# In-Home Evaluation of the Neo Care Artificial Intelligence Sound-Based Fall Detection System
## Results
### Phase 1: In-Home Trial  
Descriptive analysis of the in-home trial: Neo activations, events of concern, and technical performance. During the trial period, there were 28 falls or events of concern recorded in the logbooks. Of these, 12 occurred within the detectable zone of a Neo and were considered eligible for analysis. The remaining 16 were excluded due to the event occurring outdoors (n = 6) or technical problems (n = 10) resulting in the Neo device being disconnected at the time of the event, either because it was intentionally turned off by the participant (e.g., due to irritation from it being mistakenly triggered by everyday sounds) or WiFi disconnection. Server logs showed that the Neos detected a sound 5300 times in total. Most activations (n = 4930) were triggered by everyday sounds, while only nine were triggered by actual events, all of which were falls. The Neos failed to detect 3 out of the 12 eligible falls. The server logs showed that the most common sounds detected by the Neo were slapping/smacking (n = 1098), smoke detectors (n = 691), and thumps/thuds (n = 670, Table 1). Of the 9 correctly detected falls, the Neos detected these sounds as groaning (n = 3), slapping/smacking (n = 2), crying/sobbing (n = 1), thump/thud (n = 1), wall/moan (n = 1) and whimpering (n = 1). Reports from the logbooks suggested that, while the Neo detected the above sounds, these detections were often caused by other noises, such as dogs barking and the television. \begin{table}
\begin{tabular}{l c c c} \hline \hline  & **Neo Activated** & **Neo Activated by** **a True Fall** & **Neo Activated by** **Everyday Sounds** & **Neo Detected an** **Everyday Sound and** **Refrained from** **(n = 5300)** \\ \hline Banging & 0 & 14 & 0 & 14 \\ \hline Something breaking & 0 & 2 & 0 & 2 \\ \hline Coughing & 0 & 0 & 105 & 105 \\ \hline Crying/ & 1 & 664 & 0 & 665 \\ \hline Fire alarm & 0 & 115 & 10 & 125 \\ \hline Glass breaking & 0 & 41 & 0 & 41 \\ \hline Groaning & 3 & 32 & 0 & 35 \\ \hline Screaming & 0 & 655 & 0 & 655 \\ \hline Shattering & 0 & 4 & 0 & 4 \\ \hline Shouting & 0 & 56 & 0 & 56 \\ \hline Slapping/ & 2 & 1096 & 0 & 1098 \\ \hline Smoke detector & 0 & 579 & 112 & 691 \\ \hline Throat clearing & 0 & 0 & 134 & 134 \\ \hline Thump or thud & 1 & 669 & 0 & 670 \\ \hline Wail or moan & 1 & 96 & 0 & 97 \\ \hline Whimpering & 1 & 633 & 0 & 634 \\ \hline Yelling & 0 & 274 & 0 & 274 \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Overview of all the occurrences where the Neo was activated. An overview of the 4939 Neo activations is summarized in Table 2. Out of these, the Neo device responded correctly 1434 times. This includes four instances where it appropriately alerted a caregiver following a fall and 1430 instances where it correctly took no action, as no caregiver alert was needed. Among the nine falls that the Neo device successfully detected, it responded correctly in five cases. Specifically, it alerted a caregiver in four instances and took no action in one case, as the participant confirmed they were fine. However, there was one instance where Neo failed to alert a caregiver when it should have (i.e., when the participant indicated that they needed assistance after the fall). Additionally, technical issues interfered with the device's performance for the remaining three falls, resulting in the device not asking if the participants needed assistance after a fall. Table 3 presents the Neo's performance in detecting potentially significant events, categorized by the actual occurrence of a fall, and detections. Similarly, Table 4 presents the Neo's performance in responding to potentially significant events, categorized by whether or not an alert was required, and whether or not an alert was sent. Finally, the sensitivity and specificity metrics for the Neo's ability to detect and respond to falls are detailed in Table 5. The sensitivity for falls detection was 75.00% (95% CI: 42.81% to 94.51%) and specificity was 6.8% (6.16% to 7.54%).