Automatic analysis of uterine activity signals and use thereof for enhancing the labor and delivery experience
阅读说明：本技术 对子宫活动信号的自动分析以及在增强生产与分娩经历上的应用 (Automatic analysis of uterine activity signals and use thereof for enhancing the labor and delivery experience ) 是由 J·范德拉尔 J·J·M·基尔凯斯 于 2013-09-19 设计创作，主要内容包括：一种子宫分析装置,包括绘制设备以及耦合到所述绘制设备的至少一个控制器,并且所述子宫分析装置被配置为：采集与患者的子宫活动有关的子宫活动信号(UAS)；基于所采集的UAS来确定子宫活动信息；并且至少部分地基于所确定的子宫活动信息来在所述绘制设备上绘制内容。所述控制器可以将所确定的子宫活动信息与阈值子宫活动信息进行比较以基于决策来提供临床决策支持(CDS)。此外,所述控制器可以在检测到收缩开始时绘制呼吸指导以图示预定的呼吸模式。(A uterine analysis apparatus comprising a mapping device and at least one controller coupled to the mapping device, and configured to: acquiring a Uterine Activity Signal (UAS) related to uterine activity of a patient; determining uterine activity information based on the acquired UAS; and rendering content on the rendering device based at least in part on the determined uterine activity information. The controller may compare the determined uterine activity information to threshold uterine activity information to provide Clinical Decision Support (CDS) based on the decision. Further, the controller may plot breathing guidance to illustrate a predetermined breathing pattern when the onset of contraction is detected.)
1. A uterine activity analysis device comprising:
a rendering device (930); and
at least one controller (910) coupled to the rendering device and configured to:
acquiring a Uterine Activity Signal (UAS) corresponding to uterine activity of a patient;
analyzing the acquired uterine activity signals to determine uterine activity information, the uterine activity information including information indicative of the onset of the detected contraction; and is
Upon detecting the onset of the contraction, rendering content on the rendering device based at least in part on the determined uterine activity information,
wherein the rendered content comprises a breathing instruction comprising an animation component configured to increase in size to indicate inhalation and decrease in size to indicate exhalation.
2. The apparatus of claim 1, wherein the at least one controller is further configured to form the content according to a selected uterine activity representation theme.
3. The apparatus of claim 1, wherein the at least one controller is further configured to compare the determined uterine activity information to threshold uterine activity information and provide Clinical Decision Support (CDS) based on the decision.
4. The apparatus of claim 1, wherein the at least one controller is configured to draw a menu comprising a plurality of uterine activity representation themes for selection by a user.
5. The apparatus of claim 1, wherein the selecting is performed by the user online or offline.
6. The apparatus of claim 1, wherein the content is annotated with: information about a corresponding contraction and an event indicating a time, duration, and/or intensity at which the corresponding contraction occurred.
7. A method of rendering content related to uterine activity of a patient, the method being performed by at least one controller (910) of an imaging system (900) and comprising acts of:
acquiring a Uterine Activity Signal (UAS) corresponding to uterine activity of a patient;
analyzing the acquired uterine activity signals to determine uterine activity information, the uterine activity information including information indicative of the onset of the detected contraction; and
upon detecting the onset of the contraction, rendering content on a rendering device based at least in part on the determined uterine activity information;
wherein the rendered content comprises a breathing instruction comprising an animation component configured to increase in size to indicate inhalation and decrease in size to indicate exhalation.
8. The method of claim 7, further comprising the acts of: the content is also formed in accordance with a selected uterine activity representation theme.
9. The method of claim 7, further comprising the acts of: the determined uterine activity information is compared to threshold uterine activity information and Clinical Decision Support (CDS) is provided based on the decision.
10. The method of claim 7, further comprising the acts of: a menu is drawn comprising a plurality of uterine activity representation themes for selection by the user.
11. The method of claim 7, wherein the content is annotated with: information about a corresponding contraction and an event indicating a time, duration, and/or intensity at which the corresponding contraction occurred.
12. A computer-readable non-transitory memory medium (920) having stored thereon a computer program configured to perform the method of any one of claims 7-11.
13. The computer readable non-transitory memory medium of claim 12, wherein the computer program further comprises non-linear filtering to eliminate and/or reduce large spikes in the raw uterine activity signal.
Technical Field
The present system relates to a system that analyzes Uterine Activity Signals (UAS), and more particularly, to a system that analyzes UAS, extracts parameters and status information from the UAS, generates content based on the extracted parameters and status information, and renders the generated content thereafter, and a method of operating the system.
Background
Generally, during the child-producing process (e.g., or other birth or birth process), it is desirable to provide support for a woman to be born (e.g., later on for the patient or woman, unless context indicates otherwise) to soothe and/or to assist her during the child-producing process. Typical respiratory support systems provide respiratory support based on input provided by, for example, a patient or a professional (e.g., a doctor, nurse, midwife, etc.). For example, in US patent US 4711585 (the contents of which are incorporated herein by reference), a system is shown that requires manual input of information by the patient to synchronize the system with the patient's contractions. Unfortunately, this process is inconvenient.
