U.S. patent application number 14/832896 was filed with the patent office on 2016-02-25 for method and system for pulse diagnosis.
The applicant listed for this patent is PULSE TECTONICS LLC. Invention is credited to Robert Doane, Thomas Adrian Furness, III, Ross Melville, Brian Pal.
Application Number | 20160051203 14/832896 |
Document ID | / |
Family ID | 55347228 |
Filed Date | 2016-02-25 |
United States Patent
Application |
20160051203 |
Kind Code |
A1 |
Furness, III; Thomas Adrian ;
et al. |
February 25, 2016 |
METHOD AND SYSTEM FOR PULSE DIAGNOSIS
Abstract
A process is described for diagnosing mammalian patients,
including human patients, based on the spatial and temporal profile
of the radial arterial pulse. Pulse patterns are measured, and the
patterns and matching diagnoses added to an analytic module
including a database system.
Inventors: |
Furness, III; Thomas Adrian;
(Seattle, WA) ; Melville; Ross; (Everett, WA)
; Doane; Robert; (Bainbridge Island, WA) ; Pal;
Brian; (Medina, WA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
PULSE TECTONICS LLC |
Seattle |
WA |
US |
|
|
Family ID: |
55347228 |
Appl. No.: |
14/832896 |
Filed: |
August 21, 2015 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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62040990 |
Aug 22, 2014 |
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Current U.S.
Class: |
600/503 ;
600/502 |
Current CPC
Class: |
A61B 5/0402 20130101;
A61B 5/026 20130101; A61B 5/0004 20130101; A61B 5/6826 20130101;
A61B 5/7264 20130101; G16H 50/20 20180101; A61B 5/7225 20130101;
A61B 5/7278 20130101; A61B 5/024 20130101; A61B 5/02438 20130101;
A61B 5/7275 20130101; A61B 5/7475 20130101; A61B 5/6824 20130101;
A61B 5/7246 20130101 |
International
Class: |
A61B 5/00 20060101
A61B005/00; A61B 5/024 20060101 A61B005/024 |
Claims
1. (canceled)
2. (canceled)
3. A diagnostic system, comprising: at least one processor circuit;
at least one nontransitory memory communicatively coupled the at
least one processor circuit and which stores at least one of
processor executable instructions or data, execution of which
causes the at least processor circuit to: for each of a number of
visits by each of a plurality of subjects, receive respective pulse
signal information representative of: i) a first pulse signal
waveform captured from the respective subject at a first applied
pressure at a first location and ii) at least a second pulse signal
waveform captured from the respective subject a second applied
pressure at the first location, the second applied pressure
different than the first applied pressure, and receives diagnosis
information that includes at least a primary diagnosis associated
with the respective visit by the respective subject; store the
received respective pulse signal information and diagnosis
information to the at least one nontransitory memory; and determine
one or more correlations between various ones of a number of
defining characteristics of representations of the first and at
least the second pulse signal waveforms and the diagnosis
information.
4. The diagnostic system of claim 3 wherein for each of the number
of visits by each of the plurality of subjects, receives respective
pulse signal information representative of: iii) a third pulse
signal waveform captured from the respective subject at a third
applied pressure at the first location, the third applied pressured
different from the first and the second applied pressures.
5. The diagnostic system of claim 4 wherein for a given one of the
visits of a given one of the subjects, the received respective
pulse signal information further represents a fourth, a fifth and a
sixth pulse signal waveform captured from the respective subject at
a first, a second and a third applied pressure, respectively, at a
second location along a given artery, the second location spaced
from the first location.
6. The diagnostic system of claim 5 wherein for a given one of the
visits of a given one of the subjects, the first, the second and
the third pulse signal waveforms are captured temporally proximate
to one another.
7. The diagnostic system of claim 5 wherein for a given one of the
visits of a given one of the subjects, the first, the second, the
third, the fourth, the fifth and the sixth pulse signal waveforms
are captured temporally proximate to one another.
8. The diagnostic system of claim 4 wherein for the given one of
the visits of the given one of the subjects, the first, the second
and the third pulse signal waveforms represent pulse waveforms
captured at a first location along the radial artery proximate a
wrist bone on a thumb side of a hand of the subject at the first,
the second and the third applied pressures, respectively, and the
fourth, the fifth, and the sixth pulse signal waveforms represent
pulse waveforms captured at a second location along the radial
artery proximate the ulnar, at the first, the second and the third
applied pressures, respectively , the second location spaced from
the first location.
9. The diagnostic system of claim 8 wherein for a given one of the
visits of a given one of the subjects, the received respective
pulse signal information further represents a seventh, an eight and
a ninth pulse signal waveform captured from the respective subject
at a first, a second and a third applied pressure, respectively, at
a third location along the radial artery, the third location
closely spaced from the first and the second locations.
10. The diagnostic system of claim 9 wherein for a given one of the
visits of a given one of the subjects, the first, the second, the
third, the fourth, the fifth, the sixth, the seventh, the eight,
and the ninth pulse signal waveforms are captured substantially
concurrently with one another.
11. The diagnostic system of claim 8 wherein the first, the second
and the third pulse signal waveforms each represents respective
ones of pulse waveforms captured through a skin of the given
subject.
12. The diagnostic system of claim 3 wherein the received
respective pulse signal information represents digitized versions
of the first and the second pulse signal waveforms.
13. The diagnostic system of claim 3 wherein the at least one
processor circuit digitizes the first and second pulse signal
waveforms to generate the respective pulse signal information.
