Embodiments relate generally to medical devices, and more particularly to non-invasive medical devices, systems and methods for the detection of coronary artery and other diseases.
Cardiovascular disease is the leading cause of death in both men and women in the United States, and is a major cause of death throughout the world. According to a 2006 American Heart Association (AHA) report, approximately 80 million people in the United States have heart disease and in 2005, 864,480 people lost their lives. This accounts for 35.3 percent of all deaths or one of every 2.8 deaths in the United States according to the AHA. Cardiovascular cost the health care system approximately $368.4 billion in 2004, accounting for nearly a third of the trillion dollars spent on health care in the United States each year, again according to the AHA. Patient care accounts for 90% of this cost.
The health care system would benefit tremendously by identification of those individuals at high risk for coronary related attacks. Current evidence shows that established cardiac risk factors, such as certain abnormal levels of blood pressure, blood glucose and cholesterol and a history of smoking, possess a limited ability to estimate cardiac risk. In symptomatic patients with suspected cardiovascular disease, there are a variety of tests available to establish diagnosis. It remains a difficult problem, however, as clinical history and additional information is needed to establish the diagnosis, estimate prognosis and guide appropriate treatment. Coronary angiography is considered the “gold standard” for diagnosis, but it is invasive and costly and is an appropriate initial diagnostic study in only a minority of patients.
Other tests include exercise treadmill test, stress echocardiogram, computed tomography, calcium heart scanning and angiography. Each of these tests is ordered by clinicians after a patient is suspected to have Coronary Artery Disease (CAD). These tests vary in their accuracy with angiogram considered the gold-standard. Exercise electrocardiogram (ECG) testing is the most commonly used test because it is simple and inexpensive. The patient must be able to exercise to at least 85 percent of the predicted maximal heart rate to rule out ischemic heart disease if the test is otherwise negative. For patients who cannot exercise, have baseline ECG abnormalities that could interfere with exercise ECG testing, or in whom the exercise ECG test suggests intermediate risk, a number of alternative noninvasive tests are available including echocardiography with exercise or pharmacologic, radionuclide myocardial perfusion imaging (rMPI), using either planar or photon emission computed tomographic as the imaging method, positron emission tomography (PET) or using coronary calcium scores. Many of these tests are also invasive, time-consuming and expensive, requiring trained personnel and capital equipment.
Moreover, the aforementioned hospital-centric devices are traditionally coupled to a hospital or caregiver network in order to facilitate data transfer and data flow of the recorded data. No built-in network for data transfer and data flow exists for non-hospital-centric devices. As a result, traditional portable devices often are required to contain both sensing and analyzing components, which can be difficult and costly to engineer. Further, field-ready devices often lack the computing power to adequately analyze the recorded data. In other cases, data transfer networks must be created ad-hoc. Therefore, there is a need for improved devices, systems and methods for the detection of coronary artery disease and other diseases.
Embodiments of the present application substantially address or meet the aforementioned needs of the industry. In an embodiment, a system comprises a handheld CAD detection device or other data collection device that can measure data relating to an anatomical or physiological feature, and a networked system for storing, securely transferring, and/or processing the recorded data. Further, supplemental devices such as a computer, hub, smartphone, dongle, or other mobile networked device can facilitate data transfer between the data collection device and network-based system.
In embodiments, a handheld detection device can include components for properly placing and positioning the detection device, as well as acting as a stand-alone device which can facilitate data transfer. For example, in various embodiments, a camera, light sensor, temperature sensor, accelerometer, and/or gyroscope can be utilized. In embodiments, the aforementioned components further assist in noise reduction or noise cancellation. In alternative embodiments, an internal detection device can be arranged within a patient, either as an implantable device or as a catheter or other movable device to measure attributes of the patient's anatomy or physiology.
The above summary is not intended to describe each illustrated embodiment or every implementation of the invention. The figures and the detailed description that follow more particularly exemplify these embodiments.
Embodiments may be more completely understood in consideration of the following detailed description in connection with the accompanying drawings, in which:
While embodiments are amenable to various modifications and alternative forms, specifics thereof have been shown by way of example in the drawings and will be described in detail. It should be understood, however, that the intention is not to be limited with respect to the particular embodiments described. On the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the appended claims.
Embodiments relate to non-invasive handheld or implantable medical devices, systems and methods for the detection of coronary artery and other diseases. In an embodiment, a handheld data detection device is used in a non-invasive manner to determine whether an internal coronary artery blockage is present. In other embodiments, the data collection device can be used to diagnose pulmonary disease, carotid disease, renal artery disease, valve disease or other disorders in addition to or instead of coronary artery blockage or disease. In an embodiment, a data transfer system comprises a handheld data collection device or other data collection device, and a networked system for storing and processing the recorded data. The handheld data collection device can measure acoustic and other signals, and these data can be used to assess a likelihood of CAD, pulmonary disease, or other disorders that can be sensed by obtaining such data from the test subject, accurately and efficiently as compared to conventional techniques. In various embodiments, detection devices can detect anatomical aspects (i.e., the physical dimensions or structure of an anatomical feature) or physiological aspects (i.e., how an anatomical feature is performing) or both.