In general, Uterine Activity Signals (UAS) may be obtained using a tocodynamometer (toco) that outputs a tocograph, an intrauterine pressure catheter (IUPC) that outputs an intrauterine pressure signal, and/or a device for measuring an uterine Electrogram (EHG). Thereafter, the analysis and interpretation of the uterine activity signals may be performed manually by a human expert. This is a labor intensive, error prone and subjective process. In addition, when using a tocodynamometer to generate a UAS, a professional monitoring the signal must regularly check to ensure that the signal does not go out of scale, which may occur when the amplitude of contraction or baseline deviation is very large. If this happens (e.g. the signal goes out of scale) the professional must manually switch to a larger scale. Obviously, the professional must also regularly check whether the opposite situation occurs. Several other Clinical Decision Support (CDS) applications of the information provided by the algorithm are also possible. For example, as described in US6302849 (the contents of which are incorporated herein by reference), initiation and continuation of maternal blood pressure measurements can be prevented when there is significant uterine activity.
It is known that providing support to a lactating woman during the manufacturing process can reduce fear and stress and contribute to a positive child-bearing experience (see Rijnders M, Baston H,
Furthermore, in today's competitive health care market, it is desirable to improve the quality of care (QoC) and provide value added services, thereby distinguishing one health care provider from another. As a result of this competitive Health Care market, the focus of user perceived value will necessarily include patient experience and comfort next to functionality (see, FordRC, Myrron D, Creating Customer-focused Health Care organization. Health Care organization Review 2000; 25(4):18-33, which is incorporated herein by reference in its entirety). In obstetrics, this trend has focused on the experience of women giving young children. Parturition is one of the major events in life: evoking an extreme experience of strong emotion. A good childbirth experience is crucial to the well-being, health and relationship to the baby of a woman (see GoodmanP, Mackey MC, Tavakoli AS: Issues and innovations in the front part: Factorrelated to childbirth birth medical science of journal of Advanced Nurseing 2004; 46: 212.
Rijnders concluded in her study that most Dutch women negatively reviewed their productive experience three years post-partum (see Rijnders 2008). One conclusion in her study was that continuous support during the period of production helped to improve the woman's productive experience, as continuous support could reduce fear and stress. Fear of a child is known to lead to less effective uterine contractions, abnormal fetal heartbeat, and prolonged active production. Thus reducing fear can lead to normalization that contributes to production (see Rouhe 2009).
Furthermore, a recent review of Cochrane shows that Continuous support during production results in significantly more directed production, less caesarean section and less instrumental assist (see hodnet ED, Gates S, Hofmeyr GJ, Weston J, "Continuous support for few times during childbirth (review)", The Cochrane clinical laboratory, 2011, which is incorporated herein by reference in its entirety). In practice, one-to-one support is often not achievable for material and financial reasons.
In US 2011/0144458 a1, a method and apparatus for providing timed visual images during a child is provided. The apparatus is configured to provide a visual image timed to coincide with uterine contractions to assist the expectant mother during childbirth. The apparatus includes a computer system that converts signals obtained from strategically positioned sensors (e.g., tocodynamometer or intrauterine pressure catheter) into a biofeedback visual clip that is easily understood by the mother to be delivered.
In WO 2005/096707 a2, a state based production monitoring system and a method of monitoring a production process are disclosed. The disclosed method comprises the steps of: receiving a plurality of position signals over time from one or more positioning elements or tissue regions located at least one of the cervix and the fetal head; and determining a discrete delivery status of the fetus entirely within the body with a time resolution of better than 15 minutes in response to the position signal.
In EP 1852060 a1, a method and apparatus for displaying information relating to labor associated with an obstetric patient is disclosed. The method and apparatus implements a graphical user interface for displaying labor related information. The graphical user interface displays a first viewing window that selects a set of possible viewing windows, each viewing window of the set conveying a characteristic measure related to labor progress. The graphical user interface also displays at least one control allowing a user to select a subset of the viewing windows.
In US 2005/0267376 a1, a maternal fetal monitoring system is provided. The system can be used during all stages of pregnancy. The system includes a set of sensors, a magnification filtering unit, a calculation unit, and a graphical user interface. In a preferred embodiment, the system further comprises an intelligent unit, such as a neural network system, to analyze and interpret clinical data for prenatal, prenatal and postpartum clinical diagnosis, and labor strategies.
It is an object of the present system to overcome the disadvantages and/or make improvements in the prior art.
It is a further object of some embodiments of the present system to provide support in which physiological monitoring is performed to contribute to an improved experience and/or to provide clinical support.
Disclosure of Invention
The system(s), device(s), method(s), user interface(s), computer program(s), process (es), etc. (each of which will be referred to hereinafter as a system, unless the context clearly indicates otherwise) described herein solve problems in prior art systems.
Embodiments of the present system may include an algorithm that may analyze a Uterine Activity Signal (UAS), such as one obtained using a conventional tocodynamometer, IUPC, or EHG device. Embodiments of the present system may then process the UAS to determine information about uterine activity, such as the start, peak, and end times of contractions, the time interval between them, duration, intensity, time pattern, waveform shape, and so forth. Graphical and/or textual representations of the determined uterine activity parameters and status information may then be formed and rendered for the convenience of the user and/or for providing clinical information to a clinician, etc. Additionally, information generated by embodiments of the present system may be stored in a memory of the system for later use.
