The Application of Image Recognition and Machine Learning to Capture
Total Page：16
File Type：pdf, Size：1020Kb
Proceedings of the 54th Hawaii International Conference on System Sciences | 2021 The Application of Image Recognition and Machine Learning to Capture Readings of Traditional Blood Pressure Devices: A Platform to Promote Population Health Management for Cardiovascular Diseases Prevention Helen WY Lee1, Christopher TK Chu1, Karen KL Yiu2, Kelvin KF Tsoi1,2 1JC School of Public Health and Primary Care 2SH Big Data Decision Analytics Research Centre The Chinese University of Hong Kong [email protected] Abstract evening3. Existing literature has found incremental risk Digital solutions for Blood Pressure Monitoring (or for cardiovascular diseases in individuals with elevated Telemonitoring) have sprouted in recent years. home BP4,5,6,7,8,9 as well as strong association between Innovative solutions are often connected to the Internet morning BP readings given by HBPM and risk of stroke of Things (IoT), mobile health (mHealth) platform for and coronary events. Crucially, HBPM’s superior instance. However, clinical validity, technology cost predictive values for cardiovascular events to office BP and cross-platform data integration remain the major is equally highlighted10, owing to its validity and fidelity barriers to the application of these solutions. In this unaffected by white-coated effect and masked paper, we present an IoT-based and AI-embedded Blood hypertension11, while results from randomized Pressure Telemonitoring (BPT) system, which controlled clinical trials have also favored HBPM in facilitates home blood pressure monitoring for general BP outcomes. individuals. BPT, as a form of out-of-office blood pressure This system uses machine learning techniques to monitoring has become an emerging trend in the last enable automatic digits recognition, with an F1 score of decade, gaining considerable recognition. It can render 98.5%; and the cloud-based portal developed for valuable health information and thus provide insightful automated data synchronization and risk stratification. guidance for antihypertensive medication prescription Positive feedbacks on trial implementation are received and dosage adjustment over clinical care13. It can also from three clinics. The overall system architecture, help facilitate early detection of hypertension and development of machine learning model in digit cardiovascular symptoms, as well as elevating health identification, and cloud-based telemonitoring are consciousness in the community. addressed in this paper, alongside the followed In addition, telemedicine infrastructure is implications. profoundly heightened for chronic diseases management in the midst of COVID-19 pandemic, during the times in which social distancing is much 1. Introduction encouraged, and lockdown might even take place for 14 As an obstinate yet modifiable cardiovascular sake of disease containment . Reviews on impacts of condition, hypertension is a major concern of many telehealth have demonstrated similar health outcomes 15 medical and public health practitioner. Medical groups, , between remote monitoring and in-person care . BPT, such as European Society of Cardiology, European as facilitated by state-of-art technology, thereby serves Society of Hypertension1, American Heart Society2, as a safe, effective, and cost-effective alternative to in- Australian expert group3, and Japanese Society of person care in general. Hypertension, have well endorsed the clinical In this paper, we proposed a development of a digital significance of out-of-office blood pressure, in both BPT solution of high compatibility with existing diagnosis and control. Out-of-office blood pressure devices for BP capturing, storing and monitoring. This measuring primarily refers to Ambulatory Blood BPT solution includes image recognition of BP readings Pressure Monitoring (ABPM) and Home Blood extracted from BP devices, cloud-computing techniques Pressure Monitoring (HBPM), where the latter refers to and web-portal for remote monitoring and related blood pressure (BP) self-management in home-setting reminders or alert functions. on a day-to-day basis, usually in the morning and URI: https://hdl.handle.net/10125/71034 978-0-9981331-4-0 Page 3445 (CC BY-NC-ND 4.0) 2. Background and Related Work Hypertension Society (BIHS)21, also could not verify BPT allows transmission of domestic BP readings and recommend these alternative devices for remotely to healthcare facility12. Not only does BPT at measurements, like measuring pulse wave velocity, home improve BP outcomes, such as reducing central blood pressure monitoring or arterial stiffness, antihypertensive medication, but also minimizing given the absence of validation in the current stage. In therapeutic inertia, which