Although many embodiments described herein refer to detection of CAD, it should be understood that in embodiments the devices, systems, and methods described herein could be used to collect data corresponding to a variety of other cardiovascular or pulmonary systems, or indeed any other system in which the collection and transmission of acoustic data can be used in the detection and/or diagnosis of a disease or condition. Such conditions can include, for example, cardiac, pulmonary, valvular, renal, peripheral and/or carotid artery functions. In those embodiments below in which cardiac artery disease is discussed, it should be understood that in alternative embodiments the detection systems, devices, and methods are not limited to the treatment, detection, or diagnosis related to just one particular type of data. These conditions are often not limited to humans, and as such the devices, systems, and methods described herein can likewise apply in veterinary applications.
Referring to
Data collection device 102 comprises a device for recording, sensing, or otherwise collecting data. In an embodiment, data collection device 102 is configured to collect data from a human or animal patient. In an embodiment, data collection device 102 comprises a CAD detection device, as will be described further below. Data collection device 102 can be configured to be wireless and portable so as to collect data in remote places or places without a traditional hospital infrastructure.
Data portal device 104 comprises a base station or portal configured to interface to at least one data collection device 102. In embodiments, data portal device 104 comprises a desktop computer, laptop computer, smartphone, personal digital assistant (PDA), tablet, watch, wearable electronic device, or other suitable device. In embodiments, data portal device 104 acts as a pass-through to transfer collected data from one or more data collection devices 102 to networked or local computer system 106. In embodiments, data portal device 104 can also consolidate, combine, and/or package data in addition to transferring or broadcasting it.
In one embodiment of a pass-through device, data portal device 104 can be a dedicated pass-through device. Plug-in or battery-operated devices can be positioned in a location proximate to expected testing operations. For example, a hub device such as those commercially available from a multiplicity of companies can be plugged into a wall outlet or battery powered in an examination room where data collection device 102 is to be used. Such pass-through devices can be configured to activate upon wirelessly receiving data from associated devices (such as data collection device 102) and pass on the information to a remote device (such as networked or local computer system 106). In embodiments, data transfer can be accomplished via WiFi networks, cellular networks, mobile data networks, Bluetooth, near-field communications networks, radio frequency networks, wired Ethernet or telephone line networks, or any other transmission medium to networked or local computer system 106.
In embodiments, data collection device 102 and data portal device 104 are operably coupled by a communication network and suitable hardware. For example, both data collection device 102 and data portal device 104 can comprise Universal Serial Bus (USB), Firewire, Bluetooth, serial, EEPROM, WI-FI, or any other appropriate hardware, software, and suitable interfaces. In embodiments, data collection device 102 is configured with minimal data transmission hardware (i.e. with hardware necessary to transmit to data portal device 104), so that data collection device 102 can be more inexpensively and efficiently produced. In such embodiments, data portal device 104 can be configured with additional communication hardware to receive data from data collection device 102 and transmit the data to any number of configurations of networked or local computer system 106. In other embodiments, data collection device 102 can include some data storage capability, enabling the storage of a desired number of previous test results, software, or other information.
Networked or local computer system 106 comprises data storage and at least one processing engine, as will be described further with respect to
In another embodiment, referring to
In an embodiment, networked or local computer system 106 generally comprises server 108 and database 110. Networked or local computer system 106 embodies the computation, software, data access, and storage services, and the hardware and devices to implement them to users over a network. The components of networked or local computer system 106 can be located in a singular “cloud” or network, or spread among many devices or networks, as depicted in
Server 108 generally includes processor 112 and memory 114. Processor 112 can be any programmable device that accepts digital data as input, is configured to process the input according to instructions or algorithms, and provides results as outputs. In an embodiment, processor 112 can be a central processing unit (CPU) or a plurality of processors configured to carry out the instructions of a computer program. Processor 112 is therefore configured to perform basic arithmetical, logical, and input/output operations. In the embodiment shown in
Memory 114 can comprise volatile or non-volatile memory as required by the coupled processor 112 to not only provide space to execute the instructions or algorithms, but to provide the space to store the instructions themselves. In embodiments, volatile memory can include random access memory (RAM), dynamic random access memory (DRAM), or static random access memory (SRAM), for example. In embodiments, non-volatile memory can include read-only memory, flash memory, ferroelectric RAM, hard disk, floppy disk, magnetic tape, or optical disc storage, for example. The foregoing lists in no way limit the type of memory that can be used, as these embodiments are given only by way of example and are not intended to limit the scope of the claims.
User 116 can receive information generated by the devices, systems, and methods described above that make up system 200. For example, in embodiments it may be desirable to send information to a health care professional, patient, or other user for access either at or after the time of use of data collection device 102. User 116 can be, for example, an insurance provider, health care provider, patient, or other individual who has access to the test results, in embodiments. User 116 can receive results from data collection device 102 via server 108 at the conclusion of the use of data collection device 102. Alternatively or additionally, as depicted by the arrows connecting user 116 and database 110, user 116 can access results from prior uses of data collection device 102 that have already been sent to database 110. In some circumstances, it may be desirable to compare the results of a recently-measured dataset from data collection device 102 with one or more earlier results, in which case user 116 can receive data from both server 108 and database 110 for comparison or analysis.
As depicted in
As used herein, the term “processor” can refer to any suitable programmable device that accepts analog or digital data as input, is configured to process the input according to instructions or algorithms, and provides results as outputs. In an embodiment, the processor can be a central processing unit (CPU) configured to carry out the instructions of a computer program. In other embodiments, the processor can be an Advanced RISC (Reduced Instruction Set Computing) Machine (ARM) processor or other embedded microprocessor. In other embodiments, the processor comprises a multi-processor cluster. The processor is therefore configured to perform at least basic selected arithmetical, logical, and input/output operations.
