# Self-Reporting Technique-Based Clinical-Trial Service Platform for Real-Time Arrhythmia Detection
## 4 Discussion
### Platform Strengths  
The most important advantage of this platform is the self-reporting function. A variety of patient-monitoring systems (PMSs) have been used to collect and manage medical data [29; 30; 31]. To our knowledge, however, PMSs providing self-reporting and automatic-diagnosis functions have not yet been developed. Conventional PMSs collect multiple medical data from adjacent devices, but their performance is normally limited to the display of the gathered objective data and their relay to HISs. Inevitably, this could aggravate clinician workload. These systems may not contain subjective patient reports and daily activities, which could be related to disease progression. Therefore, clinicians need to ask patients for this information. Moreover, these systems may be unable to diagnose certain diseases, which makes clinicians thoroughly scrutinize the acquired data before decision making. It usually requires time-consuming visual inspection and manual interpretation which may be prone to interobserver variations. These weaknesses can be overcome by using this platform. We believe that the self-reporting function and consistently reliable automatic diagnosis allow clinicians to treat patients with minimum information-gathering effort. The second advantage of this platform is the centralization of spontaneous data generated by wearable devices. The data measured by wearable devices are generally saved in the internal-storage medium or uploaded to cloud services. However, to be used for medical purposes, these data should be transmitted to and saved in HISs. Thereafter, these data can be accessible to clinicians and may be utilized for further investigations and diagnoses. The solid network structure for data acquisition, transfer, storage, diagnosis, and review was fully implemented on this platform. The advantages of this platform over other PMSs, including self-report and data storage, are presented in Table 2. \begin{table}
\begin{tabular}{c c c c c} \hline \hline \multirow{2}{*}{**Features**} & \multicolumn{2}{c}{**Life Scope TR**} & **Infinity M300** & **u-Vital** & **Proposed** \\  & **BSM-6301** & **Telemetry** & **System** & **Platform** \\  & **(Nihon Kohden)** & **(Draeger)** & **(ETRI)** & **(SNUH-CTC)**\({}^{a}\)** \\ \hline
**Interface Type** & **Wired** & **Wireless** & **Wireless** & **Wireless** \\ \hline \multirow{4}{*}{Objective vital sign measurements} & _ECG_\({}^{a}\) & O & O & O & O \\  & _HRs_\({}^{a}\) & O & O & O & O \\  & _SpO2_\({}^{a}\) & O & O & O & O \\  & _BP_\({}^{a}\) & O & X & O & O \\  & _BT_\({}^{a}\) & O & X & O & O \\ \hline Subjective self-reports & X & X & X & O \\ \hline Communication between clinicians and patients & X & X & X & O \\ \hline Detection of arrhythmia & X & O & O & O \\ \hline Real-time display & O & O & O & O \\ \hline Storage of full data & O & O & O & O \\ \hline Playback review & X & X & X & O \\ \hline Market approval & FDA \({}^{a}\), CE \({}^{a}\) & FDA, CE & X & X \\ \hline \hline \end{tabular}  
* Abbreviations: ECG, electrocardiogram; HR, heart rate; SpO2, blood-oxygen saturation; BP, blood pressure; BT, body temperature; SNUH-CTC, Seoul National University Hospital Clinical Trials Center; FDA, Food and Drug Administration; CE, Conformrite Europeenne.  
\end{table} 
Table 2: Comparison of the proposed platform with other patient-monitoring systems. The third advantage is that this platform can be used for decentralized clinical trials (DCTs) [32]. Contrary to traditional centralized clinical-trial settings, wherein participants need to be present at the trial sites, in DCT settings remote consent and data acquisition take place through non-face-to-face interactions between clinicians and participants. The latest technologies such as wearable devices and Internet connectivity have paved the way for DCTs. The importance of DCTs has grown during the ongoing coronavirus disease (COVID-19) pandemic.