14. A method operation in a diagnostic system that includes at
least one processor circuit and at least one nontransitory memory
communicatively coupled the at least one processor circuit and
which stores at least one of processor executable instructions or
data, the method comprising: for each of a number of visits by each
of a plurality of subjects, receiving respective pulse signal
information representative of: i) a first pulse signal waveform
captured from the respective subject at a first applied pressure at
a first location and ii) at least a second pulse signal waveform
captured from the respective subject a second applied pressure at
the first location, the second applied pressure different than the
first applied pressure, and receives diagnosis information that
includes at least a primary diagnosis associated with the
respective visit by the respective subject; storing the received
respective pulse signal information and diagnosis information to
the at least one nontransitory memory; and determining one or more
correlations between various ones of a number of defining
characteristics of representations of the first and at least the
second pulse signal waveforms and the diagnosis information.
15. The method of claim 14 wherein for each of the number of visits
by each of the plurality of subjects, receiving the respective
pulse signal information includes receiving the pulse signal
information representative of: iii) a third pulse signal waveform
captured from the respective subject at a third applied pressure at
the first location, the third applied pressured different from the
first and the second applied pressures.
16. The method of claim 15 wherein for a given one of the visits of
a given one of the subjects, the received respective pulse signal
information further represents a fourth, a fifth and a sixth pulse
signal waveform captured from the respective subject at a first, a
second and a third applied pressure, respectively, at a second
location along a given artery, the second location spaced from the
first location.
17. The method of claim 16 wherein for a given one of the visits of
a given one of the subjects, the first, the second and the third
pulse signal waveforms are captured temporally proximate to one
another.
18. The method of claim 16 wherein for a given one of the visits of
a given one of the subjects, the first, the second, the third, the
fourth, the fifth and the sixth pulse signal waveforms are captured
temporally proximate to one another.
19. The method of claim 15 wherein for the given one of the visits
of the given one of the subjects, the first, the second and the
third pulse signal waveforms represent pulse waveforms captured at
a first location along the radial artery proximate a wrist bone on
a thumb side of a hand of the subject at the first, the second and
the third applied pressures, respectively, and the fourth, the
fifth, and the sixth pulse signal waveforms represent pulse
waveforms captured at a second location along the radial artery
proximate the ulnar, at the first, the second and the third applied
pressures, respectively, the second location spaced from the first
location.
20. The method of claim 19 wherein for a given one of the visits of
a given one of the subjects, the received respective pulse signal
information further represents a seventh, an eight and a ninth
pulse signal waveform captured from the respective subject at a
first, a second and a third applied pressure, respectively, at a
third location along the radial artery, the third location closely
spaced from the first and the second locations.
21. The method of claim 20 wherein for a given one of the visits of
a given one of the subjects, the first, the second, the third, the
fourth, the fifth, the sixth, the seventh, the eight, and the ninth
pulse signal waveforms are captured substantially concurrently with
one another.
22. The method of claim 19 wherein the first, the second and the
third pulse signal waveforms each represents respective ones of
pulse waveforms captured through a skin of the given subject.
23. The method of claim 14 wherein the receiving respective pulse
signal information includes receiving respective pulse signal
information that represents digitized versions of the first and the
second pulse signal waveforms.
24. The method of claim 14, further comprising: digitizing the
first and second pulse signal waveforms, by the at least one
processor circuit, to generate the respective pulse signal
information.
25. A system to capture diagnostic information, the system
comprising: a device, the device comprising: a first pulse waveform
transducer response to a pulse to produce a first pulse waveform
representation; a second pulse waveform transducer response to a
pulse to produce a second pulse waveform representation, the second
pulse waveform transducer spaced in use from the first pulse
waveform.
26. The system of claim 25, further comprising: a sleeve or cuff
that carries the first and the second pulse waveform transducers,
the sleeve or cuff selectively attachable and detachable to a wrist
of the subject.
27. The system of claim 25, further comprising: a third pulse
waveform transducer response to a pulse to produce a third pulse
waveform representation, the third pulse waveform transducer spaced
in use from the first and the second pulse waveform transducer.
28. The system of claim 25, further comprising: a user input device
that in use receives information that specifies at least a primary
diagnosis.
29. The system of claim 25, further comprising: at least one
communications port that transmits at least the first and the
second pulse waveform representation from the system.
30. A method of operation in a system to capture diagnostic
information, the method comprising: producing a first pulse
waveform representation that represents a first pulse waveform
detected by a first pulse waveform transducer at a first location
along a first artery and a first applied pressure; producing a
second pulse waveform representation that represents a second pulse
waveform detected by a second pulse waveform transducer at a second
location along the first artery and a first applied pressure, the
second location spaced from the first location; and transmitting
the first pulse waveform representation and the second pulse
waveform representation from diagnostic device.
31. The method of claim 30, the method further comprising:
producing a first pulse waveform representation that represents the
first pulse waveform detected by a first pulse waveform transducer
at the first location along the first artery and a second applied
pressure, the second applied pressure different than the first
applied pressure; producing a second pulse waveform representation
that represents a second pulse waveform detected by a second pulse
waveform transducer at the second location along the first artery
and a second applied pressure, the second applied pressure
different than the first applied pressure.
32. The method of claim 30, the method further comprising:
producing a first pulse waveform representation that represents the
first pulse waveform detected by a first pulse waveform transducer
at the first location along the first artery and a third applied
pressure, the third applied pressure different than the first and
the second applied pressure; producing a second pulse waveform
representation that represents a second pulse waveform detected by
a second pulse waveform transducer at the second location along the
first artery and a third applied pressure, the third applied
pressure different than the first and the second applied
pressure.
33. The method of claim 32, the method further comprising:
producing a third pulse waveform representation that represents a
third pulse waveform detected by a third pulse waveform transducer
at a third location along a first artery and a first applied
pressure, the third location different from the first and the
second locations.
34. The method of claim 33, the method further comprising:
producing a third pulse waveform representation that represents a
third pulse waveform detected by a third pulse waveform transducer
at the third location along the first artery and at a second
applied pressure, the second applied pressure different than the
first applied pressure.