Memory can comprise volatile or non-volatile memory as required by the coupled processor to not only provide space to execute the instructions or algorithms, but to provide the space to store the instructions themselves. In embodiments, volatile memory can include random access memory (RAM), dynamic random access memory (DRAM), or static random access memory (SRAM), for example. In embodiments, non-volatile memory can include read-only memory, flash memory, ferroelectric RAM, hard disk, floppy disk, magnetic tape, or optical disc storage, for example. The foregoing examples in no way limit the type of memory that can be used, as these embodiments are given only by way of example and are not intended to limit subject matter hereof. In other embodiments, the memory comprises a plurality of memories or types of memory.
As shown in
Likewise, system 300 as depicted in
Referring to
In an embodiment, user device 352 can interface to data collection device 354. In an embodiment, data collection device 354 is substantially similar to data collection device 102. User device 352 can operate data collection device 354 to collect data as described herein. In an embodiment, data collection device 354 comprises a CAD detection device, as will be described further below. Data collection device 354 is configured to interface to portal 356. Portal 356 is configured to operably couple data collection device 354 and networked or local computer system 360. Embodiments of portal 356 will be described further below. Once data is collected with data collection device 354, portal 356 can receive the collected data and transfer it to networked or local computer system 360. In embodiments, data portal 356 can be a dongle attached to a laptop computer or other device, or portal 356 can be a dedicated hub configured to receive and transmit data. In other embodiments, portal 356 can comprise a smartphone, PDA, tablet, laptop computer, desktop computer, watch, other wearable device, or any other suitable networked electronic device. Once the data is received at portal 356 from data collection device 354, portal 356 is configured to transfer the data to networked or local computer system 360.
In an embodiment, networked or local computer system 360 is substantially similar to networked or local computer system 106 as discussed above with respect to
Once the data from data collection device 354 is analyzed at networked or local computer system 360, networked or local computer system 360 can return a diagnosis or the results of the data analysis to user device 352. In embodiments, the diagnosis or results can be returned in the form of a report, text or email indication, or by other suitable notification. In embodiments (not shown), networked or local computer system 360 can return the diagnosis or results to data collection device 354 or portal 356.
Systems 100, 200, 300, and 350 as depicted in
In other embodiments, data collection device 102 can be configured to transmit and receive data directly to/from a phone, tablet, laptop, PDA, wearable electronic device (e.g., smartwatch) or other portable electronic device. In embodiments, data collection device 102 is configured with low-power Bluetooth to reduce battery consumption. In other embodiments, data collection device 102 is configured to interface to a dock in a wired or wireless configuration (for example, with low-power Bluetooth). In still other embodiments, data collection device 102 is configured to interface to an intermediate piece of networked hardware, such as a hub. In such embodiments, data collection device 102 is configured to interface to a commercially available data hub configured to push data to networked or local computer system 106. Likewise, data collection device 102 is configured to receive data or commands from a data hub. Other hubs can be used in other embodiments, such as a multipurpose hub that provides data transmission as well as physical docking, calibration, diagnostic testing, battery charging, and other functions.
In other embodiments, data collection device 102 can be configured to stream collected data to a host computer, networked or local computer system, or other electronic device. In such embodiments, the collected data is only temporarily and incompletely stored on data collection device 102, and fully assembled on the device receiving the streamed data, though this need not be the case in all embodiments. In embodiments, a mobile application on, for example, a smartphone, can be configured to receive the streamed data. In embodiments, data collection device 102 can comprise cellular data hardware (4G, LTE, etc.) in order to wirelessly transmit the collected data. In embodiments, data collection device 102 can include its own wireless data plan with a cellular data service provider. In such embodiments, results of data analysis or diagnosis (after transmission of the collected data), as will be described, can be returned or relayed back to data collection device 102, which can present the results on a display. In an embodiment, the results comprise a text-based or color-based indication of a disease diagnosis.
Referring again to
According to embodiments, a user can access a setup file on data portal device 104 via download or other initial data transfer. In embodiments, to download the setup.exe file, a special code must be entered. In an embodiment, the code is supplied by upon purchase of a system or device, or based on another transaction. In other embodiments, other verification methods can be utilized.
In embodiments, a registration process allows users to create a unique account with username, password, hospital/clinic name, email address and alternate email address to receive reports. Embodiments of the registration process also request user preferences for receiving reports, including file type, such as PDF, WORD, or EXCEL. In embodiments, user preferences include: receive a report by using primary email address, alternate email address or both.
Embodiments of the registration process can be completed on a data portal device 104 software application. Registration information can be stored on a database, such as database 110 or other database. After completing the registration process, logout from the registration process, and verification of the user email address, a link will be sent to that email address which will direct user to login window of host computer software application. After completing registration, embodiments can verify an email address for the user. If the user tries to log in without verifying an email address, then the user will see an error message indicating a need to verify an email address. For each registered user, the database can include the following information: user name, password, hospital/clinic name, email address, billing information, all reports associated to the user, and the date/time when data was uploaded by the user (date/time information stored as part of a zipping process, as will be described with respect to
In embodiments, a user can log in to access his or her account or begin a data sync. In embodiments, the login can be originated from data portal device 104. In such embodiments, data portal device 104 software application(s) can provide direction on how to start the syncing process.