In accordance with embodiments of the present system, a uterine analysis apparatus is disclosed that may include a mapping device and at least one controller coupled to the mapping device, which may be configured to: acquiring a Uterine Activity Signal (UAS) corresponding to uterine activity of a patient; determining uterine activity information based on the acquired UAS, the uterine activity information comprising information indicative of contractions related to at least one parameter of the acquired UAS; and rendering content on the rendering device based at least in part on the determined uterine activity information. It is also contemplated that the at least one controller may be further configured to form the content according to a selected uterine activity representation theme. The at least one controller may be further configured to compare the determined uterine activity information to threshold uterine activity information and provide Clinical Decision Support (CDS) based on the decision. It is also contemplated that the uterine activity information may include information related to at least one parameter or state of the acquired UAS.
Further, the at least one controller may be configured to draw a menu including a plurality of uterine activity representation themes for selection by a user. It is also contemplated that the at least one controller may be configured to plot breathing guidance to illustrate a preferred breathing pattern, for example, upon detection of the onset of contractions and/or may be manually initiated when desired.
According to yet another embodiment of the present system, a method of rendering content related to uterine activity of a patient is contemplated, which may be performed by at least one controller of the system and may include one or more acts of: acquiring a Uterine Activity Signal (UAS) corresponding to uterine activity of a patient; determining uterine activity information based on the acquired UAS, the uterine activity information comprising information indicative of contractions related to at least one parameter of the acquired UAS; and rendering content on a rendering device based at least in part on the determined uterine activity information. The method may further include an act of forming the content further according to the selected uterine activity representation theme.
Further, the method may include an act of comparing the determined uterine activity information to threshold uterine activity information and providing Clinical Decision Support (CDS) based on the decision. For example, if the amplitude of the determined uterine activity parameter information exceeds a threshold amplitude, the process may sound an alarm. It is also contemplated that the method may further include forming the uterine activity information to include information related to at least one parameter of the acquired UAS. The method may further include an act of drawing a menu including a plurality of uterine activity representation themes for selection by the user. The method may also include the act of plotting breathing guidance to illustrate a preferred breathing pattern when the onset of systole is detected.
According to yet another embodiment of the present system, a computer program stored on a computer readable memory medium is disclosed, the computer program being configured to perform the method as described above. The program portion may be further configured to form the content further in accordance with a selected uterine activity representation theme. Furthermore, the program portion may be further configured to compare the determined uterine activity information with threshold uterine activity information and determine Clinical Decision Support (CDS) based on the decision. It is also envisaged that the program portion may be further configured to form the content also in accordance with a selected uterine activity representation theme.
It is also contemplated that the program portion may be further configured to draw a menu including a plurality of uterine activity representation themes for selection by a user. It is also envisaged that the program portion is further configured to plot a breathing guidance to illustrate a preferred breathing pattern when the start of a contraction is detected.
According to an embodiment of the present system, a data visualization feedback method is disclosed, comprising: acquiring signals related to the physiology of a patient; determining at least one parameter of the signal over a period of time; determining a change in the signal over the period of time; forming content based on the determined variations of the signal; and rendering the content.
Drawings
The invention is explained in more detail, by way of example, with reference to the accompanying drawings, in which:
FIG. 1 is a flow chart illustrating a process performed by a system according to an embodiment of the present system;
FIG. 2 is a flow chart illustrating a process performed by a system according to an embodiment of the present system;
fig. 3 is a flow chart illustrating a process performed by a Peak Detector State Machine (PDSM) in accordance with embodiments of the present system;
FIG. 4 is a diagram illustrating information generated in accordance with embodiments of the present system;
FIG. 5 is a diagram illustrating information generated in accordance with embodiments of the present system;
FIG. 6 is a diagram illustrating content rendered in accordance with embodiments of the present system;
FIG. 7 is a diagram illustrating content rendered in accordance with embodiments of the present system;
FIG. 8 is a diagram illustrating portions of content rendered in accordance with embodiments of the present system; and is
Fig. 9 shows a portion of a system according to an embodiment of the present system.
Detailed Description
The following is a description of exemplary embodiments that, when taken together with the following drawings, will demonstrate the above noted features and advantages, as well as further ones. In the following description, for purposes of explanation and not limitation, example details are set forth such as architectures, interfaces, techniques, component attachments, etc. However, it will be apparent to one of ordinary skill in the art that other embodiments that depart from these details would still be understood to be within the scope of the claims. Moreover, for the purpose of clarity, detailed descriptions of well-known devices, circuits, tools, techniques and methods are omitted so as not to obscure the description of the present system. It is to be expressly understood that the drawings are included for illustrative purposes and do not represent the full scope of the present system. In the drawings, like reference numbers in different drawings may indicate like elements.
The term rendering and its formulation as used herein refers to providing content, e.g. for visualization or Clinical Decision Support (CDS), such that it can be perceived by at least one user sensation, e.g. vision. For example, the present system may draw the user interface on a display device, a wall (e.g., by projecting the user interface on the wall), etc., so that it may be viewed, interacted with, and/or otherwise perceived by the user. The term rendering may also include all actions, whether graphical, textual, etc., that are required to generate the display of content on a display device.
