A comparison of the contribution of systolic versus diastolic blood pressure to risk of coronary heart disease and the role of mean arterial pulse pressure and systolic lability have been examined prospectively in 5,127 men and women during 14 years of biennial follow-up studies. Similar gradients of risk of subsequent coronary heart disease were observed whether persons were classified by their systolic or diastolic pressure, and no “safe” or critical level could be identified. Assessment of the net effect of each, employing discriminant analysis, indicated a stronger association of systolic than diastolic pressure with risk of coronary heart disease. Neither the systolic and diastolic pressure measurements in combination nor the pulse pressure and the mean arterial pressure measurements alone discriminated better than the systolic measurement alone. Systolic lability did not predict incidence of coronary heart disease independently of the associated level of blood pressure. There was a trend of declining relative importance of diastolic and a corresponding increase in the importance of systolic pressure with advancing age. Only in those under 45 was diastolic pressure predominant. The level of casually obtained blood pressure was a good predictor of coronary heart disease. The current practice of assessing the importance of blood pressure at all ages largely on the basis of diastolic pressure and the commonly held view concerning the innocuous nature of an elevated level of systolic pressure in the elderly requires reevaluation.

Systolic Versus Diastolic Blood Pressure and Risk of Coronary Heart Disease???The Framingham Study

Pulmonary function testing

Purpose

The purpose of this review is to address important methodological issues related to conducting accelerometer-based assessments of physical activity in free-living individuals.

Methods

We review the extant scientific literature for empirical information related to the following issues: product selection, number of accelerometers needed, placement of accelerometers, epoch length, and days of monitoring required to estimate habitual physical activity. We also discuss the various options related to distributing and collecting monitors and strategies to enhance compliance with the monitoring protocol.

Results

No definitive evidence exists currently to indicate that one make and model of accelerometer is more valid and reliable than another. Selection of accelerometer therefore remains primarily an issue of practicality, technical support, and comparability with other studies. Studies employing multiple accelerometers to estimate energy expenditure report only marginal improvements in explanatory power. Accelerometers are best placed on hip or the lower back. Although the issue of epoch length has not been studied in adults, the use of count cut points based on 1-min time intervals maybe inappropriate in children and may result in underestimation of physical activity. Among adults, 3–5 d of monitoring is required to reliably estimate habitual physical activity. Among children and adolescents, the number of monitoring days required ranges from 4 to 9 d, making it difficult to draw a definitive conclusion for this population. Face-to-face distribution and collection of accelerometers is probably the best option in field-based research, but delivery and return by express carrier or registered mail is a viable option.

Conclusion

Accelerometer-based activity assessments requires careful planning and the use of appropriate strategies to increase compliance.

Conducting accelerometer-based activity assessments in field-based research

The accurate assessment of sleep is critical to better understand and evaluate its role in health and disease. The boom in wearable technology is part of the digital health revolution and is producing many novel, highly sophisticated and relatively inexpensive consumer devices collecting data from multiple sensors and claiming to extract information about users' behaviors, including sleep. These devices are now able to capture different biosignals for determining, for example, HR and its variability, skin conductance, and temperature, in addition to activity. They perform 24/7, generating overwhelmingly large data sets (big data), with the potential of offering an unprecedented window on users' health. Unfortunately, little guidance exists within and outside the scientific sleep community for their use, leading to confusion and controversy about their validity and application. The current state-of-the-art review aims to highlight use, validation and utility of consumer wearable sleep-trackers in clinical practice and research. Guidelines for a standardized assessment of device performance is deemed necessary, and several critical factors (proprietary algorithms, device malfunction, firmware updates) need to be considered before using these devices in clinical and sleep research protocols. Ultimately, wearable sleep technology holds promise for advancing understanding of sleep health; however, a careful path forward needs to be navigated, understanding the benefits and pitfalls of this technology as applied in sleep research and clinical sleep medicine.

/pdf/wearable-sleep-technology-in-clinical-and-research-settings-9ijyvopq3s.pdf

Wearable Sleep Technology in Clinical and Research Settings.

