Abstract
Life-long chronic inflammatory diseases of the airways, such as asthma and Chronic Obstructive Pulmonary Disease, are very common worldwide, affecting people of all ages, race and gender. One of the most important aspects for the effective management of asthma is medication adherence which is defined as the extent to which patients follow their prescribed action plan and use their inhaler correctly. Wireless telemonitoring of the medication adherence can facilitate early diagnosis and management of these diseases through the use of an accurate and energy efficient mHealth system. Therefore, low complexity audio compression schemes need to be integrated with high accuracy classification approaches for the assessment of adherence of patients that use of pressurized Metered Dose Inhalers (pMDIs). To this end, we propose a novel solution that enables the energy efficient monitoring of metered dose inhaler usage, by exploiting the specific characteristics of the reconstructed audio features at the receiver. Simulation studies, carried out with a large dataset of indoor & outdoor measurements have led to high levels of accuracy (98 %) utilizing only 2 % of the recorded audio samples at the receiver, demonstrating the potential of this method for the development of novel energy efficient inhalers and medical devices in the area of respiratory medicine.
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Notes
Most of the energy consumption of a biosensor comes from the radio frequency power amplifier [22]
Boosting is a classification ensemble meta algorithm that was built to answer the following question: can a set of weak learners create a single strong learner? A weak learner is defined to be a classifier which can classify subjects slightly better than random guessing. A strong learner is a classifier that is correlated with the true classification
We have assumed packets with 14 bytes header and 80 bytes payload (10 audio samples/packet), and a data rate equal to 256 kbps [28].
References
World Health Organization. Asthma. Fact sheet No 307. Available online:, http://www.who.int/mediacentre/factsheets/fs307/en/, [Online; accessed on 30-Sept-2015]
European Lung White Book. Adult asthma. Available online:, http://www.erswhitebook.org/chapters/adult-asthma/, [Online; accessed on 30-Sept-2015]
European Lung White Book. Childhood asthma. Available online:, http://www.erswhitebook.org/chapters/childhood-asthma/, [Online; accessed on 30-Sept-2015]
Innes Asher, M., Montefort, S., Bjrkstn, B., Lai, C. K. W., Strachan, D. P., Weiland, S. K., and Williams, H., Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: {ISAAC} phases one and three repeat multicountry cross-sectional surveys. The Lancet 368(9537):733–743, 2006.
Akinbami, O. J., and et al., Trends in asthma prevalence, health care use, and mortality in the united states, 2001-2010 (2012)
Masoli, M., Fabian, D., Holt, S., Beasley, R., The global burden of asthma: executive summary of the gina dissemination committee report. Allergy 59(5):469–478, 2004.
National Asthma Education and Prevention Program: How to use a metered-dose inhaler. http://www.nhlbi.nih.gov/health/public/lung/asthma/asthma_tipsheets.pdf. [Online; accessed on 26-Feb-2016]
Murphy, A. C., Proeschal, A., Brightling, C. E., Wardlaw, A. J., Pavord, I., Bradding, P., and Green, R. H., The relationship between clinical outcomes and medication adherence in difficult-to-control asthma, Thorax, pp. thoraxjnl–2011 (2012)
Howard, S., Lang, A., Patel, M., Sharples, S., and Shaw, D., Electronic monitoring of adherence to inhaled medication in asthma. Curr. Respir. Med. Rev. 10(1):50–63, 2014.
Press, V. G., Arora, V. M., Shah, L. M., Lewis, S. L., Ivy, K., Chareneau, J., and et al., Misuse of respiratory inhalers in hospitalized patients with asthma and COPD. J. Gen. Intern. Med. 26(6):635–42, 2011.
Painter, T., and Spanias, A., Perceptual coding of digital audio. Proc. IEEE 88(4):451–515, 2000.
Griffin, A., Hirvonen, T., Tzagkarakis, C., Mouchtaris, A., and Tsakalides, P., Single-channel and multi-channel sinusoidal audio coding using compressed sensing. IEEE Trans. Audio Speech Lang. Process. 19(5): 1382–1395, 2011.
Barnes, C. B., and Ulrik, C. S., Asthma and adherence to inhaled corticosteroids: Current status and future perspectives. Respir. Care 60(3):455–468, 2015.
