{"title":"Automatic Near Real-Time Outlier Detection and Correction in Cardiac Interbeat Interval Series for Heart Rate Variability Analysis: Singular Spectrum Analysis-Based Approach","authors":"M. Lang","doi":"10.2196/10740","DOIUrl":"https://doi.org/10.2196/10740","url":null,"abstract":"Background: Heart rate variability (HRV) is derived from the series of R-R intervals extracted from an electrocardiographic (ECG) measurement. Ideally all components of the R-R series are the result of sinoatrial node depolarization. However, the actual R-R series are contaminated by outliers due to heart rhythm disturbances such as ectopic beats, which ought to be detected and corrected appropriately before HRV analysis. Objective: We have introduced a novel, lightweight, and near real-time method to detect and correct anomalies in the R-R series based on the singular spectrum analysis (SSA). This study aimed to assess the performance of the proposed method in terms of (1) detection performance (sensitivity, specificity, and accuracy); (2) root mean square error (RMSE) between the actual N-N series and the approximated outlier-cleaned R-R series; and (3) how it benchmarks against a competitor in terms of the relative RMSE. Methods: A lightweight SSA-based change-point detection procedure, improved through the use of a cumulative sum control chart with adaptive thresholds to reduce detection delays, monitored the series of R-R intervals in real time. Upon detection of an anomaly, the corrupted segment was substituted with the respective outlier-cleaned approximation obtained using recurrent SSA forecasting. Next, N-N intervals from a 5-minute ECG segment were extracted from each of the 18 records in the MIT-BIH Normal Sinus Rhythm Database. Then, for each such series, a number (randomly drawn integer between 1 and 6) of simulated ectopic beats were inserted at random positions within the series and results were averaged over 1000 Monte Carlo runs. Accordingly, 18,000 R-R records corresponding to 5-minute ECG segments were used to assess the detection performance whereas another 180,000 (10,000 for each record) were used to assess the error introduced in the correction step. Overall 198,000 R-R series were used in this study. Results: The proposed SSA-based algorithm reliably detected outliers in the R-R series and achieved an overall sensitivity of 96.6%, specificity of 98.4% and accuracy of 98.4%. Furthermore, it compared favorably in terms of discrepancies of the cleaned R-R series compared with the actual N-N series, outperforming an established correction method on average by almost 30%. Conclusions: The proposed algorithm, which leverages the power and versatility of the SSA to both automatically detect and correct artifacts in the R-R series, provides an effective and efficient complementary method and a potential alternative to the current manual-editing gold standard. Other important characteristics of the proposed method include the ability to operate in near real-time, the almost entirely model-free nature of the framework which does not require historical training data, and its overall low computational complexity. (JMIR Biomed Eng 2019;4(1):e10740) doi: 10.2196/10740 JMIR Biomed Eng 2019 | vol. 4 | iss. 1 | e10740 | p. 1 https://biome","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42007044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leia C. Shum, Bulmaro A. Valdés, H. V. D. Van der Loos
{"title":"Determining the Accuracy of Oculus Touch Controllers for Motor Rehabilitation Applications Using Quantifiable Upper Limb Kinematics: Validation Study","authors":"Leia C. Shum, Bulmaro A. Valdés, H. V. D. Van der Loos","doi":"10.2196/12291","DOIUrl":"https://doi.org/10.2196/12291","url":null,"abstract":"Background: As commercial motion tracking technology becomes more readily available, it is necessary to evaluate the accuracy of these systems before using them for biomechanical and motor rehabilitation applications. Objective: This study aimed to evaluate the relative position accuracy of the Oculus Touch controllers in a 2.4 x 2.4 m play-space. Methods: Static data samples (n=180) were acquired from the Oculus Touch controllers at step sizes ranging from 5 to 500 mm along 16 different points on the play-space floor with graph paper in the x (width), y (height), and z (depth) directions. The data were compared with reference values using measurements from digital calipers, accurate to 0.01 mm; physical blocks, for which heights were confirmed with digital calipers; and for larger step sizes (300 and 500 mm), a ruler with hatch marks to millimeter units. Results: It was found that the maximum position accuracy error of the system was 3.5 ± 2.5 mm at the largest step size of 500 mm along the z-axis. When normalized to step size, the largest error found was 12.7 ± 9.9% at the smallest step size in the y-axis at 6.23 mm. When the step size was <10 mm in any direction, the relative position accuracy increased considerably to above 2% (approximately 2 mm at maximum). An average noise value of 0.036 mm was determined. A comparison of these values to cited visual, goniometric, and proprioceptive resolutions concludes that this system is viable for tracking upper-limb movements for biomechanical and rehabilitation