# In-Home Evaluation of the Neo Care Artificial Intelligence Sound-Based Fall Detection System
## Results
### Theme 1: Areas for Improvement  
Participants pointed out several aspects of the Neo system that could be enhanced. A recurring suggestion was the need for more specific and customizable sound detection to suit individual homes.  
_\"I would suggest you probably have to come into an individual home and try and record and replicate those noises. So that it became specific to yours, to the person's home, because there must be all sorts of other factors like how big the room is in which you make the noise or I'm sure there are lots of reasons why it would react to one noise in one house and not in another.\" (NCT117P1)._  
The home's layout was also mentioned as a factor affecting the Neo's accuracy. Participants noted that, while having multiple Neos could be beneficial, it also presents challenges related to power source availability.  
_\"This house has a lot of rooms. So, unless I've got one of those things everywhere [Neos], which means I'm going to have to have a lot of plugs everywhere.\" (NCT115P1)._  
Sub Theme 1: Additional Features  
Participants discussed the potential value of additional features that could be added to the Neo. The most common suggestions were visual in indicators for sound events, such as flashing lights for doorbell rings, to assist the hearing-impaired; auditory reminders for tasks, like taking medication; an activity monitor to notify family general movement; and an outdoor version suitable for the garden, which some participants describing as essential.  
_\"I think that is a must. Anyone with a garden would want one.\" (NCT115)._  
Participants also suggested that specific trigger words, like \"help\" or \"I need assistance\", could be programmed into the Neo. They noted that the system's sensitivity levels needed refinement; it was sometimes too sensitive and other times not sensitive enough.  
\begin{table}
\begin{tabular}{c c c c} \hline \hline  & \multicolumn{2}{c}{**[PERSON]’s Response 1, n=**} & **Total, n=** \\ \hline
**Alert requirement** & Inappropriate response & Appropriate response & \\ \hline
**Alert not required** & 299 & 1430 & 1730 \\ \hline
**Alert required** & 3 & 5 & 8 2 \\ \hline
**Total** & 302 & 1436 & \\ \hline \hline \end{tabular}  
* This table does not include system errors (n = 3205). 2 Alert was only required in 8 of the 9 detected falls, since in 1 instance, the participant told the device they were ok.  
\end{table}
Table 4: Neo’s response to potentially significant events.  
\begin{table}
\begin{tabular}{c c} \hline \hline  & Value (95\% CI) \\ \hline
**Fall detection** & \\ Sensitivity & 75.00\% (42.81\% to 94.51\%) \\ Specificity & 6.80\% (6.16\% to 7.54\%) \\ \hline
**Fall response** & \\ Sensitivity & 62.50\% (24.49\% to 91.48\%) \\ Specificity & 17.28\% (15.53\% to 19.15\%) \\ \hline \hline \end{tabular}
\end{table}
Table 5: Accuracy of the Neo to detect and respond to falls.  
\"So, I guess it needs to be developed more to the sounds of somebody calling out for help.\" (NCTI04P1).\" Making it more sensitive to people and not animals, you know?\" (NCTI19 CP1)._  
Other valuable features mentioned included integrating the Neo with phone call-endars for verbal appointment reminders and other health-related prompts, such as hydration reminders.  
\"It would be great if it was connected to your calendar on your phone so you don't forget you've got an appointment with the doctor or you've got dinner or lunch today.\" (NCTI13P1).