Mobilizing mHealth: interdisciplinary computer science and engineering
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Mobilizing mHealth: interdisciplinary computer science and engineering Mobilizing mHealth: interdisciplinary computer science and engineering Presentation Transcript

  • eric c. larson | eclarson.com interdisciplinary computer science and engineering mobilizing mhealth Assistant Professor Computer Science and Engineering Wednesday, September 11, 13
  • databases algorithms arch AI OS Comp Sci Wednesday, September 11, 13
  • mobile databases algorithms arch AI OS Comp Sci Wednesday, September 11, 13
  • mobile databases algorithms arch AI OS Comp Sci mhealth Wednesday, September 11, 13
  • mobile databases algorithms arch AI OS Comp Sci mhealth Wednesday, September 11, 13
  • what is mhealth? Wednesday, September 11, 13
  • stress check glucose buddy fitness trainer heart rate zombie run Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • consider physician’s need Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • compliance? cost? doctor patient? Wednesday, September 11, 13
  • compliance? cost? doctor patient? Wednesday, September 11, 13
  • cost Wednesday, September 11, 13
  • compliance Wednesday, September 11, 13
  • compliance Wednesday, September 11, 13
  • what can the mobile phone already sense ubiquitously? Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • accelerometer gyroscope magnetometer /compass dual camera / flash 1+ microphones proximity sensor capacitive sensor gps motorized actuator Wednesday, September 11, 13
  • accelerometer gyroscope magnetometer /compass dual camera / flash 1+ microphones proximity sensor capacitive sensor gps motorized actuator compliance++; cost--; dr_pat *= 10; Wednesday, September 11, 13
  • what can the mobile phone sense with clinical utility? Wednesday, September 11, 13
  • future research lung function jaundice Wednesday, September 11, 13
  • future research lung function jaundice Wednesday, September 11, 13
  • spirometer lung function?? Wednesday, September 11, 13
  • spirometer device that measures amount of air inhaled and exhaled. Wednesday, September 11, 13
  • lung function asthma COPD cystic fibrosis evaluates pulmonary impairments Wednesday, September 11, 13
  • using a spirometer flow volume volume time Wednesday, September 11, 13
  • using a spirometer flow volume volume time Wednesday, September 11, 13
  • using a spirometer flow volume volume time Wednesday, September 11, 13
  • volume-time graph volume time Wednesday, September 11, 13
  • volume-time graph volume time Wednesday, September 11, 13
  • volume-time graph volume time FEV1 FVC FEV1: Forced Expiratory Volume in 1 second FVC: Forced Vital Capacity Wednesday, September 11, 13
  • volume-time graph volume time1 sec. FEV1 FVC FEV1: Forced Expiratory Volume in 1 second FVC: Forced Vital Capacity Wednesday, September 11, 13
  • volume-time graph volume time1 sec. FEV1 FVC FEV1% = FEV1/FVC FEV1: Forced Expiratory Volume in 1 second FVC: Forced Vital Capacity Wednesday, September 11, 13
  • FEV1: Forced Expiratory Volume in 1 second FVC: Forced Vital Capacity FEV1% = FEV1/FVC Wednesday, September 11, 13
  • FEV1: Forced Expiratory Volume in 1 second FVC: Forced Vital Capacity FEV1% = FEV1/FVC > 80% healthy 60 - 79% mild 40 - 59% moderate < 40% severe Wednesday, September 11, 13
  • flow-volume graph flow volume Wednesday, September 11, 13
  • flow-volume graph flow volume Wednesday, September 11, 13
  • flow volume FEV1 FVC 1 sec. PEF PEF: Peak Expiratory Flow FEV1: Forced Expiratory Volume in 1 second FVC: Forced Vital Capacity flow-volume graph Wednesday, September 11, 13
  • flow volume normal flow-volume graph Wednesday, September 11, 13
