John A. Crowe

Application of empirical mode decomposition to heart rate variability analysis.

The analysis of heart rate variability, involving changes in the autonomic modulation conditions, demands specific capabilities not provided by either parametric or non-parametric spectral estimation methods. Moreover, these methods produce time-averaged power estimates over the entire length of the record. Recently, empirical mode decomposition and the associated Hilbert spectra have been proposed for non-linear and non-stationary time series. The application of these techniques to real and simulated short-term heart rate variability data under stationary and non-stationary conditions is presented. The results demonstrate the ability of empirical mode decomposition to isolate the two main components of one chirp series and three signals simulated by the integral pulse frequency modulation model, and consistently to isolate at least four main components localised in the autonomic bands of 14 real signals under controlled breathing manoeuvres. In addition, within the short time-frequency range that is recognised for heart rate variability phenomena, the Hilbert amplitude component ratio and the instantaneous frequency representation are assessed for their suitability and accuracy in time-tracking changes in amplitude and frequency in the presence of non-stationary and non-linear conditions. The frequency tracking error is found to be less than 0.22% for two simulated signals and one chirp series.

Monitoring the fetal heart non-invasively: a review of methods

Abstract Doppler ultrasound, ultrasound M-mode analysis, fetal electrocardiography, and fetal magnetocardiography are methods by which the fetal heart can be monitored non-invasively. In this paper, they are evaluated and compared. Customarily, it is solely the fetal heart rate, which is monitored using the Doppler ultrasound technique since it is both simple to use and cheap. However, this method inherently produces an averaged heart rate and therefore cannot give the beat-to-beat variability. Fetal electrocardiography has similar advantages, but in addition offers the potential for monitoring beat-to-beat variability and performing electrocardiogram morphological analysis. Its disadvantage is that its reliability is only 60 %, although it is the only technique that offers truly long-term ambulatory monitoring. Ultrasound M-mode analysis allows a estimation of atrial and ventricular coordination, as well as an estimation of PR intervals. Bradycardias, supraventricular tachycardias, extra systoles are readily diagnosed using this method although timing will be inaccurate. Fetal magnetocardiograms can be detected reliably and used for accurate beat-to-beat measurements and morphological analysis. Consequently, they can be used for the classification of arrhythmias and the diagnosis of a long QT syndrome and some congenital heart diseases.

Compact long-term recorder for the transabdominal foetal and maternal electrocardiogram.

Foetal heart rate (FHR) monitoring is a proven means of assessing foetal health during the antenatal period. Currently, the only widely available instrumentation for producing these data is based on Doppler ultrasound, a technology that is unsuitable for long-term use. For nearly a century, it has been known that the foetal electrocardiogram (FECG) can be detected using electrodes placed on the maternal abdomen. Although these signals suggest an alternative means of FHR derivation, their use has been limited owing to problems of poor signal-to-noise ratio. However, the eminent suitability of the transabdominal FECG for long-term FHR monitoring has suggested that perseverance with the technique would be worthwhile. The paper describes the design, construction and use of a compact, long-term recorder of three channels of 24 h antenatal transabdominal data. Preliminary use of the recorder in around 400 short recording sessions demonstrates that FHR records of equivalent quality to those from Doppler ultrasound-based instruments can be extracted from such data. The success of FHR derivation is, on average, around 65% of the recording period from around 20 weeks gestation (although this figure is reduced from around 28–32 weeks, and the success rates exhibit a wide range when individual subjects are considered). These results demonstrate that the technique offers, not only a means of acquiring long-term FHR data that are problematic to obtain by other means, but also a more patient-friendly alternative to the Doppler ultrasound technique.

Capturing User Requirements in Medical Device Development: The Role of Ergonomics

Measuring and fulfilling user requirements during medical device development will result in successful products that improve patient safety, improve device effectiveness and reduce product recalls and modifications. Medical device users are an extremely heterogeneous group and for any one device the users may include patients and their carers as well as various healthcare professionals. There are a number of factors that make capturing user requirements for medical device development challenging including the ethical and research governance involved with studying users as well as the inevitable time and financial constraints. Most ergonomics research methods have been developed in response to such practical constraints and a number of these have potential for medical device development. Some are suitable for specific points in the device cycle such as contextual inquiry and ethnography. Others, such as usability tests and focus groups, may be used throughout development. When designing user research there are a number of factors that may affect the quality of data collected, including the sample of users studied, the use of proxies instead of real end-users and the context in which the research is performed. As different methods are effective in identifying different types of data, ideally more than one method should be used at each point in development. However, financial and time factors may often constrain this.