In embodiments, from a user-portal, such as a website interface to networked or local computer system 106, the user can search database 110. In embodiments, searching can be by patient ID or by a date range in which data was uploaded by user. The user can print, download, and/or view reports from the website. In an embodiment, users who have uploaded files onto networked or local computer system 106 can only see documents uploaded by that user. In the website/portal, the user can also change account setting such as email address and password. In embodiments, database 110 is secured so that the user cannot edit any information on database 110.
Further, the user-portal or website interface to networked or local computer system 106 can be configured to present not only reports, but also raw, aggregated, summed, analyzed, or other data to the user or medical professional. In embodiments, metadata for the data can be utilized to present data on different geographic regions, particular hospitals or clinics, or specific age ranges. Such display can facilitate the identification or determination of possible patterns for specific criteria. In embodiments, networked or local computer system 106 comprises different algorithms depending on the type of disease to be diagnosed. For example, data can be analyzed according to different algorithms for coronary artery disease, other vascular disease, hypertension, erectile dysfunction, carotid evaluation, efficacy of tube or other medical device placement, transplant efficacy, and so on.
Upon initiation of data transfer, embodiments of systems are configured for data management within data portal device 104. In an embodiment, a pop up window is presented for an account login procedure if the user is new. In another embodiment, a pop up window is presented for a login for an existing user. In embodiments of the pop up window, username and password tabs are shown and “forgot password option” are presented at the bottom of the same window. If the user has forgotten his password, then a forgotten password option directs the user to the password reset webpage, which asks for the user's registered email ID or username. The password-reset link is sent to the registered email. If the email ID or username is not registered, a link directs the user to a registration process (as will be described further below). In an embodiment, cookies for saving the username will be created on the host computer software as well as on embodiments of the website. A checkbox for remembering the username can be provided on the same window.
A unique patient ID number can be associated with each data file. At times the number of data files and size of data files will require the data file to be compressed prior to sending to the networked or local computer system. There can be any number of files per data set. Data files can store myriad types and kinds of data. In an embodiment, a data file for a particular user and scan can include examination or patient-specific information, such as examination time, examination date, patient height, patient weight, location, etc. In embodiments, such information can be typed in manually via a docking station, as will be described, or through a device interface itself.
In operation, referring generally to
Embodiments are configured to display the status of the downloading process from data collection device 102 to data portal device 104 on a pop up window. If upload fails, the data upload error window is presented and all previously transferred are deleted and uploading is restarted. In an embodiment, the transferred data is compressed from the aforementioned temporary folder. Further, in embodiments, date and time information associated with the time the data was syncing, can be determined using the user device's computer clock and are stored in the ZIP file.
Referring specifically to
In an embodiment, a status of the uploading process can be provided. In certain embodiments, the status can be displayed using a software application executed or displayed by data portal device 104. In embodiments, Pause and Restart options for the uploading process are also provided. For example, Pause and Restart options for data transfer from data portal device 104 to networked or local computer system 106 can be provided in the same status window. In an embodiment, a status bar for downloading data from the data collection device 102 to data portal device 104 and for uploading data from data portal device 104 to networked or local computer system 106 can be shown in the same pop up window. In embodiments, a display window is provided that shows information with directions for searching and downloading reports by, for example, access via email or access via a website. Further embodiments provide display windows and access for troubleshooting if, for example, a report sent via email is routed to the user's spam folder.
Referring to
In an embodiment, a data processing program can be executed on, for example, cloud computing service or in a virtual machine in networked or local computer system 106. Each subfolder can be processed separately and a report can be generated by the data processing program in each subfolder. As depicted in
Once generated, the PDF file or other output can be detected when the output is created in the subfolder. The output file can be copied to a result folder. In embodiments, different subfolders can be utilized for each hospital or clinic site. Subfolders can be named according to suitable naming convention. Further, in embodiments, when the output file is detected, it can be attached to an email (as will be described further below).
After the output file is created, all the processed subfolders can be transferred to any number of data storage methods and deleted from the DATA folder.
In an embodiment, the generated output report can be emailed to the user. For example, one of the following options can be utilized. First, a .NET application can utilize a mail server. The SMTP info can be provided by any of the parties involved in the data transmission transaction. In another option, an email integrated into the cloud can be utilized. For example, along with the data output attachment, an email body can contain additional information such as patient ID, Final result associated with patient ID, and hospital name which can be retrieved from the same PDF report filename and/or database 110. In an embodiment, the email subject line can be: Site ID, Patient ID “Data Collection Results”. In embodiments, “Data Collection Results” can be specific to to the particular data collection device. Other email templates are also considered.
Referring to
Referring to
A data portal device (e.g., data portal device 104) can be positioned in a location where it can receive data from a data collection device (e.g., data collection device 102). When a test is run, the data collection device can upload a file such as a ZIP file containing test results. These test results can include, among other things, a scan 1D number corresponding to a particular patient, acoustic test results, or other information related to the scan. If a ZIP file is detected (372), the data portal device can proceed to unzip the ZIP file (374), in embodiments. In alternative embodiments, the ZIP file can be transmitted to a remote server (e.g., networked or local computer system(s) 106) to be unzipped.
A check can be performed to determine whether the unzipping process (374) was successful (376). If not, an error message can be displayed and the ZIP file can be deleted (377). If, however, the unzipping process (374) was successful, the unzipped DATA files can be loaded and processed (378).
