Predicting catastrophic health events - noninvasively and short term

"I've just picked up a fault in the AE35 unit. It's going to go 100% failure in 72 hours". These were famous words of the almighty computer HAL in "2001: A Space Odyssey". Few of us believe too much in software forecasts - be it weather, earthquakes or computer hard disk failures. Yet, we all know that sometimes it works. And such systems are very valuable, assuming they continuously improve.

Word cloud generated from QS #15 intros

Wellness is always a common theme of the many presentations and experiments of Quantified Self enthusiasts - citizen scientists quantifying everyday life in order to improve it.  "Health" was the most frequent word among the two-word introductions of QS #15 attendees, followed by variations of sleep and happiness, and ways to measure and understand it.
Are health failures predictable?  Nobody argues they are, although most available services  - such as genomic testing - provide only long term predictions.  Biomarkers that scientists are interested in are obtained through invasive or costly interventions - like blood proteins or intracranial electroencephalograms. Technologies such as Mobile Cardiac Outpatient Telemetry™ (MCOT™) developed by CardioNet  are based on real time EKG focused on heart rhythm abnormalities that can't be detected in small 24 or 48 hour windows. These relatively rare events are correlated with symptoms and used for diagnostics.

Your husband just died, … here’s his black box
(from Gordon Bell's presentation)

Perhaps in the future every one of us will leave a black box holding all the truth about our health, helping next generations to better maintain, test and repair their bodies. Many lives have already contributed to the understanding of causes and effects such as the link between cholesterol levels, diet and heart attack. But what about the short term prediction horizon,  like the 72-hour window of HAL or 30 seconds to 15-to-45 minutes warning by seizure dogs?
Could computer luminary Gordon Bell predict his heart attack if he wore his heart monitor strap while bicycling?  A cardiologist would say "no way", but maybe sometimes it's better to keep quantifying and experiment despite of what medical establishment has to say?
Data from the Women’s Health Initiative study (129,135 postmenopausal women observed over a period of nearly eight years) show that a woman’s resting heart rate may be a good indicator of her risk for a heart attack. Hsia and others (2009) found that women whose resting heart rate is more than 76 beats per minute are significantly more likely to have a heart attack than women with resting heart rate less than 62 beats a minute. This risk factor is particularly strong for women between the ages of 50 and 64, less so for women over the age of 65. (Trial NCT00000611)

Of course, women have different kinds of heart attacks than men do. They are more likely to die from a spasms of heart and the blood vessels leading to the heart, and are more likely to complain of fatigue and sleep disturbances in the weeks and months leading up to a heart attack. Sleep disturbances and decreased physiological differences between day and night are increasing heart attack and stroke risks for males too, at least for shift workers. Exercise tests  - known for their false positive results - have better cardiovascular prognostic value for smokers with high cholesterol than healthy men.

Finger arterial pulsatile volume changes or finger blood flow - related to blood pressure - is another medium-to-long term predictor of pending cardiac events. A simple, noninvasive finger sensor test called EndoPAT  can predict major cardiac events such as a heart attack or stroke for people who are considered at low or moderate risk.

AngelMed Guardian System (inventor: Dr. Tim Fischell) is an early warning system - telling 24 hrs to a week before if heart attack is coming. Average time between the cardiac event and hospital arrival is 3 hrs, and about 5 hrs before the surgery starts. By that time 90% of muscles could be dead, so 5 or 10 minute warnings could save lives.  Unfortunately, Guardian is highly invasive - sized as an iPod, it is implanted directly into the patient's chest, monitoring electrogram  waveforms and other crucial heart-signal data 24-7.

Many portable oximeters and ECG are already in the market - and even though consumers are complaining about noise and difficulties in getting readings of diagnostic intervals, the technologies will continue to improve and self-quantifiers will be finding solutions for better health.

REFERENCES
Hsia, J., Larson, J., Ockene, J., Sarto, G., Allison, M., Hendrix, S., Robinson, J., LaCroix, A., Manson, J., & , . (2009). Resting heart rate as a low tech predictor of coronary events in women: prospective cohort study BMJ, 338 (feb03 2) DOI: 10.1136/bmj.b219


Mayo Clinic (2009). High resting heart rate could predict heart attack in women. Mayo Clinic women's healthsource, 13 (7) PMID: 19498326

