Source: International Congress 2016 – Non-inflammatory assessment of airway disorders
Disease area: Airway diseases

Abstract

Introduction: Domiciliary monitoring is increasingly used in COPD. There is a trade off between the number of false-alarms raised by such systems and the sensitivity of the system to detect exacerbations. Arbitrary limits are often set, but we hypothesised that limits set for an individual patient based on an assessment of their own data would increase the sensitivity and specificity of monitoring. Here we report the effect on false-alarm calls. Based on the American guidelines, normal heart rate is 60 – 100 bpm and standard SpO2 is ³ 95%.Aim: Set the appropriate alarm limits to an individual patient to reduce the number of false alarms.Method: In this pilot study, we recorded five weeks of HR and SpO2 %, data were collected once each day prospectively from 8 COPD patients from the domiciliary telehealth project following pulmonary rehabilitation. Data collected in the first two weeks were used to set the appropriate limits for each patient by calculating the mean and SD over that period, and setting the alarm at +/- 1.5 and 1.96 SD.Result: The mean age of 8 Patients was 69.6 years (10.47 SD), 75% males, and FEV1% mean 42% (19.7 SD). The table shows the alarm frequency for each algorithm. Results are expressed as alarms/day. Setting alarms by individual parameters versus did not alter the frequency of HR alarms but reduced the frequency of SpO2 alarms.

HR 60 - 100 bpm	HR +/- 1.5 SD	HR +/- 1.96 SD	P = Kruksall Wallis	SpO2 95 - 98 %	SpO2 +/- 1.5 SD	SpO2 +/- 1.69 SD	P = Kruksall Wallis
0.13	0.15	0.07	0.343	0.28	0.02	0.02	0.046

 

Conclusion: In this study we show that alarm rates vary by arbitrary versus patient specific thresholding. We were able to decrease the false alarms and reduce the volume of calls on the team.


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Citations should be made in the following way:
Ahmed Al Rajeh (London, United Kingdom), Ahmed Al Rajeh, Michelle Obrien, Jennie Symondson, John Hurst. Patient specific parameter thresholding to support domiciliary monitoring in COPD. Eur Respir J 2016; 48: Suppl. 60, 1035

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