Neurostimulation therapy optimization based on a rated session log

• US 20040199216A1
• Filed: 04/02/2003
• Published: 10/07/2004
• Est. Priority Date: 04/02/2003
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Vinup, Daniel K., Goetz, Steven M., Lee, Michael T.
• Granted Patent: US 7,894,908 B2
• Time in Patent Office: Days
• US Class Current: 607/48
• CPC Class Codes: A61N 1/36071 Pain

Abstract

An implantable medical device delivers neurostimulation therapy to a patient according to a parameter set. A parameter set may consist of a number of programs that are delivered substantially simultaneously. When programming the implantable medical device for the patient, a clinician programmer may maintain a session log for the patient that includes a listing of programs delivered to the patient and rating information provided by a clinician and the patient for programs of the list. The listing may be ordered according to the rating information in order to facilitate the selection of programs for a parameter set. A program library that may include particularly effective programs organized according to a directory structure may be stored in a memory. One or both of the implantable medical device and a patient programmer may store usage information that provides an objective assessment of therapy use by the patient, and allows a clinician to later improve the therapy based on the usage information.

Claims

1. A method comprising:

controlling an implantable medical device to deliver neurostimulation therapy to a patient according to a neurostimulation therapy program;

recording rating information relating to effectiveness of delivery of neurostimulation therapy according to the program in treating symptoms of the patient and side effects experienced by the patient due to the delivery of neurostimulation therapy according to the program in response to the delivery; and

associating the program and the rating information in a memory.

2. The method of claim 1, wherein recording rating information comprises receiving the rating information from a user.

3. The method of claim 2, wherein the user is a clinician.

4. The method of claim 1, wherein the information relating to effectiveness of delivery of neurostimulation therapy includes information relating to at least one of coverage area and degree of symptom relief provided by delivery of neurostimulation according to the program.

5. The method of claim 1, wherein the rating information includes information relating to a plurality of metrics for rating the program.

6. The method of claim 5, wherein the rating information includes numerical values for at least some of the metrics.

7. The method of claim 6, wherein recording the rating information comprises:

displaying a user input field for one of the metrics to the user via a display; and

receiving a numerical value selected by a user using the user input field.

8. The method of claim 1, wherein the rating information includes information relating to performance of the implantable medical device while delivering neurostimulation therapy according to the program.

9. The method of claim 1, wherein associating the program and the rating information comprises storing information identifying the program and the associated rating information as part of a session log that includes information identifying neurostimulation therapy programs tested on the patient during a programming session and rating information associated with the programs tested on the patient.

10. The method of claim 9, further comprising:

controlling the implantable medical device to deliver neurostimulation therapy according to each of a plurality of neurostimulation programs; and

storing information identifying one of the programs as part of the session log.

11. The method of claim 9, wherein storing information identifying the program comprises storing information identifying neurostimulation therapy parameters for the program.

12. The method of claim 11, wherein the parameters include at least one of a pulse amplitude, a pulse width, a pulse rate, selected electrodes, and polarities of selected electrodes.

13. The method of claim 1, further comprising:

storing an indication that the program is an undesired program; and

providing a visual indication that the program is undesired.

14. A device comprising:

a memory to store information; and

a processor to control an implantable medical device to deliver neurostimulation therapy to a patient according to a neurostimulation therapy program, record rating information relating to effectiveness of delivery of neurostimulation therapy according to the program in treating symptoms of the patient and side effects experienced by the patient due to the delivery of neurostimulation therapy according to the program in response to the delivery, and associate the program and the rating information in the memory.

15. The device of claim 14, wherein the processor receives the rating information from a user.

16. The device of claim 15, wherein the user is a clinician.

17. The device of claim 14, wherein the information relating to effectiveness of delivery of neurostimulation therapy includes information relating to at least one of coverage area and degree of symptom relief provided by delivery of neurostimulation according to the program.

18. The device of claim 14, wherein the rating information includes information relating to a plurality of metrics for rating the program.

19. The device of claim 18, wherein the rating information includes numerical values for at least some of the metrics.

20. The device of claim 19, further comprising a display, wherein the processor receives rating information by displaying a user input field for one of the metrics via the display, and receiving a numerical value selected by a user using the user input field.

