Department of Palliative Medicine, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Institute of High-Frequency Technology, Hamburg University of Technology (TUHH), Hamburg, Germany.
BMC Palliat Care. 2024 Nov 30;23(1):273. doi: 10.1186/s12904-024-01592-3.
Heart rate (HR) monitoring is a medical standard to provide information about a patient's health status. In palliative care, relationship and social engagement are crucial therapeutic concepts. For fear of disrupting communication, social contact, and care, continuous HR monitoring is underutilised despite its potential to inform on symptom burden and therapeutic effects. This study investigates radar-based HR monitoring as an innovative and burden-free approach for palliative care patients, compares its accuracy with conventional ECG methods, and shows potential for therapeutic guidance.
A single-centre, comparative clinical trial was conducted with palliative care patients at the ward of the Department of Palliative Medicine of the University Hospital of Erlangen. The HR measurements obtained with radar were compared with Holter ECG (study arm I, overnight) and Task Force Monitor (TFM)-based ECG validation recordings (study arm II, one hour). In addition, long-term radar measurements without validation were analysed in comparison with clinical health records (study arm III).
Both validation methods showed correlation by scatter plot, modified Bland-Altman plot, and equivalence testing. N = 34 patients participated in study arm I. HR of 4,079 five-minute intervals was analysed. Radar measurements and ECG showed high agreement: difference of HRs was within [Formula: see text]5 bpm in 3780 of 4079 (92.67%) and within ±13.4 bpm ([Formula: see text]1.96 times the SD of the mean) in 3979 (97.55%) intervals, respectively. In study arm II, n = 19 patients participated. 57,048 heart beats were analysed. The HR difference was within [Formula: see text]5 bpm for 53,583 out of 57,048 beats (93.93%) and within [Formula: see text]8.2 bpm ( ± 1.96 times the SD of the mean) in 55,439 beats (97.25%), respectively. Arm III showed HR changes extracted from radar data in correlation with symptoms and treatment.
Radar-based HR monitoring shows a high agreement in comparison with ECG-based HR monitoring and thus offers an option for continuous and above all burden-free HR assessment, with the potential for use in symptom management in palliative care, among others. Further research and technological advancements are still necessary to fully realize this innovative approach in enhancing palliative care practices.
心率(HR)监测是提供患者健康状况信息的医学标准。在姑息治疗中,人际关系和社会参与是至关重要的治疗概念。尽管心率监测有潜力提供症状负担和治疗效果的信息,但由于担心会干扰沟通、社会接触和护理,尽管其具有潜力,但仍未得到充分利用。本研究调查了基于雷达的 HR 监测作为一种创新的、无负担的姑息治疗患者方法,比较了其与传统心电图方法的准确性,并展示了其在治疗指导方面的潜力。
在埃尔兰根大学医院姑息医学系的病房中,对姑息治疗患者进行了一项单中心、对照临床试验。将雷达获得的 HR 测量值与 Holter ECG(研究臂 I,过夜)和基于任务 Force Monitor(TFM)的 ECG 验证记录(研究臂 II,一小时)进行比较。此外,还对未经验证的长期雷达测量值与临床健康记录进行了分析(研究臂 III)。
两种验证方法均通过散点图、修正的 Bland-Altman 图和等效性检验显示出相关性。研究臂 I 有 34 名患者参与。分析了 4079 个 5 分钟间隔的 HR。雷达测量和 ECG 显示出高度一致性:在 4079 个间隔中的 3780 个(92.67%)和在 3979 个间隔中的 3840 个(97.55%),HR 差异在 [Formula: see text]5 bpm 以内,在 4079 个间隔中的 3840 个(97.55%)和在 3979 个间隔中的 3840 个(97.55%),HR 差异在 [Formula: see text]13.4 bpm 以内(均为均值的 [Formula: see text]1.96 倍标准差)。在研究臂 II 中,有 19 名患者参与。分析了 57048 个心跳。HR 差异在 53583 个心跳中在 [Formula: see text]5 bpm 以内(93.93%),在 55439 个心跳中在 [Formula: see text]8.2 bpm 以内(均为均值的 [Formula: see text]1.96 倍标准差)。臂 III 显示从雷达数据中提取的 HR 变化与症状和治疗相关。
与基于 ECG 的 HR 监测相比,基于雷达的 HR 监测具有高度一致性,因此为连续且最重要的无负担 HR 评估提供了一种选择,具有在姑息治疗中的症状管理等方面的应用潜力。为了充分实现这一创新方法在增强姑息治疗实践中的潜力,仍需要进一步的研究和技术进步。