Wavelet transform as a potential tool for ECG analysis and compression

The recently introduced wavelet transform is a member of the class of time-frequency representations which include the Gabor short-time Fourier transform and Wigner-Ville distribution. Such techniques are of significance because of their ability to display the spectral content of a signal as time elapses. The value of the wavelet transform as a signal analysis tool has been demonstrated by its successful application to the study of turbulence and processing of speech and music. Since, in common with these subjects, both the time and frequency content of physiological signals are often of interest (the ECG being an obvious example), the wavelet transform represents a particularly relevant means of analysis. Following a brief introduction to the wavelet transform and its implementation, this paper describes a preliminary investigation into its application to the study of both ECG and heart rate variability data. In addition, the wavelet transform can be used to perform multiresolution signal decomposition. Since this process can be considered as a sub-band coding technique, it offers the opportunity for data compression, which can be implemented using efficient pyramidal algorithms. Results of the compression and reconstruction of ECG data are given which suggest that the wavelet transform is well suited to this task.

Dependence of inertial measurements of distance on accelerometer noise

An investigation is made into the errors in estimated position that are caused by noise and drift effects in stationary accelerometers. An analytical study is made into the effects of biases in the accelerometer data and the effects of changing the cut-off frequency in the anti-aliasing filter. The root mean square errors in position are calculated as a function of time and sampling frequency. A comparison is made between the theoretical results and experimental data taken from two commercial accelerometers. Recommendations are made regarding the calibration of accelerometers prior to their use in practical situations.

A user-centred approach to requirements elicitation in medical device development: A case study from an industry perspective

The healthcare industry is dependent upon the provision of well designed medical devices. To achieve this it is recommended that user-centred design should begin early, and continue throughout device development. This is a challenge, particularly for smaller companies who may lack the necessary expertise and knowledge. The aim of this study was to conduct a rigorous yet focused investigation into the user requirements for a new medical imaging device. Open-ended semi-structured interviews were conducted with potential clinical users of the device to investigate the clinical need for the device and the potential benefits for patients and clinical users. The study identified a number of new and significant clinical needs that suggested that the concept of the device should be fundamentally changed. The clinical and organisational priorities of the clinical users were identified, as well as a number of factors that would act as barriers to the safe and effective adoption of the device. The developers reported that this focused approach to early requirements elicitation would result in an improved product, reduce the time to market, and save the time and cost of producing and evaluating an inappropriate prototype.

Interpretation of heart rate variability via detrended fluctuation analysis and αβ filter

Detrended fluctuation analysis (DFA), suitable for the analysis of nonstationary time series, has confirmed the existence of persistent long-range correlations in healthy heart rate variability data. In this paper, we present the incorporation of the alphabeta filter to DFA to determine patterns in the power-law behavior that can be found in these correlations. Well-known simulated scenarios and real data involving normal and pathological circumstances were used to evaluate this process. The results presented here suggest the existence of evolving patterns, not always following a uniform power-law behavior, that cannot be described by scaling exponents estimated using a linear procedure over two predefined ranges. Instead, the power law is observed to have a continuous variation with segment length. We also show that the study of these patterns, avoiding initial assumptions about the nature of the data, may confer advantages to DFA by revealing more clearly abnormal physiological conditions detected in congestive heart failure patients related to the existence of dominant characteristic scales.

THE FEASIBILITY OF LONG-TERM FETAL HEART RATE MONITORING IN THE HOME ENVIRONMENT USING MATERNAL ABDOMINAL ELECTRODES

It is well established that fetal and maternal electrocardiograms (ECGs) can be obtained from the maternal abdomen using standard surface electrodes, although this cannot be guaranteed. The unobtrusive and non-invasive nature of such monitoring lends itself naturally to the long-term ambulatory collection of this data on cardiac activity. By employing suitable algorithms it would then be possible to extract records of both fetal and maternal heart rate. This article presents results of the collection of raw electrophysiological signals, containing both fetal and maternal ECGs from a single volunteer from the 20th week of gestation until term. The significance of the data is that they were recorded by the mother herself in her own environment. Previously written software was then used to extract fetal and maternal heart rate data. These results demonstrate the feasibility of using this method for the long-term recording of fetal and maternal heart rate in the mothers normal surroundings.

Short communication: A web-based tool for eliciting probability distributions from experts

We present a web-based probability distribution elicitation tool: The MATCH Uncertainty Elicitation Tool. The Tool is designed to help elicit probability distributions about uncertain model parameters from experts, in situations where suitable data is either unavailable or sparse. The Tool is free to use, and offers five different techniques for eliciting univariate probability distributions. A key feature of the Tool is that users can log in from different sites and view and interact with the same graphical displays, so that expert elicitation sessions can be conducted remotely (in conjunction with tele- or videoconferencing). This will make probability elicitation easier in situations where it is difficult to interview experts in person. Even when conducting elicitation remotely, interviewers will be able to follow good elicitation practice, advise the experts, and provide instantaneous feedback and assistance.