Method and apparatus for measuring representational motions in a medical context

• US 20080243033A1
• Filed: 03/20/2008
• Published: 10/02/2008
• Est. Priority Date: 03/21/2007
• Status: Active Grant

• Current Assignee: Lahey Clinic Foundation Incorporated, Massachusetts Institute of Technology
• Original Assignee: Massachusetts Institute of Technology
• Inventors: Davis, Randall, Penney, Dana L.
• Granted Patent: US 8,740,819 B2
• Time in Patent Office: Days
• US Class Current: 600/595
• CPC Class Codes: A61B 5/002 Monitoring the patient using a local or closed circuit, e.g. in a room or building A61B5/0017 takes precedence
• CPC Class Codes: A61B 5/1124 Determining motor skills
• CPC Class Codes: A61B 5/16 Devices for psychotechnics using teaching or educational appliances G09B1/00 - G09B7/00; Testing reaction times ; Devices for evaluating the psychological state
• 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 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: G09B 7/00 Electrically-operated teaching apparatus or devices working with questions and answers mechanically operated G09B3/00; computing arrangements G06F
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• 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

Abstract

Disclosed is an apparatus and corresponding method to capture individual representational motions made by a person while performing a neuropsychological test. A user of the apparatus and method may be allowed to view, edit, classify, and retrieve any captured and recorded motions made by the person. In one embodiment, a capture unit, such as a digitizer, captures the motions made by a person while performing a Clock Drawing Test, and the captured data may then be reported in a myriad of ways. The apparatus and method also provide a means to standardize administration and scoring of writing utensil and paper based neuropsychological testing administered to a person or control and test groups for domestic or international applications. By analyzing individual representational motions made by a person while performing a neuropsychological test, unexpectedly more information may be gleaned from the test than was available to physicians from only a completed drawing.

Claims

1. A method of measuring representational motions made by a person in a medical context, the method comprising:

capturing with spatial precision individual representational motions made by a person in a medical context in a form of representations that signify neurocognitive mechanisms underlying the motions; and

reporting information based on the representations of the individual representational motions.

2. The method as claimed in claim 1 wherein capturing the individual representational motions includes logging timestamps corresponding to the individual representational motions.

3. The method as claimed in claim 2 wherein logging timestamps includes recording with temporal precision real-time timestamps indicating the times at which the person made the individual representational motions.

4. The method as claimed in claim 1 wherein capturing the individual representational motions includes capturing the individual representational motions under multiple conditions.

5. The method as claimed in claim 4 wherein capturing the individual representational motions under multiple conditions includes capturing with spatial precision individual representational motions made by the person in at least one of the following conditions:

free-drawn, in which the person makes the individual representational motions based upon recall and understanding of instructions;

pre-drawn, in which the person makes the individual representational motions upon receiving a pre-drawn figure that the person must copy;

or completion, in which the person makes the individual representational motions upon receiving a partially pre-drawn figure that the person must complete after receiving one or more instructions.

6. The method as claimed in claim 1 wherein capturing with spatial precision is defined by capturing the individual representational motions within a tolerance recognized as acceptable to measure accurately an individual representational motion by the person in the medical context.

7. The method as claimed in claim 1 wherein the medical context includes at least one of the following conditions:

neuropsychological, neurological, neurogenetic, geriatric, pediatric, normal aging, baseline assessment, or general health.

8. The method as claimed in claim 1 wherein the medical context includes clinical evaluation of therapeutic interventions.

9. The method as claimed in claim 1 wherein the medical context includes diagnostic purposes and screening purposes.

10. The method as claimed in claim 1 wherein the information includes at least one of the following:

at least one property of the representations, a metric based on at least one of the representations, a diagnosis, or representations of the individual representational motions.

11. The method as claimed in claim 10 wherein a diagnosis includes a list of potential diagnoses, a list of observations, or a list of observations and corresponding potential diagnoses.

12. The method as claimed in claim 1 further including measuring at least one property of the individual representational motions.

13. The method as claimed in claim 12 wherein measuring the at least one property of the individual representational motions includes measuring at least one of the following:

at least one characteristic of a stroke of an individual representational motion, segment of an individual representational motion, multiple individual representational motions, or transition between at least two individual representational motions made by the person.

14. The method as claimed in claim 1 further includes reporting information about the person corresponding to the medical context as a function of at least one property.

15. The method as claimed in claim 14 wherein reporting information about the person corresponding to the medical context as a function of at least one property includes calculating a metric as a function of (i) data representing the individual representational motions produced by capturing the individual representational motions and (ii)(a) data representing known standards corresponding to the individual representational motions or (b) data empirically measured in the past representing the same or similar representational motions made by the person or at least one other person.

