Use of periodicity in medical data analysis

• US 8,150,503 B2
• Filed: 07/13/2009
• Issued: 04/03/2012
• Est. Priority Date: 09/19/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Schatz, Kelly, Sweeney, Robert J.
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Gedeon, Brian T
• Application Number:
  US12/502,059
• Publication Number:
  US 20090275811A1
• Time in Patent Office: 995 Days
• Field of Search: 600/509, 600/513, 600/515
• US Class Current: 600/509
• CPC Class Codes: A61N 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/37211 Means for communicating with stimulators

Abstract

A patient management system is described that includes an implantable device for collecting one or more physiological parameter values and associated timestamps indicating the time at which the value is collected. The system is then configured to determine the periodic variation, if any, of a particular physiological parameter and use that periodicity in assessing changes in the parameter values over time.

Claims

1. A method comprising:

configuring a medical data management device to collect values of one or more physiological parameters along with associated timestamps indicative of the times at which the parameter values were measured;

configuring an implantable medical device that includes circuitry for measuring values of one or more physiological parameters to communicate the parameter values to the medical data management device along with associated timestamps indicative of the times at which the parameter values were measured; and

,

configuring the medical data management device to use the timestamps associated with the collected parameter values of a physiological parameter to measure the periodic variation, if any, of that particular physiological parameter, and wherein the periodic variation of a physiological parameter is determined by computing an autocorrelation function of a time series of collected parameter values.

2. The method of claim 1 wherein the physiological parameter values and associated timestamps collected by the medical data management device include one or more parameter values and timestamps as communicated to the medical management device via wireless telemetry.

3. The method of claim 1 further comprising configuring the medical data management device to identify the period or periods at which the parameter varies as the lag value at which the autocorrelation function exhibits a peak.

4. The method of claim 1 wherein the physiological parameter values represent values of the parameter averaged over a specified period of time.

5. The method of claim 1 further comprising configuring the medical data management device to compare a present value of a parameter with a previous value of the parameter in a manner which takes into account the periodic variation of the parameter.

6. The method of claim 5 wherein the present value of the parameter represents the values of the parameter averaged over a first period of time and wherein the previous value of the parameter represents the values of the parameter averaged over a second period of time, the previous value of the parameter being regarded as a baseline value.

7. The method of claim 6 further comprising configuring the medical data management device to set an alarm if the difference between the present and previous values of one or more parameters exceeds a specified threshold a specified number of times or over a specified period of time.

8. The method of claim 5 further comprising configuring the medical data management device to compute a health status parameter as a function of the differences between the present and past values of one or more physiological parameters.

9. The method of claim 5 further comprising configuring the medical data management device to compute the conditional probability of an adverse health event as a function of the differences between the present and past values of one or more physiological parameters.

10. The method of claim 1 further comprising configuring the medical data management device to compare a present value of a parameter with a previous value of the parameter measured at a time such that the time interval between the measurement times of the present and previous parameter values is equal to a period of the periodic variation of the parameter.

11. The method of claim 10 further comprising configuring the medical data management device to compare a present value of a parameter with a previous value of the parameter, wherein the present and previous values of the parameter are measured at a similar time of day, day of the week, or day of the month in accordance with whether the periodic variation of the parameter is daily, weekly, or monthly, respectively.

12. The method of claim 1 further comprising configuring the medical data management device to identify parameters with similar periodic variations.

13. The method of claim 1 further comprising configuring the medical data management device to use the collected values of a physiological parameter to periodically re-determine the periodic variation of that parameter.

14. The method of claim 1 further comprising configuring the medical data management device to set an alarm if the periodic variation of a particular physiological parameter changes by a specified threshold amount.

15. The method of claim 1 further comprising configuring the medical data management device to compute a trend in the values of a physiological parameter that are measured at a similar time of day, day of the week, or day of the month in accordance with whether the periodic variation of the parameter is daily, weekly, or monthly, respectively.

16. The method of claim 1 wherein the one or more physiological parameters measured by the implantable medical device includes heart rate.

17. The method of claim 1 wherein the one or more physiological parameters measured by the implantable medical device includes an estimate of heart rate variability.

18. The method of claim 1 wherein the one or more physiological parameters measured by the implantable medical device includes a measurement of exertion level.

19. The method of claim 1 further comprising configuring the medical data management device to use timestamps associated with collected parameter values of an externally communicated physiological parameter not measured by the implantable device to measure the periodic variation, if any, of the externally communicated physiological parameter, and wherein the periodic variation is determined by computing an autocorrelation function of a time series of collected parameter values.

20. A patient management system, comprising:

a medical data management device configured to collect values of one or more physiological parameters along with associated timestamps indicative of the times at which the parameter values were measured;

an implantable medical device that includes circuitry for measuring values of one or more physiological parameters and circuitry for communicating the parameter values to the medical data management device along with associated timestamps indicative of the times at which the parameter values were measured; and

,

wherein the medical data management device is further configured to use the timestamps associated with the collected parameter values of a physiological parameter to measure the periodic variation of that particular physiological parameter based upon a time series of collected parameter values.