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Knowledge-driven Personalized Contextual mHealth
Service for Asthma Management in Children
Pramod Anantharam, Tanvi Banerj...
2
http://www.technologyreview.com/featuredstory/426968/the-patient-of-the-future/
MIT Technology Review, 2012
The Patient ...
Through analysis of physical,
physiological, and environmental
observations, our cellphones could
act as an early warning ...
Asthma Dementia Heart Failure Liver Cirrhosis
kHealth Application Areas
4
5
1http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/
2http://www.lung.org/lung-disease/asthma/resources/facts-a...
6
Asthma: A Multi-faceted and Symptomatically Variable Health Issue
Personal level
Signals
Public level
Signals
Population...
7
Asthma: Actionable Information
How is my Asthma control?
Should I take additional medication today?
How can I reduce my ...
8
Personal level
Signals
Public level
Signals
Population level
Signals
Domain
Knowledge
Asthma: Challenges in Heterogeneit...
Sensordrone
(Carbon monoxide,
temperature, humidity)
9
Sensor Platforms
Android Device
(w/ kHealth App)
Total cost: ~ $550...
kHealth Kit: Sensor Platforms
Sensordrone
• Precision gas sensor
• Reducing gas sensor
• Oxidizing gas sensor
• Non-contac...
kHealth Kit: Android Application
11
For collecting observations from both machine sensors
and from patients in the form of...
kHealth: Health Signal Processing Architecture
Personal level
Signals
Public level
Signals
Population level
Signals
Domain...
13
Patient Health Score (diagnostic)
Risk assessment
model
Semantic
Perception
Personal level
Signals
Public level
Signals...
14
Patient Vulnerability Score (prognostic)
Risk assessment
model
Semantic
Perception
Personal level
Signals
Public level
...
15
Sensordrone – for monitoring
environmental air quality
Wheezometer – for monitoring
wheezing sounds
Can I reduce my ast...
16
Usability and decision support trial
Dr. Shalini G. Forbis, MD, MPH
Deployment Details and Data Collection
kHealth kit was deployed with four patients for feasibility study of data collectio...
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0.5
0.6
0.7
0.8
0.9
1
Did patient take
albuterol last night due
to cough or wheeze?
0
0.05
0.1
0.15
0.2
...
0
0.1
0.2
0.3
0.4
0.5
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How much did asthma or
asthma symptoms limit
patient's activity today?
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0.05
0.1
...
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0.1
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0.3
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0.5
0.6
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0.8
0.9
1
Has patient had
wheeze, chest
tightness, or asthma
related cough today?
0
0.05
0.1...
0
0.5
1
1.5
2
2.5
Pollen
0
0.1
0.2
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0.4
0.5
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0.8
0.9
1
How much did asthma or
asthma symptoms limit
patient's ac...
Conclusion
Unprecedented and Continuous Access to Intimate Patient Data is Possible
• Doctors can utilize this information...
Future Work
Carry out a Large Scale Pilot & Clinical Trial
• kHealth kit is prepared to be deployed with over 200 asthma p...
Acknowledgements
Partial support for this research was provided by Wright State University’s VP of
Research under a challe...
Thank you 
Thank you, and please visit us at http://knoesis.org
For more information on kHealth, please visit us at http:...
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Knowledge-driven Personalized Contextual mHealth Service for Asthma Management in Children

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Wide adoption of smartphones and availability of low-cost sensors has resulted in seamless and continuous monitoring of physiology, environment, and public health notifications. However, personalized digital health and patient empowerment can become a reality only if the complex multisensory and multimodal data is processed within the patient context. Contextual processing of patient data along with personalized medical knowledge can lead to actionable information for better and timely decisions. We present a system called kHealth capable of aggregating multisensory and multimodal data from sensors (passive sensing) and answers to questionnaire (active sensing) from patients with asthma. We present our preliminary data analysis comprising data collected from real patients highlighting the challenges in deploying such an application. The results show strong promise to derive actionable information using a combination of physiological indicators from active and passive sensors that can help doctors determine more precisely the cause, severity, and control level of asthma. Information synthesized from kHealth can be used to alert patients and caregivers for seeking timely clinical assistance to better manage asthma and improve their quality of life.

