title: Dynamic Threshold Analysis of Daily Oxygen Saturation for Improved Management of COPD Patients.
abstract: This study presents a novel dynamic threshold algorithm that is applied to daily self-measured SpO2 data for management of chronic obstructive pulmonary disease (COPD) patients in remote patient monitoring to improve accuracy of detection of exacerbation. Conventional approaches based on a fixed threshold applied to a single SpO 2 reading to detect deterioration in patient condition are known to have poor accuracy and result in high false alarm rates. This study develops and evaluates use of a dynamic threshold algorithm to reduce false alarm rates. Daily data from four COPD patients with a record of clinical interventions during the period were selected for analysis. We model the SpO2 time-series data as a combination of a trend and a stochastic component (residual). We estimate the long-term trend using a locally weighed least-squares (low-pass) filter over a long-term processing window. Results show that the time evolution of the long-term trend indicated exacerbation with improved accuracy compared to a fixed threshold in our study population. Deterioration in the condition of a patient also resulted in an increase in the standard deviation of the residual (σres ), from 2% or less when the patient is in a healthy condition to 4% or more when condition deteriorates. Statistical analysis of the residuals showed they had a normal distribution when the condition of the patient was stable but had a long tail on the lower side during deterioration.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Clarke
authors.forename: Hulya
authors.initials: H
authors.lastname: Gokalp
authors.forename: Joanna
authors.initials: J
authors.lastname: Fursse
authors.forename: Russell W
authors.initials: RW
authors.lastname: Jones
mesh_terms: D000465:Algorithms; D006801:Humans; D015233:Models, Statistical; D010100:Oxygen / Q000097:blood*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D012815:Signal Processing, Computer-Assisted; D017216:Telemedicine / Q000379:methods; D013686:Telemetry / Q000379:methods*
chemical_list: D010100:Oxygen