16. The method as claimed in claim 14 wherein reporting information about the person corresponding to the medical context as a function of at least one property includes determining a pass or fail result based on the at least one property of the individual representational motions with respect to at least one criterion.

17. The method as claimed in claim 14 wherein reporting information about the person corresponding to the medical context as a function of at least one property includes producing at least one metric of the at least one property.

18. The method as claimed in claim 14 wherein reporting information about the person corresponding to the medical context as a function of at least one property includes transmitting the at least one property via either a local or wide area network.

19. The method as claimed in claim 1 wherein capturing individual representational motions includes digitizing handwritten motions.

20. The method as claimed in claim 19 wherein digitizing handwritten motions includes digitizing handwritten motions made by the person in producing graphical figures or text.

21. The method as claimed in claim 19 wherein digitizing handwritten motions by the person includes digitizing handwritten motions made by the person in producing a visible, physical mark.

22. The method as claimed in claim 19 wherein digitizing the handwritten motions further includes collecting data from a digitizing stylus used by the person in performing the handwritten motions.

23. The method as claimed in claim 21 wherein collecting the data from the digitizing stylus includes collecting data corresponding to positioning the digitizing stylus relative to material comprising self-identifying marks correlating to spatial locations on or in the material.

24. The method as claimed in claim 1 wherein capturing the individual representational motions includes digitizing motion of a body part of the person in connection with an activity other than or in addition to handwritten motions.

25. The method as claimed in claim 1 wherein the individual representational motions are defined by at least one of the following:

change in position of an appendage of the person relative to a reference point, acceleration, rate, time of making an individual representational motion relative to other individual representational motions, starting and ending positions relative to expected positions, or via point positions relative to expected via point positions between a starting position and an ending position.

26. The method as claimed in claim 1 further including displaying the individual representational motions as a single image.

27. The method as claimed in claim 1 further including displaying the individual representational motions in a chronological sequence.

28. The method as claimed in claim 1 further including interactively displaying the individual representational motions in a chronological sequence in real-time, fast forward mode, or slow motion mode.

29. The method as claimed in claim 1 further comprising analyzing the individual representational motions based on the spatial precision of the individual representational motions, at least one property of the individual representational motions, or a metric calculated as a function of at least one of the individual representational motions.

30. The method as claimed in claim 29 wherein analyzing the individual representational motions includes classifying the individual representational motions according to the medical context.

31. The method as claimed in claim 29 wherein analyzing the individual representational motions includes analyzing the individual representational motions based on a chronological sequence by which the person made the individual representational motions.

32. The method as claimed in claim 29 wherein the at least one property of the individual representational motions includes geometric properties and wherein analyzing the individual representational motions includes classifying the individual representational motions based on geometric properties of the individual representational motions.

33. The method as claimed in claim 29 wherein the at least one property of the individual representational motions includes temporal properties and wherein analyzing the individual representational motions includes classifying the individual representational motions based on the temporal properties of the individual representational motions.

34. The method as claimed in claim 29 wherein the at least one property of the individual representational motions includes geometric properties and temporal properties and wherein analyzing the individual representational motions includes classifying the individual representational motions based on a combination of the geometric and temporal properties of the individual representational motions.

35. The method as claimed in claim 29 further comprising accepting user indications of misclassifications and user indications of correct classifications of the individual representational motions.

36. The method as claimed in claim 29 wherein analyzing the individual representational motions includes analyzing the individual representational motions based on a chronological sequence by which the person made the individual representational motions, including pauses between individual representational motions.

37. The method as claimed in claim 29 wherein analyzing the individual representational motions includes analyzing angular displacements or at least one geometrical relationship between (i) a given individual representational motion at two moments or periods in time, (ii) two different individual representational motions, or (iii) an individual representational motion and a fixed location relative to the individual representational motion.

38. The method as claimed in claim 29 wherein analyzing the individual representational motions includes analyzing transitions between the individual representational motions.

39. The method as claimed in claim 1 further comprising calculating at least one metric of at least one property and generating a report of the at least one metric.

40. The method as claimed in claim 1 further comprising transmitting at least one of the following about the individual representational motions made by the person:

representations of the individual representational motions;

measurements of at least one property of the individual representational motions;

reports of a metric of at least one property;

or images, either single image or a chronological sequence, of the individual representational motions.

41. The method as claimed in claim 1 further including adding data to a database about the individual representational motions made by the person.

42. The method as claimed in claim 41 wherein the data includes at least one of the following:

data based on the individual representational motions, stroke classification, stroke splitting points, stroke origination points, or measurement of the at least one property of the individual representational motions.

