Feasibility, functionality, and user experience with wearable technologies for acute exacerbation monitoring in patients with severe COPD
Bibliographic record
Abstract
Background: The increasing interest in remote patient monitoring technologies in patients with chronic obstructive pulmonary disease (COPD) requires a phased and stepwise investigative approach, which includes high-risk clinical subgroups who stand to benefit most from such innovations. Methods: Patients aged > 40 with spirometry-confirmed COPD presenting with a current acute exacerbation (ECOPD) were recruited from a tertiary centre Day Hospital in this prespecified feasibility study. Heart rate, respiratory rate, oxygen saturation, skin temperature, and daily activity and overnight sleep quality parameters were collected remotely by a wearable biometric wristband and ring for 21 consecutive days. “Total ambulatory wear time” and “percent of useable data” for eligible vital sign parameters were calculated. Correlation and agreement between cardiorespiratory vital sign data were performed using Spearman’s correlation rho and the Bland-Altman test, respectively. User experience was measured with end-of-study System Usability Scale (SUS) questionnaires. Results: Nine participants (mean age 66.8 ± 8.4 years, 22% female, mean FEV 1 1.4L (34.1% predicted), with “severe” (56%) or “very severe” (44%) COPD) experiencing a current ECOPD were included. Wear time was 94% (wristband) and 88.2% (ring) of the total ambulatory study period. Wristband-obtained data (every 1 min, artefact-free) revealed 99.2% and 98.6% of all heart rate and temperature data, respectively, was useable, whereas only 17.6% of all respiratory rate data was useable. Ring-obtained data (every 5 min, “average” and “good” quality) revealed 84.5% of all heart rate data was useable. Cross-sectional analyses with nurse-obtained vital signs revealed correlation coefficients of 0.56 ( p = 0.11) and 0.81 ( p = 0.0086) for wristband-obtained and ring-obtained heart rate, respectively, and only 0.15 ( p = 0.74) for wristband-obtained respiratory rate, without evidence of systematic/proportional bias. Longitudinal heart rate and respiratory rate inter-device analyses demonstrated correlations of 0.86 ( p < 0.001) and 0.65 ( p < 0.001), respectively. Finally, end-of-study SUS scores were 86.4/100 (wristband) and 89.2/100 (ring). Conclusion: Older adults with severe/very severe COPD experiencing a current ECOPD were capable of autonomous physiological data collection/upload/transmission from their home environment over several weeks using sophisticated wearable biometric technology, with favourable user experiences. Cross-sectional and longitudinal comparative results call into question the paradigm of single sets of infrequent/interval vital sign checks as the current “gold-standard” in frontline clinical practice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".