Paper: http://www.knoesis.org/library/resource.php?id=2153

Citation:
Pramod Anantharam, Tanvi Banerjee, Amit Sheth, Krishnaprasad Thirunarayan, Surendra Marupudi, Vaikunth Sridharan, Shalini G. Forbis, Knowledge-driven Personalized Contextual mHealth Service for Asthma Management in Children , IEEE 4th International Conference on Mobile Services, June 27 - July 2, 2015, New York, USA.

Published in: Health & Medicine
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Knowledge-driven Personalized Contextual mHealth Service for Asthma Management in Children

  1. 1. Knowledge-driven Personalized Contextual mHealth Service for Asthma Management in Children Pramod Anantharam, Tanvi Banerjee, Amit Sheth, Krishnaprasad Thirunarayan, Surendra Marupudi, Vaikunth Sridharan Ohio Center of Excellence in Knowledge-enabled Computing(Kno.e.sis), Wright State University, USA Presentation for: IEEE 4th International Conference on Mobile Services, June 27 – July 2, 2015, NY, USA
  2. 2. 2 http://www.technologyreview.com/featuredstory/426968/the-patient-of-the-future/ MIT Technology Review, 2012 The Patient of the Future
  3. 3. Through analysis of physical, physiological, and environmental observations, our cellphones could act as an early warning system to detect serious health conditions, and provide actionable information canary in a coal mine Empowering Individuals (who are not Larry Smarr!) for their own health kHealth: knowledge-enabled healthcare 3
  4. 4. Asthma Dementia Heart Failure Liver Cirrhosis kHealth Application Areas 4
  5. 5. 5 1http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/ 2http://www.lung.org/lung-disease/asthma/resources/facts-and-figures/asthma-in-adults.html 3Akinbami et al. (2009). Status of childhood asthma in the United States, 1980–2007. Pediatrics,123(Supplement 3), S131-S145. 25 million 300 million $50 billion 155,000 593,000 People in the U.S. are diagnosed with asthma (7 million are children)1. People suffering from asthma worldwide2. Spent on asthma alone in a year2 Hospital admissions in 20063 Emergency department visits in 20063 Asthma: Severity of the problem
  6. 6. 6 Asthma: A Multi-faceted and Symptomatically Variable Health Issue Personal level Signals Public level Signals Population level Signals 1Marcus, Philip, Kevin R. Murphy, Abid Rahman, and Christopher D. O’Brien. "Intrapatient symptom variability in adults and children with asthma: Results of a survey." Advances in therapy 22, no. 5 (2005): 488-497. “ … survey indicates that adult patients and caregivers of pediatric patients report variability in asthma symptoms over time, even when asthma medications are taken.”1
  7. 7. 7 Asthma: Actionable Information How is my Asthma control? Should I take additional medication today? How can I reduce my asthma attacks at home? “… Far better an approximate answer to the right question, which is often vague, than the exact answer to the wrong question, which can always be made precise.” -- John Tukey, Ann. Math. Stat. 33 (1962
  8. 8. 8 Personal level Signals Public level Signals Population level Signals Domain Knowledge Asthma: Challenges in Heterogeneity, Variability, and Personalization http://www.tuberktoraks.org/managete/fu_folder/2011-03/html/2011-3-291-311.html Contextual Personalized Actionable OR
  9. 9. Sensordrone (Carbon monoxide, temperature, humidity) 9 Sensor Platforms Android Device (w/ kHealth App) Total cost: ~ $550 kHealth Kit for the application for Asthma management Along with sensor platforms in the kit, the application uses a variety of population level signals from the web: Pollen level Air Quality Temperature & Humidity Node Sensor (exhaled Nitric Oxide) Fitbit ChargeHR (Activity, sleep quality) 9
  10. 10. kHealth Kit: Sensor Platforms Sensordrone • Precision gas sensor • Reducing gas sensor • Oxidizing gas sensor • Non-contact thermometer • Humidity sensor • Temperature sensor • Light sensor • Color sensors • Pressure • Proximity • Expansion connector Node Sensor • Exhaled Nitric Oxide Fitbit ChargeHR • Heart Rate • All-Day Activity • Sleep Monitoring 10
  11. 11. kHealth Kit: Android Application 11 For collecting observations from both machine sensors and from patients in the form of a questionnaire