35. The method of claim 30, further comprising: receiving
information that specifies at least a primary diagnosis via at
least one user input device.
36. The method of claim 35, further comprising: transmitting the
received information that specifies at least a primary symptom
along with the first pulse waveform representation, the second
pulse waveform representation and at least a first applied pressure
signal from diagnostic device.
Description
BACKGROUND
Description of the Related Art
[0001] Sphygmology is highly desirable as a tool, with sense and
simplicity, inexpensive, and accessible leading to substantial
diagnostic yield. (van Tellingen C. De pulsibus-or sense and
simplicity in daily medical practice. Int J Cardio1.
2010;142:201-6.) Despite this, sphygmology has been largely
abandoned by Western medicine even though taking your pulse is
still a routine part of most doctor's visits. The rate and strength
of a pulse can be used to determine hydration, arterial blockage,
levels of fitness, systolic blood pressure, heart failure,
hypertrophic obstructive cardiomyopathy, hyperdynamic circulation,
cardiac tamponade, pericarditis, chronic sleep apnea, croup, and
obstructive lung disease. Recent Western research has indicated
that severe aortic stenosis may be associated with a weak and
delayed pulse; a bifid systolic pulse can be produced in some
obstructive cardiomyopathies; a bounding pulse indicates a large
stroke volume with a rapid fall-off, occurring in hyperkinetic
states, such as fever, anemia and thyrotoxicosis. (Libby P, Bonow R
O, Mann D L, Libby P. 8th ed. Philadelphia: Saunders Elsevier;
2008. Braunwald's heart diseases.)
[0002] Sphygmology is still an important part of some traditional
medicine systems. According to the practice, each pulse consists of
four parts, an expansion followed by a pause and a contraction
followed by a second pause. Ten criteria are used to evaluate the
pulse, size, fastness or slowness, strength or weakness, shortness
or length of pulse intervals, softness or hardness, similarity or
dissimilarity, regularity or irregularity in diverse pulses and
harmony related to musical nature of the pulse. (Ibn Sina. Tehran:
Selsele Intisharat-e Anjomane Asare Melli; 1951.)
[0003] Pulse diagnosis is a quick, inexpensive, and non-invasive
diagnostic tool. When performed by trained professionals, it can be
an effective means for determining patient's health. However, pulse
diagnosis requires sensitivity and skill and has been generally
supplanted by modern technology such as EKG reading or
echocardiograph as its accuracy frequently depends on the knowledge
and the experience of the practitioner. There is therefore a need
for a means for consistently relating a pulse to a specific
diagnosis that is not dependent on the knowledge and experience of
the practitioner.
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS
[0004] To easily identify the discussion of any particular element
or act, the most significant digit or digits in a reference number
refer to the figure number in which that element is first
introduced.
[0005] FIG. 1 is a system diagram of an embodiment of a system for
pulse based diagnosis.
[0006] FIG. 2 is an action flow diagram of an embodiment of a
process for utilizing a system for pulse diagnosis.
[0007] FIG. 3 is a flow chart of an embodiment of a process for
utilizing a system for pulse diagnosis.
[0008] FIG. 4 is a system diagram of an embodiment of a system for
pulse based diagnosis.
[0009] FIG. 5 is an action flow diagram of an embodiment of a
process for utilizing a system for pulse based diagnosis.
[0010] FIG. 6 is a flow chart of an embodiment of a process for
utilizing a system for pulse based diagnosis.
[0011] FIG. 7 is an embodiment of a pulse sensing and remote
telemetry device.
[0012] FIG. 8 is an embodiment a machine system to implement a
pulse measurement system in an institutional setting.
[0013] FIG. 9 is an embodiment of a computer system machine and a
machine communication network.
DETAILED DESCRIPTION
Glossary
[0014] "Database" in this context refers to an organized collection
of data (states of matter representing values, symbols, or control
signals to device logic), structured typically into tables that
comprise `rows` and `columns`, although this structure is not
implemented in every case. One column of a table is often
designated a `key` for purposes of creating indexes to rapidly
search the database.
[0015] "Module" in this context refers to logic having boundaries
defined by function or subroutine calls, branch points, application
program interfaces (APIs), or other technologies that provide for
the partitioning or modularization of particular processing or
control functions. Modules are typically combined via their
interfaces with other modules to carry out a machine process.
[0016] "Portal" in this context refers to a web site or other
network component that offers an aggregation of resources and
services, such as e-mail, forums, search engines, and online
shopping.
[0017] "Profile" in this context refers to a machine memory
organization representing a set of correlated values associated
with a physical thing (object, person, etc.)
[0018] "Sensor" in this context refers to a device or composition
of matter that responds to a physical stimulus (as heat, light,
sound, pressure, magnetism, or a particular motion) and transmits a
resulting impulse (as for measurement or operating a control)
[0019] "Web page" in this context refers to a file configured for
access and display via a web browser over the Internet, or
Internet-compatible networks. Also, logic defining an information
container that is suitable for access and display using Internet
standard protocols. Content defined in a web page is typically
accessed using a web browser, and displayed. Web pages may provide
navigation to other web pages or content via hypertext links. Web
pages frequently subsume other resources such as style sheets,
scripts and images into their final presentation. Web pages may be
retrieved for display from a local storage device, or from a remote
web server via a network connection.
[0020] Description
[0021] Coronary heart disease and stroke are the top two killers of
people throughout the world. Worldwide, 3.2 million people die
annually, with treatment costs rising to US $151.9 billion
annually. Early warning signs are often missed until a patent is
symptomatic or has a heart attack.
[0022] Traditional Chinese Medicine (TCM) has the potential of
providing an early warning system of cardiovascular and other
diseases, in addition to therapy protocols using herbal medicine.
TCM using pulse diagnosis has been practiced for over 2000 years.