The present system relates to monitoring of physiological conditions, either in a clinical setting, or on a home-based basis, etc. (e.g., home-based monitoring of production). However, although the following will be exemplarily described with respect to physiological conditions during production (e.g. uterine activity), it is to be expressly understood that the present system is also applicable to other healthcare areas, such as those characterized by long-term processes, treatment and/or monitoring. For example, the present system may be suitably applied to complex situations where different physiological parameters are collected and/or where the patient experiences a physically unpleasant or emotionally difficult experience. In these situations, data visualization feedback may help improve patient experience and/or treatment by providing additional insight and/or positive encouragement in a more understandable and comforting manner. The present system may also be suitably applied to assist oncology patients receiving chemotherapy, family members and/or clinicians involved in such treatment, patients receiving (hemodialysis) treatment, family members and/or clinicians involved in such treatment, patients experiencing infertility problems (females), family members and/or clinicians involved in such treatment/monitoring, monitoring of patients in intensive care, family members and/or clinicians involved in such treatment/monitoring, monitoring of patients suffering from chronic diseases such as diabetes, fibromyalgia or Multiple Sclerosis (MS), and the like.
For the sake of brevity of the following discussion, the present system will be described with respect to monitoring uterine activity during a child. However, it should be expressly understood that this exemplary discussion should be understood to encompass each of the above and others to which the present system may be suitably applied.
Fig. 1 is a flow chart illustrating a process 100 performed by a system according to an embodiment of the present system. Process 100 may be performed using one or more computers that may communicate over a network and that may obtain information from and/or store information to one or more memories (which may be located locally and/or remotely from each other). Process 100 may include one or more of the following actions. Additionally, one or more of the acts may be combined and/or divided into sub-acts, if desired. Additionally, one or more of these actions may be skipped depending on the setting. In operation, the process may begin during act 101 and then continue to act 103.
During act 103, the process may collect sensor information. The sensor information may include information related to uterine activity of a patient and/or other information related to the patient. For example, the sensor information may comprise a Uterine Activity Signal (UAS) comprising information related to uterine activity of the patient. According to some embodiments, the UAS may be a tocodynamometer graph, an intrauterine pressure signal (IUPC), an uterine Electrogram (EHG), the like, and/or combinations thereof. In accordance with embodiments of the present system, the UAS may be formed and/or processed in real-time. However, in yet other embodiments, the UAS may be delayed, stored (e.g., in a memory of the system), and/or processed at a later time.
The UAS may contain many large artifacts, which are often due to movement of the patient, e.g. due to breathing or changing position, and may resemble pulses (e.g. spikes), especially when the UAS comprises one or more signals generated by a tocodynamometer (e.g. a tocodynamometer), but such artifacts may also occur in IUPC and EHG signals. UAS obtained according to embodiments of the present system are shown in fig. 4 and 5, which are diagrams 400 and 500, respectively, showing information generated according to embodiments of the present system. For example, fig. 4 and 5 each include a UAS402 and a
When a UAS (e.g., UAS402 and UAS 502) is generated by, for example, a tocodynamometer or other device, small movements of the patient may induce noise in these signals, such as spikes and/or other large artifacts. Additionally, the monitored signals (e.g., UAS402 and UAS 502) can have large and/or varying (e.g., changing) baseline offsets. For example, the baseline shift may substantially change (change) whenever the patient moves and/or changes position. After completing act 103, the process may continue to act 105.
During act 105, the process may determine UAS parameter information (USPI) from the UAS. The USPI may include a threshold signal, a derivative signal(s) (e.g., first and/or second smooth derivative(s) with respect to time), percent movement information (MPI) (e.g., percent movement) and Baseline Jump Detection Information (BJDI), and cleaned signal information. This information and the method for deriving the information will be discussed with respect to the process shown in fig. 2.
According to some embodiments, the process may sanitize the UAS so that information such as sanitized signals, threshold signals, derivatives, and the like may be extracted therefrom. The process may clean the UAS so that, for example, noise such as spikes, pulses, etc., and/or baseline offsets, etc., may have a reduced effect on the analysis and interpretation of the UAS. For example, a change in the baseline offset for the UAS may confuse a sudden increase or decrease in the baseline offset with the start or end of a contraction. Furthermore, without proper processing, the reliability of various estimations (e.g., of the strength of the detected shrinkage) may be compromised. Thus, during act 105, an estimate of the baseline shift is subtracted from the signal. Additionally, a sudden increase and/or decrease in the baseline shift may cause the UAS to be out of specification. Thus, during act 105, the process may subtract the estimate of the baseline offset from the UAS to obtain an estimated UAS signal with the baseline offset removed (which, except for simplicity, will be referred to simply as UAS). After completing act 105, the process may continue to act 107.
During act 107, the process may determine UAS contraction parameters and/or state information (USPS), which may include information related to the current parameters and/or state of the UAS, such as one or more of start, peak, and end times (of contraction), time between contractions, duration (of contraction), and a sanitized signal. At least a portion of the USPS may be determined using a Peak Detector State Machine (PDSM), which may determine the USPS based on one or more of the USPI and the UAS. The process for performing real-time or offline peak detection and determining the USPS is discussed with reference to fig. 3. Referring to fig. 4 and 5, the parameter and status information (e.g., included in the USPS) extracted by the PDSM may include, for example, information such as listed in table 1, as will be described below with reference to fig. 2 and 3.