  12. 12. kHealth: Health Signal Processing Architecture Personal level Signals Public level Signals Population level Signals Domain Knowledge Risk Model Events from Textual Streams Take Medication before going to work Avoid going out in the evening due to high pollen levels Contact doctor Analysis Personalized Actionable Information Data Acquisition & Aggregation 12 12
  13. 13. 13 Patient Health Score (diagnostic) Risk assessment model Semantic Perception Personal level Signals Public level Signals Domain Knowledge Population level Signals GREEN – Well Controlled YELLOW – Not well controlled Red – Poor control How controlled is my asthma?
  14. 14. 14 Patient Vulnerability Score (prognostic) Risk assessment model Semantic Perception Personal level Signals Public level Signals Domain Knowledge Population level Signals Patient health Score How vulnerable* is my control level today? *considering changing environmental conditions and current control level GREEN – Low YELLOW – Moderate Red – High
  15. 15. 15 Sensordrone – for monitoring environmental air quality Wheezometer – for monitoring wheezing sounds Can I reduce my asthma attacks at night? What are the triggers? What is the wheezing level? What is the propensity toward asthma? What is the exposure level over a day? Commute to Work Decision Support for Doctors and Patients: A Scenario Luminosity CO level CO in gush during day time Actionable Information Personal level Signals Public level Signals Population level Signals What is the air quality indoors?
  16. 16. 16 Usability and decision support trial Dr. Shalini G. Forbis, MD, MPH
  17. 17. Deployment Details and Data Collection kHealth kit was deployed with four patients for feasibility study of data collection and preliminary analysis of data to derive value 17
  18. 18. 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1 Did patient take albuterol last night due to cough or wheeze? 0 0.05 0.1 0.15 0.2 0.25 Exhaled Nitric Oxide Medication (Albuterol) related to decreasing Exhaled Nitric Oxide 18
  19. 19. 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1 How much did asthma or asthma symptoms limit patient's activity today? 0 0.05 0.1 0.15 0.2 0.25 Exhaled Nitric Oxide Activity limitation related to high exhaled Nitric Oxide 19
  20. 20. 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1 Has patient had wheeze, chest tightness, or asthma related cough today? 0 0.05 0.1 0.15 0.2 0.25 Exhaled Nitric Oxide Low exhaled Nitric Oxide observed with absence of coughing 20
  21. 21. 0 0.5 1 1.5 2 2.5 Pollen 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1 How much did asthma or asthma symptoms limit patient's activity today? Activity limitation observed with high pollen activity 21
  22. 22. Conclusion Unprecedented and Continuous Access to Intimate Patient Data is Possible • Doctors can utilize this information for informed decision making • Require techniques to find promising hypothesis to be vetted by doctors Personalized Treatment of Asthma is Challenging • Asthma is a multifaceted and symptomatically variable ailment • Patient specific understanding of response to triggers would help in personalization Contextual Application for Actionable Information is Challenging • Detecting recurring conditions of response to triggers is required for context awareness • Background knowledge from doctors would be crucial for recommending actions
  23. 23. Future Work Carry out a Large Scale Pilot & Clinical Trial • kHealth kit is prepared to be deployed with over 200 asthma patients Formulate Patient Vulnerability Score • This score is not formally specified in the asthma diagnosis guidelines from NIH1 • The complexity of asthma makes it hard to define vulnerability score (prognostic) • Personalization is crucial even if such a score can be defined Add New Sensors for Monitoring Triggers such as Smoke and Indoor Air Quality • We need these sensors for correlating it with the report of asthma attacks • Remedial measures can be suggested by experts based on indoor conditions 1 http://www.nhlbi.nih.gov/files/docs/guidelines/asthgdln.pdf
  24. 24. Acknowledgements Partial support for this research was provided by Wright State University’s VP of Research under a challenge grant.
  25. 25. Thank you  Thank you, and please visit us at http://knoesis.org For more information on kHealth, please visit us at http://knoesis.org/projects/khealth Link to the paper: http://www.knoesis.org/library/resource.php?id=2153

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