In some settings, a ZIP file contains data relating to more than one patient. In loop 380, the results from the data files are analyzed sequentially to generate emailed reports relating to each patient. In alternative embodiments, reports can be generated in other formats or can be sent by other mechanisms than PDF, or delivered by alternative mechanisms instead of email. In some embodiments, the components of loop 380 can be carried out at various locations, such as spreading the analysis to generate each report amongst various networked or local computer systems (e.g., networked or local computer systems 106a-106c as shown in
Referring to
In the embodiment shown in
In the event that there is a failure to create a ZIP file, the process shown in
In embodiments, data collection device 102 comprises a device for recording, sensing, or otherwise collecting data. Referring to
As shown in
CAD detection device 400 can be used in conjunction with an identification element, such scanning area identification pads or a patient scan sequence guide 500 as shown in
Referring to
Use of such internally-placed sensors facilitates the use of techniques such as fractional flow reserve (FFR), optical coherence tomography (OCT), and/or intravascular ultrasound (IVUS). Each of these methods can be used to determine if coronary blockages or other conditions are significant enough to warrant an intervention such as a stent or coronary artery bypass operation, for example. These techiques can provide quantitative measurements, which can be used by the practitioner to generate a precise assessment relating to potential blockages or other conditions.
Referring to
As shown in
In alternative embodiments, sequence guide 500 could include a variety of other position sequences, and could include more or fewer steps, or could even depict a single location to be scanned. For example, in one embodiment, sequence guide 500 could relate to a test of lungs, rather than a heart, and therefore the positions to be used will be different from those shown on sequence guide 500. In embodiments, sequence guide 500 can include directions for testing of animals, rather than of humans as shown in
As shown in
In embodiments, sequence guide 500 such as the one depicted in
In some settings, such as a clinic in which tests will be routinely performed, sequence guide 500 could be provided in a different format, such as a wall-hung poster or handheld, laminated card. In embodiments, the RFID or other signal associated with the steps shown in sequence guide 500 (“A” through “D”) do not vary between tests. In these embodiments, a single poster can be provided for use with the CAD detection device 400 over multiple tests. The Patient Number, however, can be different for each test subject. A variety of solutions are available to provide the Patient Number to the CAD detection device 400. These include “lottery style” tickets that each test subject receives, in which the RFID or other chip is housed within packaging that can only be open destructively, for example. Providing multiple Patient Number identifiers with a single sequence guide 500 can improve cost-efficiency for the test provider while maintaining anonymity of the health care data.
In an embodiment, referring specifically to
In another embodiment, sequence guide 500 can be electromagnetically shielded such that data from wireless chips cannot be read from outside sequence guide 500. In an embodiment, the cover of sequence guide 500 is integrated with a shield. In an embodiment, the shield comprises conductive or magnetic materials, such as sheet metal, metal screen, and metal foam, or electromagnetically integrated paint or other coating.
In an embodiment of manufacturing sequence guide 500, RFID, NFC, or other wireless chips can be laid in a strip on the relevant scanning area identification pads. Such strip-based manufacturing saves time and money in producing sequence guide 500.
In an embodiment, sequence guide 500 can be integrated with a single removable patch. The patch can be removed from its coupling to sequence guide 500 and applied to a patient. In an embodiment, the patch comprises a sensor, circuitry, guide portion or other component at each relative location necessary to make a determination on the disease the system is intended to diagnose, such as coronary artery disease. For example, a single patch can be shaped to encompass all four locations (for example, those shown in
Sequence guide 500 can further comprise, in an embodiment, a display screen for displaying the results of the analysis or diagnosis of a particular disease. In other embodiments, a portion of sequence guide 500 comprises invisible ink or a heads-up display that can likewise display the results of the analysis or diagnosis of a particular disease.
Referring to
CAD detection device 400, as described above, comprises a handheld detection device that can be used in a non-invasive manner to determine whether an internal coronary artery blockage is present.
In an embodiment, referring to
In the embodiment depicted in
One pressure sensor 606a collects data related to the presence or absence of a turbulent pressure wave in a coronary artery. Blood flow is periodic in time and laminar in flow. A blockage can act as a nozzle within an artery, causing turbulence to occur. This turbulence creates a turbulent pressure wave that can be detected by pressure sensor 606a. Pressure sensor 606b, in one embodiment, is included for noise cancelling, such as active and/or passive noise cancelling to filter out ambient noise and other irrelevant information.
In other embodiments, one or both of sensors 606a and 606b can comprise acoustic or other sensors suitable for data collection, active and/or passive noise cancellation and/or other tasks related to the operation of CAD detection device 400. For example, in one embodiment of noise cancellation, background noise is sampled by at least one sensor 606a or 606b and subtracted from an overall signal in order to cancel noise and improve signal quality. In this and other embodiments, one or both of sensors 606a and 606b and/or related components and circuitry are mechanically potted, or encapsulated, to improve noise cancellation. In embodiments, one or both of sensors 606a and 606b are electrically shielded to reduce noise. Still other sensors in addition to sensors 606a and 606b also can be included in device 400, even though they are not specifically depicted in
Automatic signal strength detection circuitry and signal processing techniques can also be implemented in embodiments to improve signal quality. For example, in one embodiment, a signal kernel or shape is determined from signal samples and compared with an overall signal or pattern to determine whether the sample fits. If not, new data can be collected, existing data can be otherwise processed, and/or detection device 400 can be repositioned, among other tasks.