TABLE 1
With respect to acts 105 and 107, according to some embodiments, the process may analyze the UAS and extract desired uterine activity information from the UAS. The uterine activity information may include information related to the USPA, uterine activity status, and the like.
With regard to acts 105 and 107, during the first filtering act, artifacts in the UAS may be significantly suppressed by (weighted) median, (weighted) order statistics, decision-based, or other non-linear filtering, followed by smoothing with a linear and/or non-linear smoothing filter or filters. If a low pass filter is used as the first filtering action to perform linear filtering, artifacts in the UAS will be wiped out over time rather than suppressed. Due to the specific nature of the noise in the UAS, which is typically non-gaussian and asymmetric, a non-linear filter will provide better suppression of the noise than a linear Finite Impulse Response (FIR) or Infinite Impulse Response (IIR) filter can provide. For example, the tocodynamometer generates a UAS signal that includes more positive noise spikes than negative noise spikes. Thus, a non-linear filter, such as a weighted order statistics filter, can take such asymmetry into account while preserving desired signal characteristics better than can be performed using a linear filter.
Additionally, embodiments of the present system may include a detector to detect a jump in baseline offset. This detector may be based on the fact that the level of UAS is significantly different before and after the jump, while the change of the signal on either side is relatively small.
Additionally, embodiments of the present system may include a detector to detect whether the acquired UAS needs to be scaled (e.g., when it is out of scale, or when it is very small during strong contractions), and may trigger an autoscale adjuster based on the output of the detector.
The large variability in contractions makes proper peak detection and extraction (e.g., substantially in real time) of uterine activity parameters difficult. Accordingly, embodiments of the present system may employ one or more algorithms that address this fact by computing an intermediate signal (e.g., a threshold signal, which is a smoothed version of the cleaned UAS) (see FIG. 2). In addition, according to some embodiments, the parameters extracted by the process may also aid in the interpretation of fetal Heart Rate (HR) traces in a clinical setting.
After completing act 107, the process may continue to act 109.
During act 109, the process may form content corresponding to the determined USPS. The content may be formed using any suitable graphics generator process, typically a graphics process that may be performed by a Graphics Application (GA), which may be programmable by the system and/or user, if desired. The content may include information, such as text and/or graphics, which may be used to render a representation of at least part of the USPS, such as the start, peak and end times of one or more contractions, the time between two (adjacent) contractions, the duration of one or more contractions, and information about the progress of the expansion and internal examination moments. Information about the expansion progress and the internal examination timing may be manually input by a professional (e.g., a doctor, etc.). For example, fig. 6-8 illustrate content formed by a Graphics Application (GA) according to the USPS, and may be rendered according to embodiments of the present system. The GA may generate content that may include information suitable for visualizing the progress of production, and/or provide production respiratory support. The content may also include information related to sound and/or visual data, graphical information, etc., and may be formed according to system and/or user-defined themes.
For example, according to embodiments of the present system, the visualization of the progress of the production may include information related to uterine activity, such as start, peak and/or end times of contractions, time intervals between them, their durations, intensities, temporal patterns, waveform shapes, etc., each of which may be plotted (independently and/or in conjunction with other information) to visualize the progress of the patient during the production in real-time or offline mode. In this way, the GA may generate content corresponding to the UAS, USPS, and/or USPI, which may be used to form (data) visualizations unique to each patient. The content may be further personalized according to default settings and/or patient settings. For example, a user (e.g., a patient and/or a companion of the patient, a professional, etc.) may further personalize the visualization by, for example, selecting their preferred theme and color from a plurality of available themes and/or colors. Furthermore, to provide respiratory support, the content may be formed to provide real-time support for the convenience of the patient. For example, during production, the content may include visual breathing guidance, which may provide real-time support to the patient, for example to assist in pattern breathing training, to help the patient focus on the attention during systole and reduce pain. In addition, the GA may form the content, such that an automatic synchronization of the contraction of the patient may be made possible. Additionally, the breathing guidance may include one or more production breathing techniques for sufficient support during different phases of production, as may be selected automatically or by a user. Information relating to the one or more production breathing techniques may be stored in a memory of the system and may be selected as desired. Additionally, the process may begin breathing guidance at the user's convenience, for example, when the beginning of a contraction is detected, if desired. Additionally, with respect to the breathing guidance, the breathing guidance may be generated according to a presentation/visualization theme (which may be selected by a user and/or system). Accordingly, a menu including a plurality of breathing guidance presentation themes for selection by the user may be drawn through the process for selection by the user. After completing act 109, the process may continue to act 111.
