INTER-RELATION BETWEEN WITHIN-PATIENT DECOMPENSATION DETECTION ALGORITHM AND BETWEEN-PATIENT STRATIFIER TO MANAGE HF PATIENTS IN A MORE EFFICIENT MANNER

• US 20080161700A1
• Filed: 12/27/2006
• Published: 07/03/2008
• Est. Priority Date: 12/27/2006
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Carlson, Gerrard M., Sachanandani, Haresh G., Sweeney, Robert J., Siejko, Krzysztof Z., Peterson, Jon, Cazares, Shelley, Stalsberg, Kevin J.
• Granted Patent: US 9,022,930 B2
• Time in Patent Office: Days
• US Class Current: 600/481
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• 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: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network
• CPC Class Codes: G16H 40/60 for the operation of medical equipment or devices
• CPC Class Codes: G16H 40/63 for local operation
• 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
• CPC Class Codes: G16H 70/60 relating to pathologies

Abstract

This document discusses, among other things, systems and methods for using one or more inter-relations between within-patient detection methods and between-patient stratifier methods. A method comprises obtaining results of a first physiological assessment, wherein the first physiological assessment includes a between-patient assessment; and using the results to adjust one or more parameters of a second physiological assessment, wherein the second physiological assessment includes a within-patient assessment.

Claims

1. A method comprising:

obtaining results of a first physiological assessment, wherein the first physiological assessment includes a between-patient assessment; and

using the results to adjust one or more parameters of a second physiological assessment, wherein the second physiological assessment includes a within-patient assessment.

2. The method of claim 1, wherein the first and second physiological assessments include a predictive calculation to determine one of a first risk of disease or a second risk of disease.

3. The method of claim 2, wherein the first risk of disease is measured using a longer timeframe than the second risk of disease.

4. The method of claim 1, wherein the first and second physiological assessments include a predictive calculation to determine one or more of:

a risk of death in a first timeframe, a risk of a change in quality of life in a second timeframe, or a risk of heart failure decompensation in a third timeframe.

5. The method of claim 1, wherein the one or more parameters include a threshold, a probabilistic model, or a weighting factor.

6. The method of claim 5, wherein the weighting factor is associated with one or more sensors.

7. The method of claim 1, comprising adjusting the one or more parameters automatically.

8. The method of claim 1, comprising using the results to control whether the second physiological assessment is evaluated.

9. The method of claim 1, comprising adjusting the one or more parameters to enhance one or more performance measures.

10. The method of claim 9, wherein the performance measures are related to one or more of:

false positives of the second physiological assessment or false negatives of the second physiological assessment.

11. The method of claim 10, wherein the performance measures include a specificity or a sensitivity.

12. The method of claim 10, wherein the performance measures include one or more of a positive predictive value, a negative predictive value, or a number of false positives per year.

13. The method of claim 1, wherein using the results to adaptively adjust one or more parameters includes:

notifying a clinician of the results;

providing a proposed adjustment to one or more parameters; and

adjusting one or more parameters if the clinician approves the proposed adjustment.

14. The method of claim 1, wherein using the results to adaptively adjust one or more parameters comprises:

automatically adjusting one or more parameters; and

notifying a clinician of the results and the one or more adjusted parameters.

15. The method of claim 1, comprising:

obtaining a second result of the second physiological assessment; and

using the second results to adjust one or more parameters of the first physiological assessment.

16. A system comprising:

a patient device comprising;

a communication module adapted to obtain results of a first physiological assessment, wherein the first physiological assessment includes a between-patient assessment; and

an analysis module adapted to use the results to adjust one or more parameters of a second physiological assessment, wherein the second physiological assessment includes a within-patient assessment.

17. The system of claim 16, wherein the first and second physiological assessments include a predictive calculation to determine one of a first risk of disease or a second risk of disease.

18. The system of claim 17, wherein the first risk of disease is measured using a longer timeframe than the second risk of disease.

19. The system of claim 16, wherein the one or more parameters include a threshold, a probabilistic model, or a weighting factor.

20. The system of claim 19, wherein the weighting factor is associated with one or more sensors.

21. The system of claim 16, wherein the analysis module is adapted to adjust the one or more parameters automatically.

22. The system of claim 16, wherein the analysis module is adapted to use the results to control whether the second physiological assessment is evaluated.

23. The system of claim 16, wherein the analysis module is adapted to adjust the one or more parameters to enhance one or more performance measures related to false positives or false negatives of the second physiological assessment.

24. The system of claim 16, wherein the analysis module is adapted to use the communication module to:

notify a clinician of the results;

provide a proposed adjustment to one or more parameters; and

adjust one or more parameters if the clinician approves the proposed adjustment.

25. The method of claim 16, wherein the communication module is adapted to obtain a second result of the second physiological assessment;

and wherein the analysis module is adapted to use the second results to adjust one or more parameters of the first physiological assessment.

26. An apparatus comprising:

means for obtaining results of a first physiological assessment, wherein the first physiological assessment is a between-patient assessment; and

means for using the results to adjust one or more parameters of a second physiological assessment, wherein the second physiological assessment includes a within-patient assessment.

27. A method comprising:

obtaining results of a first physiological assessment, wherein the first physiological assessment includes a within-patient assessment; and

using the results to adjust one or more parameters of a second physiological assessment, wherein the second physiological assessment includes a between-patient assessment.

28. The method of claim 27, wherein the first and second physiological assessments include a predictive calculation to determine one of a first risk of disease or a second risk of disease.

29. The method of claim 28, wherein the first risk of disease is measured using a shorter timeframe than the second risk of disease.

30. The method of claim 27, comprising adjusting the one or more parameters automatically.

31. The method of claim 27, comprising using the results to control whether the second physiological assessment is evaluated.

32. The method of claim 27, wherein using the results to adaptively adjust one or more parameters comprises:

automatically adjusting one or more parameters; and

notifying a clinician of the results and the one or more adjusted parameters.

33. The method of claim 27, comprising:

obtaining a second result of the second physiological assessment; and

using the second results to adjust one or more parameters of the first physiological assessment.