POST-HOSPITAL-DISCHARGE COPD-PATIENT MONITORING USING A DYNAMIC BASELINE OF SYMPTOMS/MEASUREMENT

• US 20160029971A1
• Filed: 03/05/2014
• Published: 02/04/2016
• Est. Priority Date: 03/18/2013
• Status: Active Grant

• Current Assignee: Koninklijke Philips N.V.
• Original Assignee: Koninklijke Philips N.V.
• Inventors: SACHDEV, Birpal Singh, MURDOCH, Robert William
• Granted Patent: US 10,327,711 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/7271 Specific aspects of physiological measurement analysis A61B5/316, A61B5/349 and A61B5/374 take precedence
• 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 40/67 for remote operation
• CPC Class Codes: G16H 50/70 for mining of medical data, e.g. analysing previous cases of other patients

Abstract

Systems and methods for monitoring subjects after discharge from a hospital use a dynamic baseline to determine whether a caregiver needs to be notified regarding exacerbation of a medical state of a subject. The subjects are chronic obstructive pulmonary disease (COPD) patients. The dynamic baseline is determined by aggregating (for example averaging) multiple values of a sequence of values for a metric that quantifies one or both of a patient symptom (e.g. the number of overnight apnea occurrences) and/or lung function of a subject (e.g. forced expiratory volume in 1 second). Multiple metrics may be combined to generate the value that is monitored for a subject.

Claims

1. A system configured to monitor subjects, wherein the subjects are chronic obstructive pulmonary disease (COPD) patients, the system comprising:

one or more processors configured to execute computer program modules, the computer program modules comprising;

a metric module configured to obtain a sequence of values for a first metric that quantifies one or both of a patient symptom related to chronic obstructive pulmonary disease and/or lung function of a subject, wherein individual values correspond to different times, such that individual values in the sequence of values correspond to times during a defined period;

a dynamic baseline module configured to determine dynamic baselines for subjects, such that a first dynamic baseline is determined for the subject by aggregating a first set of individual values of the sequence, wherein the dynamic baseline module is further configured to adjust the first dynamic baseline by aggregating a second set of individual values of the sequence, wherein the second set includes at least one particular individual value that is not included in the first set; and

an alert module configured to determine whether a caregiver needs to be notified regarding exacerbation of a medical state of the subject, wherein the determination by the alert module is based on a comparison of one or more individual values for the first metric with the first dynamic baseline as adjusted.

2. The system of claim 1, wherein the defined period is between 8 hours and 48 hours.

3. The system of claim 1, wherein the determination by the alert module is further based on whether a difference between one or more individual values for the first metric and the first dynamic baseline breaches both of a magnitude threshold and a duration threshold.

4. The system of claim 1, further comprising:

a variability module configured to determine variability of multiple individual values for the first metric, such that a first variability is determined of multiple individual values for the first metric;

a static baseline module configured to determine static baselines for subjects, such that a first static baseline is determined for the subject by aggregating multiple individual values for the first metric, wherein determination of the first static baseline is based on the first variability,

wherein the determination by the alert module is based on a comparison of one or more individual values from the metric module and the first static baseline.

5. The system of claim 1, further comprising one or more sensors configured to generate output signals conveying information related to one or more parameters associated with one or both of a patient symptom related to chronic obstructive pulmonary disease and/or lung function of the subject, wherein the metric module is configured to obtain the sequence of values for the first metric by a determination based on the output signals generated by the one or more sensors.

6. The system of claim 1, wherein the metric module is further configured to obtain a second sequence of values for a second subject, wherein the dynamic baseline module is further configured to determine a second dynamic baseline for the second subject, wherein the alert module is further configured to determine whether a caregiver needs to be notified regarding exacerbation of a medical state of the second subject, the system further comprising:

a long-term metric module configured to compare progression of medical state between the subject and the second subject spanning a period of at least a year, wherein the comparison is based on determinations by the alert module.

7. A method for monitoring subjects, wherein the subjects are chronic obstructive pulmonary disease (COPD) patients, the method comprising:

obtaining a sequence of values for a first metric that quantifies one or both of a patient symptom related to chronic obstructive pulmonary disease and/or lung function of a subject, wherein individual values correspond to different times, such that individual values in the sequence of values correspond to times during a defined period;

determining a first dynamic baseline for the subject by aggregating a first set of individual values of the sequence;

adjusting the first dynamic baseline by aggregating a second set of individual values of the sequence, wherein the second set includes at least one particular individual value that is not included in the first set; and

determining whether a caregiver needs to be notified regarding exacerbation of a medical state of the subject, wherein the determination whether the caregiver needs to be notified is based on a comparison of one or more individual values for the first metric with the first dynamic baseline as adjusted.

