NeuroVision™: A Smartphone Application for Neurology and Telemedicine

NeuroVision™：用​​于神经病学和远程医疗的智能手机应用程序

• 批准号: 10663164
• 负责人: Bhawna Shiwani
• 金额: $ 32.09万
• 依托单位: ALTEC, INC.
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-15 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10663164
• 关键词: 3-Dimensional; Address; Adherence; Adopted; Algorithms; Architecture; Area; Body part; COVID-19 pandemic; Caregivers; Caring; Cellular Phone; Clinical; Computer Vision Systems; Computer software; Data; Development; Devices; Ensure; Essential Tremor; Evaluation; Evidence based practice; Face; Family member; Feedback; Focus Groups; Gait; Guidelines; Health Services; Health Technology; Healthcare; Home; Huntington Disease; Individual; Instruction; Involuntary Movements; Joints; Laboratories; Legal patent; Lower Extremity; Maps; Measures; Mechanics; Monitor; Motion; Motor; Motor Activity; Movement; Movement Disorders; Multi-site clinical study; Muscle; Neurologic; Neurological outcome; Neurologist; Neurology; Outcome; Outcome Measure; Parkinson Disease; Participant; Patient Care; Patients; Periodicals; Persons; Pharmaceutical Preparations; Phase; Populations at Risk; Procedures; Process; Protocols documentation; Quality of life; Reporting; Resolution; Sampling; Schedule; Secure; Specialist; Specific qualifier value; Speech; Standardization; Stroke; Structure; Summary Reports; Symptoms; System; Tablets; Technology; Teleconferences; Telemedicine; Testing; Therapeutic Intervention; Titrations; United States National Institutes of Health; Upper Extremity; Video Recording; Videoconferencing; Vision; Visit; Visual; Vulnerable Populations; Work; body position; clinical care; clinical outcome measures; commercial prototype; cost; design; eHealth; follow-up; health assessment; health management; kinematics; medical specialties; mobile application; motor disorder; motor impairment; motor symptom; nervous system disorder; new technology; novel strategies; pandemic disease; patient population; prototype; remote assessment; remote delivery; research clinical testing; response; sensor; sensor technology; smartphone application; telehealth; usability; videoconference; wearable sensor technology

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.

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利益 除了COVID大流行之外，脆弱人群以及那些因与专业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，从亲自护理的转变已经破坏了他们的能力， 利用目前的远程保健技术进行全面的运动评估。虽然视频会议 平台已经能够对语言、面部和上身症状进行一些神经学评估， 神经系统疾病如帕金森病（PD）需要对不同的神经系统疾病进行全面的视觉检查。 运动任务和运动症状，这些都很容易被狭窄的视野所阻碍， 标准远程医疗视频会议交互的受限2D视觉显示。克服这些 限制并提供定量结果，我们的计算机视觉专家团队正在与领先的 神经学家开发远程记录和量化规定的神经运动评估的方法 使用智能手机（3D）深度传感摄像头在家中执行任务，以通知随后的远程医疗访问， 视频样本和相应的数值结果度量。虽然我们的团队和其他人的发展 在计算机视觉领域，已经使用全身姿态估计算法和固定的3D相机来 测量关节力学，我们的试点工作证明了一种新的方法，以获得神经的可行性 步态、转移和精细运动评估任务的结果直接来自从 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， 目标1中的定位和标测算法，以获得n=10的运动损伤结局指标 PD参与者在黄金标准运动捕捉方面达到+/- 5%的误差。目标2将添加 指导性说明、合规性反馈和软件的摘要报告。由此产生的NeuroVision™ 将在n=5名独立神经科医生中对原型的可用性和感知价值进行临床评价 n=10例PD患者。患者护理助理将获取基于智能手机的记录 或家庭成员在我们的实验室使用NeuroVision™应用程序。由此产生的报告将提供给 转介神经科医生，用于通知预定的远程保健访问。我们的里程碑是实现有利的 Likert可用性评级（≥8/10）和神经科医生对感知临床价值和接受度的高评级。 涉及患者和护理人员的焦点小组将为设计一个更好的 完整的Phase II NeuroVision™系统，满足家庭使用要求，支持更广泛的 常见的神经系统疾病，并提供安全的电子健康评估报告。预商用 将测试原型的可用性和临床价值，以告知远程保健随访访视，以满足需求 目前，在更广泛的PD、原发性震颤、卒中和亨廷顿病高危患者人群中， 需要安全可靠地获得常规临床护理，以提高健康和生活质量。