43. The method as claimed in claim 41 further including responding to queries to the database with data about the individual representational motions made by the person.

44. The method as claimed in claim 43 further including collecting fees to access the data in the database.

45. The method as claimed in claim 44 wherein collecting fees includes collecting fees in the form of subscription service fees.

46. The method as claimed in claim 1 further including reporting information about the individual representational motions as a function of at least one property.

47. The method as claimed in claim 46 wherein reporting information about the individual representational motions as a function of at least one property includes calculating a metric as a function of (i) data representing the individual representational motions produced by capturing the individual representational motions and (ii)(a) data representing known standards corresponding to the individual representational motions or (b) data empirically measured in the past representing the same or similar representational motions made by the person or at least one other person.

48. The method as claimed in claim 46 wherein reporting information about the individual representational motions as a function of at least one property includes determining a pass or fail result based on the at least one property of the individual representational motions with respect to at least one criterion.

49. The method as claimed in claim 46 wherein reporting information about the individual representational motions as a function of at least one property includes producing at least one metric of the at least one property.

50. The method as claimed in claim 46 wherein reporting information about the individual representational motions as a function of at least one property includes transmitting the at least one property via either a local or wide area network.

51. The method as claimed in claim 1 performed in at least one of the following settings:

a medical facility, teaching facility, clinic, office or a school.

52. The method as claimed in claim 1 performed under supervision of a medical practitioner.

53. The method as claimed in claim 1 performed in an absence of a medical practitioner.

54. The method as claimed in claim 1 further including identifying motor skill changes in the person at an early stage of a cause of the motor skill changes.

55. The method as claimed in claim 1 further including identifying cognitive skill changes in the person at an early stage of a cause of the cognitive skill changes.

56. The method as claimed in claim 1 further including identifying motor or cognitive skill changes of the person in a longitudinal study.

57. The method as claimed in claim 1 further including identifying motor or cognitive skill changes of the person.

58. The method as claimed in claim 1 further including identifying whether to adjust a pharmaceutical dosage administered to the person.

59. The method as claimed in claim 1 further including identifying whether to adjust treatment administered to the person.

60. The method as claimed in claim 1 further including contributing to differential diagnosis.

61. The method as claimed in claim 1 further including identifying additional tests useful in establishing a diagnosis.

62. The method as claimed in claim 1 further including identifying changes of implantable interventions in the person.

63. The method as claimed in claim 1 further including changing parameters of the implantable interventions in the person.

64. The method as claimed in claim 1 performed on a control group and a test group and further including:

calculating metrics as a function of at least one property for the control group and the test group; and

developing a standard for domestic or international application based on the metrics associated with the control and test groups.

65. An apparatus for measuring representational motions made by a person in a medical context, the apparatus comprising:

a capture unit to capture with spatial precision individual representational motions made by a person in a medical context in a form of representations that signify neurocognitive mechanisms underlying the motions; and

a report unit coupled to the capture unit and configured to report information based on representations of the individual representational motions.

66. The apparatus as claimed in claim 65 wherein the capturing unit includes a timing unit to produce timestamps and further includes a logging unit coupled to the timing unit and configured to log timestamps corresponding to the individual representational motions.

67. The apparatus as claimed in claim 66 wherein the timing unit is configured to produce real-time timestamps and wherein the logging unit is configured to record the real-time timestamps to indicate the times at which the person made the individual representational motions.

68. The apparatus as claimed in claim 65 wherein the capture unit is configured to capture the individual representational motions under multiple conditions.

69. The apparatus as claimed in claim 68 wherein the capture unit is configured to capture individual representational motions made by the person in at least one of the following conditions:

free-drawn, in which the person makes the individual representational motions based upon recall and understanding of instructions;

pre-drawn, in which the person makes the individual representational motions upon receiving a pre-drawn figure that they must copy;

or completion, in which the person makes the individual representational motions upon receiving a partially pre-drawn figure that they must complete after receiving one or more instructions.

70. The apparatus as claimed in claim 65 wherein the capture unit is configured to capture the individual representational motions within a tolerance recognized as acceptable to measure accurately an individual representational motion by the person in the medical context.

71. The apparatus as claimed in claim 65 wherein the medical context includes at least one of the following conditions:

neuropsychological, neurological, neurogenetic, geriatric, pediatric, normal aging, baseline assessment, or general health.

72. The apparatus as claimed in claim 65 wherein the medical context includes clinical evaluation of therapeutic interventions.