is defined as unchanged other words, individual efforts made on HBPM could go treatment strategies despite deterioration in BP in vain. performance16. Besides, regarding the lack of API and service Traditionally, hypertensive patients bring along their providers integration, limited analytical functions of handwritten blood pressure records to clinic-visit for these solutions have hampered their usage as clinical doctor’s reference of their home BP profile. As a result, reference for healthcare professionals22, but merely for fragmented blood pressure records hampers the personal reference purpose. Hardly can HBPM and BPT systematic collection and storage for building up interoperably exert their full potential in maximizing the individual health profile, one of the major limitations to clinical significance under such constraints and diagnosis. therefore worth of attention. 2.1. Current BPT Technical Solutions 2.2. Proposed BPT Digital Solutions With the advent of telemonitoring technology, a Therefore, we proposed a novel BPT digital solution number of solutions have been invented. For example, that overcomes the abovementioned barriers of existing automated upper-arm BP monitors (with internally solutions. Our system is made to aggravate clinically installed data transmission function) such as Bluetooth validated and accurate BP readings by smartphones’ BP monitors, were invented for easier data storage and photo capturing function, from existing BP monitors transmission. Despite its high acceptability, accuracy that make use of seven-segment display screen, and and incremental benefits in long-term care including but communicate data among multiple platform, along with not limited to better quality of life of patients12, certain cloud-computing techniques for analytics upon amelioration on healthcare resources utilization and data from BP logging. costs17 as well as, connectivity issue arises as another The digits recognition focuses on seven-segment point of concern18. While its limited integration on displays since it is of the highest adoptability among BP application program interface (API) and service monitors, accounting for 97.2% of the recommended BP providers, narrow analytics ability such as data monitors for home-use, as advocated by BIHS21. A summary, coupled with its high technology-related machine learning model is developed on the digit costs, further offsets its cost-effectiveness. Given the identification. cost reduction and popularity of smartphones as a result Cloud-server serves as a midpoint for data storage, of plummeting costs of telecommunications, the mobile integration and communication, and hence allowing health market is surging correspondingly, with real-time data synchronization and sharing for BPT, smartphones widely incorporated in BPT. Today, five which exhibits in the form of web-portal system. On one billion of the world population owe mobile devices with hand, it provides analytics and reporting while on over half of them are with smartphones19. Other another hand, it triggers corresponding feedbacks, solutions include (1) Smartphone applications coupled reminders and alert. with external BP sensor or permitting manual BP input Our system strives to be a smart digital BPT solution (function as BP e-journal), (2) smartphone-based of superb usability, cost-effective, validity, and cuffless BP monitors (such as finger intelligence, in replacement of traditional tedious photoplethysmography via smartphone camera), and (4) handwritten BP recordings, exorbitant BPT wearable devices, such as wrist tonometry-embedded technologies, unpromising devices. With the smartwatches. demonstration of our system, it is also hoped that similar Despite enhanced affordability, doubts and concerns application can be made on other important biometrics over these technologies remain. First and foremost, in managing chronic diseases, including blood glucose, variations prevail in terms of the accuracy of BP weight and BMI, to name a few. Also, in contribution to monitors, resulting in invalid BP readings, which do the big data bank, guiding towards precision medicine little help or even lead to incorrect clinical decisions. and personalized health profile. According to the latest investigation by Picone on BP devices in marketplace20, only 8% of the wrist cuff 3. System Architecture devices and none of the cuffless wearable devices could The proposed workflow home-based BPT system is pass the International Validation Standards. illustrated in Figure 1. Health data capturing module for International medical groups such as British and Ireland patients in form of mobile application platform, Page 3446 analytics cloud-server, web-portal module for of interest by bounding boxes as input and further labels healthcare professionals and an open RESTful API