title: Health checkup and telemedical intervention program for preventive medicine in developing countries: verification study.
abstract: BACKGROUND
  The prevalence of non-communicable diseases is increasing throughout the world, including developing countries.
  
  
  OBJECTIVE
  The intent was to conduct a study of a preventive medical service in a developing country, combining eHealth checkups and teleconsultation as well as assess stratification rules and the short-term effects of intervention.
  
  
  METHODS
  We developed an eHealth system that comprises a set of sensor devices in an attaché case, a data transmission system linked to a mobile network, and a data management application. We provided eHealth checkups for the populations of five villages and the employees of five factories/offices in Bangladesh. Individual health condition was automatically categorized into four grades based on international diagnostic standards: green (healthy), yellow (caution), orange (affected), and red (emergent). We provided teleconsultation for orange- and red-grade subjects and we provided teleprescription for these subjects as required.
  
  
  RESULTS
  The first checkup was provided to 16,741 subjects. After one year, 2361 subjects participated in the second checkup and the systolic blood pressure of these subjects was significantly decreased from an average of 121 mmHg to an average of 116 mmHg (P<.001). Based on these results, we propose a cost-effective method using a machine learning technique (random forest method) using the medical interview, subject profiles, and checkup results as predictor to avoid costly measurements of blood sugar, to ensure sustainability of the program in developing countries.
  
  
  CONCLUSIONS
  The results of this study demonstrate the benefits of an eHealth checkup and teleconsultation program as an effective health care system in developing countries.
authors: Medical Information Center, Kyushu University Hospital, Fukuoka, Japan. y-nohara@info.med.kyushu-u.ac.jp.
authors: Yasunobu
authors: http://orcid.org/0000-0002-2805-6597
authors: Y
authors: Nohara
authors: Eiko
authors: http://orcid.org/0000-0002-8631-2886
authors: E
authors: Kai
authors: Partha Pratim
authors: http://orcid.org/0000-0003-2688-6332
authors: PP
authors: Ghosh
authors: Rafiqul
authors: http://orcid.org/0000-0002-6275-9472
authors: R
authors: Islam
authors: Ashir
authors: http://orcid.org/0000-0002-8125-471X
authors: A
authors: Ahmed
authors: Masahiro
authors: http://orcid.org/0000-0002-9038-9376
authors: M
authors: Kuroda
authors: Sozo
authors: http://orcid.org/0000-0001-9235-9333
authors: S
authors: Inoue
authors: Tatsuo
authors: http://orcid.org/0000-0002-1945-6150
authors: T
authors: Hiramatsu
authors: Michio
authors: http://orcid.org/0000-0002-9967-5336
authors: M
authors: Kimura
authors: Shuji
authors: http://orcid.org/0000-0003-2965-2910
authors: S
authors: Shimizu
authors: Kunihisa
authors: http://orcid.org/0000-0002-7741-846X
authors: K
authors: Kobayashi
authors: Yukino
authors: http://orcid.org/0000-0001-5310-9841
authors: Y
authors: Baba
authors: Hisashi
authors: http://orcid.org/0000-0002-5906-7571
authors: H
authors: Kashima
authors: Koji
authors: http://orcid.org/0000-0002-4288-1606
authors: K
authors: Tsuda
authors: Masashi
authors: http://orcid.org/0000-0001-6658-6743
authors: M
authors: Sugiyama
authors: Mathieu
authors: http://orcid.org/0000-0002-2366-2993
authors: M
authors: Blondel
authors: Naonori
authors: http://orcid.org/0000-0003-2477-9672
authors: N
authors: Ueda
authors: Masaru
authors: http://orcid.org/0000-0003-4027-2994
authors: M
authors: Kitsuregawa
authors: Naoki
authors: http://orcid.org/0000-0003-4926-8772
authors: N
authors: Nakashima
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002908:Chronic Disease / Q000517:prevention & control*; D003695:Delivery of Health Care; D003906:Developing Countries; D055695:Electronic Prescribing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011315:Preventive Medicine / Q000379:methods*; D019114:Remote Consultation / Q000295:instrumentation; D012307:Risk Factors; D017216:Telemedicine; D055815:Young Adult
keywords: body area network; developing countries; preventive medicine; public health informatics; sensor; teleconsultation
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