73. The apparatus as claimed in claim 65 wherein the medical context includes diagnostic purposes.

74. The apparatus as claimed in claim 65 wherein the information includes at least one of the following:

at least one property of the representations, a metric based on at least one of the representations, a diagnosis, or representations of the individual representational motions.

75. The apparatus as claimed in claim 74 wherein the diagnosis includes a list of potential diagnoses, a list of observations, or a list of observations and corresponding potential diagnoses.

76. The apparatus as claimed in claim 65 further including a measurement unit configured to measure at least one property of the individual representational motions.

77. The apparatus as claimed in claim 76 wherein the measurement unit is configured to measure at least one property of the individual representational motions and the at least one property includes one of the following:

at least one characteristic of a stroke of an individual representational motion, segment of an individual representational motion, multiple individual representational motions, or transition between at least two individual representational motions made by the person.

78. The apparatus as claimed in claim 65 wherein the report unit is configured to report information about the person corresponding to the medical context as a function of at least one property.

79. The apparatus as claimed in claim 78 wherein the report unit is coupled to a calculation module and the calculation module is configured to calculate a metric as a function of (i) data representing the individual representational motions produced by capturing the individual representational motions and (ii)(a) data representing known standards corresponding to the individual representational motions or (b) data empirically measured in the past representing the same or similar representational motions made by the person or at least one other person.

80. The apparatus as claimed in claim 78 wherein the report unit includes a result module to determine a pass or fail result based on the at least one property of the individual representational motions with respect to at least one criterion.

81. The apparatus as claimed in claim 78 wherein the report unit is configured to report information about the person in a form of at least one metric of the at least one property.

82. The apparatus as claimed in claim 78 wherein the report unit includes a transmitter module to transmit the at least one property via either a local or wide area network.

83. The apparatus as claimed in claim 65 wherein the capture unit includes a digitizer unit configured to digitize handwritten motions.

84. The apparatus as claimed in claim 83 wherein the digitizer unit is configured to digitize handwritten motions made by the person to produce graphical figures or text.

85. The apparatus as claimed in claim 83 wherein the digitizer unit is configured to digitize handwritten motions made by the person to produce a visible, physical mark.

86. The apparatus as claimed in claim 83 wherein the digitizer unit further includes and is coupled to a collection unit to collect data from a digitizing stylus used by the person in performing the handwritten motions.

87. The apparatus as claimed in claim 86 wherein the collection unit to collect the data from the digitizing stylus is configured to collect data in the form of positions of the digitizing stylus relative to material comprising self-identifying marks correlating to spatial locations on or in the material.

88. The apparatus as claimed in claim 65 wherein the capture unit includes a digitizer unit to digitize motion of a body part of the person in connection with an activity other than or in addition to handwritten motions.

89. The apparatus as claimed in claim 65 wherein the individual representational motions are defined by at least one of the following:

change in position of an appendage of the person relative to a reference point, acceleration, rate, time of making an individual representational motion relative to other individual representational motions, starting and ending positions relative to expected positions, or via point positions relative to expected via point positions between a starting position and an ending position.

90. The apparatus as claimed in claim 65 further including a display unit to display the individual representational motions as a single image.

91. The apparatus as claimed in claim 65 further including a display unit to display the individual representational motions in a chronological sequence.

92. The apparatus as claimed in claim 65 further including a display unit to interactively display the individual representational motions in a chronological sequence in real-time, fast forward mode, or slow motion mode.

93. The apparatus as claimed in claim 65 further comprising an analyzer unit configured to analyze the individual representational motions based on the spatial precision of the individual representational motions, at least one property of the individual representational motions, or a metric calculated as a function of at least one of the individual representational motions.

94. The apparatus as claimed in claim 93 wherein the analyzer unit includes a classifier module that is configured to classify the individual representational motions according to the medical context.

95. The apparatus as claimed in claim 93 wherein the analyzer unit is configured to analyze the individual representational motions based on the chronological sequence by which the person made the individual representational motions.

96. The apparatus as claimed in claim 93 wherein the analyzer unit includes a classifier module to classify the individual representational motions based on geometric properties of the individual representational motions.

97. The apparatus as claimed in claim 93 wherein the analyzer unit includes a classifier module to classify the individual representational motions based on temporal properties of the individual representational motions and wherein the at least one property of the individual representational motions includes temporal properties.

98. The apparatus as claimed in claim 93 wherein the analyzer unit includes a classifier module to classify the individual representational motions based on a combination of the geometric and temporal properties of the individual representational motions and wherein the at least one property of the individual representational motions includes geometric properties and temporal properties.

99. The apparatus as claimed in claim 93 further including a user interactive unit to accept user indications of misclassifications and user indications of correct classifications of the individual representational motions.

