Systems approach to comorbidity assessment

• US 8,679,009 B2
• Filed: 06/15/2010
• Issued: 03/25/2014
• Est. Priority Date: 06/15/2010
• Status: Active Grant

• Current Assignee: Flint Hills Scientific, LLC
• Original Assignee: Flint Hills Scientific, LLC
• Inventors: Osorio, Ivan
• Primary Examiner(s): Thomson, Bill
• Assistant Examiner(s): Sands, Davin K
• Application Number:
  US12/816,348
• Publication Number:
  US 20110306845A1
• Time in Patent Office: 1,379 Days
• Field of Search: 600/300, 600/301, 128903-905, 128/920, 705 2- 5
• US Class Current: 600/300
• CPC Class Codes: A61B 5/01 Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue clinical contact thermometers G01K13/20
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• 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 5/165 Evaluating the state of mind, e.g. depression, anxiety
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61B 5/417 the bone marrow
• CPC Class Codes: A61B 5/42 Detecting, measuring or recording for evaluating the gastrointestinal, the endocrine or the exocrine systems A61B1/00, A61B5/4857, A61B5/486, A61B5/4866, A61B5/4869 take precedence
• CPC Class Codes: A61B 5/4842 Monitoring progression or stage of a disease
• CPC Class Codes: A61B 5/4866 Evaluating metabolism A61B5/083 takes precedence
• CPC Class Codes: A61B 5/4884 inducing physiological or psychological stress, e.g. applications for stress testing
• 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 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• 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

Abstract

Methods, systems, and apparatus for assessing a state of a comorbidity associated with a primary disease are provided. The methods comprise receiving at least one autonomic index, neurologic index, stress marker index, psychiatric index, endocrine index, adverse effect of therapy index, physical fitness index, or quality of life index of a patient; comparing the at least one index to at least one reference value; and assessing a state of a body system of the patient that is a site of the comorbidity, based on the comparison. A computer readable program storage device encoded with instructions that, when executed by a computer, perform the method described above is also provided. A medical device system capable of implementing the method described above is also provided.

Claims

1. A non-transitory computer readable program storage unit encoded with instructions that, when executed by a computer, perform a method for assessing a body system for an emergence of a comorbidity associated with a primary disease, comprising:

receiving at least one of an autonomic index, a neurologic index, a stress marker index, a psychiatric index, an endocrine index, or a quality of life index of a patient;

comparing the at least one index to at least one reference value associated with the at least one index;

assessing a susceptibility of a the body system to the emergence of the comorbidity at least partially caused by the primary disease based on the comparing, wherein the body system comprises at least one of an autonomic system, a neurologic system, a psychiatric system, an endocrine system, or subsystems of the foregoing; and

providing an output relating to the assessing, wherein the output comprises at least one of increased susceptibility, decreased susceptibility, stable susceptibility, or a determination that a the susceptibility cannot be determined.

2. The non-transitory computer readable program storage unit of claim 1, wherein the method further comprises assessing a susceptibility of a second body system to the comorbidity associated with the primary disease based on the comparing, wherein the second body system comprises at least one of an autonomic system, a neurologic system, a psychiatric system, an endocrine system, or subsystems of the foregoing, and the output comprises at least one of second increased susceptibility, second decreased susceptibility, second stable susceptibility, or a determination that the susceptibility cannot be determined.

3. The non-transitory computer readable program storage unit of claim 1, wherein the output further comprises at least one of a magnitude of a change of an increased susceptibility, a magnitude of a change of a decreased susceptibility, a rate of change of an increased susceptibility, or a rate of change of a decreased susceptibility.

4. The non-transitory computer readable program storage unit of claim 1, wherein the method further comprises assessing a state of the primary disease of the patient based on comparing at least one second index to at least one second reference value, wherein the output further comprises primary disease stability, primary disease progression, primary disease regression, or a finding that a primary disease state cannot be determined.

5. The non-transitory computer readable program storage unit of claim 4, wherein the output further comprises identifying at least a second comorbidity associated with the primary disease.

6. The non-transitory computer readable program storage unit of claim 4, wherein the method further comprises providing a warning signal to the patient, a physician, or a caregiver if the output comprises primary disease progression, primary disease regression, or primary disease state indeterminability.

7. The non-transitory computer readable program storage unit of claim 6, wherein the warning signal is proportional to at least one of a magnitude of a change of a progression, a rate of change of a progression, or a role of the body system in the overall health of the patient.

8. The non-transitory computer readable program storage unit of claim 1, wherein the primary disease is epilepsy;

receiving comprises receiving at least one autonomic index selected from a cardiovascular parameter, a respiration parameter, a body temperature parameter, a skin resistance parameter, or two or more thereof; and

at least one neurologic index selected from an attention aptitude parameter, a responsiveness parameter, a memory parameter, a kinetic parameter, a cognitive aptitude parameter, a quality of life parameter, or two or more thereof.