Therefore, active noise cancellation can be implemented in embodiments of CAD detection device 400 as described above. Passive noise cancellation can be implemented in combination with active noise cancellation, or on its own, in other embodiments. Materials such as, but not limited to, rubber, foam, sponge, glass fiber, ceramic fiber, mineral fiber, vinyl, tape, or sound-absorbing coatings and pastes or combinations thereof can be disposed proximate one or both of sensors 606a and 606b or otherwise suitably arranged on or within device 400 in order to passively reduce noise.
In embodiments, one or both of sensors 606a and 606b or another sensor of device 400 can comprise pressure sensors or other sensors suitable for sensing the pressure applied by a user to CAD detection device 400 in preparation for or during patient scanning. In embodiments, one or both of sensors 606a and 606b can comprise pressure sensors or other sensors suitable for sensing the pressure applied by a user to detection device 400 in combination with the ability to collect data related to the presence or absence of a turbulent pressure wave in a coronary artery. In other embodiments, an additional sensor or plurality of sensors is configured for sensing the pressure applied by a user to detection device 400 in preparation for or during patient scanning.
In embodiments, the pressure applied by a user is measured and compared against a minimum value representative of a typical amount of minimum pressure to establish a signal, and a maximum value representative of a typical amount of maximum pressure so as to not max out the measured signal. If the measured pressure exceeds the maximum value, an error message can be displayed to the user via a user interface. Likewise, if the measured pressure is below the minimum value, an error message can be displayed to the user via the user interface. Other threshold minimum and maximum values can also be used, depending on the patient, user, or other appropriate factors.
Power supply 608 can comprise a battery in embodiments, such as a rechargeable battery or a replaceable battery. Rechargeable power supply 608 can be inductance-style, two-pin, charge by computer, and/or charge by AC wall outlet, or some other suitable charging configuration. In embodiments, power supply 608 can be powered or recharged through inductive charging. Power supply 608 can also be configured to allow for multiple different charging schemes. For example, CAD detection device 400 can interface with a charging station by physical coupling or cable, and/or CAD detection device 400 can couple by USB or other cable to a computer, docking station, wall outlet or other source of power. In embodiments, one power supply 608 is electrically shielded to reduce noise.
Controller 610 controls the operation of CAD detection device 400. During scanning, controller 610 can control a graphical user interface (GUI), a timer and the general operation of CAD detection device 400. In embodiments, the GUI is electrically shielded to reduce noise. Controller 610, via the GUI and/or an audible indicator, can also prompt a user to carry out various tasks, such as to apply CAD detection device 400 to one or more of patient scan sequence guide 500 areas or patient areas, to move on to a next guide area, tag or patient area, to rescan a particular guide area, tag or patient area, to reposition CAD detection device 400 if data of sufficient quality is not detected, to recharge CAD detection device 400 and other functions. CAD detection device 400 further comprises a timer, such as part of controller 610, for each scan to ensure that sufficient data is collected at each scan site. In one embodiment, this timer can automatically start as soon as data of a sufficient quality is detected by sensor 606a, though other procedures can be used in other embodiments.
Controller 610 can be subservient to and/or operate in conjunction with an external controller coupled by wire or wirelessly in embodiments. In embodiments, controller 610 can carry out processing of collected data, for example to determine a presence of coronary artery disease based on data sampled by at least one of sensors 606a and 606b at the patient data acquisition locations associated with identification areas guide 500, though in other embodiments data processing is carried out external to CAD detection device 400, as described above. Controller 610 operates in cooperation with memory 612, which stores collected data until it is transferred to an external device or manually or automatically deleted and can be of any suitable type. Controller 610 also can correlate data sampled by sensors 606a and/or 606b with a data acquisition location using the identification element, such as sequence guide 500.
Communication circuitry 614 is configured to transfer data to and from CAD detection device 400. For example, after scan data is collected for a particular patient and stored in memory 612, the raw scan data can be packaged and transferred wired or wirelessly to, for example, data portal device 104 or networked or local computer system 106 for processing and determination of whether CAD may be present.
In another embodiment, CAD detection device 400 optionally further comprises a camera 616, photo or optical sensor, or other similar device. In embodiments, camera 616 can be configured to read or detect barcodes, such as one or more QR codes on sequence guide 500. In an embodiment, instead of visually moving from “A-B-C-D” as part of the sequence scanning, a QR code can be scanned by camera 616 and the subsequent sensing of the appropriate portion of the patient then conducted in any order. In embodiments, camera 616 is further configured for detecting or aligning to a portion of the patient's body. In embodiments, camera 616, along with appropriate software executable by controller 610, is configured to detect markers, flags, or any other suitable landmark of the patient to aid in aligning CAD detection device 400 to the patient. In another embodiment, camera 616 is configured to detect position of motion relative to the patient.
In another embodiment, CAD detection device 400 optionally further comprises a light sensor 618. In embodiments, light sensor 618 can be utilized to detect the proximity of CAD detection device 400 to the body of the patient. For example, a greater amount of light will be detectable by light sensor 618 when CAD detection device 400 is further from the patient. Likewise, less light will be detectable by light sensor 618 when CAD detection device 400 is proximate the patient. Such light sensing can be utilized to properly place and position CAD detection device 400.
In another embodiment, CAD detection device 400 optionally further comprises a temperature sensor 620. In embodiments, temperature sensor 620 can be utilized to detect the proximity of CAD detection device 400 to the body of the patient. For example, a lower temperature will be detectable by temperature sensor 620 when CAD detection device 400 is further from the patient. Likewise, a higher temperature will be detectable by temperature sensor 620 when CAD detection device 400 is proximate the patient. Such temperature sensing can be utilized to properly place and position CAD detection device 400. In embodiments, temperature sensor 602 can be used to measure the temperature of a patient.