However, TCM is not appreciated or used widely in western medical
practice, partly due to a large variability in TCM diagnosis and
treatments.
[0023] Described herein is a system that builds on TCM practice to
provide a low cost, accurate warning and diagnosis system for
assessing cardiovascular disease. The system provides an early
warning system for stoke and heart attack so that intervention is
possible. The system utilizes pulse tectonics to characterize and
interpret blood flow dynamics of the cardiovascular system, and to
promote health and wellness and as early warning system for
cardiovascular disease including stroke and heart attacks. The
system includes sensors for the acquisition of the dynamic
properties of arterial pulse that represent the functioning of the
cardiovascular system including the heart, blood, and its
interaction and profusion through the blood vessels, tissue and
organs. The collected signals are processed to diagnose various
health-related conditions.
[0024] Sensors are employed for the acquisition of pulse
information. Interpretation of pulse information follows. The
system deconstructs data acquired by a TCM practitioner to build a
database of TCM diagnosis related to the acquired pulse waveforms.
The system compares new patient pulse waveforms with patterns in
the database to determine a most likely diagnosis, and supplements
efficacy of comparison with computer models. The database may be
built utilizing a number of approaches, or combinations of these
approaches. In one embodiment, "feel through" sensors are employed
to collect time/pressure measurements during actual diagnostics of
patients by human practitioners. Due to problems with noise (from
the pulse of the practitioner), this approach may be utilized as a
first pass to later stages that refine the measurements. In another
embodiment (which may supplement the "feel through sensor"
technique), a visual and/or auditory representation of the pressure
vs time characteristics of the pulse may be provided to the
practitioner. This enables the practitioner to see and hear what
they feel through the sensors, providing validation and additional
interpretation of the signals. In another embodiment (which may
supplement either or both of the others), a cuff is utilized on the
patient to collect measurements. The cuff does not suffer
interference/noise from pulse signals of the practitioner, and thus
may provide very accurate readings.
[0025] The system is non invasive, low cost, and provides an early
warning system for cardiovascular and associated diseases when
intervention can be most effective.
[0026] Measurements collected or characteristics identified from
measurements include pulse transit time (reflectometry), blood flow
dynamics (strength of the heart), arterial stiffness (cardiac
efficiency), and blood viscosity.
[0027] The system may be utilized to diagnose a number of
conditions, including coronary ischemia, heart valve function,
heart muscle inflammation, mitral valve problems, bundle branch
blockages, tricuspid valve problems, high blood pressure, aortic
valve problems, irregular heart beat, aortic insufficiency, atrial
fibrillation, small vessel blockage, tachycardia, weak heart,
bradycardia, enlarged heart, congestive heart, coronary aneurism
(hematoma), and arterial stiffness. The system may include a TCM
waveform database comprising visual and acoustic representations of
signal waveforms indicative of various conditions.
[0028] The system may be utilized to diagnose mammalian patients,
especially human patients, based on a spatial and temporal profile
of the radial arterial pulse. The patterns of the pulse may be
measured by any means generally used including manually and/or with
the use of sensors or other electronic or medical devices. Pulse
patterns and matching diagnoses may added to the database through
system modeling, practitioner input, known diagnoses, known
patterns, echocardiograms, mechanical instrumentation or a
combination thereof. The pulse pressure, shape, flow, depth, rate,
regularity, width, length, smoothness, stiffness, and strength of a
patient are measured and the pattern of the pulse is entered into
the database. The patient's pulse pattern is compared to pulse
patterns in the database with recorded diagnoses, and a diagnosis
is rendered.
[0029] A layout of pressure sensors along a blood vessel may
provide the system with a complete description of the three
dimensional undulation of the vessel along an arm, leg, or other
area of the body (typically, an arm). A pressure wave through the
area is measured and correlated versus a timing signal (pressure
wave vs time). This pressure wave is further correlated with
cardiac events (typically, heart beats). Signal processing is
applied to the collected data set and correlations to identify and
quantify pressure reflections, timing of reflections, and the
amplitude and phase of reflections with respect to primary waves
and possibly also with respect to one another.
[0030] A data input module receives data from the layout of
pressure sensors along the blood vessel, and provides the data to a
signal processing module. The signal processing module applies the
data to determine a description of the three dimensional undulation
of the vessel and to identify the pressure wave versus time, and to
correlate the pressure wave with cardiac events, as described
above. The signal processing module identifies and quantifies
pressure reflections, timing of reflections, and the amplitude and
phase of reflections with respect to primary waves and possibly
also with respect to one another. All of this information may then
be compared against stored patterns in a diagnostic database, for a
best fit with known pathological "signatures" (e.g., a blocked
artery somewhere in the body). The collected data and analysis may
be sufficient to identify the pathology very specifically (e.g.,
blockage, extent of blockage, and location of blockage in the
body), or only generally (e.g., a blockage somewhere in the body).
An appropriate treatment plan may then be formulated.
[0031] As used herein, depth of the pulse is the vertical position
of the arterial pulse below the measurement surface (e.g., skin),
and is rated along a continuum. Rate is the number of beats in a
minute. Regularity is the rhythm of the arterial pulse, which is
categorized as either regular or irregular. Width is the intensity
of the arterial pulse. Length is the range of the arterial pulse
that can be sensed. Smoothness is the slickness of the arterial
pulse. Stiffness is the elasticity of the radial artery. Finally,
strength is the forcefulness of the arterial pulse relative to the
change in pressure applied.
[0032] The pulse wave form is assessed at one or more depths,
specifically a superficial, middle and/or deep level. A superficial
level is directly below the skin level and is located by resting
sensors or fingers directly above the radial artery. The only
pressure exerted being passive weight. The deep level is situated
directly above the surface of the radius. It is located by first
occluding the radial artery by exerting heavy pressure upon the
artery, pushing it against the surface of the radius until the
pulsations cease and then slowly releasing the pressure until the
pulsation returns. This type of occlusion causes a subsequent
initial rush in the blood flow, rendering it necessary to allow a
few seconds for the pulse to equalize, while maintaining the same
finger pressure, before pulse assessment continues. The middle
level is located midway between the superficial and deep levels.