  • flow volume normal obstructive flow-volume graph Wednesday, September 11, 13
  • obstructive diseases resistance in air path leads to reduced air flow Wednesday, September 11, 13
  • obstructive diseases resistance in air path leads to reduced air flow Wednesday, September 11, 13
  • restrictive diseases lungs are unable to pump enough air and pressure Wednesday, September 11, 13
  • restrictive diseases lungs are unable to pump enough air and pressure Wednesday, September 11, 13
  • flow-volume graph Flow Volume normal obstructive Wednesday, September 11, 13
  • flow-volume graph Flow Volume normal restrictive obstructive Wednesday, September 11, 13
  • clinical spirometry Wednesday, September 11, 13
  • home spirometry Wednesday, September 11, 13
  • home spirometry faster detection rapid recovery trending Wednesday, September 11, 13
  • home spirometry high cost barrier patient compliance less coaching limited integration challenges with Wednesday, September 11, 13
  • flow rate volume lung function airflow sensor Wednesday, September 11, 13
  • flow rate volume lung function airflow sensor sound pressure microphone Wednesday, September 11, 13
  • flow rate volume lung function airflow sensor sound pressure microphone processing estimated Wednesday, September 11, 13
  • SpiroSmart availability cost portability more effective coaching interface integrated uploading Wednesday, September 11, 13
  • Using SpiroSmart Wednesday, September 11, 13
  • Using SpiroSmart Wednesday, September 11, 13
  • Using SpiroSmart ] Wednesday, September 11, 13
  • Using SpiroSmart ] Wednesday, September 11, 13
  • Using SpiroSmart ] Wednesday, September 11, 13
  • Using SpiroSmart Wednesday, September 11, 13
  • study design x 3 x 3 Wednesday, September 11, 13
  • study enrollment Wednesday, September 11, 13
  • study enrollment participants 52 18-75 years old, mostly healthy18-75 years old, mostly healthy study a Wednesday, September 11, 13
  • study enrollment participants 52 18-75 years old, mostly healthy18-75 years old, mostly healthy study a participants 10 12-17 years old, mixed healthy/abnormal12-17 years old, mixed healthy/abnormal study b Wednesday, September 11, 13
  • study enrollment participants 52 18-75 years old, mostly healthy18-75 years old, mostly healthy study a participants 10 12-17 years old, mixed healthy/abnormal12-17 years old, mixed healthy/abnormal study b participants 56 10-69 years old, mostly abnormal10-69 years old, mostly abnormal study c enrolledby pulmonologists Wednesday, September 11, 13
  • audio Wednesday, September 11, 13
  • audio flow features Wednesday, September 11, 13
  • audio flow features measures regression FEV1 FVC PEF Wednesday, September 11, 13
  • 0 1 2 3 4 0 5 10 15 Flow(L/s) Volume(L) 1 2 3 4 Volume(L) 0 1 2 3 4 0 5 10 15 Flow(L/s) Volume(L) 0 2 4 6 8 10 0 1 2 3 4 time(s) Volume(L) audio flow features measures regression curve regression FEV1 FVC PEF Wednesday, September 11, 13
  • 0 1 2 3 4 0 5 10 15 Flow(L/s) Volume(L) 1 2 3 4 Volume(L) 0 1 2 3 4 0 5 10 15 Flow(L/s) Volume(L) 0 2 4 6 8 10 0 1 2 3 4 time(s) Volume(L) audio flow features measures regression curve regression lung function FEV1 FVC PEF Wednesday, September 11, 13
  • 0 1 2 3 4 5 6 7 −1 −0.5 0 0.5 1 time(s) amplitude flow features Wednesday, September 11, 13
  • 0 1 2 3 4 5 6 7 −1 −0.5 0 0.5 1 time(s) amplitude flow features vocal tractsource output frequency(Hz) 1 2 3 4 5 6 0 500 1000 1500 2000 2500 Wednesday, September 11, 13
  • 0 1 2 3 4 5 6 7 −1 −0.5 0 0.5 1 time(s) amplitude flow features 0 1 2 3 4 5 6 7 −1 −0.5 0 0.5 1 time(s) amplitude envelope detection 0 1 2 3 4 5 6 7 −1 −0.5 0 0.5 1 time(s) amplitude resonance tracking 0 1 2 3 4 5 6 7 −1 −0.5 0 0.5 1 lpc8raw time(s) amplitude flow estimation features vocal tractsource output 0 1 2 3 4 5 6 7 −1 −0.5 0 0.5 1 lpc8raw time(s) amplitude auto-regressive estimate frequency(Hz) 1 2 3 4 5 6 0 500 1000 1500 2000 2500 Wednesday, September 11, 13
