Only then will telemonitoring achieve the aim of preventing hospital admissions , contributing to the reduction of health re source utilization and improving the quality of life of patients
Major reported factors associated with the limited effectiveness of home telemonitoring interventions in chronic respiratory conditions include the lack of useful early predictors , poor patient compliance and the poor performance of conventional algorithms for detecting deteriorations .
This article provides a systematic review of existing algorithms and the factors associated with their performance in detecting exacerbations and supporting clinical decisions in patients with chronic obstructive pulmonary disease ( COPD ) or asthma .
Detecting exacerbations using the Clinical COPD Questionnaire
Background Early treatment of COPD exacerbations has shown to be important . Despite a non-negligible negative impact on health related quality of life , a large proportion of these episodes is not reported ( no change in treatment ) . Little is known whether ( low burden ) strategies are able to capture these unreported exacerbations . Methods The Clinical COPD Question naire ( CCQ ) is a short question naire with great evaluative properties in measuring health status . The current explorative study evaluates the discriminative properties of weekly CCQ assessment in detecting exacerbations . Results In a multicentre prospect i ve cohort study , 121 patients , age 67.4 ± 10.5 years , FEV1 47.7 ± 18.5 % pred were followed for 6 weeks by daily diary card recording and weekly CCQ assessment . Weeks were retrospectively labeled as stable or exacerbation ( onset ) weeks using the Anthonisen symptom diary-card algorithm . Change in CCQ total scores are significantly higher in exacerbation-onset weeks , 0.35 ± 0.69 compared to -0.04 ± 0.37 in stable weeks ( p < 0.001 ) . Performance of the Δ CCQ total score discriminating between stable and exacerbation onset weeks was sufficient ( area under the ROC curve 0.75 ) . At a cut off point of 0.2 , sensitivity was 62.5 ( 50.3 - 73.4 ) , specificity 82.0 ( 79.3 - 84.4 ) , and a positive and negative predictive value of 43.5 ( 35.0 - 51.0 ) and 90.8 ( 87.8 - 93.5 ) , respectively . Using this cut off point , 22 ( out of 38 ) unreported exacerbations were detected while 39 stable patients would have been false positively ' contacted ' . Conclusions Weekly CCQ assessment is a promising , low burden method to detect unreported exacerbations . Further research is needed to vali date discriminative performance and practical implication s of the CCQ in detecting exacerbations in daily care
Only then will telemonitoring achieve the aim of preventing hospital admissions , contributing to the reduction of health re source utilization and improving the quality of life of patients
Major reported factors associated with the limited effectiveness of home telemonitoring interventions in chronic respiratory conditions include the lack of useful early predictors , poor patient compliance and the poor performance of conventional algorithms for detecting deteriorations .
This article provides a systematic review of existing algorithms and the factors associated with their performance in detecting exacerbations and supporting clinical decisions in patients with chronic obstructive pulmonary disease ( COPD ) or asthma .