(King et al., ACUPUNCTURE IN MEDICINE 2002;20(4):150-159).
[0033] In some embodiments, the pulse pattern is measured by a
practitioner by any means generally used. In some embodiments, a
clinician may place their index, middle and ring finger on the
wrist of a patient over the radial artery. The index finger may be
placed below the wrist bone on the thumb side of the patient's hand
with the middle finger and ringer finger placed next to the index
finger. The clinician may enter a description of the pulse pattern
into the database to determine a diagnosis. In some embodiments, a
written description is entered. In other embodiments, a verbal
description is entered. In yet another embodiment the wave form or
pulse wave may be graphically recorded and entered into the
database.
[0034] In some embodiments, the pulse pattern is collected by
sensors on the practitioner's finger. A practitioner may wear one
or more sensors on one or more fingers. In some embodiments,
sensors are worn on the index, middle and ring fingers, or a
combination thereof. In further embodiments, multiple sensors may
be worn on each finger. In another embodiment, sensors may be
included in a cuff or sleeve which is put around a patient's arm.
Sensors may be in a linear array or a series of linear arrays along
the finger and/or across the hand. Microdisplacements resulting
from the transfer of the pulse undulations under the skin may in
some implementations be measured by the interference of coherent
light from the surface of the skin without contact as viewed by a
video camera as laser speckle. Microdisplacements resulting on the
surface of the skin may in some cases be measured by processing the
signal from a video camera to measure subtle movements of the skin.
In all embodiment above, the sensor detects the pulse wave form as
well as the amount of pressure used to measure the pulse. The
sensors convert the pulse to a signal that can be transmitted to an
analog amplifier. The signal is converted to a digital signal and
sent to a transceiver. The received signal is then sent to a
digital signal processor. The signal is then sent to a database and
compared to other pulse patterns. Once a match is found, the
diagnosis for the patient is displayed.
[0035] In one embodiment, signal analysis on the collected sensor
signals comprises time series analysis of digital signal streams,
including auto-correlation, cross correlations, power spectral
distribution, cross spectral distribution, Fourier Analysis,
wavelet analysis, principal component analysis, root mean square
matching and similar and/or custom analysis tools. These tools will
reduce the pulse train into a form of eigenvalues that enable rapid
comparison within large databases of patient data.
[0036] Patient data from the database can be used in various
assessments for determining the health of the patient and pulse
measurements may be combined with as little or as much additional
patient data as desired. In some embodiments, the database may
store patient related data, e.g. a patient identifier and/or
patient demographic information. The database may also be able to
generate reports using the report generation module. The disease
management recommendations module can store various treatment
recommendations that can be included in patient reports based on
the analysis of the data gathered from the pulse. The comparative
data store can store comparative data from healthy patients and/or
patients with a chronic illness and combinations of pulse patters
and diagnoses.
[0037] In some embodiments, a patient may complete a questionnaire
to improve the diagnostic capabilities of the system. The
questionnaires can address any of a number of health conditions.
For example, in some embodiments, rating scales may be used to
assess the health and mental condition of the patient. Exemplary
health and mental rating scales include, but are not limited to,
those discussed in: Bruett T L, Overs R P. A critical review of 12
ADL scales. Phys Ther 1969;49:857-862; Zimmer J G, Rothenberg B M,
Andresen E. Functional assessment. In: Andresen E M, Rothenberg B,
Zimmer J G, eds. Assessing the health status of older adults. New
York: Springer, 1997:1-40; Kuriansky J, Gurland B. The performance
test of activities of daily living. Int J Aging Hum Devel
1976;7:343-352; Haley S M, Ludlow L H, Gans B M, et al. Tufts
Assessment of Motor Performance: an empirical approach to
identifying motor performance categories. Arch Phys Med Rehabil
1991;72:359-366; Hamilton M. Diagnosis and rating of anxiety. Br J
Psychiatry 1969; Special Publication #3:76-79. Taylor J A. A
personality scale of manifest anxiety. J Abnorm Soc Psychol
1953;48:285-290; Salisbury J L, Sherrill D, Friedman S T, et al;
Comparison of two scoring methods for the short form of the
Manifest Anxiety Scale and Eysenck's Extraversion (E) and
Neuroticism (N) scales. Psychol Rep 1968;22:1235-1236; Bendig A W.
The development of a short form of the Manifest Anxiety Scale. J
Consult Psychol 1956;20:384; Reynolds C R, Richmond B O. Revised
Children's Manifest Anxiety Scale (RCMAS) manual. Los Angeles:
Western Psychological Services, 1985; Hamilton M. The assessment of
anxiety states by rating. Br J Med Psychol 1959;32:50-55; Bech P,
Kastrup M, Rafaelsen O J. Minicompendium of rating scales for
states of anxiety, depression, mania, schizophrenia, with
corresponding DSM-III syndromes. Acta Psychiatr Scand 1986;73
(suppl 326):1-37; Moran P W, Lambert M J. A review of current
assessment tools for monitoring changes in depression. In: Lambert
M J, Christensen E R, DeJulio S S, eds; Cronholm B, Schalling D,
Asberg M. Development of a rating scale for depressive illness. Mod
Probl Pharmacopsychiatry 1974;7:139-150; Lambert M J, Hatch D R,
Kingston M D, et al. Zung, Beck, and Hamilton rating scales as
measures of treatment outcome: a metaanalytic comparison. J Consult
Clin Psychol 1986;54:54-59. Huppert F A, Tym E. Clinical and
neuropsychological assessment of dementia. Br Med Bull
1986;42:11-18; Ramsdell J W, Rothrock J F, Ward H W, et al.