Devices To Keep you Healthy

An armband device that can be worn all day - during workouts, at the office and at home - will calculate all calories you burn. You can connect it to a computer to tabulate your calorie intake versus what you're burning off. The Exerspy interactive system will pump up your workouts, and could make you healthy - but only if you make healthy choices by yourself.
Another gadget from Philips, DirectLife, will track calories you burn and display your daily progress by green lights - each one makes you 15% closer to your daily 100% activity target. Your overall progress can be monitored on your PC, daily or hourly - after you upload data from Activity Monitor to your PC. Exercise could be fun. Ubisoft's Just Dance game for Wii teaches you dance moves, lets you to compete with up to four players and have a dance party. It monitors your arm movements increasing your heart rate. The miCoach not only measures your hou eart rate, but gives you real time audio coaching and asks to speed up when you start slacking off. Using a small foot pod you tie into your sneaker, it tracks your speed and distance too, letting to manage the numbers on the Adidas website. You could also keep track of your mileage with the a solar powered odometere, if you like. Another device - Sensewear, an arm band from Bodymedia, enables automated monitoring of calories burned, dietary intake, duration of physical activity and sleep. A USB port allows the patient to periodically upload data from the armband to a website loaded with charts, graphs, and other data that allows both patient and physician to make informed decisions. Device by Toumaz, called Sensium, provides ultra low power monitoring of ECG, temperature, blood glucose and oxygen levels. It can also interface to 3 axis accelerometers, pressure sensors and includes a temperature sensor on chip. Sensium Life Pebble streams the data using a wireless datalink over a short range ( ~5m) to a Sensium USB adapter or data logger. Mio Watch (left) measures your heart rate, while other "smart" watches such as Garmin can wirelessly communicate with your scales and body composition monitor. Withing Wifi Scale will even automatically update your weight on Twitter, sending your stats to your computer and your iPhone. A personal calorie management device called Bodybugg measures calorie expenditure. Another pocket-sized piece of technology - Fitbit (also called a pedometer on steroids) - promises to tell you the number of calories burned, steps taken, miles walked, and quality of sleep in addition to the intensity of exercise you’ve had all day.
It also records and stores detailed daily data for a week and summarized daily data for a month. Using the same 3D motion sensing technology as the Nintendo Wii, the creators of the Fitbit hope to turn everyday activities into a fitness game. The gadget uploads your activity stats, including calories burned, wirelessly to the web. You can wear it in your pocket, clipped to your pants, bra or your wrist.

Can it be any easier? Sure, it can. PhiloMetron is creating a bandage-sized smart patch that will also do the usual counting of calories. Besides, at the end of the day it could tell you what to do to make the next day even more successful. It also suggests taking a quick walk when it’s needed, to help things on their way. The patch sends all information collected during the day to your cell phone, by a Bluetooth connection.
Of course, not everyone can make the best food choices. It’d be far easier for most people if you ha d a diet itian to follow you around and tell you what to do. It's such a hassle to have to manually en ter every food... One of possibl e solution is is to use FoodScanner, a new app that scans package bar codes for quick and easy calorie logging.

Device by Toumaz, called Sensium, provides ultra low power monitoring of ECG, temperature, blood glucose and oxygen levels. It can also interface to 3 axis accelerometers, pressure sensors and includes a temperature sensor on chip. Sensium Life Pebble streams the data using a wireless datalink over a short range ( ~5m) to a Sensium USB adapter or data logger. Cardionet system monitors every heartbeat during normal daily activities, for up to 21 days, and detects, records, and transmits event data automatically to the prescribing physician via wireless phone. In a not so far away future, many other bodily functions and environmental influences will be monitored 24x7 - examples are the daily fluctuations in hormone levels and medications taken - Proteus ingestible event markers (IEMs, shown on the right) could send ultra-low-power digital signals through the body to a microelectronic receiver that may look like a small bandage style skin patch. The receiver date- and time-stamps, decodes, and records information such as the type of drug, the dose, and the place of manufacturing.

Of course, it's not just food, medications and calories. There is more to health than measurements of outcomes. Device shown on the right uses ultrasonic sensors to detect how close you are to the screen and remind you to sit up straight - by showing flashing LED lights or chime once when you’re leaning too close to your monitor. To keep it running just plug it into your USB port. You can purchase it for $21.99 from Sourcing Map. (See also PC Gadgets, USB Gadgets, iPosture, UberGizmo; USB Posture Alert Reminder).
You can wear another gudget (shown on the top left) around your neck, and when you start to slouch, it’ll correct you with an audible alarm. Designed in Japan, it sells for $8.43 by DealExtreme.

But what about viruses, bacteria, fungi infections and nasty little mosquitos? Some startups are working on that too. We will only mention the simplest device already on the market - a $5 USB Ultrasonic Mosquito Pest Repeller.
This little device could eliminate the use of pesticides and other harmful bug sprays, although it is still unclear if it actually works.
And what about accidents? What if you can't keep you hands off your cell phone while driving? Driving while distracted (DWD) due to texting would make accidents 23 times more likely, while talking on a cell phone while driving, even hands-free, makes drivers as likely to cause a crash as someone considered legally drunk. A new blocking device can help you to avoid accidents. CellControl plugs into the car computer terminals, links to cell phones via Bluetooth and a downloadable application. When the vehicle is in motion (more than 1mph), the device blocks all incoming and outgoing calls, plus texts and e-mails. You can still call emergency numbers though. Passenger cell phones are not affected.

Aurametrix is developing decision support systems and noninvasive personal monitoring devices to help you evaluate health risks, decide on preventative measures, estimate cost/benefits of performing diagnostic tests. Better tools for a healthier world.