9. The non-transitory computer readable program storage unit of claim 8, wherein receiving further comprises receiving at least one stress marker index selected from a cortisol parameter, a catecholamine parameter, a lactic acid parameter, or two or more thereof.

10. The non-transitory computer readable program storage unit of claim 8, wherein the at least one autonomic index comprises at least one of a cardiovascular parameter or a respiratory parameter, and the at least one neurologic index comprises at least one of a responsiveness parameter or a kinetic parameter.

11. The non-transitory computer readable program storage unit of claim 1, wherein the method further comprises forecasting a state of the body system, wherein the forecast comprises a body system stability, a body system improvement, a body system deterioration, or a finding that no forecast can be made.

12. The non-transitory computer readable program storage unit of claim 1, wherein receiving comprises receiving a plurality of autonomic indices, neurologic indices, stress marker indices, psychiatric indices, endocrine indices, physical fitness indices, quality of life indices, or two or more thereof;

and

the at least one index comprises a weighted composite of the plurality of autonomic indices, neurologic indices, stress marker indices, psychiatric indices, endocrine indices, physical fitness indices, quality of life indices, or two or more thereof.

13. The non-transitory computer readable program storage unit of claim 1, wherein the at least one reference value is based on the patient'"'"'s index value history or on normative data.

14. The non-transitory computer readable program storage unit of claim 1, wherein the at least one index comprises a measure of central tendency, a measure of dimensionality, a measure of fractality, a measure of stationarity, a measure of long-range dependency, a measure of clustering, a distribution of measures of central tendency, a distribution of measures of dimensionality, a distribution of measures of fractality, a distribution of measures of stationarity, a distribution of measures of long-range dependency, a distribution of measures of clustering, or two or more thereof.

15. The non-transitory computer readable program storage unit of claim 1, wherein an output of an increased susceptibility is indicative of a deterioration of the patient'"'"'s health, an output of a decreased susceptibility is indicative of an improvement of the patient'"'"'s health, an output of a stable susceptibility is indicative of a stability of the patient'"'"'s health, an output of deterioration in quality of life is indicative of a deterioration of the patient'"'"'s mental health, an output of improvement in quality of life is indicative of an improvement of the patient'"'"'s mental health, or an output of indeterminability of susceptibility is indicative of indeterminability of the patient'"'"'s health.

16. The non-transitory computer readable program storage unit of claim 4, wherein an output of primary disease deterioration is indicative of a deterioration of the patient'"'"'s health, an output of primary disease improvement is indicative of an improvement of the patient'"'"'s health, an output of primary disease stability is indicative of a stability of the patient'"'"'s health, or an output of indeterminability of a primary disease is indicative of indeterminability of the patient'"'"'s health.

17. The non-transitory computer readable program storage unit of claim 12, further comprising determining the state of health of a patient using said weighted composite index.

20. The non-transitory computer readable program storage unit of claim 1, wherein the method further comprises providing a warning signal to the patient, a physician, or a caregiver if the output comprises increased susceptibility or indeterminability of susceptibility.

18. A non-transitory computer readable program storage unit encoded with instructions that, when executed by a computer, perform a method for assessing a body system for an emergence of a comorbidity associated with a primary disease, comprising:

receiving a first index selected from the group consisting of an autonomic index, a neurologic index, a stress marker index, a psychiatric index, an endocrine index, a physical fitness index, and a quality of life index of a patient;

comparing the first index to at least one reference value associated with the at least first index;

assessing a susceptibility of a body system to the emergence of the comorbidity at least partially caused by the primary disease based on the comparing, wherein the body system comprises at least one of an autonomic system, a neurologic system, a psychiatric system, an endocrine system, or subsystems of the foregoing;

assessing a state of the patient'"'"'s health based on the assessing the susceptibility of the body system to the emergence of the comorbidity; and

providing an output relating to at least one of the assessment of the susceptibility of the body system or the assessment of the state of the patient'"'"'s health, wherein the output comprises at least one of increased susceptibility, decreased susceptibility, stable susceptibility, a determination that the susceptibility of the body system cannot be determined, a stable health state, a poorer health state, an improved health state, or a finding that the state of the patient'"'"'s health cannot be determined.

19. A medical device system, comprising:

a body index determination unit capable of determining at least one of an autonomic index, at least one neurologic index, at least one stress marker index, at least one psychiatric index, at least one endocrine index, at least one adverse effect of therapy index, at least one physical fitness index, or at least one quality of life index;

an index comparison unit capable of comparing at least one said index with at least one reference value;

a body system susceptibility assessment unit capable of assessing a susceptibility of a body system to an emergence of a comorbidity at least partially caused by a primary disease of a patient, wherein the body system comprises at least one of an autonomic system, a neurologic system, a psychiatric system, an endocrine system, an hepatic system, a renal system, a bone marrow system, a skin system, or subsystems of the foregoing; and

an output unit capable of providing an output relating to the assessing, wherein the output comprises at least one of increased susceptibility, decreased susceptibility, stable susceptibility, or a determination that a susceptibility of the body system cannot be determined.