GLYCEMIC HEALTH METRIC DETERMINATION AND APPLICATION

• US 20130102867A1
• Filed: 12/10/2012
• Published: 04/25/2013
• Est. Priority Date: 12/29/2010
• Status: Active Grant

• Current Assignee: Medtronic Minimed Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Minimed Incorporated (Medtronic Plc)
• Inventors: Desborough, Lane, Monirabbasi, Salman, Palerm, Cesar
• Granted Patent: US 10,390,740 B2
• Time in Patent Office: Days
• US Class Current: 600/365
• 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 5/0004 characterised by the type of physiological signal transmitted
• CPC Class Codes: A61B 5/1451 for interstitial fluid
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: A61B 5/1473 invasive, e.g. introduced into the body by a catheter A61B5/1482 takes precedence
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/6849 in combination with a needle set
• CPC Class Codes: A61B 5/7225 Details of analog processing, e.g. isolation amplifier, gain or sensitivity adjustment, filtering, baseline or drift compensation A61B5/30, A61B5/316 take precedence; transformers for specific applications H01F38/00; amplifiers H03F
• CPC Class Codes: A61B 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

Disclosed are methods, apparatuses, etc. for determination and application of a metric for assessing a patient'"'"'s glycemic health. In one particular implementation, a computed metric may be used to balance short-term and long-term risks associated with a particular therapy.

Claims

1. A method comprising:

at a special purpose computing apparatus, computing a profile of a blood glucose concentration of a patient based, at least in part, on observations of said blood glucose concentration collected at a blood glucose monitoring device, said profile comprising at least a computed mean blood glucose concentration and an indication of a statistical dispersion;

applying a cost or loss function to said computed profile to compute a metric representative of a glycemic health of the patient, said cost or loss function being based, at least in part, on an application of a log-square operation to at least one of the computed mean or said indication of said statistical dispersion; and

affecting a therapy applied to said patient based, at least in part, on said computed metric.

2. The method of claim 1, wherein said indication of said statistical dispersion comprises a standard deviation.

3. The method of claim 1, wherein said metric comprises a unidimensional metric.

4. The method of claim 1, wherein affecting said therapy comprises setting a target blood glucose level or target blood glucose range of said patient based, at least in part, on said computed metric.

5. The method of claim 1, wherein said loss or cost function is further based, at least in part, on application of a log-square function to a target blood glucose concentration value.

6. The method of claim 5, wherein said metric substantially has the form:

Loss(G_T)=log₁₀(σ

)²+[log 10(μ

)−

log₁₀(G_T)]², where;

G_T is the target blood glucose concentration value;

μ

is the computed mean; and

σ

is the measure of the statistical dispersion.

7. The method of claim 1, wherein the metric is indicative of a portion of time the blood glucose concentration has been within a predetermined range of blood glucose concentration over a duration.

8. The method of claim 1, wherein the predetermined range of blood glucose concentration is 80-180 mg/dl.

9. The method of claim 1, wherein affecting the therapy applied to said patient further comprises affecting a closed-loop insulin delivery system based, at least in part, on said computed metric.

10. The method of claim 9, wherein affecting said closed-loop insulin delivery system further comprises affecting a periodic command based, at least in part, on said computed metric.

11. The method of claim 1, and further comprising triggering an alarm in response to said computed metric.

12. An apparatus comprising:

one or more processors to;

for each of a plurality of patients, (i) determine a profile of a blood glucose concentration of said patient based, at least in part, on observations of said blood glucose concentration collected at a blood glucose monitoring device, said profile comprising at least a computed mean blood glucose concentration and an indication of a statistical dispersion, and (ii) apply a cost or loss function to said profile to compute a metric representative of a glycemic health of the patient, said cost or loss function being based, at least in part, on an application of a log-square operation to at least one of the computed mean or the indication of said statistical dispersion; and

rank said patients for treatment according to a triage policy based, at least in part, on said computed metrics.

13. The apparatus of claim 12, and further comprising communication interface components to receive messages from a communication network, said one or more processors further to:

compute said metrics based, at least in part, on messages received through said communication interface components from computing platforms co-located with said patients.

14. The apparatus of claim 13, wherein said messages comprise measurements of blood glucose concentration collected at glucose monitoring devices.

15. A method performed by a special purpose computing apparatus, the method comprising:

for each of a plurality of patients, (i) determining a profile of a blood glucose concentration of said patient based, at least in part, on observations of said blood glucose concentration collected at a blood glucose monitoring device, said profile comprising at least a computed mean blood glucose concentration and an indication of a statistical dispersion, and (ii) applying a cost or loss function to said computed profile to compute a metric representative of a glycemic health of the patient, said cost or loss function being based, at least in part, on an application of a log-square operation to at least one of the computed mean or said indication of said statistical dispersion, wherein profiles of observations of blood glucose of said patients being obtained under multiple predefined therapies; and

ranking said predefined therapies based, at least in part, on said computed metrics.

16. The method of claim 15, wherein said predefined therapies are defined, at least in part, by closed-loop system design features.

17. The method of claim 15, wherein said indication of said statistical dispersion comprises a standard deviation.

18. The method of claim 15, wherein said loss or cost function is further based, at least in part, on application of a log-square function to a target blood glucose concentration value.

19. The method of claim 18, wherein said metric substantially has the form:

Loss(G_T)=log₁₀(σ

)²+[log 10(μ

)−

log₁₀(G_T)]², where;

G_T is the target blood glucose concentration value;

μ

is the computed mean; and

σ

is the measure of the statistical dispersion.

20. The method of claim 15, wherein the metric is indicative of a portion of time the blood glucose concentration has been within a predetermined range of blood glucose concentration over a duration.