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The Philips wearable biosensor in transcatheter aortic valve implantation treatment workflow. Usability and feasibility of the wearable biosensor

Braem, C.I.R (2019) The Philips wearable biosensor in transcatheter aortic valve implantation treatment workflow. Usability and feasibility of the wearable biosensor.

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Abstract:Transcatheter aortic valve implantation (TAVI) is currently standard care for intermediate to high risk patients in patients with aortic valve stenosis, which is associated with aging and has a high burden on health care. Current screening tools however are insufficient as frailty is not included. A wearable sensor could allow for an in-depth analysis for screening TAVI patients. Besides, post-procedure monitoring and TAVI follow-up could benefit from extended monitoring. This thesis reviews the usability and feasibility of the Philips wearable biosensor for TAVI workflow. The TELE-TAVI study is an observational, prospective, investigator initiated pilot, started in June 2018 in the Amsterdam UMC, location AMC (Amsterdam, the Netherlands). The wearable biosensor (Philips Medical Systems, Andover, Massachusetts, USA) is a lightweight, wireless, wearable medical-grade biosensor, that can measure vital signs and detects posture for up to 4 days. Healthy volunteers and patients in work-up for TAVI were included. Healthy volunteers were enrolled and received one biosensor to test the system technically. TAVI patients received the wearable biosensor thrice; before the TAVI procedure (T0), directly post TAVI procedure on the cardiac care unit (CCU) (T1) and 6-weeks after the TAVI procedure (T2). The reliability of the biosensors vital signs was compared to a standard care monitor (Philips MP70 monitor, Philips Healthcare, Eindhoven, the Netherlands). Posture detection reliability was tested with walking exercises and compared to diaries and data collection reliability was assessed. TAVI patient experience with the system was reviewed with the post study system usability questionnaire (PSSUQ) and a custom made questionnaire. Activity was estimated with the integral of the modulus of the accelerometer output (IMA), and with thresholds activity classification and daily activity levels were computed. At February 22nd of 2019, a total of 6 healthy and 24 TAVI patients were enrolled in the TELE-TAVI study. Eighteen and eight TAVI patients completed measurements at T1 and T2, respectively and ten patients dropped out. The TAVI population is 76.6 (± 4.8) years old, 75% male. Vital signs limit of agreement was between -3.9 -7.0 and -8.1 and 7.8 for heart and respiratory rate respectively. Walking was detected by the biosensor if the gait speed was higher than 0.7 m/s. After one day, posture detection diverged substantially. Of the 96 recording hours, 56.2% is recorded with no gaps in the data. 45 wearability questionnaires were received and the PSSUQ showed an overall system satisfaction of 63.2% (± 30.7%). Sensor wear was comfortable, but the sensor fell off in 31% of the patients IMA correlates with gait speed (r2 = 0.8 and p<0.01). No, low, medium and high activity levels are 63.3%, 25.2%, 10.9% and 0.6%, respectively and daily activity levels are 40.8%, 28.7%, 12.2% and 0.6%. Patients tolerated wearing the biosensor well and activity classification can give insight in patient activity patterns. The feasibility of the wearable biosensors is as of yet insufficient, as the reliability of the biosensor is deficient compared to the predefined criteria. Data collection reliability is low and posture detection is unusable, as detection deteriorates within a day. The usability of the wearable biosensor shows great promise to improve TAVI work flow and encourages research in sensor technology in elderly.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:30 exact sciences in general, 44 medicine, 50 technical science in general
Programme:Technical Medicine MSc (60033)
Link to this item:http://purl.utwente.nl/essays/77157
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