During act 111, the content may be rendered, for example, displayed by any suitable display of the system (e.g., a monitor and/or projector). Thus, the content may be displayed, if desired, on, for example, a wall of a birth room, on a portable display device, or the like. The patient, the patient's companion, and/or a professional (e.g., midwife, doctor, nurse, caregiver, etc.) may tune the breathing guidance exercises to be performed by the patient by, for example, indicating timing (e.g., breathing rate, etc.) and actions. Additionally, a user, such as a patient, may interact with embodiments of the present system to personalize the breathing guidance by, for example, selecting a theme and/or color(s) that they prefer, as further depicted herein. Thus, using the plotted information, the patient, companion, and/or professional (e.g., midwife, doctor, nurse, caregiver, etc.) can tune the breathing exercises performed by the patient by, for example, instructing timing and actions. The process may continually repeat the actions of process 100 until it is requested (e.g., by the system and/or user) to end. Additionally, the parameters may include corresponding confidence levels, if desired. These confidence levels may indicate the accuracy of the calculation for each variable of the UAS parameter signal.
Fig. 6-8 are diagrams illustrating content rendered according to embodiments of the present system. Referring to fig. 6, according to the subject matter for drawing breathing guidance, the drawn content may include a series of animated circles 602 (e.g., animated circles) that may serve as breathing guidance and may be drawn sequentially (in time). The breathing guidance may be started, for example, when a (strong) contraction is detected, e.g. a contraction greater than or equal to a contraction threshold. However, in yet further embodiments, the breathing guidance may be initiated by the patient manually and/or in response to other detected parameters, conditions, etc., if desired. For example, the circle may grow (e.g., increase in diameter, e.g., using a shaded ring or the like) to indicate when the patient should inhale, and may instead indicate when the patient should exhale. Thus, the breathing guidance may illustrate a preferred breathing pattern. Each of the animation coil(s) may provide information to the patient to tell the patient when to breathe, thereby establishing a desired rhythm. Additionally, the color of the
Additionally, graphics such as lines, arrows, alphanumeric characters (e.g., letters, words (e.g., wheeze, inhale, exhale, etc.)) arrows, and the like, may be generated and/or drawn for the convenience of the user(s).
Referring to fig. 7, the content may include a series of information items, such as branches, flowers and/or legends, according to the subject of the visualization for the progress of production. The content may include a drawing of the USPS for the patient (e.g., during production or possibly production) and may grow as production progresses. For example, the distance between the branches of the first handle (see
Referring to fig. 8, according to yet another theme, the content may be provided in the form of a diagram including a number of columns and/or diagrams. The distance between adjacent bars (see fig. 1, 8) may indicate the time between two contractions, wherein the longer the time between contractions, the longer the distance, and vice versa. The thickness of each bar may indicate the duration of the contraction (see fig. 2, 8), wherein the longer the duration of the contraction, the wider the bar, and vice versa. The length of each bar (see 3, fig. 8) can be used to visualize the amount of uterine distension, with the length of the corresponding bar increasing accordingly as the distension progresses. Thus, according to embodiments of the present system, the greater the expansion, the greater the length of each strip, and vice versa. The intensity of the shrinkage may be illustrated using color. For example, the color of the (current) bar may change from light to dark to indicate the intensity of the current shrink, wherein, for example, the darker the color, the greater the intensity of the shrink, and vice versa. The internal examination instants may be visualized with an indicator (see 5) separating one series of bars from another series of bars.
After completing act 111, the process may continue to act 113, where the process may store information generated by the process (e.g., UAS(s), determined USPI and USPS, the content, and/or selected subject matter) for later use. Thus, after delivery, the content may be stored for later use, such as a birth memorabilia. The process may then repeat (e.g., to generate more graphical information) or may end, if desired.
According to other embodiments of the present system, different mappings of uterine activity parameters (e.g., UAS parameters) to visualizations are possible, as can be set by the system and/or the user. Additionally, in yet further embodiments, computer-generated graphics or other media forms (e.g., light, sound, touch, etc.) may be used to map the uterine activity parameters and thus to communicate the progress of that production to a user, such as a professional (e.g., doctor, nurse, midwife, etc.) and/or patient.
Fig. 2 is a diagram illustrating a
TABLE 2
Referring to table 2, time and amplitude related (exemplary) values of AP are specified in seconds and signal units (e.g., tocodynamometer units), respectively, and are listed between corresponding brackets. After completing
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Thus, if it is determined that the UAS is broken, constant, or poor, the process may determine that the UAS signal is inappropriate, and then the process may reset a variable during
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With respect to the filter, the non-linear artifact suppression filter may be configured for different signal contexts in accordance with embodiments of the present system. For example, since many of the large artifacts are forward pulse-like signals, one or more non-linear filters may be advantageously used that may take into account temporal and rank order to take advantage of this and/or other properties of the desired signal and noise. Examples are clipping mean filters, L-filters, C-filters, M-filters, R-filters, weighted order filters, multi-level median filters, median hybrid filters, stacked filters, polynomial filters, data dependent filters, decision-based filters and morphological filters. After completing
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During act 229, the process may generate content based on the information input to the graphics engine. More specifically, the graphics engine may determine and form content that corresponds to the USPS and may be formed according to the selected theme and/or color to be drawn, as discussed above with reference to act 111 of process 100. After completing act 229, the process may continue to act 231. During act 231, the process may draw the content using any suitable method, such as a display, a projector, a speaker, a haptic device, and so forth. In accordance with embodiments of the present system, acts 229, 231 may run continuously, periodically, and/or on any other type of schedule as desired.
