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A web application for follow-up of results from a mobile device test battery for Parkinson's disease patients
Örebro University, School of Science and Technology. Department of Economy and Society, Computer Engineering, Dalarna University, Borlänge, Sweden.ORCID iD: 0000-0002-2372-4226
Department of Economy and Society, Computer Engineering, Dalarna University, Borlänge, Sweden.
Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden.
Department of Economy and Society, Computer Engineering, Dalarna University, Borlänge, Sweden.
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2011 (English)In: Computer Methods and Programs in Biomedicine, ISSN 0169-2607, E-ISSN 1872-7565, Vol. 104, no 2, p. 219-226Article in journal (Refereed) Published
Abstract [en]

This paper describes a web-based system for enabling remote monitoring of patients with Parkinson's disease (PD) and supporting clinicians in treating their patients. The system consists of a patient node for subjective and objective data collection based on a handheld computer, a service node for data storage and processing, and a web application for data presentation. Using statistical and machine learning methods, time series of raw data are summarized into scores for conceptual symptom dimensions and an “overall test score” providing a comprehensive profile of patient's health during a test period of about one week. The handheld unit was used quarterly or biannually by 65 patients with advanced PD for up to four years at nine clinics in Sweden. The IBM Computer System Usability Questionnaire was administered to assess nurses’ satisfaction with the web application. Results showed that a majority of the nurses were quite satisfied with the usability although a sizeable minority were not. Our findings support that this system can become an efficient tool to easily access relevant symptom information from the home environment of PD patients.

Place, publisher, year, edition, pages
Amsterdam: Elsevier, 2011. Vol. 104, no 2, p. 219-226
Keywords [en]
Parkinson's disease, Test battery, Web application, Decision support, Remote patient monitoring, Telemedicine, Principal component analysis
National Category
Information Systems
Research subject
Computer and Systems Science
Identifiers
URN: urn:nbn:se:oru:diva-20469DOI: 10.1016/j.cmpb.2011.07.017ISI: 000296945100024PubMedID: 21872355Scopus ID: 2-s2.0-80054120422OAI: oai:DiVA.org:oru-20469DiVA, id: diva2:461314
Note

7th IFAC Symposium on Modelling and Control in Biomedical Systems

Available from: 2011-12-02 Created: 2011-12-02 Last updated: 2018-01-12Bibliographically approved
In thesis
1. Mobile systems for monitoring Parkinson's disease
Open this publication in new window or tab >>Mobile systems for monitoring Parkinson's disease
2011 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis presents the development and evaluation of IT-based methods and systems for supporting assessment of symptoms and enabling remote monitoring of Parkinson‟s disease (PD) patients. PD is a common neurological disorder associated with impaired body movements. Its clinical management regarding treatment outcomes and follow-up of patients is complex. In order to reveal the full extent of a patient‟s condition, there is a need for repeated and time-stamped assessments related to both patient‟s perception towards common symptoms and motor function. In this thesis, data from a mobile device test battery, collected during a three year clinical study, was used for the development and evaluation of methods. The data was gathered from a series of tests, consisting of selfassessments and motor tests (tapping and spiral drawing). These tests were carried out repeatedly in a telemedicine setting during week-long test periods. One objective was to develop a computer method that would process tracedspiral drawings and generate a score representing PD-related drawing impairments. The data processing part consisted of using the discrete wavelet transform and principal component analysis. When this computer method was evaluated against human clinical ratings, the results showed that it could perform quantitative assessments of drawing impairment in spirals comparatively well. As a part of this objective, a review of systems and methods for detecting the handwriting and drawing impairment using touch screens was performed. The review showed that measures concerning forces, accelerations, and radial displacements were the most important ones in detecting fine motor movement anomalies. Another objective of this thesis work was to design and evaluate an information system for delivering assessment support information to the treating clinical staff for monitoring PD symptoms in their patients. The system consisted of a patient node for data collection based on the mobile device test battery, a service node for data storage and processing, and a web application for data presentation. A system module was designed for compiling the test battery time series into summary scores on a test period level. The web application allowed adequate graphic feedback of the summary scores to the treating clinical staff. The evaluation results for this integrated system indicate that it can be used as a tool for frequent PD symptom assessments in home environments.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2011. p. 56
Series
Örebro Studies in Technology, ISSN 1650-8580 ; 22
Keywords
Home assessments, Parkinson‟s disease, mobile computing technology, e-diary, discrete wavelet transform, principal component analysis
National Category
Computer and Information Sciences
Research subject
Information technology
Identifiers
urn:nbn:se:oru:diva-20552 (URN)
Presentation
2011-12-15, Örebro universitet, Teknikhuset, rum T131, Fakultetsgatan1, Örebro, 13:15 (English)
Opponent
Supervisors
Available from: 2011-12-12 Created: 2011-12-12 Last updated: 2018-01-12Bibliographically approved
2. Mobile systems for monitoring Parkinson's disease
Open this publication in new window or tab >>Mobile systems for monitoring Parkinson's disease
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A challenge for the clinical management of Parkinson's disease (PD) is the large within- and between-patient variability in symptom profiles as well as the emergence of motor complications which represent a significant source of disability in patients. This thesis deals with the development and evaluation of methods and systems for supporting the management of PD by using repeated measures, consisting of subjective assessments of symptoms and objective assessments of motor function through fine motor tests (spirography and tapping), collected by means of a telemetry touch screen device.

