Patent Application
20110021940
The present invention relates to systems and methods to assist in obtaining measurements related to the evaluation of a person's pulmonary function.
Pulmonary evaluation equipment allows the measurement of one or more aspects of a person's pulmonary function. Such measurements can be helpful, for example, in determining the extent of a person's healing after a lung injury, in evaluating an asthma patient's lung capacity, or for ensuring pulmonary health during routine physical checkups.
Depending on which characteristic of pulmonary function is being measured, a person may need to exert some effort to provide the necessary input to the equipment being used. For example, a person may need to perform certain maneuvers at certain times during a test. In a hospital, doctor's office, or laboratory, technicians are available to provide instructions and encouragement to the person throughout the duration of the test; however, when using pulmonary evaluation equipment alone or without a trained technician, persons may be unable to complete a test properly, or may be unsure of whether the test results are improving or satisfactory. Moreover, quality of tests may vary in the same pulmonary laboratory or doctor's office due to difference in test technician coaching skills. The same patient tested by different technician in follow-on visits may have inconsistent test results due to variations in coaching techniques.
Some pulmonary evaluation equipment includes a video monitor that can provide visual encouragement. However, such visual feedback does not always result in clear communication with the person, and not all pulmonary evaluation equipment includes a display monitor for visual encouragement.
Accordingly, a system and method are needed to provide users of pulmonary evaluation equipment with non-visual instructions, encouragement, and feedback.
Exemplary embodiments of the present invention that are shown in the drawings are summarized below. These and other embodiments are more fully described in the Detailed Description section. It is to be understood, however, that there is no intention to limit the invention to the forms described in this Summary of the Invention or in the Detailed Description. One skilled in the art can recognize that there are numerous modifications, equivalents and alternative constructions that fall within the spirit and scope of the invention as expressed in the claims.
The present invention relates to pulmonary diagnostic. In one exemplary embodiment, the present invention can include a method of providing audible signals related to measurement of pulmonary function, the method comprising receiving a pulmonary input through a receiver, transferring the pulmonary input to a sensor, generating an input signal, using the sensor, based on the pulmonary input, and generating a responsive audible signal through a speaker, wherein the responsive audible signal is based on the input signal. The pulmonary input may comprise, for example, an inhalation, exhalation, gas content reading, or other pulmonary input. The responsive audible signal may comprise a verbal audible signal, a tone, or some combination of both. The responsive audible signal could be for instruction and/or encouragement. The method could further include generating audible instruction signals that are not necessarily related to the pulmonary input. For example, the audible instruction signals could be based on the type of pulmonary test being performed, and the timing requirements of such a test, and/or the age and health condition of the user.
In another exemplary embodiment, the present invention can include a system for measuring pulmonary function, comprising a receiver configured to accept an input from a pulmonary system of a person, an input carrier, connected to the receiver and configured to carry the input from the receiver to a sensor, the sensor configured to measure a value of the input, a processor connected to the sensor, wherein the processor is configured to select an audible signal in response to the value of the input, and a speaker connected to the processor, wherein the speaker is configured to generate audible feedback based on the audible signal. This system could be incorporated into a plethysmograph or used as a separate handeld device. Other features, such as a display screen, user interface, test gas chamber, shutter, or other feature related to a pulmonary test may be further incorporated into the system. Moreover, features that allow data stored on the system to be transmitted to other locations could be easily incorporated into the system.
As previously stated, the above-described embodiments and implementations are for illustration purposes only. Numerous other embodiments, implementations, and details of the invention are easily recognized by those of skill in the art from the following descriptions and claims.
Various objects and advantages and a more complete understanding of the present invention are apparent and more readily appreciated by reference to the following Detailed Description and to the appended claims when taken in conjunction with the accompanying Drawings, wherein:
Referring now to the drawings, where like or similar elements are designated with identical reference numerals throughout the several views,
Various embodiments of each of these elements will be recognized by persons of skill in the art. For example, the receiver 1100 may comprise a mouthpiece, a tube, a plurality of tubes, a receptacle, a sensor, or another appropriate device for receiving a pulmonary input (meaning an input from a person's pulmonary system) from a person using a pulmonary measurement machine 1000. A receiver 1100 may be designed to accept as a pulmonary input an inhalation or exhalation from a person, or it may be designed to be inserted into a person's lungs, or near a person's diaphragm, or anywhere else where a pulmonary input may be received. A person may or may not have to exert physical activity to effect or create the pulmonary input.
Various embodiments of the input carrier 1150 are possible as well. It may be, for example, a tube, or it may be a receptacle configured to removably attach first to the receiver 1100, where it can collect a pulmonary input, and then to pulmonary measurement machine 1000 in such a way as to expose the sensor 1200 to the pulmonary input. In some embodiments, a receiver 1100 and input carrier 1150 may be unnecessary; for example, the sensor 1200 may be configured to be placed inside a person's lungs, and may be capable of transmitting a voltage through a wire to the processor 1250.