According to yet other embodiments of the present system, the process may use an expert knowledge/CDS system. For example, in some embodiments, the process may compare uterine activity information to threshold information and perform certain actions based on the results of the comparison. For example, if it is determined that the magnitude of the signal corresponding to uterine activity exceeds a threshold, the process may administer a drug (e.g., in a default or determined amount, based on a system setting) and/or sound an alarm based on the system setting. Thus, embodiments of the present system may employ a CDS approach to, for example, administer a drug and/or trigger an alarm as appropriate.
In addition, pattern recognition may be applied to the cleansed signal to distinguish the contractions by type, e.g., final contraction(s) from ordinary contraction(s), if desired. Thus, the process may determine that the shrinkage is normal or final, and may plot the results of the determination.
Fig. 3 is a flow diagram illustrating a
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During act 313, the process may initialize the shrink parameters for the current shrink, may reset and/or save the current shrinkStart time t of contractionbAnd a "start" may be issued. After completing act 313, the process may continue to function block 340 beginning with
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If, however, the condition is not satisfied, the process may continue to act 345.
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During act 371, the process may set TPEA "fall" is issued and thereafter proceeds to function block 320 beginning with
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The issued parameter information may then be transmitted to the graphics engine for further processing in accordance with embodiments of the present system.
In yet further embodiments, the process may determine a baseline offset for the UAS and adjust the baseline offset when it is determined to be out of a threshold limit or superscalar. Additionally, if the UAS is determined to be superscalar, the process may automatically scale the UAS (if desired) so that the UAS is no longer superscalar. The process may further adjust the time delay to improve signal detection reliability.
Embodiments of the present system may provide Clinical Decision Support (CDS) for the convenience of a user (e.g., a patient and/or a professional). For example, it is envisaged that all uterine activity data collected during the production process may be recorded/saved to a memory of the system, such as an optical disc storage device, a permanent memory and/or any other (future) data storage technology that may provide offline use. This data may then be used, for example, to provide items (e.g., information items) in a visual representation, such as obtained after online or offline processing, representing the user's contractions (e.g., flowers, plants, balloons, etc.). According to embodiments of the present system, the items may be annotated with information about the corresponding contraction/event (e.g., a timestamp, duration, and/or intensity indicating the time at which the corresponding contraction occurred). This may also be performed in an interactive manner. For example, items of the visual representation (e.g., flowers) for contraction may be made selectable (e.g., by clicking) and/or "zoomable. However, for example, when a user selects an information item or portion thereof relating to a corresponding contraction, relevant information about the contraction, such as time (e.g., time of occurrence), duration and/or intensity, may be displayed on the screen. This functionality can significantly help review events that occur during production (and their nature) ("in fact, at time 12:13, I have such a strong contraction … …"). This forms a kind of "postpartum care" or postpartum recall of (strong and/or nice) memory.
The uterine activity data may be used to (re-) process the processing (signal processing parameters and/or algorithms may be adjusted), which may provide better results when processed offline, and/or to obtain different visualizations (or even multiple visualizations) by adjusting, for example, visualization parameters. The uterine activity data can be used to (re-) process the data to obtain different visualizations (themes) by applying different mappings (e.g. mapping the extracted UA parameters to a garden of plants/trees instead of a tree, or a mapping of a set of balloons). According to the present system, the visual representation is provided as a visual metaphor for the data so that the data can be easily understood without directly analyzing or reviewing the details of the data. The metaphor is provided in the form of a mapping of the data to visual elements, e.g., the length of the contraction may be mapped to the size of the leaves, the time between contractions may be mapped to the distance between the leaves, etc. These mappings may be provided in the form of selectable topics (e.g., leaves, balloons, etc.).
It is also envisaged that any unexpected mapping(s) may be used and that the mapping may be adjusted by the user, also in a real-time application of the method, online/on line. The cleaned signal itself may even be displayed-possibly overlapping with the extracted parameters and/or states. Offline, or even different, visualizations may be made, if desired by the user, for example. Additionally, the patient, spouse and/or professional may also prefer a summary of statistics for various events, such as the total number of contractions and/or the average frequency of contractions. This information may be provided, for example, in a home monitoring scenario. In addition, the information may be transmitted to a health provider or the like. Home-based monitoring, including production, is possible with the apparatus, methods and computer programs of the present application, but also for other healthcare areas featuring long-term processes, treatments and/or monitoring. The present invention is able to collect different physiological parameters therein and the patient experiences a complex context correlation of physical discomfort and/or emotional distress experience, and such data visualization feedback can help improve the patient's experience and/or treatment by providing additional insight and positive encouragement to the patient and caregiver in a more understandable and comforting manner. In any case, it is not intended to limit the invention of the present application, other examples in which the apparatus, methods and computer programs of the present invention can be used include tumor patients receiving chemotherapy, renal dialysis patients receiving (haemo) dialysis treatment, monitoring of diabetic patients controlling their blood glucose, monitoring in women suffering from (unexplained) infertility problems, and/or monitoring of critical care patients by providing data visualization as feedback to the home.