One aim of the thesis was to develop methods for objective quantification and analysis of the severity of motor impairments being represented in spiral drawings and tapping results. This was accomplished by first quantifying the digitized movement data with time series analysis and then using them in data-driven modelling for automating the process of assessment of symptom severity. The objective measures were then analysed with respect to subjective assessments of motor conditions. Another aim was to develop a method for providing comparable information content as clinical rating scales by combining subjective and objective measures into composite scores, using time series analysis and data driven methods. The scores represent six symptom dimensions and an overall test score for reflecting the global health condition of the patient. In addition, the thesis presents the development of a web-based system for providing a visual representation of symptoms over time allowing clinicians to remotely monitor the symptom profiles of their patients. The quality of the methods was assessed by reporting different metrics of validity, reliability and sensitivity to treatment interventions and natural PD progression over time.

Results from two studies demonstrated that the methods developed for the fine motor tests had good metrics indicating that they are appropriate to quantitatively and objectively assess the severity of motor impairments of PD patients. The fine motor tests captured different symptoms; spiral drawing impairment and tapping accuracy related to dyskinesias (involuntary movements) whereas tapping speed related to bradykinesia (slowness of movements). A longitudinal data analysis indicated that the six symptom dimensions and the overall test score contained important elements of information of the clinical scales and can be used to measure effects of PD treatment interventions and disease progression. A usability evaluation of the web-based system showed that the information presented in the system was comparable to qualitative clinical observations and the system was recognized as a tool that will assist in the management of patients.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2014. p. 87
Series
Örebro Studies in Technology, ISSN 1650-8580 ; 57
Keywords
automatic assessments, data visualization, data-driven modelling, home assessments, information technology, mobile computing, objective measures, Parkinson’s disease, quantitative assessments, remote monitoring, spirography, symptom severity, tapping tests, telemedicine, telemetry, time series analysis, web technology
National Category
Computer and Information Sciences Computer Sciences
Research subject
Information technology; Computer Science
Identifiers
urn:nbn:se:oru:diva-33090 (URN)978-91-7668-988-2 (ISBN)
Public defence
2014-02-14, Clas Ohlsonsalen, Tenoren, Skomakargatan 1, Borlänge, 13:00 (English)
Opponent
Supervisors
Available from: 2014-01-22 Created: 2014-01-14 Last updated: 2018-01-11Bibliographically approved

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