As with the other elements of the pulmonary measurement machine 1000, various embodiments of the sensor 1200 are also possible. The sensor 1200 may be a pressure sensor, flow sensor, viscosity sensor, density sensor, humidity sensor, mechanical sensor, chemical sensor, pneumotach, hot-wire anemometer, or any of a variety of other sensors known to persons of skill in the art. The processor 1250 may be any processor capable of accepting an input from a sensor 1250, calculating a value in one or multiple steps, and, alone or in combination with other hardware, choosing a responsive audible signal (meaning an audible signal that corresponds in some way to the pulmonary input itself or to the value calculated by the processor 1250) from an audible signal storage device 1300 and causing the responsive audible signal to be played on a speaker 1350.
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In one embodiment of the pulmonary measurement machine 1000 shown in
Characteristics of a pulmonary input that may be measured using a system such as the pulmonary measurement machine 1000 include spirometric flow, spirometric volume, and oxygen concentration, among other things.
The processor 1250 can use the signal produced by the sensor 1200 in response to the pulmonary input to calculate a desired value. For example, if the desired value is the total exhalation volume and the sensor is an enclosed propeller anemometer, the processor 1250 can use the voltage to determine the rotational velocity of the propeller, which it can use to calculate the air speed at each moment during the exhalation. By integrating the air speed over time and multiplying the result by the cross-sectional area of the anemometer, the total volume can be closely approximated. Other values of characteristics can be calculated using appropriate sensors and formulas. Once the processor 1250 has calculated the desired value or values, it can locate within the audible signal storage unit 1300 one or more responsive audible signals to play through the speaker 1350 in response to the calculated value or values. The processor may also locate, within the audible signal storage unit 1300, one or more audible instruction signals to play through the speaker 1350 in response to factors other than pulmonary inputs. For example, the processor 1250 could run a program where some audible instruction signals are selected based on factors such as time, age, type of pulmonary test being performed and/or other non-pulmonary input variables. Responsive audible signals may also be selected on a combination of both a pulmonary input and some other non-pulmonary input factor (such as time, heart rate, age of user, etc.). Moreover, the calculated value used to select the responsive audible signal(s) may directly relate to a characteristic of the pulmonary input, or it may indirectly relate to a characteristic of the pulmonary input. For example, the calculated value could be a total volume, or it could be a rate of change of total volume, or it could be a difference between two or more measurements of total volume.
The responsive audible signal chosen by the processor 1250 may, for example, be a tone that increases in pitch over time in proportion to the magnitude of the value representing the total volume of air exhaled by the user, such that as the user exhales the tone generated by the speaker 1350 rises in pitch. The user can know whether his total volume is increasing from use to use by comparing the highest pitches achieved in each successive use of the pulmonary measurement machine 1000. Similarly, an audible instruction signal chosen by the processor 1250 may, for example, be a tone that increases in pitch over time in proportion to the magnitude of the value representing the volume of air the user should be exhaling. In this way, the audible instruction signal could provide instructions as to how the user is to perform a given test. For more complicated pulmonary test types, such as an Inspiratory Capacity test for a Chronic Obstructive Pulmonary Disease patient, or simpler tests, such as a Peak Expiratory Flow (PEF) test or Forced Expiratory Volume in 1 second (FEV1) test, the audible signal storage unit 1300 may need to provide verbal instructions or verbal instructions in combination with tones and other audio cues. As will be understood by those skilled in the art, some audible signals would actually start before any pulmonary inputs are received, while others will be used during and after a pulmonary input or pulmonary inputs.
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Here as with other embodiments, a variety of audible signals (whether responsive audible signals or audible instruction signals) may be used consistent with the present invention, and those signals may be chosen for a variety of reasons. An audible (tonal or verbal) signal may be provided to patients to improve accuracy, consistency and repeatability of pulmonary function tests by encouraging patients to achieve maximal effort, guiding patients through complex maneuvers, reducing patient anxiety and reducing dependency on coaching skills of test technicians. For example, the responsive audible signal generated as audible feedback to the user may be a tone, a musical composition, verbal encouragement, verbal instructions, or some other sound. The responsive audible signal may be played before the input, during the input or after the input is completed. The audible signal may change, either continuously over time or in response to various values, including measured pulmonary inputs, heart rate, or time. The audible signal could be generated according to a pre-determined timing sequence, triggered by occurrence of specific events, or created in response to patient's input during test. For example, a measurement of the amplitude of spirometric flow may trigger audible feedback in the form of a tone. Or, if an inhalation or exhalation that lasts a specific amount of time is needed, a monotone could play for the duration of that time period, or the tone could increase in volume or pitch as time passes until it stops when the necessary time period has ended. Also, the audible signal storage unit can contain instructions for producing an audible signal in addition to or instead of only storing previously produced audible signals. For example, in addition to containing a stored congratulatory message, the audible signal storage unit can contain instructions for producing a tone that varies in pitch according to the calculated value of the input.
