System and method for providing diagnosis and monitoring of respiratory insufficiency for use in automated patient care

• US 20020169367A1
• Filed: 05/20/2002
• Published: 11/14/2002
• Est. Priority Date: 11/16/1999
• Status: Active Grant

• Current Assignee: Gust H. Bardy
• Original Assignee: Gust H. Bardy
• Inventors: Bardy, Gust H.
• Granted Patent: US 7,207,945 B2
• Time in Patent Office: Days
• US Class Current: 600/300
• CPC Class Codes: A61B 2505/03 Intensive care
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/0535 Impedance plethysmography for measuring blood flow A61B5/0295
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/1112 Global tracking of patients, e.g. by using GPS
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/145 Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissuemeasuring of blood pressure or blood flow A61B5/02; non-radiation detecting or locating of foreign bodies in blood A61B5/06
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: A61B 5/14539 for measuring pH
• CPC Class Codes: A61B 5/14546 for measuring analytes not otherwise provided for, e.g. ions, cytochromes
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61N 1/3624 occurring in the atrium, i.e. atrial tachycardia
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/20 : for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/70 : for mining of medical data, e.g. analysing previous cases of other patients
• CPC Class Codes: G16H 70/60 : relating to pathologies
• CPC Class Codes: Y10S 128/92 : Computer assisted medical diagnostics
• CPC Class Codes: Y10S 128/923 : by comparison of patient data to other data

Abstract

An automated system and method for diagnosing and monitoring respiratory insufficiency and outcomes thereof is described. A plurality of monitoring sets is retrieved from a database. Each of the monitoring sets include recorded measures relating to patient information recorded on a substantially continuous basis. A patient status change is determined by comparing at least one recorded measure from each of the monitoring sets to at least one other recorded measure. Both recorded measures relate to the same type of patient information. Each patient status change is tested against an indicator threshold corresponding to the same type of patient information as the recorded measures which were compared. The indicator threshold corresponds to a quantifiable physiological measure of a pathophysiology indicative of respiratory insufficiency.

Claims

1. A system for providing diagnosis and monitoring of respiratory insufficiency for use in automated patient care, comprising:

a comparison module comparing at least one recorded physiological measure to at least one other recorded physiological measure on a substantially regular basis to quantify a change in patient pathophysiological status for equivalent patient information; and

an analysis module evaluating an absence, an onset, a progression, a regression, and a status quo of respiratory insufficiency dependent upon the change in patient pathophysiological status.

2. A system according to claim 1, further comprising:

a diagnostic module comparing the change in patient pathophysiological status to an indicator threshold corresponding to a quantifiable physiological measure indicative of respiratory insufficiency.

3. A system according to claim 1, further comprising:

a management module managing the respiratory insufficiency through administration of at least one of antibiotic and antiviral therapies, bronchodilator therapies, oxygen therapies, antiinflammation therapies, electrical therapies, and mechanical therapies.

4. A system according to claim 1, further comprising:

a database module retrieving the at least one recorded physiological measure and the at least one other recorded physiological measure from monitoring sets stored in a database.

5. A system according to claim 4, further comprising:

a server system collecting the at least one recorded physiological measure and the at least one other recorded physiological measure into each monitoring set recorded on a substantially continuous basis or derived therefrom.

6. A system according to claim 5, further comprising:

at least one of an implantable medical device and an external medical device recording the at least one recorded physiological measure and the at least one other recorded physiological measure.

7. A system according to claim 1, further comprising:

the analysis module evaluating an absence, an onset, a progression, a regression, and a status quo of diseases other than respiratory insufficiency dependent upon the change in patient pathophysiological status.

8. A system according to claim 1, further comprising:

a diagnostic module comparing at least one recorded quality of life measure to at least one other recorded quality of life measure on a substantially regular basis to qualify a change in patient pathophysiological status.

9. A system according to claim 1, further comprising:

a stored stickiness indicator defined for at least one physiological measure corresponding to a temporal boundary on one of patient diagnosis and treatment;

a diagnostic module timing each change in patient pathophysiological status for the equivalent patient information and determining one of a revised patient diagnosis and treatment responsive to each change in patient pathophysiological status with a timing exceeding the stickiness indicator.

10. A system according to claim 1, further comprising:

a diagnostic module comparing the change in patient pathophysiological status to a reference baseline comprising recorded physiological measures recorded during an initial time period.

11. A system according to claim 1, further comprising:

a diagnostic module comparing the change in patient pathophysiological status to equivalent patient information from at least one of an individual patient, a peer group, and a overall patient population.

12. A system according to claim 1, further comprising:

a diagnostic module grading the change in patient pathophysiological status on a fixed scale based on a degree of deviation from a pre-defined indicator threshold and performing a summation over a plurality of the graded changes to determine an overall change in patient pathophysiological status.

13. A system according to claim 1, further comprising:

a diagnostic module determining probabilistic weightings of the change in patient pathophysiological status on a statistical deviation and trends via linear fits from a pre-defined indicator threshold and performing a summation over a plurality of the probabilistic weightings to determine an overall change in patient pathophysiological status.

15. A method according to claim 14, further comprising:

comparing the change in patient pathophysiological status to an indicator threshold corresponding to a quantifiable physiological measure indicative of respiratory insufficiency.

16. A method according to claim 14, further comprising:

managing the respiratory insufficiency through administration of at least one of antibiotic and antiviral therapies, bronchodilator therapies, oxygen therapies, antiinflammation therapies, electrical therapies, and mechanical therapies.