With respect to process 300, the process may be performed by a finite state machine (FSN), which may transition between a limited number of states, which may be represented by, for example,
Referring to act 311 of
The reasons for the other functional blocks and the corresponding states are substantially similar. For example, assuming an arbitrary state, at several points in time t, the process may determine whether it is still "contracting properly" and may therefore perform several determinations to determine this. For example, at several points in time, the "rise time" TascCan be calculated as the difference between the current time and the start time of the current peak/contraction. Similarly, a fall time T from the peak time until the current time may be calculateddesc. Both values are clearly limited to the intervals observed in clinical practice. These intervals may be defined by T for the rise timeasc,min,Tasc,max]Is defined and consists of [ T ] for the fall timedesc,min,Tdesc,max]And (4) limiting. If these times are not in the proper interval, then the current shrink candidate is "aborted" and the process returns to the "shrink out" state of
It should be clearly understood that these and other euphoria described herein are intended only as an illustration of how these and other states may be determined. Other actions, algorithms, parameters, etc. will readily occur to those of ordinary skill in the art and are intended to be encompassed by the description of the present system.
Fig. 9 illustrates portions of a
The operational acts may include configuring the
The operational action may include a request for, providing, forming and/or drawing information, such as information related to uterine activity of the patient. The
The methods of the present system are particularly suited to be carried out by a processor programmed with a computer software program, such program containing modules corresponding to one or more of the individual steps or acts described and/or contemplated by the present system.
Accordingly, embodiments of the present system provide one or more algorithms for automatically analyzing uterine activity signals, which may be acquired, for example, using a tocodynamometer, IUPC, and/or EHG device. Obstetric and/or gynecological information about uterine activity, such as start, peak and end times of contractions, as well as time intervals therebetween, their durations, intensities, time patterns, waveform shapes, etc., may be determined and thereafter used to generate a graphical representation for the convenience of the user and/or patient.
Thus, embodiments of the present system may include two parts: (1) algorithms for automatically analyzing uterine activity signals, such as obtained in real time or in an off-line mode using conventional tocodynamometers, IUPCs and/or EHG devices, and may develop corresponding information; and (2) the specific application of the information provided by the algorithm may plot information to enhance the woman's productive and childbirth experience in the hospital with the help of properly timed respiratory support, and/or visualization of the state and progress of the productive process. Additionally, embodiments of the present system may also use the information provided by embodiments of the present system to provide a mapping that facilitates an interactive birth process, which may provide a more positive delivery and/or childbirth experience for the parturient. Embodiments of the present system may provide an environment for a candidate mother to provide directions during a manufacturing process in a personal and unobtrusive manner. The guidance may include a drawing of information that is to visualize the productive process and/or aid the respiratory process (e.g., inhalation) of the mother.
In general, the detection of start, peak and end times is very difficult to perform automatically (close to) in real time, since the various parameters related to the contractions, such as their heights and the time intervals between them, can vary greatly. Therefore, whatever input signal representation of the contraction is used, any algorithm for automatically extracting those parameters requires a sophisticated peak detector for obtaining reliable detection. The reliability with which a pinch can be detected depends among other things on how much delay is allowed. The proposed algorithm comprises a peak detector in which a clear trade-off can be made between allowed processing and detection delays on the one hand and the reliability of the result on the other hand.
Additionally, the algorithm allows for an explicit trade-off between:
-allowed processing and detection delays on the one hand and reliability of the extracted parameters on the other hand; in the off-line mode, substantially perfect analysis is possible;
-the signal level above which or at which the start of a contraction is detected, and the number of detections of errors and/or pauses.
Furthermore, in addition to this, the individual parameters allow for an explicit trade-off between time between possible peak detections and explicit peak decision on the one hand, and reliability of peak detection on the other hand.
Further modifications to the present system will be readily apparent to those of ordinary skill in the art and are also encompassed by the appended claims.
Finally, the above-discussion is intended to be merely exemplary of the present system and should not be construed as limiting the appended claims to any particular embodiment or group of embodiments. Thus, while the present system has been described with reference to exemplary embodiments, it should also be appreciated that numerous modifications and alternative embodiments may be devised by those having ordinary skill in the art without departing from the broader and intended spirit and examples of the present system as set forth in the claims that follow. The specification and drawings are accordingly to be regarded in an illustrative manner and are not intended to limit the scope of the appended claims.
In interpreting the appended claims, it should be understood that:
a) the word "comprising" does not exclude the presence of other elements or acts than those listed in a given claim;
b) the word "a" or "an" preceding an element does not exclude the presence of a plurality of such elements;
c) any reference signs in the claims do not limit their scope;
d) several "units" may be represented by the same item or hardware or software implemented structure or function;
e) any of the disclosed elements may be comprised of hardware portions (e.g., comprising discrete and integrated electronic circuitry), software portions (e.g., computer programmed), and any combination thereof;
f) the hardware portion may be made up of one or both of analog and data portions;
g) any of the disclosed devices or portions thereof may be combined together or divided into additional portions unless explicitly stated otherwise;
h) no particular sequence of acts or steps is intended to be required unless explicitly indicated; and is
i) The term "plurality" of elements includes two or more of the claimed elements and does not imply any particular range of numbers of elements; that is, the plurality of elements may be as few as two elements and may include an immeasurable number of elements.
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