Expert system for patient medical information analysis

• US 20060010090A1
• Filed: 07/12/2004
• Published: 01/12/2006
• Est. Priority Date: 07/12/2004
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Kadhiresan, Veerichetty, Carlson, Gerrard M., Brockway, Marina, Kovtun, Vladimir
• Granted Patent: US 7,433,853 B2
• Time in Patent Office: Days
• US Class Current: 706/46
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/076 Permanent implantations telemetry using implanted circuitry A61B5/0031; implanted stimulators for therapy A61N1/3605, A61N1/362, A61N1/372
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/7232 involving compression of the physiological signal, e.g. to extend the signal recording period
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61B 5/7267 involving training the classification device
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: G06N 5/04 Inference or reasoning models
• CPC Class Codes: G06N 7/01 Probabilistic graphical models, e.g. probabilistic networks
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

A plurality of chronic sensors are used to facilitate diagnosis and medical decision making for an individual patient. An expert system evaluates the sensor data, combines the sensor data with stored probability data and provides an output signal for notification or medical intervention.

Claims

1. A system comprising:

a plurality of input devices each of which is adapted to provide an input signal based on a patient state, the plurality of input devices including at least one implantable sensor and at least one external sensor;

a knowledge base corresponding to the plurality of input devices;

an inference engine coupled to the plurality of input devices and having access to the knowledge base, the inference engine configured to generate an inference based on a combination of at least one input signal and the knowledge base and configured to provide a feedback signal to the knowledge base based on the inference; and

an output device configured to generate an output based on the inference.

2. The system of claim 1, wherein at least one input device includes a heart failure sensor.

3. The system of claim 1, further including a storage device having at least one inference rule stored thereon, the inference rule configured to generate the inference.

4. The system of claim 1, wherein the input signal includes temporal information.

5. The system of claim 1, wherein at least one input device is configured to receive data from a user.

6. The system of claim 1, wherein at least one input device is coupled to the inference engine by a wireless telemetry link.

7. The system of claim 1, wherein at least one input device includes a blood pressure sensor, a mass sensor, a fluid sensor, an accelerometer, a temperature sensor, an impedance measuring device or a data entry terminal configured for operation by the patient.

8. The system of claim 1, wherein the knowledge base includes an expression of a probability corresponding to an input signal or an expression of a relationship between at least two input signals.

9. The system of claim 1, wherein the knowledge base includes at least one of patient history, pharmaceutical data, population data, pharmacogenomics data, cost data and clinical study data.

10. The system of claim 1, wherein the inference engine includes a processor configured to execute an expert system algorithm.

11. The system of claim 10, wherein the expert system algorithm includes at least one of a Bayesian network, fuzzy logic, a decision tree, a neural network and a self-organized map.

12. The system of claim 1, wherein the inference engine is configured to generate an inference in real time.

13. The system of claim 1, wherein the inference engine includes programming to identify a trend or to assign a probability to an input signal.

14. The system of claim 1 further including a communication network coupled to at least one of the output device or at least one input device.

15. The system of claim 14, wherein the communication network is coupled to a medical facility.

16. The system of claim 1, wherein the output device is configured to present a prompt and wherein an input device is configured to receive a user-entered reply.

17. The system of claim 1, wherein the output device is configured to select a therapy regimen.

18. The system of claim 17, wherein the therapy regimen includes delivering an electrical pulse or delivering a drug.

19. The system of claim 1, wherein a weight ascribed to at least one input device is adjusted based on the feedback signal.

20. The system of claim 1, further including a data compressor coupled to the knowledge base.

21. A method comprising:

receiving a plurality of input signals from a patient, at least one signal generated by an implantable sensor and at least one signal generated by an external device;

executing a program to generate an inference based on a combination of the plurality of input signals and a knowledge base;

providing a feedback signal to the knowledge base, the feedback signal generated based on the inference; and

producing an output signal based on the inference.

22. The method of claim 21, wherein receiving the plurality of input signals includes receiving user entered data.

23. The method of claim 21, wherein receiving the plurality of input signals includes receiving cardiac, cardiopulmonary and cardiorenal data.

24. The method of claim 21, wherein receiving the plurality of input signals includes receiving a wireless signal.

25. The method of claim 21, further including providing a prompt to enter data.

26. The method of claim 21, wherein combining the plurality of signals includes accessing a knowledge database corresponding to the ambulatory patient.

27. The method of claim 21, wherein producing the output includes notifying a physician.

28. The method of claim 21, wherein producing the output includes providing an instruction to an implantable device.

29. The method of claim 21 further including adjusting a weight ascribed to at least one signal of the plurality of input signals based on the feedback signal.

30. The method of claim 21, further including compressing data stored in the knowledge base.

31. A device comprising:

means for receiving a plurality of input signals from a patient, at least one signal corresponding to an implantable sensor and at least one signal corresponding to an external sensor;

means for storing a knowledge base having data corresponding to at least one input signal;

means for generating an inference based on the plurality of input signals and the knowledge base;

means for adjusting the knowledge base based on the inference; and

means for communicating an output corresponding to a remote device, the output based on the inference.

32. The device of claim 38, further including a wireless telemetry system coupling at least one signal of the plurality of signals to the means for generating the inference.

33. The device of claim 38, wherein the means for communicating the output includes a wireless transceiver.

34. The device of claim 38, wherein the means for communicating the output includes a telemetry system in communication with an implantable device.