  • curve regression −1 0 1 2 3 4 5 0 0.1 0.2 0.3 0.4 time(s) featurevalue 0 1 2 3 4 5 0 0.1 0.2 0.3 0.4 time(s) featurevalue feature 1 feature N windowedmachine learningregression ... Wednesday, September 11, 13
  • −1 0 1 2 3 4 5 0 2 4 6 8 time(s) flow(L/s) curve regression −1 0 1 2 3 4 5 0 0.1 0.2 0.3 0.4 time(s) featurevalue 0 1 2 3 4 5 0 0.1 0.2 0.3 0.4 time(s) featurevalue feature 1 feature N curve output windowedmachine learningregression ... Wednesday, September 11, 13
  • results measures regression Wednesday, September 11, 13
  • results measures regression Wednesday, September 11, 13
  • curve regression −2 0 2 4 6 0 5 10 15 volume(L) flow(L/s) −1 0 1 2 3 4 0 2 4 6 8 volume(L) flow(L/s) Wednesday, September 11, 13
  • curve regression −2 0 2 4 6 0 5 10 15 volume(L) flow(L/s) −2 0 2 4 6 0 5 10 15 volume(L) flow(L/s) −1 0 1 2 3 4 0 2 4 6 8 volume(L) flow(L/s) −1 0 1 2 3 4 0 2 4 6 8 volume(L) flow(L/s) Wednesday, September 11, 13
  • curve regression −2 0 2 4 6 0 5 10 15 volume(L) flow(L/s) −2 0 2 4 6 0 5 10 15 volume(L) flow(L/s) −2 0 2 4 6 0 5 10 15 volume(L) flow(L/s) −1 0 1 2 3 4 0 2 4 6 8 volume(L) flow(L/s) −1 0 1 2 3 4 0 2 4 6 8 volume(L) flow(L/s) Wednesday, September 11, 13
  • curve regression −2 0 2 4 6 0 5 10 15 volume(L) flow(L/s) −2 0 2 4 6 0 5 10 15 volume(L) flow(L/s) −2 0 2 4 6 0 5 10 15 volume(L) flow(L/s) −2 0 2 4 6 0 5 10 15 volume(L) flow(L/s) −1 0 1 2 3 4 0 2 4 6 8 volume(L) flow(L/s) −1 0 1 2 3 4 0 2 4 6 8 volume(L) flow(L/s) Wednesday, September 11, 13
  • can SpiroSmart curves be used for diagnosis? Wednesday, September 11, 13
  • survey Wednesday, September 11, 13
  • • 10 subjects curves survey Wednesday, September 11, 13
  • • 5 pulmonologists • 10 subjects curves survey Wednesday, September 11, 13
  • • 5 pulmonologists • 10 subjects curves • unaware if from SpiroSmart / spirometer survey Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • results normal minimal obstructive mild obstructive moderate obstructive severe obstructive restrictive inadequate Wednesday, September 11, 13
  • results normal minimal obstructive mild obstructive moderate obstructive severe obstructive restrictive inadequate identical 64% Wednesday, September 11, 13
  • results normal minimal obstructive mild obstructive moderate obstructive severe obstructive restrictive inadequate one off 10% identical 64% Wednesday, September 11, 13
  • results normal minimal obstructive mild obstructive moderate obstructive severe obstructive restrictive inadequate one off 10% identical 64% Wednesday, September 11, 13
  • results normal minimal obstructive mild obstructive moderate obstructive severe obstructive restrictive inadequate false positive 14% one off 10% identical 64% Wednesday, September 11, 13
  • results normal minimal obstructive mild obstructive moderate obstructive severe obstructive restrictive inadequate false negative 4% false positive 14% one off 10% identical 64% Wednesday, September 11, 13
  • results normal minimal obstructive mild obstructive moderate obstructive severe obstructive restrictive inadequate error 8% false negative 4% false positive 14% one off 10% identical 64% Wednesday, September 11, 13
  • results normal minimal obstructive mild obstructive moderate obstructive severe obstructive restrictive inadequate error 8% false negative 4% false positive 14% one off 10% identical 64% abnormal vs normal 96% Wednesday, September 11, 13
  • appropriate for screening and early diagnosis Wednesday, September 11, 13
  • appropriate for screening and early diagnosis in the home? in the developing world? Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • in 10 years, COPD will surpass AIDS/HIV as cause of death in developing nations Wednesday, September 11, 13