Evaluation of cognitive impairment in the elderly. J Gen Intern Med
1990;5:55-64; McKhann G, Drachman D, Folstein M, et al. Clinical
diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work
Group under the auspices of Department of Health and Human Services
Task Force on Alzheimer's disease. Neurology 1984;34:939-944;
Hersch E L, Kral V A, Palmer R B. Clinical value of the London
Psychogeriatric Rating Scale. J Am Geriatr Soc 1978;26:348-354;
Crockett D, Tuokko H, Koch W, et al. The assessment of everyday
functioning using the Present Functioning Questionnaire and the
Functional Rating Scale in elderly samples. Clin Gerontol
1989;24:3-25; Frederiksen L W, Lynd R S, Ross J. Methodology in the
measurement of pain. Behav Ther 1978;9:486-488; Dalton J A, McNaull
F. A call for standardizing the clinical rating of pain intensity
using a 0 to 10 rating scale. Cancer Nurs 1998;21:46-49; Fordyce W
E, Lansky D, Calsyn D A, et al. Pain measurement and pain behavior.
Pain 1984;18:53-69. According to some embodiments, the
questionnaires can be implemented on a web portal and the user is
presented with a web page or series of web pages that present the
questionnaire to the patient and capture the patient's response.
The responses may be stored with the patient profile and combined
with other patient information or transmitted to the clinician for
use when analyzing a diagnosis and determining a course of
treatment.
[0038] The techniques and procedures described herein may be
implemented via logic distributed in one or more computing devices.
The particular distribution and choice of logic may vary according
to implementation.
[0039] Those having skill in the art will appreciate that there are
various logic implementations by which processes and/or systems
described herein can be effected (e.g., hardware, software, and/or
firmware), and that the preferred vehicle will vary with the
context in which the processes are deployed. "Software" refers to
logic that may be readily readapted to different purposes (e.g.
read/write volatile or nonvolatile memory or media). "Firmware"
refers to logic embodied as read-only memories and/or media.
Hardware refers to logic embodied as analog and/or digital
circuits. If an implementer determines that speed and accuracy are
paramount, the implementer may opt for a hardware and/or firmware
vehicle; alternatively, if flexibility is paramount, the
implementer may opt for a solely software implementation; or, yet
again alternatively, the implementer may opt for some combination
of hardware, software, and/or firmware. Hence, there are several
possible vehicles by which the processes described herein may be
effected, none of which is inherently superior to the other in that
any vehicle to be utilized is a choice dependent upon the context
in which the vehicle will be deployed and the specific concerns
(e.g., speed, flexibility, or predictability) of the implementer,
any of which may vary. Those skilled in the art will recognize that
optical aspects of implementations may involve optically-oriented
hardware, software, and or firmware.
[0040] The foregoing detailed description has set forth various
embodiments of the devices and/or processes via the use of block
diagrams, flowcharts, and/or examples. Insofar as such block
diagrams, flowcharts, and/or examples contain one or more functions
and/or operations, it will be understood as notorious by those
within the art that each function and/or operation within such
block diagrams, flowcharts, or examples can be implemented,
individually and/or collectively, by a wide range of hardware,
software, firmware, or virtually any combination thereof Several
portions of the subject matter described herein may be implemented
via Application Specific Integrated Circuits (ASICs), Field
Programmable Gate Arrays (FPGAs), digital signal processors (DSPs),
or other integrated formats. However, those skilled in the art will
recognize that some aspects of the embodiments disclosed herein, in
whole or in part, can be equivalently implemented in standard
integrated circuits, as one or more computer programs running on
one or more computers (e.g., as one or more programs running on one
or more computer systems), as one or more programs running on one
or more processors (e.g., as one or more programs running on one or
more microprocessors), as firmware, or as virtually any combination
thereof, and that designing the circuitry and/or writing the code
for the software and/or firmware would be well within the skill of
one of skill in the art in light of this disclosure. In addition,
those skilled in the art will appreciate that the mechanisms of the
subject matter described herein are capable of being distributed as
a program product in a variety of forms, and that an illustrative
embodiment of the subject matter described herein applies equally
regardless of the particular type of signal bearing media used to
actually carry out the distribution. Examples of a signal bearing
media include, but are not limited to, the following: recordable
type media such as floppy disks, hard disk drives, CD ROMs, digital
tape, and computer memory.
[0041] In a general sense, those skilled in the art will recognize
that the various aspects described herein which can be implemented,
individually and/or collectively, by a wide range of hardware,
software, firmware, or any combination thereof can be viewed as
being composed of various types of "circuitry." Consequently, as
used herein "circuitry" includes, but is not limited to, electrical
circuitry having at least one discrete electrical circuit,
electrical circuitry having at least one integrated circuit,
electrical circuitry having at least one application specific
integrated circuit, circuitry forming a general purpose computing
device configured by a computer program (e.g., a general purpose
computer configured by a computer program which at least partially
carries out processes and/or devices described herein, or a
microprocessor configured by a computer program which at least
partially carries out processes and/or devices described herein),
circuitry forming a memory device (e.g., forms of random access
memory), and/or circuitry forming a communications device (e.g., a
modem, communications switch, or optical-electrical equipment).
[0042] Those skilled in the art will recognize that it is common
within the art to describe devices and/or processes in the fashion
set forth herein, and thereafter use standard engineering practices
to integrate such described devices and/or processes into larger
systems. That is, at least a portion of the devices and/or
processes described herein can be integrated into a network
processing system via a reasonable amount of experimentation.