In another embodiment, CAD detection device 400 optionally further comprises one or more accelerometers 622. In embodiments, accelerometer 622 is configured to detect proper acceleration of CAD detection device 400. For example, if accelerometer 622 detects an acceleration when CAD detection device 400 is in a data sense mode, it can be determined that CAD detection device 400 has moved or shifted during sensing and the data measured during that point may have errors or otherwise be incorrect. Such acceleration sensing can be utilized to properly place and position CAD detection device 400. In embodiments, an indication of a shift can be provided to the user via the GUI of CAD detection device 400. In still further embodiments, accelerometers 622 can provide drop detection. If CAD detection device 400 is dropped and accelerometers 622 detect sharp acceleration, CAD detection device 400 can be deactivated so that results from a damaged device 400 are not used in diagnosis. In embodiments, a detected drop can be transmitted to a licensor or owner of the equipment.
In an embodiment, CAD detection device 400 optionally further comprises one or more gyroscopes 624. In embodiments, gyroscope 624 is configured to detect an orientation or change in orientation of CAD detection device 400. For example, if gyroscope 624 detects a change in orientation of CAD detection device 400 when CAD detection device 400 is in a data sense mode, it can be determined that CAD detection device 400 has tilted during sensing and the data measured during that point may have errors or otherwise be incorrect. Such orientation sensing can be utilized to properly place and position CAD detection device 400. In embodiments, an indication of a tilt can be provided to the user via the GUI of CAD detection device 400.
In an embodiment of CAD detection device 400 comprising gyroscope 624, noise determination can be conducted by determination of orientation or movement sensed by gyroscope 624. In embodiments, based on the amount of movement sensed by gyroscope 624, additional determination can be made of the source of the noise, such as lung noise, digestive noise, or movement of the device. In such embodiments, CAD detection device 400 comprises a single sensor 606a, and does not include a secondary sensor for noise reduction or noise cancellation.
In an embodiment, CAD detection device 400 optionally further comprises an SD card port configured to receive an SD card or other portable memory. In such embodiments, CAD detection device 400 is effectively infinitely expandable such that an unlimited number of data sets can be stored. In other embodiments, an internal memory such as MANIC can be incorporated, which is not removable from CAD detection device 400.
In embodiments, CAD detection device 400 can be configured for gain control. In an embodiment, gain control can be automated. For example, an impedance measurement can detect abdominal loading or feedback and the gain adjusted appropriately. Gain can therefore be modified based on an impedance feedback. In embodiments, gain tuning or control can be based at least in part on data downloaded from an Electronic Health Record (EHR). In embodiments, CAD detection device 400 can be pre-calibrated before use.
Embodiments of CAD detection device 400 can be utilized with existing systems to provide supplemental functionality to those systems. For example, CAD detection device 400 can be operably coupled to an electrocardiography (ECG or EKG) device. Data sensed or detected by CAD detection device 400 can supplement electrocardiogram data. In embodiments, the supplemented or combined data can be incorporated into a diagnosis or used in further data analysis. In embodiments, CAD detection device 400 can be operably coupled to other existing systems.
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In another embodiment, hub 602 further comprises a microphone or other suitable voice sensor such that system 600 can be verbally or audibly commanded with hub 602. For example, voice commands can be given to hub 602 to command CAD detection device 400, such as to turn on, turn off, activate, sense data, or otherwise command CAD detection device 400. In an embodiment, identifying patient data can be spoken into hub 602. In embodiments, the data sensed from CAD detection device 200 can be combined into a single package with the patient data spoken into hub 602.
In an embodiment, hub 602 can further comprise a user-mountable attachment, such as a bracelet or necklace. In such embodiments, hub 602 can be worn by the patient or caregiver. Hub 602 can be worn such that hub 602 is placed on the user to facilitate speaking or otherwise commanding system 600 or components of system 600 via voice or other audible commands.
In embodiments, a kit can comprise a CAD detection device 400 and a hub 602. In embodiments, a kit further comprises sequence guide 500. In other embodiments, a kit can further comprise instructions for use of CAD detection device 400, hub 602, and/or sequence guide 500. In embodiments, sequence guide 500 contains instructions for use of CAD detection device 400 and hub 602.
In embodiments, drivers, software, and other executables, if necessary, can be installed on hub 602. In one embodiment, data transfer from CAD detection device 400 to hub 604 is initiated using RFID technology embedded in a USB Bluetooth hub 602. The hub drivers can be pre-installed, in embodiments.
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Dongle 602 is one possible physical embodiment of a hub or data portal device, as previously described, although in alternative embodiments various other structures could be used either with or without a host computer 604a to transfer information to or from a remote server. For example, in the embodiment shown in
A test result, such as an indication of the presence or absence of coronary artery disease and/or a recommendation for further review or analysis, can be transferred back to CAD detection device 400 from networked or local computer system 106 or other remote server via communications circuitry and displayed on a display (e.g., display 603a of
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A data portal device or hub can be used to carry out those activities shown in
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Docking station 704 comprises hardware configured to receive one or more CAD detection devices 702. In an embodiment, docking station 704 is configured to receive CAD detection device 702 by a physical plugging, wiring or other coupling. Tab 705 closes around at least a portion of CAD detection device 702 to promote good contact between CAD detection device 702 and docking station 704. In addition, tab 705 can reduce or eliminate light, noise, and/or vibration that could otherwise affect communication between CAD detection device 702 and docking station 704.