  • in 10 years, COPD will surpass AIDS/HIV as cause of death in developing nations Wednesday, September 11, 13
  • future research lung function jaundice Wednesday, September 11, 13
  • future research lung function jaundice Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • neonatal jaundice in the US kernicterus: 21 hazardous jaundice: 1158 extreme jaundice: 2,317 severe jaundice: 35,000 phototherapy: 290,000 visible jaundice: 3.5 million births/year: 4.1 million Wednesday, September 11, 13
  • Method Accuracy Disadvantages TSB Gold standard (r=1.0) Painful, costly, inconvenient, delayed TcB Accurate (r= 0.75 -0.93) Meter = $7000 tips $5 unavailable in most physician offices Visual assessment (provider or parent) not accurate (r= 0.36 - 0.7), underestimates severity No standardization lighting, pigmentation Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • bilicam Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • participants 40 0-4 days old, collected in nursery0-4 days old, collected in nursery study a Wednesday, September 11, 13
  • participants 40 0-4 days old, collected in nursery0-4 days old, collected in nursery study a Wednesday, September 11, 13
  • Color Linearization • Camera Settings Adjustment • Light Source Estimation Image Segmentation • Quality Control for Distance, Lighting, and Shadow • Sternum, Forehead, Card Segmented Color Calibration • Dynamic Least Squares Regression • Automatic Feature Selection Neonatal Skin Response to Bilirubin • Skin Independent Color Transformations Applied • Multivariate Machine Learning Regression bilicam Wednesday, September 11, 13
  • 051015 TcBvalues 0 5 10 15 bilicam values Fitted values bilicam bilirubinlevel bilicam estimation 0 15 155 10 5 10 mg/dl r=0.91 bilicam initial results Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • • near term: screening Wednesday, September 11, 13
  • • near term: screening • medium term: TSB study Wednesday, September 11, 13
  • • near term: screening • medium term: TSB study • long term: developing world Wednesday, September 11, 13
  • • near term: screening • medium term: TSB study • long term: developing world “in many resource poor nations, hyperbilirubinemia is the second or third leading cause of infant mortality and disability” Wednesday, September 11, 13
  • future research lung function jaundice Wednesday, September 11, 13
  • future research lung function jaundice Wednesday, September 11, 13
  • oxygen volume, VO2 Wednesday, September 11, 13
  • blood pressure Wednesday, September 11, 13
  • intra ocular pressure Wednesday, September 11, 13
  • intra ocular pressure Wednesday, September 11, 13
  • Wednesday, September 11, 13
  • activity detection elder care daily activity logs congestive heart failure health markers via phone blood pressure pulse oximetry stress opportunistic sensing pain management detecting circulation Wednesday, September 11, 13
  • activity detection elder care daily activity logs congestive heart failure health markers via phone blood pressure pulse oximetry stress opportunistic sensing pain management detecting circulation developing world Wednesday, September 11, 13
  • take away • CSE has a large role in the coming evolution of mHealth, equal to doctors • sensing and clinical utility • deploy in clinic, deploy in world, then release • ... look for a new mobile application sensing course ... Wednesday, September 11, 13
  • eric c. larson | eclarson.com interdisciplinary computer science and engineering mobilizing mhealth Assistant Professor Computer Science and Engineering eclarson.com eclarson@lyle.smu.edu @ec_larson Thank You! Wednesday, September 11, 13