[0043] The foregoing described aspects depict different components
contained within, or connected with, different other components. It
is to be understood that such depicted architectures are merely
exemplary, and that in fact many other architectures can be
implemented which achieve the same functionality. In a conceptual
sense, any arrangement of components to achieve the same
functionality is effectively "associated" such that the desired
functionality is achieved. Hence, any two components herein
combined to achieve a particular functionality can be seen as
"associated with" each other such that the desired functionality is
achieved, irrespective of architectures or intermedial components.
Likewise, any two components so associated can also be viewed as
being "operably connected", or "operably coupled", to each other to
achieve the desired functionality.
DRAWINGS
[0044] FIG. 1 is a system diagram of an embodiment of a system for
pulse based diagnosis. FIG. 2 is an action flow diagram of an
embodiment of a process for utilizing a system for pulse diagnosis.
FIG. 3 is a flow chart of an embodiment of a process for utilizing
a system for pulse diagnosis. The system comprises Clinician 102,
Sensor 104, Modeling 106, database 108, and Diagnostic module 112.
The database 108 receives a reading signal from the Sensor 104 and
in response searches for a pattern match based on signal received
(302). The database 108 receives an input signal from the Clinician
102 and in response searches for a pattern match based on signal
received (304). The database 108 receives an input signal from the
Modeling 106 and in response searches for a pattern match based on
signal received (306). The Diagnostic module 112 receives a data
set signal from the database 108 and in response displays the
diagnosis (308).
[0045] FIG. 4 is a system diagram of an embodiment of a system for
pulse based diagnosis. FIG. 5 is an action flow diagram of an
embodiment of a process for utilizing a system for pulse based
diagnosis. FIG. 6 is a flow chart of an embodiment of a process for
utilizing a system for pulse based diagnosis. Together these
drawings illustrate a system of logic components that produce a
diagnostic assessment/report from patient data, comparative data,
stored treatments and diagnostic data. The system comprises Patient
profile memory 402, Diagnostic data memory 406,
diagnostics/reporting module 408, Disease management memory 410,
and Comparative data memory 412. The diagnostics/reporting module
408 receives a treatments signal from Disease management memory
410, a patient data signal from Patient profile memory 402, a
comparative data signal from Comparative data memory 412, and a
diagnostic data signal from Diagnostic data memory 406 and in
response generates a diagnostic assessment (diagnosis)/report (see
602, 604, 606, and 608).
[0046] FIG. 7 illustrates a device 700 that may implement an
embodiment of a pulse sensing and remote telemetry device. Logic
720 provides device system control over other components and
coordination between those components as well as signal processing
for the device. Signal processing and system control logic 720
extracts baseband signals from the radio frequency signals received
by the device, and processes baseband signals up to radio frequency
signals for communications transmitted from the device. Logic 720
may comprise a central processing unit, digital signal processor,
and/or one or more controllers or combinations above these
components. The device may further comprise memory 708 which may be
utilized by the central processors, digital signal processors in
controllers of the systems logic 720. The device 700 may include
sensor(s) 710 to detect and measure pulse signals, for example
pressure and/or audio sensors, in the manners already
described.
[0047] Images, video and other display information, for example,
user interface optical patterns, may be output to a display module
730 which may for example operate as a liquid crystal display or
may utilize other optical output technology. The display module 730
may also operate as a user input device, being touch sensitive
where contact or close contact by a use's finger or other device
handled by the user may be detected by transducers. An area of
contact or proximity to the display module 730 may also be detected
by transducers and this information may be supplied to the control
logic 720 to affect the internal operation of the mobile device 700
and to influence control and operation of its various
components.
[0048] Audio signals may be provided to an audio circuit 722 from
which signals output to one and more speakers to create pressure
waves in the external environment representing the audio.
[0049] The device 700 may operate on power received from a battery
716. The battery capability and energy supply may be managed by a
power management module 718.
[0050] Another user interface device operated by control logic 720
is a keypad 728 which responds to pressure or contact events by a
user of the device. As noted the keypad may in some cases be
implemented by transducers of the display module 730.
[0051] The device 700 may generate short range wireless signals to
influence other devices in its proximity, and may receive wireless
signals from those proximate devices using antenna 736. Short range
radio signals may influence the device, or be generated by the
device for output to the environment, through a BlueTooth, WiFi or
other RF module 726. Other forms of electromagnetic radiation may
be used to interact with proximate devices, such as infrared (not
illustrated). The device 700 may convert audio phenomenon from the
environment into internal electro or optical signals by using
microphone and the audio circuit 722.
[0052] FIG. 8 illustrates an embodiment a machine system to
implement a pulse measurement system in an institutional setting.
An IP sensor 810 responds to a physical stimulus from the
environment with output signals that represent the physical
stimulus (see description of possible sensors for a pulse
measurement system). The signal is output in Internet Protocol (IP)
format (for example), and propagated via a router 814 and a bridge
818 to a server system. Another sensor 812 does not have IP
protocol capability and so outputs signals in a different (e.g.,
analog or non-IP digital) format to an IP-enabled device 820 which
converts the signals output by the sensor 812 into an IP protocol
and communicates them via a router 816 and bridge 818 to the server
system. The server system in this example comprises a number of
separate server devices, typically each implemented in the
separated machine, although this is not necessarily the case. The
signals from the sensors are provided via a load balancing server
808 to one or more application server 804 and one or more database
server 816. Load balancing server 808 maintains an even load
distribution to the other server, including web server 802,
application server 804, and database server 806. In one
implementation of a pulse measurement system, the application
server 804 may implement an analytic/diagnostic/reporting system
and the database server 806 may implement one or more data storage
components as described for example in conjunction with FIG. 4.
Each server in the drawing may represent in effect multiple servers
of that type. The signals from the sensors 810, 812 influence one
or more processors of the application server 804 to carry out
various transformations for pulse diagnosis. Database server 806
may provide signals in response to resource requests indicative of
stored patient data, comparative data, diagnostic data, and disease
management data. The signals applied to the database server 806 may
cause the database server 806 to access and certain memory
addresses, which correlates to certain rows and columns in a memory
device. These signals from the database server 806 may also be
applied to application server 804 via the load balancing server
808. The system may supply signals to the web server 802, which in
turn converts the signals to resources available via the Internet
or other WAN by devices of users of the system (client
devices).
