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Background
This is a systematic review protocol to identify automated features, applied technologies, and algorithms in the electronic early warning/track and triage system (EW/TTS) developed to predict clinical deterioration (CD).
Methodology
This study will be conducted using PubMed, Scopus, and Web of Science databases to evaluate the features of EW/TTS in terms of their automated features, technologies, and algorithms. To this end, we will include any English articles reporting an EW/TTS without time limitation. Retrieved records will be independently screened by two authors and relevant data will be extracted from studies and abstracted for further analysis. The included articles will be evaluated independently using the JBI critical appraisal checklist by two researchers.
Discussion
This study is an effort to address the available automated features in the electronic version of the EW/TTS to shed light on the applied technologies, automated level of systems, and utilized algorithms in order to smooth the road toward the fully automated EW/TTS as one of the potential solutions of prevention CD and its adverse consequences.
While driving, stress is caused by situations in which the driver estimates their ability to manage the driving demands as insufficient or loses the capability to handle the situation. This leads to increased numbers of driver mistakes and traffic violations. Additional stressing factors are time pressure, road conditions, or dislike for driving. Therefore, stress affects driver and road safety. Stress is classified into two categories depending on its duration and the effects on the body and psyche: short-term eustress and constantly present distress, which causes degenerative effects. In this work, we focus on distress. Wearable sensors are handy tools for collecting biosignals like heart rate, activity, etc. Easy installation and non-intrusive nature make them convenient for calculating stress. This study focuses on the investigation of stress and its implications. Specifically, the research conducts an analysis of stress within a select group of individuals from both Spain and Germany. The primary objective is to examine the influence of recognized psychological factors, including personality traits such as neuroticism, extroversion, psychoticism, stress and road safety. The estimation of stress levels was accomplished through the collection of physiological parameters (R-R intervals) using a Polar H10 chest strap. We observed that personality traits, such as extroversion, exhibited similar trends during relaxation, with an average heart rate 6% higher in Spain and 3% higher in Germany. However, while driving, introverts, on average, experienced more stress, with rates 4% and 1% lower than extroverts in Spain and Germany, respectively.
This study investigates the application of Force Sensing Resistor (FSR) sensors and machine learning algorithms for non-invasive body position monitoring during sleep. Although reliable, traditional methods like Polysomnography (PSG) are invasive and unsuited for extended home-based monitoring. Our approach utilizes FSR sensors placed beneath the mattress to detect body positions effectively. We employed machine learning techniques, specifically Random Forest (RF), K-Nearest Neighbors (KNN), and XGBoost algorithms, to analyze the sensor data. The models were trained and tested using data from a controlled study with 15 subjects assuming various sleep positions. The performance of these models was evaluated based on accuracy and confusion matrices. The results indicate XGBoost as the most effective model for this application, followed by RF and KNN, offering promising avenues for home-based sleep monitoring systems.
In order to ensure sufficient recovery of the human body and brain, healthy sleep is indispensable. For this purpose, appropriate therapy should be initiated at an early stage in the case of sleep disorders. For some sleep disorders (e.g., insomnia), a sleep diary is essential for diagnosis and therapy monitoring. However, subjective measurement with a sleep diary has several disadvantages, requiring regular action from the user and leading to decreased comfort and potential data loss. To automate sleep monitoring and increase user comfort, one could consider replacing a sleep diary with an automatic measurement, such as a smartwatch, which would not disturb sleep. To obtain accurate results on the evaluation of the possibility of such a replacement, a field study was conducted with a total of 166 overnight recordings, followed by an analysis of the results. In this evaluation, objective sleep measurement with a Samsung Galaxy Watch 4 was compared to a subjective approach with a sleep diary, which is a standard method in sleep medicine. The focus was on comparing four relevant sleep characteristics: falling asleep time, waking up time, total sleep time (TST), and sleep efficiency (SE). After evaluating the results, it was concluded that a smartwatch could replace subjective measurement to determine falling asleep and waking up time, considering some level of inaccuracy. In the case of SE, substitution was also proved to be possible. However, some individual recordings showed a higher discrepancy in results between the two approaches. For its part, the evaluation of the TST measurement currently does not allow us to recommend substituting the measurement method for this sleep parameter. The appropriateness of replacing sleep diary measurement with a smartwatch depends on the acceptable levels of discrepancy. We propose four levels of similarity of results, defining ranges of absolute differences between objective and subjective measurements. By considering the values in the provided table and knowing the required accuracy, it is possible to determine the suitability of substitution in each individual case. The introduction of a “similarity level” parameter increases the adaptability and reusability of study findings in individual practical cases.