Sumino, K., and Cabana, M. D., Medication adherence in asthma patients. Curr. Opin. Pulm. Med. 19: 49–53, 2013.
Kikidis, D., and et al., The digital asthma patient: The history and future of inhaler based health monitoring devices. J. Aerosol Med. Pulm. Drug Deliv. 29(3):219–232, 2016.
Ingerski, L. M., Hente, E. A., Modi, A. C., and Hommel, K. A., Electronic measurement of medication adherence in pediatric chronic illness: a review of measures. J. Pediatr. 159:528–534 , 2011.
Chan, A. H., Reddel, H. K., Apter, A., Eakin, M., Riekert, K., and Foster, J. M., Adherence monitoring and e-health: How clinicians and researchers can use technology to promote inhaler adherence for asthma. J. Allergy Clin. Immunol. Pract. 1:446–454 , 2013.
Chan, A. H., Harrison, J., Black, P. N., Mitchell, E. A., and Foster, J. M., Using electronic monitoring devices to measure inhaler adherence: A practical guide for clinicians. J. Allergy Clin. Immunol. Pract. 3(3):335–349, 2015. e5.
Boulet, L. P., Vervloet, D., Magar, Y., and Foster, J. M., Adherence: The goal to control asthma. Clin. Chest. Med. 33:405–417.
Taylor, T. E., and et al., An acoustic method to automatically detect pressurized metered dose inhaler actuations. Engineering in Medicine and Biology Society (EMBC), 2014 36th Annual International Conference of the IEEE. IEEE (2014)
Kikidis, D., Votis, K., and Tzovaras, D., Utilizing convolution neural networks for the acoustic detection of inhaler actuations. IEEE E-Health and Bioengineering Conference (EHB) (2015)
Khan, J. Y., Yuce, M. R., Bulger, G., and Harding, B., Wireless body area network (wban) design techniques and performance evaluation. J. Med. Syst. 36(3):1441–1457, 2012.
Friedman, J., Hastie, T., Hfling, H., and Tibshirani, R., Pathwise coordinate optimization, Tech. Rep., Ann. Appl. Stat. (2007)
Donoho, D. L., Compressed sensing. IEEE Trans. Inf. Theory 52(4):1289–1306, 2006.
Rubinstein, R., Bruckstein, A. M., and Elad, M., Dictionaries for sparse representation modeling. Proc. IEEE 98(6):1045–1057, 2010.
Gilbert, A., and Indyk, P., Sparse recovery using sparse matrices. Proc. IEEE 98(6):937–947, 2010.
LAN/MAN Standards Committee of the IEEE Computer Society: IEEE STandard for Local and metropolitan area networks – Part 15.6: Wireless Body Area Networks, IEEE Std 802.15.6–2012 (2012)
Movassaghi, S., and et al., Wireless body area networks: a survey. IEEE Commun. Surveys Tuts. PP(99): 1–29, 2014.
Angelosante, D., Bazerque, J. A., and Giannakis, G. B., Online adaptive estimation of sparse signals: Where rls meets the ℓ 1 -norm. IEEE Trans. Signal Process 58(7):3436–3447 , 2010.
Laska, J. N.., Boufounos, P. T.., Davenport, M. A.., and Baraniuk, R. G.., Democracy in action:Quantization, saturation, and compressive sensing. Appl. Comput. Harmon. Anal. 31(3):429–443, 2011. ISSN 1063-5203. http://dx.doi.org/10.1016/j.acha.2011.02.002.
Hastie, T., Tibshirani, R., and Friedman, J., The elements of statistical learning: data mining, inference, and prediction, Springer Series in Statistics, 2nd ed (2009)
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This work has been supported by the H2020-PHC-2014-2015 Project MyAirCoach (Grant Agreement No. 643607).
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Lalos, A.S., Lakoumentas, J., Dimas, A. et al. Energy Efficient Monitoring of Metered Dose Inhaler Usage. J Med Syst 40, 285 (2016). https://doi.org/10.1007/s10916-016-0642-y
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DOI: https://doi.org/10.1007/s10916-016-0642-y