21. The device of claim 14, wherein the rating information includes information relating to performance of the implantable medical device while delivering neurostimulation therapy according to the program.

22. The device of claim 14, wherein the processor stores information identifying the program and the associated rating information as part of a session log that includes information identifying neurostimulation therapy programs tested on the patient during a programming session and rating information associated with the programs tested on the patient.

23. The device of claim 22, wherein the processor controls the implantable medical device to deliver neurostimulation therapy according to a plurality of neurostimulation programs, and stores information identifying one of the transmitted programs as part of the session log.

24. The device of claim 22, wherein the processor stores information identifying neurostimulation therapy parameters for the program.

25. The device of claim 24, wherein the parameters include at least one of a pulse amplitude, a pulse width, a pulse rate, selected electrodes, and polarities of selected electrodes.

26. The device of claim 14, further comprising a display, wherein the processor stores an indication that the program is an undesired program, and provides a visual indication that the program is undesired via the display.

27. A computer-readable medium, comprising instructions that cause a processor to:

control an implantable medical device to deliver neurostimulation therapy to a patient according to a neurostimulation therapy program;

record rating information relating to effectiveness of delivery of neurostimulation therapy according to the program in treating symptoms of the patient and side effects experienced by the patient due to the delivery of neurostimulation therapy according to the program in response to the delivery; and

associate the program and the rating information in a memory.

28. The computer-readable medium of claim 27, wherein the instructions cause a processor to receive the rating information from a user.

29. The computer-readable medium of claim 28, wherein the user is a clinician.

30. The computer-readable medium of claim 27, wherein the information relating to effectiveness of delivery of neurostimulation therapy includes information relating to at least one of coverage area and degree of symptom relief provided by delivery of neurostimulation according to the program.

31. The computer-readable medium of claim 27, wherein the rating information includes information relating to a plurality of metrics for rating the program.

32. The computer-readable medium of claim 31, wherein the rating information includes numerical values for at least some of the metrics.

33. The computer-readable medium of claim 32, wherein the instructions cause a processor to:

display a user input field for one of the metrics via a display; and

receive a numerical value selected by a user using the user input field.

34. The computer-readable medium of claim 27, wherein the rating information includes information relating to performance of the implantable medical device while delivering neurostimulation therapy according to the program.

35. The computer-readable medium of claim 27, wherein the instructions cause a processor to store information identifying the program and the associated rating information as part of a session log that includes information identifying neurostimulation therapy programs tested on the patient during a programming session and rating information associated with the programs tested on the patient.

36. The computer-readable medium of claim 35, wherein the instructions cause a processor to:

control the implantable medical device to deliver neurostimulation therapy according to each of a plurality of neurostimulation programs; and

store information identifying one of the programs as part of the session log from the user.

37. The computer-readable medium of claim 35, wherein the instructions that cause a processor to store information identifying the program comprise instructions that cause a processor to store information identifying neurostimulation therapy parameters for the program.

38. The computer-readable medium of claim 37, wherein the parameters include at least one of a pulse amplitude, a pulse width, a pulse rate, selected electrodes, and polarities of selected electrodes.

39. The computer-readable medium of claim 27, further comprising instructions that cause a processor to:

store an indication that the program is an undesired program; and

provide a visual indication that the program is undesired.

40. A method comprising:

storing information identifying neurostimulation therapy programs tested on a patient during a programming session and rating information associated with each of the programs that relates to effectiveness of delivery of neurostimulation therapy according to the programs in treating symptoms of the patient and side effects experienced by the patient due to the delivery of neurostimulation therapy according to the programs in a memory as part of a session log for the programming session; and

displaying a list of the identified programs and associated rating information via a display.

41. The method of claim 40, further comprising receiving the rating information from a clinician.

42. The method of claim 40, wherein the rating information includes information relating to performance of the implantable medical device while delivering neurostimulation therapy according to the programs.

43. The method of claim 40, wherein displaying a list comprises displaying a list of the programs ordered according to the rating information.

