TOWARD A PERSONAL HEALTH SOCIETY IN CARDIOLOGY Jocelyne Fayn and Paul Rubel IEEE TRANSACTIONS ON INFORMATION TECHNOLOGY IN BIOMEDICINE, VOL. 14, NO. 2, MARCH 2010 Presentor: 陳麒文

Enhanced Personal, Intelligent, and Mobile system for Early Detection and Interpretation of Cardiac Syndromes (EPI-MEDICS). Information and communication technology (ICT) personal health systems (PHSs) standard communication protocol for computer- assisted electrocardiography (SCP-ECG) general practitioner (GP)

introduction Missed diagnoses have been widely reported ECG recording remains the most important evaluation of patients with chest pain

NEW ERA OF PERSONAL DEVICES FOR PHEALTH: THE EPI-MEDICS EXAMPLE first prerequisite for enabling a secure delivery of preventive, personalized and citizen- centered, high-quality health care Reliability Adaptability Usability PEM is an affordable, easy-to-use, and portable device that can be held in one hand as a cellular phone

Information Capture and Restitution (V1, V3, V4, V5, V6) = f (I, II, V2) Information Processing and Embedded Intelligence PEM embeds all the standard ECG preprocessing steps such as beat typification and wave delineation Providing any citizen with a powerful decision-support system (DSS) for myocardial ischemia and arrhythmia detection Information Management Support SCP-ECG, EHR

AMBIENT INTELLIGENCE, INFORMATION-PROCESSING BUSINESS SERVICES, AND PHS Patient-Specific 3-D to 12-lead ECG Synthesis based on a multiple linear regression technique and the other being an ANN architecture ECG Analysis Software Factory ECG processing steps of SCP-ECG format decoding, baseline drift correction, filtering, beat typification, median or typical beat determination, wave delineation, and global and lead-by lead measurement computation Cardiac Risk Probability Computation probability accuracy measured by the area under the receiver operating characteristic (ROC) curve, obtained with the Bayesian architecture, was greater than 6% compared with the use of logistic regression or ANN-based methods ECG-Based MultiClassifier Decision Making for Myocardial Infarction multiclassifier-based method combining the ANN architecture for ECG interpretation and the Bayesian risk score probability

CONTEXT-AWARENESS AND INTELLIGENT, AMBIENT COMMUNICATION SERVICES, AND PHS Major and medium alarms sends by means of Bluetooth and general packet radio system (GPRS) Reason severity, personal info, current ECG, HER, most recent baseline ECG (reference ECG), clinical signs, last ECG before alarm SCP-ECG

EVALUATION RESULTS AND DISCUSSION On 10% of these patients, new episodes of arrhythmia events have been detected there is no evidence of rejection of the PEM- ECGs

CONCLUSION The overall architecture we present in this paper toward a personal health society in cardiology may be considered as a reference example and reused in other medical domains

Q&A