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Cited by 39Asthma and respiratory diseasesMobile Health and mHealth ApplicationsPhonocardiography and Auscultation Techniques

The Development of an Automated Device for Asthma Monitoring for Adolescents: Methodologic Approach and User Acceptability

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Rhee, Hyekyun, Miner, Sarah, Sterling, Mark, Halterman, Jill S, Fairbanks, Eileen·2014·JMIR mHealth and uHealth
DOI 10.2196/mhealth.3118PMC PMC4114416
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Abstract

BACKGROUND: Many adolescents suffer serious asthma related morbidity that can be prevented by adequate self-management of the disease. The accurate symptom monitoring by patients is the most fundamental antecedent to effective asthma management. Nonetheless, the adequacy and effectiveness of current methods of symptom self-monitoring have been challenged due to the individuals' fallible symptom perception, poor adherence, and inadequate technique. Recognition of these limitations led to the development of an innovative device that can facilitate continuous and accurate monitoring of asthma symptoms with minimal disruption of daily routines, thus increasing acceptability to adolescents. OBJECTIVE: The objectives of this study were to: (1) describe the development of a novel symptom monitoring device for teenagers (teens), and (2) assess their perspectives on the usability and acceptability of the device. METHODS: Adolescents (13-17 years old) with and without asthma participated in the evolution of an automated device for asthma monitoring (ADAM), which comprised three phases, including development (Phase 1, n=37), validation/user acceptability (Phase 2, n=84), and post hoc validation (Phase 3, n=10). In Phase 1, symptom algorithms were identified based on the acoustic analysis of raw symptom sounds and programmed into a popular mobile system, the iPod. Phase 2 involved a 7 day trial of ADAM in vivo, and the evaluation of user acceptance using an acceptance survey and individual interviews. ADAM was further modified and enhanced in Phase 3. RESULTS: Through ADAM, incoming audio data were digitized and processed in two steps involving the extraction of a sequence of descriptive feature vectors, and the processing of these sequences by a hidden Markov model-based Viterbi decoder to differentiate symptom sounds from background noise. The number and times of detected symptoms were stored and displayed in the device. The sensitivity (true positive) of the updated cough algorithm was 70% (21/30), and, on average, 2 coughs per hour were identified as false positive. ADAM also kept track of the their activity level throughout the day using the mobile system's built in accelerometer function. Overall, the device was well received by participants who perceived it as attractive, convenient, and helpful. The participants recognized the potential benefits of the device in asthma care, and were eager to use it for their asthma management. CONCLUSIONS: ADAM can potentially automate daily symptom monitoring with minimal intrusiveness and maximal objectivity. The users' acceptance of the device based on its recognized convenience, user-friendliness, and usefulness in increasing symptom awareness underscores ADAM's potential to overcome the issues of symptom monitoring including poor adherence, inadequate technique, and poor symptom perception in adolescents. Further refinement of the algorithm is warranted to improve the accuracy of the device. Future study is also needed to assess the efficacy of the device in promoting self-management and asthma outcomes.

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  • Studies demonstrate that the wearable chest device ADAMM can be used to track adolescent asthma.

    “Studies demonstrate that the wearable chest device, ADAMM, can be used to track adolescent asthma [26-28].”

    From Wearables and the Medical Revolution (2018) · cites this paper as [27]

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  1. [23]Young S Evermann G Gales M Hain T Kershaw D Liu XA Moore G Odell J Ollason D Povey D Valtchev V Woodland P The HTK book (for HTK version 3.4) 2006 2014-05-16 Cambridge, UK Cambridge University Engineering Department http://www.iet.ntnu.no/courses/ttt4185/current/web/comp_assign/semoppg2/htkbook.pdf 6PcUj4meb

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Authors
Rhee, H., Miner, S., Sterling, M., Halterman, J. S., & Fairbanks, E.
Affiliations
  • University of Rochester Medicine (US)
  • Rochester Institute of Technology (US)
Corresponding author
Rhee, Hyekyun
ORCID
Venue
JMIR mHealth and uHealth
Publisher
JMIR Publications Inc.
Published
2014-06-19
Volume
2
Issue
2
Pages
e27
ISSN
2291-5222 (ISSN-L)
DOI
10.2196/mhealth.3118
PMC
PMC4114416
OpenAlex
W1971279952
Cited by
39
References
40
Citations by year
2026: 1 · 2025: 5 · 2024: 5 · 2023: 3 · 2022: 4 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 4 · 2017: 4 · 2016: 4 · 2015: 3 · 2014: 1
FWCI
2.67
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR mhealth and uhealth (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
National Institute of Nursing Research (R01NR011169)
Topics
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Phonocardiography and Auscultation Techniques
Keywords
asthma, adolescents, symptom self-monitoring, cough detection, acoustic analysis, hidden Markov models, Viterbi decoding, user acceptance, usability, asthma self-management, activity monitoring, accelerometer, mobile health, iPod, symptom awareness, device development, symptom perception, adherence, feature extraction, false positives, sensitivity

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