44. The method of claim 43, wherein the rating information includes information relating to a plurality of metrics for rating the programs.

45. The method of claim 44, wherein displaying a list comprises displaying a list ordered according to selection of one or more of the metrics by a user.

46. The method of claim 44, wherein displaying a list comprises:

calculating an overall rating for each of the programs of the session log based on at least some of the metrics; and

displaying a list of the programs ordered according to the overall ratings.

47. The method of claim 46, wherein calculating an overall rating comprises applying weighting factors to at least some of the metrics.

48. The method of claim 44, wherein the rating information includes numerical values for at least some of the metrics.

49. The method of claim 40, further comprising:

receiving a program selection made by a user from the list; and

including the selected program within a parameter set.

50. The method of claim 40, further comprising:

receiving a program selection made by a user from the list; and

storing the selected program as part of a program library within a memory according to a set of hierarchical categories that relate to characteristics of neurostimulation programs.

51. The method of claim 50, wherein storing the selected program as part of a program library comprises discarding at least some of the information identifying the selected program and the rating information associated with the selected program.

52. The method of claim 51, wherein discarding at least some of the information identifying the selected program comprises discarding amplitude information.

53. The method of claim 40, further comprising prompting a user to select at least one of two compared programs for removal from the list.

54. The method of claim 40, further comprising prompting a user to select at least one of two compared programs for inclusion in a parameter set.

55. The method of claim 40, further comprising automatically selecting programs identified in the session log for inclusion in a parameter set based on the rating information.

56. A device comprising:

a display to display information to a user;

a memory to store a session log for a patient that includes information identifying neurostimulation therapy programs tested on the patient during a programming session and rating information associated with each of the programs that relates to effectiveness of delivery of neurostimulation therapy according to the programs in treating symptoms of the patient and side effects experienced by the patient due to the delivery of neurostimulation therapy according to the programs; and

a processor to display a list of the identified programs and associated rating information via the display.

57. The device of claim 56, wherein the processor receives the rating information from a clinician.

58. The device of claim 56, wherein the rating information includes information relating to performance of the implantable medical device while delivering neurostimulation therapy according to the program.

59. The device of claim 56, wherein the processor displays the list of the programs ordered according to the rating information.

60. The device of claim 59, wherein the rating information includes information relating to a plurality of metrics for rating the programs, and wherein the processor displays the list ordered according to a metric selected by a user.

61. The device of claim 59, wherein the processor calculates an overall rating for each of the programs based on at least some of the metrics, and displays the list ordered according to the overall ratings.

62. The device of claim 56, wherein the processor receives a program selection made by a user from the list, and includes the selected program within a parameter set.

63. The device of claim 56, wherein the processor selects programs identified in the session log for inclusion in a parameter set based on the rating information.

64. A computer-readable medium comprising instructions that cause a processor to:

store a session log for a patient that includes information identifying neurostimulation therapy programs tested on the patient during a programming session and rating information associated with each of the neurostimulation therapy programs that relates to effectiveness of delivery of neurostimulation therapy according to the programs in treating symptoms of the patient and side effects experienced by the patient due to the delivery of neurostimulation therapy according to the programs in a memory; and

display a list of the identified programs and associated rating information via a display.

65. The computer-readable medium of claim 64, further comprising instructions that cause a processor to receive the rating information from a clinician.

66. The computer-readable medium of claim 64, wherein the instructions cause a processor to display the list of the programs ordered according to the rating information.

67. The computer-readable medium of claim 66, wherein the rating information includes information relating to a plurality of metrics for rating the program, and wherein the instructions cause a processor to display the list ordered according to a metric selected by a user.

68. The computer-readable medium of claim 66, wherein the instructions cause a processor to calculate an overall rating for each of the programs of the session log based on at least some of the metrics, and display the list ordered according to the overall ratings.

69. The computer-readable medium of claim 64, further comprising instructions that cause a processor to:

receive a program selection made by a user from the list; and

include the selected program within a parameter set.

70. The computer-readable medium of claim 64, further comprising instructions that cause a processor to select programs identified in the session log for inclusion in a parameter set based on the rating information.