100. The apparatus as claimed in claim 93 wherein the analyzer unit is configured to analyze the individual representational motions based on a chronological sequence by which the person made the individual representational motions, including pauses between individual representational motions.

101. The apparatus as claimed in claim 93 wherein the analyzer unit is configured to analyze the individual representational motions based on angular displacements or at least one geometrical relationship between (i) a given individual representational motion at two moments or periods in time, (ii) two different individual representational motions, or (iii) an individual representational motion and a fixed location relative to the individual representational motion.

102. The apparatus as claimedin claim 65 wherein the analyzer unit is configured to analyze the individual representational motions based on transitions between the individual representational motions.

103. The apparatus as claimed in claim 65 further comprising a calculation unit to compute at least one metric of at least one property of the individual representational motions and wherein the computation unit is coupled to the report unit to report the at least one metric.

104. The apparatus as claimed in claim 65 further comprising a transmitter unit to transmit at least one of the following about the individual representational motions made by the person:

representations of the individual representational motions;

measurements of the at least one property of the individual representational motions;

reports of the metric of at least one property;

or images, either single image or a chronological sequence, of the individual representational motions.

105. The apparatus as claimed in claim 65 further including a database module to store data about the individual representational motions made by the person.

106. The apparatus as claimed in claim 105 wherein the data includes at least one of the following data based on the individual representational motions:

stroke classification, stroke splitting points, stroke origination points, or measurement of the at least one property of the individual representational motions.

107. The apparatus as claimed in claim 105 wherein the database is configured to respond to queries with data about the individual representational motions made by the person.

108. The apparatus as claimed in claim 107 further includes a fee collection unit configured to collect fees and to grant access to metadata or the data in the database.

109. The apparatus as claimed in claim 108 wherein the fee collection unit is configured to collect fees in a form of subscription service fees.

110. The apparatus as claimed in claim 65 wherein the report unit is configured to report information about the individual representational motions as a function of at least one property of the individual representational motions.

111. The apparatus as claimed in claim 110 further including a calculation unit coupled to the report unit and wherein the calculation unit is configured to calculate at least one metric as a function of (i) data representing the individual representational motions produced by capturing the individual representational motions and (ii)(a) data representing known standards corresponding to the individual representational motions or (b) data empirically measured in the past representing the same or similar representational motions made by the person or at least one other person.

112. The apparatus as claimed in claim 110 wherein the report unit includes a result module to determine a result based on at least one property of the individual representational motions with respect to at least one criterion.

113. The apparatus as claimed in claim 110 wherein the report unit is configured to report the information in a form of at least one metric of at least one property.

114. The apparatus as claimed in claim 110 wherein the report unit further includes a transmitter module to transmit the at least one property via either a local or wide area network.

115. The apparatus as claimed in claim 65 configured for use in at least one of the following settings:

medical, academic, rehabilitation, office, or screening clinics.

116. The apparatus as claimed in claim 65 configured for use under supervision of a medical practitioner.

117. The apparatus as claimed in claim 65 configured for use in an absence of a medical practitioner.

118. The apparatus as claimed in claim 65 further including an identification unit to identify motor skill changes in the person at an early stage of a cause of the motor skill changes.

119. The apparatus as claimed in claim 65 further including an identification unit to identify cognitive skill changes in the person at an early stage of a cause of the cognitive skill changes.

120. The apparatus as claimed in claim 65 further including an identification unit to identify motor or cognitive skill changes in the person during a longitudinal study.

121. The apparatus as claimed in claim 65 further including an identification unit to identify motor or cognitive skill changes in the person.

122. The apparatus as claimed in claim 65 further including an identification unit to identify whether to adjust a pharmaceutical dosage administered to the person.

123. The apparatus as claimed in claim 65 further including an identification unit to identify whether to adjust a treatment administered to the person.

124. The apparatus as claimed in claim 65 further including a diagnosis unit to contribute to the differential diagnosis of the person.

125. The apparatus as claimed in claim 65 further including a test unit to identify additional tests for establishing a diagnosis.

126. The apparatus as claimed in claim 65 further includes a detection unit to detect changes of implantable interventions in the person.

127. The apparatus as claimed in claim 65 further includes a parameter unit to change parameters of implantable interventions in the person based on at least one property of the individual representational motions.

128. The apparatus as claimed in claim 65 configured for use on a control group and a test group and further including:

a metric unit to calculate metrics as a function of the at least one property for the control group and the test group; and

a server configured to assist in developing a standard for a domestic or international application based on the metrics associated with the control and test groups.