applications. The accuracy of the system was also compared with accuracy values from previous studies using other commercially available devices and a multicamera, marker-based professional motion tracking system. Conclusions: The study found that the linear position accuracy of the Oculus Touch controllers was within an agreeable range for measuring human kinematics in rehabilitative upper-limb exercise protocols. Further testing is required to ascertain acceptable repeatability in multiple sessions and rotational accuracy. (JMIR Biomed Eng 2019;4(1):e12291) doi: 10.2196/12291","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68428666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Plante, Anna C. O'Kelly, Bruno Urrea, Zane T. Macfarlane, L. Appel, Edgar R Miller III, R. Blumenthal, S. Martin
{"title":"Auralife Instant Blood Pressure App in Measuring Resting Heart Rate: Validation Study","authors":"T. Plante, Anna C. O'Kelly, Bruno Urrea, Zane T. Macfarlane, L. Appel, Edgar R Miller III, R. Blumenthal, S. Martin","doi":"10.2196/11057","DOIUrl":"https://doi.org/10.2196/11057","url":null,"abstract":"Background: mHealth apps that measure heart rate using pulse photoplethysmography (PPG) are classified as class II (moderate-risk) Food and Drug Administration devices; therefore, these devices need clinical validation prior to public release. The Auralife Instant Blood Pressure app (AuraLife IBP app) is an mHealth app that measures blood pressure inaccurately based on a previous validation study. Its ability to measure heart rate has not been previously reported. Objective: The objective of our study was to assess the accuracy and precision of the AuraLife IBP app in measuring heart rate. Methods: We enrolled 85 adults from ambulatory clinics. Two measurements were obtained using the AuraLife IBP app, and 2 other measurements were achieved with a oscillometric device. The order of devices was randomized. Accuracy was assessed by calculating the relative and absolute mean differences between heart rate measurements obtained using each AuraLife IBP app and an average of both standard heart rate measurements. Precision was assessed by calculating the relative and absolute mean differences between individual measurements in the pair for each device. Results: The relative and absolute mean (SD) differences between the devices were 1.1 (3.5) and 2.8 (2.4) beats per minute (BPM), respectively. Meanwhile, the within-device relative and absolute mean differences, respectively, were <0.1 (2.2) and 1.7 (1.4) BPM for the standard device and −0.1 (3.2) and 2.2 (2.3) BPM for the AuraLife IBP app. Conclusions: The AuraLife IBP app had a high degree of accuracy and precision in the measurement of heart rate. This supports the use of PPG technology in smartphones for monitoring resting heart rate. (JMIR Biomed Eng 2018;3(1):e11057) doi: 10.2196/11057","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42189482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Relationship Between the Applied Occlusal Load and the Size of Markings Produced Due to Occlusal Contact Using Dental Articulating Paper and T-Scan: Comparative Study","authors":"Shravya Reddy, P. Kumar, Vyoma Venkatesh Grandhi","doi":"10.2196/11347","DOIUrl":"https://doi.org/10.2196/11347","url":null,"abstract":"Background: The proposed experimental design was devised to determine whether a relationship exists between the occlusal load applied and the size of the markings produced from tooth contact when dental articulating paper and T-Scan are interposed alternatively. Objective: The objective of our study was to compare the relationship between contact markings on an articulating paper and T-Scan for an applied occlusal load. Methods: In this in vitro study, dentulous maxillary and mandibular dies were mounted on a metal jig and articulating paper and T-Scan sensor were placed alternatively between the casts. Loads simulating occlusal loads began at 25 N and incrementally continued up to 450 N. The resultant markings (180 marks resulting from articulating paper and 138 from T-Scan) were photographed, and the marks were analyzed using MOTIC image analysis and sketching software. Descriptive statistical analyses were performed using one-way analysis of variance, Student t test, and Pearson correlation coefficient method. Results: Statistical interpretation of the data indicated that with articulating paper, the mark area increased nonlinearly with increasing load and there was a false-positive result. The characteristics of the paper mark appearance did not describe the amount of occlusal load present on a given tooth. The contact marking obtained using T-Scan for an applied occlusal load indicated that the mark area increased with increase in the load and provided more predictable results of actual load content within the occlusal contact. Conclusions: The size of an articulating paper mark may not be a reliable predictor of the actual load content within the occlusal contact, whereas a T-Scan provides more predictable results of the actual load content within the occlusal contact. (JMIR Biomed Eng 2018;3(1):e11347) doi: 10.2196/11347","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44541231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}