Cardiovascular diseases (CVD) are leading contributors to global mortality, necessitating advanced methods for vital sign monitoring. Heart Rate Variability (HRV) and Respiratory Rate, key indicators of cardiovascular health, are traditionally monitored via Electrocardiogram (ECG). However, ECG's obtrusiveness limits its practicality, prompting the exploration of Ballistocardiography (BCG) as a non-invasive alternative. BCG records the mechanical activity of the body with each heartbeat, offering a contactless method for HRV monitoring. Despite its benefits, BCG signals are susceptible to external interference and present a challenge in accurately detecting J-Peaks. This research uses advanced signal processing and deep learning techniques to overcome these limitations. Our approach integrates accelerometers for long-term BCG data collection during sleep, applying Discrete Wavelet Transforms (DWT) and Ensemble Empirical Mode Decomposition (EEMD) for feature extraction. The Bi-LSTM model, leveraging these features, enhances heartbeat detection, offering improved reliability over traditional methods. The study's findings indicate that the combined use of DWT, EEMD, and Bi-LSTM for J-Peak detection in BCG signals is effective, with potential applications in unobtrusive long-term cardiovascular monitoring. Our results suggest that this methodology could contribute to HRV monitoring, particularly in home settings, enhancing patient comfort and compliance.
Sleep is essential to physical and mental health. However, the traditional approach to sleep analysis—polysomnography (PSG)—is intrusive and expensive. Therefore, there is great interest in the development of non-contact, non-invasive, and non-intrusive sleep monitoring systems and technologies that can reliably and accurately measure cardiorespiratory parameters with minimal impact on the patient. This has led to the development of other relevant approaches, which are characterised, for example, by the fact that they allow greater freedom of movement and do not require direct contact with the body, i.e., they are non-contact. This systematic review discusses the relevant methods and technologies for non-contact monitoring of cardiorespiratory activity during sleep. Taking into account the current state of the art in non-intrusive technologies, we can identify the methods of non-intrusive monitoring of cardiac and respiratory activity, the technologies and types of sensors used, and the possible physiological parameters available for analysis. To do this, we conducted a literature review and summarised current research on the use of non-contact technologies for non-intrusive monitoring of cardiac and respiratory activity. The inclusion and exclusion criteria for the selection of publications were established prior to the start of the search. Publications were assessed using one main question and several specific questions. We obtained 3774 unique articles from four literature databases (Web of Science, IEEE Xplore, PubMed, and Scopus) and checked them for relevance, resulting in 54 articles that were analysed in a structured way using terminology. The result was 15 different types of sensors and devices (e.g., radar, temperature sensors, motion sensors, cameras) that can be installed in hospital wards and departments or in the environment. The ability to detect heart rate, respiratory rate, and sleep disorders such as apnoea was among the characteristics examined to investigate the overall effectiveness of the systems and technologies considered for cardiorespiratory monitoring. In addition, the advantages and disadvantages of the considered systems and technologies were identified by answering the identified research questions. The results obtained allow us to determine the current trends and the vector of development of medical technologies in sleep medicine for future researchers and research.
The scoring of sleep stages is one of the essential tasks in sleep analysis. Since a manual procedure requires considerable human and financial resources, and incorporates some subjectivity, an automated approach could result in several advantages. There have been many developments in this area, and in order to provide a comprehensive overview, it is essential to review relevant recent works and summarise the characteristics of the approaches, which is the main aim of this article. To achieve it, we examined articles published between 2018 and 2022 that dealt with the automated scoring of sleep stages. In the final selection for in-depth analysis, 125 articles were included after reviewing a total of 515 publications. The results revealed that automatic scoring demonstrates good quality (with Cohen's kappa up to over 0.80 and accuracy up to over 90%) in analysing EEG/EEG + EOG + EMG signals. At the same time, it should be noted that there has been no breakthrough in the quality of results using these signals in recent years. Systems involving other signals that could potentially be acquired more conveniently for the user (e.g. respiratory, cardiac or movement signals) remain more challenging in the implementation with a high level of reliability but have considerable innovation capability. In general, automatic sleep stage scoring has excellent potential to assist medical professionals while providing an objective assessment.
Unintrusive health monitoring systems is important when continuous monitoring of the patient vital signals is required. In this paper, signals obtained from accelerometers placed under a bed are processed with ballistocardiography algorithms and compared with synchronized electrocardiographic signals.
Accurate monitoring of a patient's heart rate is a key element in the medical observation and health monitoring. In particular, its importance extends to the identification of sleep-related disorders. Various methods have been established that involve sensor-based recording of physiological signals followed by automated examination and analysis. This study attempts to evaluate the efficacy of a non-invasive HR monitoring framework based on an accelerometer sensor specifically during sleep. To achieve this goal, the motion induced by thoracic movements during cardiac contractions is captured by a device installed under the mattress. Signal filtering techniques and heart rate estimation using the symlets6 wavelet are part of the implemented computational framework described in this article. Subsequent analysis indicates the potential applicability of this system in the prognostic domain, with an average error margin of approximately 3 beats per minute. The results obtained represent a promising advancement in non-invasive heart rate monitoring during sleep, with potential implications for improved diagnosis and management of cardiovascular and sleep-related disorders.