The particular responsive audible signal played in response to a value or values calculated from a pulmonary input can be chosen for a variety of reasons, including to encourage the user to adjust the input, to provide instructions, to provide information about the input, or for other reasons known to persons of ordinary skill in the art. For example, the responsive audible signal could be motivational feedback in the form of verbal encouragement. If a favorable rate of change occurs, the user receives congratulatory audible feedback (i.e. “Good job!” or “Keep up the good work!”), and if an unfavorable rate of change occurs, the user receives encouraging audible feedback (i.e. “Try a little harder!” or “You can do better! Let's try again!”). Or, the audible instruction signal might comprise instructions relevant to the pulmonary test being administered (i.e. “inhale now” or “continue exhaling” or “breathe deeply”).
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The above aspects, and other aspects not specifically described, can be modified in a variety of ways, only some of which are described herein. One modification or addition that may be desirable is the ability to take multiple measurements over the duration of the user's input, such that a processor 1250, for example, can choose a new audible signal, or can change a previously-chosen audible signal, based on values updated either continuously (i.e. in real-time) or at a set interval (i.e. every seven seconds). In this way the audible feedback generated to the user can vary in response to changing values (such as time, pulmonary input values, heart rate, etc.). For example, for pulmonary input value, repeated measurement also allows for a determination of whether the pulmonary input characteristic being measured is increasing or decreasing, and appropriate responsive audible feedback can be generated accordingly. Since it may take more time to play a given responsive audible signal than it takes to make multiple measurements, a set number of successive values can be averaged. This allows each responsive audible signal to be chosen based on an average value calculated at a slow enough frequency to ensure that each responsive audible signal has sufficient time to be played before playback of a new responsive audible signal is initiated.
Pulmonary evaluations coupled with audio feedback need not be devoid of other incentive devices; for example, the evaluations could include visual feedback as well. Further, the evaluations may be conducted using a stationary device, a portable device, or even a handheld device.
One application of the present invention is for use in spirometry. Spirometry is a test that measures how an individual inhales or exhales volumes of air as a function of time. For example, spirometry can be used to measure the changes in lung volumes (but not the absolute lung volumes) as well as flow rates achieved by an individual during inspiration and expiration. This is useful for detecting, characterizing, and quantifying the severity of lung diseases. However, while spirometry can be undertaken using many different types of equipment, it requires cooperation between the subject and whomever is conducting the test, and the results obtained will depend on technical as well as personal factors. (Miller M R, Hankinson J, Brusasco V, et al. Standardisation of Spirometry, Eur Respir J 2005; 26: 319-338.)
Typical spirometry measurements will require patient to: (a) breath normally (tidal breathing) initially, and (b) perform maximal inhalation and/or followed by maximal exhalation (or vice versa) after a stable tidal breathing pattern is achieved. During maximal inhalation or exhalation, test technician would provide various verbal instructions to a patient such as inhale rapidly, inhale more, exhale rapidly, keep on blowing, etc.
After tidal breathing is established, the pulmonary measurement machine 1000 can select and provide audible instruction signals for complete exhalation and inhalation. As the patient is exhaling or inhaling, encouragement can be provided in various forms, such as “Good job, keep going.” Alternately, an acoustic tone with increasing frequency will “incentivize” patient to provide more effort. This encouragement and instruction can continue until a minimum inhalation or exhalation rate is achieved. For example, once the pulmonary measurement machine 1000 detects less than 0.025 L of air is expired/inhaled in 1 second or patient has tried to exhale for more than 6 seconds (3 seconds for patients under 10 years old), the program can move to the next step until testing is complete.
In another embodiment, the present invention could be used to instruct and coach a user through a series of maneuvers required for body plethysmography.
In another embodiment, the present invention could be used to assist with measuring diffusing capacity. Diffusing capacity is a measure of lung's capacity to exchange gas across the alveolar-capillary interface. The standard approach is to measure the rate of carbon monoxide uptake when a small amount of CO is included in the breathing gas. One of the most common CO uptake method is the single breath CO diffusing capacity measurement.
Once exhalation is complete, the user could be provided with instructions to inhale rapidly and maximally. For this embodiment, the pulmonary measurement machine 1000 could further comprise a test gas chamber (not shown) which can release a specified amount of inhale test gas through the receiver 1100 so it is inhaled by the user. For single-breath DLCO for example, the inhale test gas would comprise typically around 3000 ppm of CO. Once the inhalation had dropped below a certain rate, or lasted a certain period of time, the processor 1250 selects audible instruction signal(s) that encourage patient to hold breath for 10 seconds (+/−2 seconds). For example, this could include multiple forms of encouragement at the same time as, or independent from, a countdown. At the end of the breath hold, audible instruction signals would be provided to exhale rapidly. For the exhalation, the pulmonary measurement machine 1000 could further comprise a gas analyzer (single-sample or continuous) to determine the amount of CO present in the exhalation. This gas analyzer could be incorporated as part of the sensor 1200 or could be designed separately into the machine 1000.
In conclusion, the present invention provides, among other things, a system and method for providing audible feedback to a user of a pulmonary evaluation machine. Those skilled in the art can readily recognize that numerous variations and substitutions may be made in the invention, its use and its configuration to achieve substantially the same results as achieved by the embodiments described herein. Accordingly, there is no intention to limit the invention to the disclosed exemplary forms. Many variations, modifications, and alternative constructions fall within the scope and spirit of the disclosed invention as expressed in the claims.