17. A method according to claim 14, further comprising:

retrieving the at least one recorded physiological measure and the at least one other recorded physiological measure from monitoring sets stored in a database.

18. A method according to claim 17, further comprising:

collecting the at least one recorded physiological measure and the at least one other recorded physiological measure into each monitoring set recorded on a substantially continuous basis or derived therefrom.

19. A method according to claim 18, further comprising:

recording the at least one recorded physiological measure and the at least one other recorded physiological measure with at least one of an implantable medical device and an external medical device.

20. A method according to claim 14, further comprising:

evaluating an absence, an onset, a progression, a regression, and a status quo of diseases other than respiratory insufficiency dependent upon the change in patient pathophysiological status.

21. A method according to claim 14, further comprising:

comparing at least one recorded quality of life measure to at least one other recorded quality of life measure on a substantially regular basis to qualify a change in patient pathophysiological status.

22. A method according to claim 14, further comprising:

defining a stickiness indicator for at least one physiological measure corresponding to a temporal boundary on one of patient diagnosis and treatment;

timing each change in patient pathophysiological status for the equivalent patient information; and

determining one of a revised patient diagnosis and treatment responsive to each change in patient pathophysiological status with a timing exceeding the stickiness indicator.

23. A method according to claim 14, further comprising:

comparing the change in patient pathophysiological status to a reference baseline comprising recorded physiological measures recorded during an initial time period.

24. A method according to claim 14, further comprising:

comparing the change in patient pathophysiological status to equivalent patient information from at least one of an individual patient, a peer group, and a overall patient population.

25. A method according to claim 14, further comprising:

grading the change in patient pathophysiological status on a fixed scale based on a degree of deviation from a pre-defined indicator threshold; and

performing a summation over a plurality of the graded changes to determine an overall change in patient pathophysiological status.

26. A method according to claim 14, further comprising:

determining probabilistic weightings of the change in patient pathophysiological status on a statistical deviation and trends via linear fits from a pre-defined indicator threshold; and

performing a summation over a plurality of the probabilistic weightings to determine an overall change in patient pathophysiological status.

27. A computer-readable storage medium for a device holding code for performing the method according to claim 14.

29. A system according to claim 28, further comprising:

the analyzer analyzing the physiological measures in the physiological measures set relative to the other physiological measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of diseases other than respiratory insufficiency.

30. A system according to claim 28, further comprising:

the server system receiving a set of one or more quality of life measures relating to patient information recorded on a substantially continuous basis or derived therefrom;

the database module storing the quality of life measures set into the patient care record for the individual patient into the database; and

the analyzer analyzing the quality of life measures in the physiological measures set relative to the other quality of life measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of respiratory insufficiency.

31. A system according to claim 28, further comprising:

the server system receiving a set of one or more baseline physiological measures relating to patient information recorded during an initial time period or derived therefrom;

the database module storing the baseline physiological measures set into the patient care record for the individual patient into the database; and

the analyzer analyzing the physiological measures in the physiological measures set relative to the baseline physiological measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of respiratory insufficiency.

32. A system according to claim 28, further comprising:

a comparison module retrieving the other physiological measures from measures sets for at least one of an individual patient, a peer group, and a overall patient population.

14. A method for providing diagnosis and monitoring of respiratory insufficiency for use in automated patient care, comprising:

comparing at least one recorded physiological measure to at least one other recorded physiological measure on a substantially regular basis to quantify a change in patient pathophysiological status for equivalent patient information; and

evaluating an absence, an onset, a progression, a regression, and a status quo of respiratory insufficiency dependent upon the change in patient pathophysiological status.

28. A system for analyzing a patient status for respiratory insufficiency for use in automated patient care, comprising:

a server system receiving a set of one or more physiological measures relating to patient information recorded on a substantially continuous basis or derived therefrom;

a database module storing the physiological measures set into a patient care record for an individual patient into a database; and

an analyzer analyzing one or more of the physiological measures in the physiological measures set relative to one or more other physiological measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of respiratory insufficiency.

33. A method for analyzing a patient status for respiratory insufficiency for use in automated patient care, comprising:

receiving a set of one or more physiological measures relating to patient information recorded on a substantially continuous basis or derived therefrom;

storing the physiological measures set into a patient care record for an individual patient into a database; and

analyzing one or more of the physiological measures in the physiological measures set relative to one or more other physiological measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of respiratory insufficiency.

34. A method according to claim 33, further comprising:

analyzing the physiological measures in the physiological measures set relative to the other physiological measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of diseases other than respiratory insufficiency.

35. A method according to claim 33, further comprising:

receiving a set of one or more quality of life measures relating to patient information recorded on a substantially continuous basis or derived therefrom;

storing the quality of life measures set into the patient care record for the individual patient into the database; and

analyzing the quality of life measures in the physiological measures set relative to the other quality of life measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of respiratory insufficiency.

36. A method according to claim 33, further comprising:

receiving a set of one or more baseline physiological measures relating to patient information recorded during an initial time period or derived therefrom;

storing the baseline physiological measures set into the patient care record for the individual patient into the database; and

analyzing the physiological measures in the physiological measures set relative to the baseline physiological measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of respiratory insufficiency.

37. A method according to claim 33, further comprising:

retrieving the other physiological measures from measures sets for at least one of an individual patient, a peer group, and a overall patient population.

38. A computer-readable storage medium for a device holding code for performing the method according to claim 33.