[0053] FIG. 9 illustrates an embodiment of a computer system
machine and a machine communication network. The computer system
900 may implement an embodiment of a pulse diagnostic system as
described herein, for example one or more of the components of FIG.
1, 4, or 8. A particular computer system 900 of the machine network
may include one or more processing units 912, a system memory 914
and a system bus 916 that couples various system components
including the system memory 914 to the processing units 912. The
processing units 912 may be any logic processing unit, such as one
or more central processing units (CPUs), digital signal processors
(DSPs, application-specific integrated circuits (ASICs), field
programmable gate arrays (FPGAs), etc. The system bus 916 can
employ any known bus structures or architectures, including a
memory bus with memory controller, a peripheral bus, and a local
bus. The system memory 914 includes read-only memory (ROM) 918 and
random access memory (RAM) 920. A basic input/output system (BIOS)
922, which can form part of the ROM 918, contains basic routines
that help transfer information between elements within the computer
system 900, such as during start-up.
[0054] The computer system 900 may also include a plurality of
interfaces such as network interface 960, interface 958 supporting
modem 957 or any other wireless/wired interfaces.
[0055] The computer system 900 may include a hard disk drive 924
for reading from and writing to a hard disk 925, an optical disk
drive 926 for reading from and writing to removable optical disks
930, and/or a magnetic disk drive 928 for reading from and writing
to magnetic disks 932. The optical disk 930 can be a CD-ROM, while
the magnetic disk 932 can be a magnetic floppy disk or diskette.
The hard disk drive 924, optical disk drive 926 and magnetic disk
drive 928 may communicate with the processing unit 912 via the
system bus 916. The hard disk drive 924, optical disk drive 926 and
magnetic disk drive 928 may include interfaces or controllers (not
shown) coupled between such drives and the system bus 916, as is
known by those skilled in the relevant art. The drives 924, 926 and
928, and their associated computer-readable storage media 925, 930,
932, may provide non-volatile and non-transitory storage of
computer readable instructions, data structures, program modules
and other data for the computer system 900. Although the depicted
computer system 900 is illustrated employing a hard disk 924,
optical disk 926 and magnetic disk 928, those skilled in the
relevant art will appreciate that other types of computer-readable
storage media that can store data accessible by a computer may be
employed, such as magnetic cassettes, flash memory, digital video
disks (DVD), Bernoulli cartridges, RAMs, ROMs, smart cards, etc.
For example, computer-readable storage media may include, but is
not limited to, random access memory (RAM), read-only memory (ROM),
electrically erasable programmable read-only memory (EEPROM), flash
memory, compact disc ROM (CD-ROM), digital versatile disks (DVD) or
other optical disk storage, magnetic cassettes, magnetic tape,
magnetic disk storage or other magnetic storage devices, solid
state memory or any other medium which can be used to store the
desired information and which may be accessed by processing unit
912.
[0056] Program modules can be stored in the system memory 914, such
as an operating system 934, one or more application programs 936,
other programs or modules 938 and program data 940. Application
programs 936 may include instructions that cause the processor(s)
912 to automatically provide dynamic selection of data and
telecommunication service providers before or during communications
between various devices such as, for example, a mobile device and a
landline telephone. Other program modules 938 may include
instructions for handling security such as password or other access
protection and communications encryption. The system memory 914 may
also include communications programs, for example, a Web client or
browser 941 for permitting the computer system 900 to access and
exchange data with sources such as Web sites of the Internet,
corporate intranets, extranets, or other networks and devices as
described herein, as well as other server applications on server
computing systems. The browser 941 in the depicted embodiment is
markup language based, such as Hypertext Markup Language (HTML),
Extensible Markup Language (XML) or Wireless Markup Language (WML),
and operates with markup languages that use syntactically delimited
characters added to the data of a document to represent the
structure of the document. A number of Web clients or browsers are
commercially available such as those from Mozilla, Google, and
Microsoft.
[0057] Although illustrated as being stored in the system memory
914, the operating system 934, application programs 936, other
programs/modules 938, program data 940 and browser 941 can be
stored on the hard disk 925 of the hard disk drive 924, the optical
disk 930 of the optical disk drive 926 and/or the magnetic disk 932
of the magnetic disk drive 928.
[0058] An operator can enter commands and information into the
computer system 900 through input devices such as a touch screen or
keyboard 942 and/or a pointing device such as a mouse 944, and/or
via a graphical user interface. Other input devices can include a
microphone, joystick, game pad, tablet, scanner, etc. These and
other input devices are connected to one or more of the processing
units 912 through an interface 946 such as a serial port interface
that couples to the system bus 916, although other interfaces such
as a parallel port, a game port or a wireless interface or a
universal serial bus (USB) can be used. A monitor 948 or other
display device is coupled to the system bus 916 via a video
interface 950, such as a video adapter. The computer system 900 can
include other output devices, such as speakers, printers, etc.
[0059] The computer system 900 can operate in a networked
environment using logical connections to one or more remote
computers and/or devices. For example, the computer system 900 can
operate in a networked environment using logical connections to one
or more mobile devices, landline telephones and other service
providers or information servers. Communications may be via a wired
and/or wireless network architecture, for instance wired and
wireless enterprise-wide computer networks, intranets, extranets,
telecommunications networks, cellular networks, paging networks,
and other mobile networks. Communication may take place between the
computer system 900 and external devices via a WAN 954 or LAN 952.
External devices may include other computer system 908a-n
(collectively, 908) and external storage devices 906.
* * * * *