经视觉™ 原型将在n=5名独立神经学家中进行可用性和感知价值的临床评估 N=10名帕金森病患者。基于智能手机的录音将由患者的护理助理获取 或家庭成员使用我们实验室中的神经视觉™应用程序。生成的报告将提供给 转诊神经科医生，用于通知预定的远程医疗访问。我们的里程碑是实现有利的 利克特可用性评级(≥8/10)以及神经科医生对临床价值和接受度的高评级。 涉及患者和护理者的焦点小组将为设计更多的 完整的第二阶段NeuroVision™系统，满足家庭使用要求，支持更广泛的 常见的神经疾病，并提供安全的电子健康评估报告。商业预售 将测试原型在通知远程医疗后续访问以满足需求方面的可用性和临床价值 目前患有帕金森病、原发性震颤、中风和亨廷顿病的更广泛的高危患者 需要安全可靠地获得常规临床护理，以保障健康和生活质量。

The transformative shift in healthcare to in-home telehealth services is projected to deliver long term benefits beyond the COVID pandemic to vulnerable populations, and those underserved due to isolation from specialty care centers. For the neurologist, however, the shift away from in-person care has disrupted the ability to perform comprehensive motor assessments with current telehealth technologies. While video conferencing platforms have enabled some neurological evaluations of speech, facial, and upper body symptoms, most neurological disorders such as Parkinson’s disease (PD) require a comprehensive visual examination of different movement tasks and motor symptoms that are all too easily obstructed by the narrow field-of-view and constrained 2D visual display of standard telehealth video-conferencing interactions. To overcome these limitations and offer quantitative outcomes, our team of computer vision experts is partnering with leading neurologists to develop a remote means of recording and quantifying prescribed neurological motor assessment tasks in the home using a smartphone (3D) depth-sensing camera to inform a subsequent telehealth visit with video samples and corresponding numerical outcome metrics. While developments from our group and others in the area of computer vision have used total body pose estimation algorithms and stationary 3D cameras to measure joint mechanics, our pilot work demonstrates the feasibility of a new approach to derive neurological outcomes of gait, transfer, and fine motor assessment tasks directly from depth data recorded from a nonstationary (handheld) smartphone. In Phase I we will build upon this work to develop simultaneous localization and mapping algorithms in Aim 1 to obtain outcome measures of motor impairment from n=10 participants with PD that achieve +/- 5% error with respect to gold-standard motion capture. Aim 2 will add guided instructions, compliance feedback, and summary reports to the software. The resulting NeuroVision™ prototype will be clinically evaluated for usability and perceived value among n=5 independent neurologists and n=10 of their patients with PD. Smartphone-based recordings will be acquired by the patient’s care assistant or family member using the NeuroVision™ app in our laboratory. The resulting report will be provided to the referring neurologist, to be used to inform a scheduled telehealth visit. Our milestones are to achieve favorable Likert usability ratings (≥8/10) and high ratings of perceived clinical value and acceptance from the neurologists. Focus groups involving the patient and caregiver will provide additional feedback for a designing a more complete Phase II NeuroVision™ system that meets in-home use requirements, supports a broader range of common neurological conditions, and provides a secure eHealth assessment report. The pre-commercial prototype will be tested for usability and clinical value in informing telehealth follow-up visits to meet the needs of a broader population of at-risk patients with PD, Essential Tremor, Stroke, and Huntington’s disease currently in need of safe and reliable access to routine clinical care for health and quality of life.