Original Article: Randomised open label cross-over pilot study comparing feasibility of S-patch vs 24 hour holter in Frail Older People with Falls (Preprint)
Notice bibliographique
Résumé
Background: Falls commonly cause injuries in older adults and can present with syncope or presyncope. Typically, frail older adults with cognitive impairment are underrepresented in research and experience difficulty tolerating conventional ECG monitoring devices. S-Patch is a novel, lightweight dual-lead device designed to provide continuous ECG monitoring for up to 72 hours with minimal interference to daily activities. Objective: This study aimed primarily to evaluate the feasibility, tolerability, and adherence of the S-Patch compared with standard 24-hour Holter monitoring in older adults (aged ≥60 years) presenting with unwitnessed falls, syncope, or near-syncope, as assessed by wear duration, completion rates, and patient-reported experience. The secondary objective of this study was to assess device usability and compare arrhythmia detection rates between the devices in a real-world setting. Methods: This prospective, single-center, randomized, open-label, crossover feasibility pilot study was conducted from March 8, 2020, to February 28, 2023. Participants were randomized 1:1 into group A (Holter followed by S-Patch) or group B (S-Patch followed by Holter), enabling up to 4 days of continuous monitoring. Results: Seventy patients were enrolled, of whom 32 (45.7%) had cognitive impairment, and the majority were frail. Group A participants were older (86.9 vs 82.9 years) with higher use of dementia medications (6/35, 17.1% vs 3/35, 8.6%). Frailty was highly prevalent across the cohort, and fear of falling was significantly greater among frail patients (P=.04). Both devices were well tolerated, with no difference in overall device preference, but S-Patch enabled substantially longer monitoring durations compared to Holter. Mean S-Patch wear time exceeded 60 hours and was significantly longer when the device was applied first (68.8 vs 62.9 h; P=.04), suggesting acceptance and adherence. Importantly, tolerability was maintained in frail patients with cognitive impairment. Arrhythmia detection rates were observed as comparable, with both devices identifying one clinically significant arrhythmia, resulting in pacemaker implantation. Conclusions: S-Patch is a feasible, well-tolerated cardiac monitoring device in frail older adults and those with cognitive impairment. Compared with Holter, S-Patch supported longer continuous monitoring without compromising patient acceptability, an important consideration in real-world clinical practice.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,003 | 0,002 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,021 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».