8. The method of claim 7, wherein the defined period is between 8 hours and 48 hours.

9. The method of claim 7, wherein the determination whether the caregiver needs to be notified is further based on whether a difference between one or more individual values for the first metric and the first dynamic baseline breaches both of a magnitude threshold and a duration threshold.

10. The method of claim 7, further comprising:

determining a first variability of multiple individual values for the first metric; and

determining a first static baseline for the subject by aggregating multiple individual values for the first metric, wherein determination of the first static baseline is based on the first variability,

wherein the determination whether the caregiver needs to be notified is based on a comparison of one or more individual values for the first metric and the first static baseline.

11. The method of claim 7, further comprising:

generating output signals conveying information related to one or more parameters associated with one or both of a patient symptom related to chronic obstructive pulmonary disease and/or lung function of the subject, wherein obtaining the sequence of values for the first metric is based on the output signals.

12. The method of claim 7, further comprising:

obtaining a second sequence of values for the first metric that quantifies one or both of a patient symptom and/or lung function of a second subject, wherein individual values correspond to different times, such that individual values in the sequence correspond to times during a period between 8 and 48 hours;

determining a second dynamic baseline for the second subject by aggregating multiple individual values of the second sequence, the second dynamic baseline being based on between 4 and 20 individual values;

determining whether a caregiver needs to be notified regarding exacerbation of a medical state of the second subject, wherein the determination is based on a comparison of one or more individual values for the first metric from the second sequence and the second dynamic baseline; and

comparing progression of medical state between the subject and the second subject spanning a period of at least a year, wherein the comparison is based on determinations whether a caregiver needs to be notified regarding exacerbation of the medical state.

13. A system configured to monitor subjects, wherein the subjects are chronic obstructive pulmonary disease (COPD) patients, the system comprising;

means for obtaining a sequence of values for a first metric that quantifies one or both of a patient symptom related to chronic obstructive pulmonary disease and/or lung function of a subject, wherein the lung function is related to chronic obstructive pulmonary disease, wherein individual values correspond to different times, such that individual values in the sequence correspond to times during a defined period;

means for determining a first dynamic baseline for the subject by aggregating a first set of individual values of the sequence;

means for adjusting the first dynamic baseline by aggregating a second set of individual values of the sequence, wherein the second set includes at least one particular individual value that is not included in the first set; and

means for determining whether a caregiver needs to be notified regarding exacerbation of a medical state of the subject, wherein the determination whether the caregiver needs to be notified is based on a comparison of one or more individual values for the first metric with the first dynamic baseline as adjusted.

14. The system of claim 13, wherein the defined period is between 8 hours and 48 hours.

15. The system of claim 13, wherein operation of the means for determining whether the caregiver needs to be notified is further based on whether a difference between one or more individual values for the first metric and the first dynamic baseline breaches both of a magnitude threshold and a duration threshold.

16. The system of claim 13, further comprising:

means for determining a first variability of multiple individual values for the first metric; and

means for determining a first static baseline for the subject by aggregating multiple individual values for the first metric, wherein determination of the first static baseline is based on the first variability,

wherein operation of the means for the determination whether the caregiver needs to be notified is based on a comparison of one or more individual values for the first metric and the first static baseline.

17. The system of claim 13, further comprising:

means for generating output signals conveying information related to one or more parameters associated with one or both of a patient symptom related to chronic obstructive pulmonary disease and/or lung function of the subject, wherein operation of the means for obtaining the sequence of values for the first metric is based on the output signals.

18. The system of claim 13, wherein the means for obtaining the sequence is further configured to obtain a second sequence of values for the first metric that quantifies one or both of a patient symptom and/or lung function of a second subject, wherein individual values correspond to different times, such that individual values in the sequence correspond to times during a period between 8 and 48 hours,

wherein the means for determining the first dynamic baseline is further configured to determine a second dynamic baseline for the second subject by aggregating multiple individual values of the second sequence, the second dynamic baseline being based on between 4 and 20 individual values,

wherein the means for determining whether the caregiver needs to be notified is further configured to determine whether a caregiver needs to be notified regarding exacerbation of a medical state of the second subject, wherein the determination is based on a comparison of one or more individual values for the first metric from the second sequence and the second dynamic baseline, the system further comprising:

means for comparing progression of medical state between the subject and the second subject spanning a period of at least a year, wherein the comparison is based on determinations whether a caregiver needs to be notified regarding exacerbation of the medical state.