Background: With the rise of mobile medicine, the development of new technologies such as smart sensing, and the popularization of personalized health concepts, the field of smart wearable devices has developed rapidly in recent years. Among them, medical wearable devices have become one of the most promising fields. These intelligent devices not only assist people in pursuing a healthier lifestyle but also provide a constant stream of health care data for disease diagnosis and treatment by actively recording physiological parameters and tracking metabolic status. Therefore, wearable medical devices have the potential to become a mainstay of the future mobile medical market.
Objective: Although previous reviews have discussed consumer trends in wearable electronics and the application of wearable technology in recreational and sporting activities, data on broad clinical usefulness are lacking. We aimed to review the current application of wearable devices in health care while highlighting shortcomings for further research. In addition to daily health and safety monitoring, the focus of our work was mainly on the use of wearable devices in clinical practice.
Methods: We conducted a narrative review of the use of wearable devices in health care settings by searching papers in PubMed, EMBASE, Scopus, and the Cochrane Library published since October 2015. Potentially relevant papers were then compared to determine their relevance and reviewed independently for inclusion.
Results: A total of 82 relevant papers drawn from 960 papers on the subject of wearable devices in health care settings were qualitatively analyzed, and the information was synthesized. Our review shows that the wearable medical devices developed so far have been designed for use on all parts of the human body, including the head, limbs, and torso. These devices can be classified into 4 application areas: (1) health and safety monitoring, (2) chronic disease management, (3) disease diagnosis and treatment, and (4) rehabilitation. However, the wearable medical device industry currently faces several important limitations that prevent further use of wearable technology in medical practice, such as difficulties in achieving user-friendly solutions, security and privacy concerns, the lack of industry standards, and various technical bottlenecks.
Conclusions: We predict that with the development of science and technology and the popularization of personalized health concepts, wearable devices will play a greater role in the field of health care and become better integrated into people’s daily lives. However, more research is needed to explore further applications of wearable devices in the medical field. We hope that this review can provide a useful reference for the development of wearable medical devices.

/pdf/wearable-health-devices-in-health-care-narrative-systematic-2f964x4hzh.pdf

Wearable Health Devices in Health Care: Narrative Systematic Review

Wearable technologies will play an important role in advancing precision medicine by enabling measurement of clinically-relevant parameters describing an individual's health state. The lifestyle and fitness markets have provided the driving force for the development of a broad range of wearable technologies that can be adapted for use in healthcare. Here we review existing technologies currently used for measurement of the four primary vital signs: temperature, heart rate, respiration rate, and blood pressure, along with physical activity, sweat, and emotion. We review the relevant physiology that defines the measurement needs and evaluate the different methods of signal transduction and measurement modalities for the use of wearables in healthcare.

Wearable Devices for Precision Medicine and Health State Monitoring

Using a Real-Time Location System for Assessment of Patient Ambulation in a Hospital Setting

Social media as a tool to monitor adherence to HIV antiretroviral therapy.

The present invention provides a system and method for monitoring personal health of the user. The method includes detecting a plurality of physiological parameters. The plurality of physiological parameters are collected and analyzed. Afterwards, the plurality of analyzed physiological parameters are transferred at pre defined time interval to at least one computing device for monitoring the personal health of the user.

Personal Health Monitoring Device

Excessive smartphone use has been linked to adverse health outcomes including distracted driving, sleep disorders, and depression. Responding to this growing trend, apps have been developed to support users in overcoming their dependency on smartphones. In that vein, our investigation explored the “big data” available on these types of apps to gain insights about them. We narrowed our search of apps, then reviewed content and functionality of 125 Android and iOS apps that purport to reduce device usage in the United States and elsewhere. This sample was curated based on popularity through the market research tool, App Annie (which indicates revenue and downloads per category of app and by country). The apps fell into 13 broad categories, each of which contained several different features related to filters, usage controls, and monitoring programs. Findings suggest that social media technologies, including smartphone apps, are being attempted for use for health behavior change. We discuss methods of sorting through “big data” generated by apps that purport to curb smartphone addiction. Finally, we propose data-driven features, such as social facilitation and gamification, that developers might use to enhance the effectiveness of these apps.

David Bychkov

Papers

Wearable Devices for Precision Medicine and Health State Monitoring

Using a Real-Time Location System for Assessment of Patient Ambulation in a Hospital Setting

Social media as a tool to monitor adherence to HIV antiretroviral therapy.

Personal Health Monitoring Device

Facing Up to Nomophobia: A Systematic Review of Mobile Phone Apps that Reduce Smartphone Usage