Burns Michael L, Sinha Anik, Hoffmann Alexander, Wu Zewen, Medina Inchauste Tomas, Retsky Aaron, Chesney David, Kheterpal Sachin, Shah Nirav
Department of Anesthesiology, University of Michigan Health System, Ann Arbor, MI, United States.
Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, United States.
JMIR Biomed Eng. 2023 Sep 7;8:e46653. doi: 10.2196/46653.
The incentive spirometer is a basic and common medical device from which electronic health care data cannot be directly collected. As a result, despite numerous studies investigating clinical use, there remains little consensus on optimal device use and sparse evidence supporting its intended benefits such as prevention of postoperative respiratory complications.
The aim of the study is to develop and test an add-on hardware device for data capture of the incentive spirometer.
An add-on device was designed, built, and tested using reflective optical sensors to identify the real-time location of the volume piston and flow bobbin of a common incentive spirometer. Investigators manually tested sensor level accuracies and triggering range calibrations using a digital flowmeter. A valid breath classification algorithm was created and tested to determine valid from invalid breath attempts. To assess real-time use, a video game was developed using the incentive spirometer and add-on device as a controller using the Apple iPad.
In user testing, sensor locations were captured at an accuracy of 99% (SD 1.4%) for volume and 100% accuracy for flow. Median and average volumes were within 7.5% (SD 6%) of target volume sensor levels, and maximum sensor triggering values seldom exceeded intended sensor levels, showing a good correlation to placement on 2 similar but distinct incentive spirometer designs. The breath classification algorithm displayed a 100% sensitivity and a 99% specificity on user testing, and the device operated as a video game controller in real time without noticeable interference or delay.
An effective and reusable add-on device for the incentive spirometer was created to allow the collection of previously inaccessible incentive spirometer data and demonstrate Internet-of-Things use on a common hospital device. This design showed high sensor accuracies and the ability to use data in real-time applications, showing promise in the ability to capture currently inaccessible clinical data. Further use of this device could facilitate improved research into the incentive spirometer to improve adoption, incentivize adherence, and investigate the clinical effectiveness to help guide clinical care.
激励肺活量计是一种基本且常见的医疗设备，无法直接收集电子医疗保健数据。因此，尽管有大量研究调查其临床应用，但在最佳设备使用方法上仍几乎没有共识，且支持其预期益处（如预防术后呼吸并发症）的证据也很少。
本研究的目的是开发并测试一种用于采集激励肺活量计数据的附加硬件设备。
设计、制造并测试了一种附加设备，该设备使用反射光学传感器来识别普通激励肺活量计的容积活塞和流量浮筒的实时位置。研究人员使用数字流量计手动测试了传感器水平精度和触发范围校准。创建并测试了一种有效的呼吸分类算法，以确定有效呼吸尝试和无效呼吸尝试。为了评估实时使用情况，使用激励肺活量计和附加设备作为控制器，利用苹果iPad开发了一款视频游戏。
在用户测试中，容积传感器位置捕获精度为99%（标准差1.4%），流量捕获精度为100%。中位数和平均容积在目标容积传感器水平的7.5%（标准差6%）范围内，最大传感器触发值很少超过预期传感器水平，这表明在两种相似但不同的激励肺活量计设计上的放置具有良好的相关性。呼吸分类算法在用户测试中显示出100%的灵敏度和99%的特异性，并且该设备作为视频游戏控制器实时运行，没有明显干扰或延迟。
创建了一种用于激励肺活量计的有效且可重复使用的附加设备，以允许收集以前无法获取的激励肺活量计数据，并展示了在普通医院设备上的物联网应用。该设计显示出高传感器精度以及在实时应用中使用数据的能力，有望捕获目前无法获取的临床数据。进一步使用该设备可能有助于改进对激励肺活量计的研究，以提高其采用率、激励依从性并研究临床有效性，从而帮助指导临床护理。