In embodiments, CAD detection device 702 can communicate with docking station 704 to perform a self-test, calibration, or other diagnostic functions. These diagnostic features of docking station 704 can be used to assess the functionality of any of the sensors (e.g., sensors 606-624 previously described with respect to
In embodiments, CAD detection device 702 further comprises a hardware port for data transfer. Likewise, docking station 704 comprises a corresponding port for data transfer. In other embodiments, docking station 704 is configured to receive CAD detection device 702 by a wireless connection, such as a near-field or RFID communication. In embodiments, docking station 704 is further configured to charge or recharge a power supply of CAD detection device 702, such as power supply 608 as discussed with respect to CAD detection device 400. The relative orientation of device 702 and docking station 704 to accomplish docking can be different than that depicted in
In operation of docking station 704, once CAD detection device 702 has completed data collection as described above, CAD detection device 702 can be plugged into, docked, or otherwise coupled to docking station 704. Docking station 704 can then receive the collected data. Once received, in embodiments, docking station 704 can be configured to analyze the data. In other embodiments, as described above with respect to
Docking station 704 is shown in more detail in
Speaker 706 can emit acoustic vibrations for testing of CAD detection device 702. When docked, as shown in
In embodiments, pins 710 can be used to route signal from CAD detection device 702 to docking station 704. These signals can include, for example, the detected signals during a self-test or calibration procedure, or the signals acquired during a test of a patient. Additionally or alternatively, pins 710 can be used to charge a battery in CAD detection device 702.
In alternative embodiments, the relative positions of speaker 706, electrical contact pads 708, and/or pins 710 can be changed within dish portion 712. Furthermore, dish portion 712 can have a different size or shape than that which is shown in
In some embodiments, self-testing of CAD detection device 702 can be required by the software on CAD detection device 702 before an additional test can be run. Depending on the type and frequency of testing, CAD detection device can be diagnosed and calibrated by docking station 704 before every test, or before every other test, or before every third test, etc. In some embodiments, a diagnostic test can be required after a certain amount of time has elapsed, no matter how many intervening patient tests have been performed. In embodiments, a remote user could send a request via internet to hub, then via Bluetooth to the device 702 to perform a sensor test. The user could communicate to the CAD detection device 702 via wireless Internet, for example, in embodiments where CAD detection device 702 includes a chip that allows it to connect to the Internet. The user could also upgrade the firmware remotely via Over The Air (OTA) technology.
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As shown, CAD detection device 800 can further comprise a display or screen. In embodiments, the display can comprise OLED monochrome, full color or a heads-up projected display. In embodiments, the number of LED lights activated can be used to indicate a status of CAD detection device 800. In embodiments, CAD detection device 800 can further comprise a graphics card configured to operate or present on the display or screen. In embodiments, the display or screen is a touchscreen. In embodiments, the display or screen comprises a membrane switch. In another embodiment, the display or screen comprises a capacitive screen.
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In embodiments, multiple attempts are provided at each site to successfully record a heartbeat signal and/or the associated data. If CAD detection device 800 is unsuccessful after a number of tries, the system moves on to the next site. Such site progression is discussed further with respect to
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In embodiments, the aforementioned sequence of
In embodiments, CAD detection device 800 can display a number of error messages. For example, referring to
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Any of the plurality of remote detection devices 904a-904g can compare a sensed data set to the stored data sets at the learning process 902 to determine a likelihood that a test subject has a coronary artery disease. The comparison can occur either at the detection devices 904a-904g, or the comparison can be made at a cloud-based server, as described with respect to
Various embodiments of systems, devices, and methods have been described herein. These embodiments are given only by way of example and are not intended to limit the scope of the invention. It should be appreciated, moreover, that the various features of the embodiments that have been described may be combined in various ways to produce numerous additional embodiments. Moreover, while various materials, dimensions, shapes, configurations and locations, etc. have been described for use with disclosed embodiments, others besides those disclosed may be utilized without exceeding the scope of the invention.
Persons of ordinary skill in the relevant arts will recognize that the invention may comprise fewer features than illustrated in any individual embodiment described above. The embodiments described herein are not meant to be an exhaustive presentation of the ways in which the various features of the invention may be combined. Accordingly, the embodiments are not mutually exclusive combinations of features; rather, the invention may comprise a combination of different individual features selected from different individual embodiments, as understood by persons of ordinary skill in the art.
Any incorporation by reference of documents above is limited such that no subject matter is incorporated that is contrary to the explicit disclosure herein. Any incorporation by reference of documents above is further limited such that no claims included in the documents are incorporated by reference herein. Any incorporation by reference of documents above is yet further limited such that any definitions provided in the documents are not incorporated by reference herein unless expressly included herein.
For purposes of interpreting the claims for the present invention, it is expressly intended that the provisions of Section 112, sixth paragraph of 35 U.S.C. are not to be invoked unless the specific terms “means for” or “step for” are recited in a claim.
The present application claims the benefit of U.S. Provisional Application No. 62/043,052 filed Aug. 28, 2014, which is hereby incorporated herein in its entirety by reference.
Filing Document | Filing Date | Country | Kind |
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PCT/US2015/047530 | 8/28/2015 | WO | 00 |
Number | Date | Country | |
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62043052 | Aug 2014 | US |