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A study on home based Parkinson's disease monitoring and evaluation: design, development, and evaluation

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Parkinson's disease, the most prevalent movement disorder of the central nervous system, is a chronic condition that affects more than 1000,000 U.S. residents and about 3% of the population over the age of 65. The characteristic symptoms include tremors, bradykinesia,

Parkinson's disease, the most prevalent movement disorder of the central nervous system, is a chronic condition that affects more than 1000,000 U.S. residents and about 3% of the population over the age of 65. The characteristic symptoms include tremors, bradykinesia, rigidity and impaired postural stability. Current therapy based on augmentation or replacement of dopamine is designed to improve patients' motor performance but often leads to levodopa-induced complications, such as dyskinesia and motor fluctuation. With the disease progress, clinicians must closely monitor patients' progress in order to identify any complications or decline in motor function as soon as possible in PD management. Unfortunately, current clinical assessment for Parkinson's is subjective and mostly influenced by brief observations during patient visits. Thus improvement or decline in patients' motor function in between visits is extremely difficult to assess. This may hamper clinicians while making informed decisions about the course of therapy for Parkinson's patients and could negatively impact clinical care. In this study we explored new approaches for PD assessment that aim to provide home-based PD assessment and monitoring. By extending the disease assessment to home, the healthcare burden on patients and their family can be reduced, and the disease progress can be more closely monitored by physicians. To achieve these aims, two novel approaches have been designed, developed and validated. The first approach is a questionnaire based self-evaluation metric, which estimate the PD severity through using self-evaluation score on pre-designed questions. Based on the results of the first approach, a smart phone based approach was invented. The approach takes advantage of the mobile computing technology and clinical decision support approach to evaluate the motor performance of patient daily activity and provide the longitudinal disease assessment and monitoring. Both approaches have been validated on recruited PD patients at the movement disorder program of Barrow Neurological Clinic (BNC) at St Joseph's Hospital and Medical Center. The results of validation tests showed favorable accuracy on detecting and assessing critical symptoms of PD, and shed light on promising future of implementing mobile platform based PD evaluation and monitoring tools to facilitate PD management.

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Date Created
2013

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Warning a distracted driver: smart phone applications, informative warnings and automated driving take-over requests

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While various collision warning studies in driving have been conducted, only a handful of studies have investigated the effectiveness of warnings with a distracted driver. Across four experiments, the present study aimed to understand the apparent gap in the literature

While various collision warning studies in driving have been conducted, only a handful of studies have investigated the effectiveness of warnings with a distracted driver. Across four experiments, the present study aimed to understand the apparent gap in the literature of distracted drivers and warning effectiveness, specifically by studying various warnings presented to drivers while they were operating a smart phone. Experiment One attempted to understand which smart phone tasks, (text vs image) or (self-paced vs other-paced) are the most distracting to a driver. Experiment Two compared the effectiveness of different smartphone based applications (app’s) for mitigating driver distraction. Experiment Three investigated the effects of informative auditory and tactile warnings which were designed to convey directional information to a distracted driver (moving towards or away). Lastly, Experiment Four extended the research into the area of autonomous driving by investigating the effectiveness of different auditory take-over request signals. Novel to both Experiment Three and Four was that the warnings were delivered from the source of the distraction (i.e., by either the sound triggered at the smart phone location or through a vibration given on the wrist of the hand holding the smart phone). This warning placement was an attempt to break the driver’s attentional focus on their smart phone and understand how to best re-orient the driver in order to improve the driver’s situational awareness (SA). The overall goal was to explore these novel methods of improved SA so drivers may more quickly and appropriately respond to a critical event.

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Date Created
2017