Journal of Medical Engineering and Technology最新文献

The work presents a convenient and practical wearable heart rate monitoring method and a cost-effective implementation of a recording system based on commercial over-ear headphones. The selected headphones can be easily replaced by any other over-ear headphones due to the modular structure of the system and custom 3D printed ear pads. Dry contact conductive textile removes any discomfort and the need for preparation for electrodes or the user's skin. Evaluated 4.4% R-R interval detection error makes the proposed method a perfect candidate for continuous heart rate monitoring for daily use.

Millions of children and young people (CYP) in the UK are affected by chronic or rare health conditions. Rapid advances in science and technology have resulted in CYP with chronic and rare conditions now surviving well into adulthood. New technologies have the potential to improve short- and long-term health outcomes for CYP with health conditions, prevent adult onset disease and complications, and reduce the burden on health services. There is thus a need for targeted investment and appropriate governance in child health technology development to address the specific needs of this population; health technology must be versatile to meet the social, anatomical, cognitive, psychological, and physiological changes inherent to childhood development. Despite the growing demand for health technology for a sizeable global population, industry still wrongly perceives the market size is relatively small, and health technology development is often localised and fragmented with limited scope for spread and adoption. These challenges can be overcome by validating and prioritising unmet needs, involving CYP and their families throughout the innovation pathway, facilitating effective partnerships with key stakeholders, and utilising national and international infrastructure and networks. This paper outlines five innovations supported by NIHR Children and Young People MedTech Co-operative that illustrate how common challenges in child health technology development can be overcome. It is essential that we continue to address such challenges and invest in the health and wellbeing of CYP.

The successful development and implementation of any healthcare technology requires input from multiple stakeholders including clinical leads, trust information technology directorates as well as project management and procurement. In this process however, a key stakeholder that is often overlooked is the patient.This paper illustrates the crucial importance of patient involvement to avoid poor design and poor uptake of technology and subsequently poor health outcomes.To highlight this, we share a case example evidencing involvement of people with lived experience of foot ulcers resulting from Diabetic foot neuropathy throughout identification of unmet technology needs, design requirements for the device and iterative device development and evaluation.

Evidence suggests that much of the digital technology available and provided to older adults to enable self-management of long-term conditions is under-utilised. This research focuses on three conditions prevalent amongst older adults: diabetes, dementia and chronic kidney disease and explores the individual enablers and barriers to the use of digital self-management technology. The paper reports findings from a series of three systematic reviews of qualitative research (qualitative evidence syntheses). These reviews informed the design of a Delphi study. The first round of the Delphi involving 15 expert interviews is reported. The findings highlight common themes across the three conditions: how technology is used; barriers to use; assessing individual needs when selecting technology; support requirements; multi-functional self-management technologies; trust, privacy and data sharing; achieving accessible and aspirational design. Some emerging recommendations have been suggested to guide the design, and provision of technology to older adults. These will extended and refined through subsequent rounds of the Delphi method.

The anatomical, physiological, and developmental changes which arise as children mature through childhood and adolescence support the need to develop new health technologies that meet the specific requirements of children and young people (CYP). Failing to involve CYP during the development of technology increases the risk that the outcome falls short of their expectations and needs, leading to rejection of novel interventions. Through participation in health technology development, CYP and their families can provide context, insight, personal experience and tacit knowledge to ensure that the end-product is usable, acceptable, and can be integrated into its intended environment. A nuanced, balanced understanding of the methods that can be used to facilitate participation will support researchers in choosing an effective approach to involving CYP in health technology development. Methodological approaches include patient and public involvement and engagement, co-design, and experienced based co-design. These methods can be used in isolation or in combination, to facilitate meaningful involvement of CYP and encourage the development of impactful solutions, in consideration of the context, stakeholders, and objectives of the project. We provide the rationale and justification for involving CYP in health technology design and development, an explanation of the methods supporting meaningful involvement, and case studies exemplifying real world application of these methods with positive outputs.

People with mobility impairments have reported that improving their walking is one of the most important goals of their rehabilitation. Novel robotic technologies using powered exoskeletons for the lower limb could potentially offer efficient and less labour-intensive approaches to rehabilitation with shorter recovery times. To gather users' and carers' perspectives of assistive device use to provide information to design personalised and safe mobility rehabilitation technology. Semi-structured interviews were carried out with people with experience of mobility impairments. Iterative data collection was used to gather information about the social phenomena surrounding patient interaction and requirements for assistive devices for mobility impairments. Cycles of continuous data collection and thematic analysis using a theoretical, semantic approach was used to develop key themes within the data. We interviewed eight people: six people with mobility impairments and two carers. We identified five main themes: relationship with assistive technology, requirements for assistive technology, function and goal setting, personal factors to assistive device use and psychosocial factors to assistive device use. There was variability in the importance placed on each theme, particularly in the trade-off between the function and comfort of assistive technology. Patients emphasised the need for assistive technology to be personalised; they reported the ability to stand, control spasticity and involvement in community roles as key goals of their rehabilitation. These results highlight the variation in requirements for assistive technology between people with different mobility impairments; individuals' experiences are unique and future prototypes need to account for different levels of impairments and personal goals. These findings will also inform the user evaluation stage of assistive device testing. The acceptability of assistive devices is dependent upon a number of factors, including personalisation, comfort and function. Future pilot studies should gather qualitative data to determine the acceptability of actual device use.

The development of medical technologies that effectively meet clinical and patient needs increasingly relies upon collaborative working between clinicians, businesses and universities. While this "open" innovation process may provide access to additional resources, knowledge, and expertise the process is not frictionless. At the personal level, individuals may have different ways of working and incentives and at the organisational level, partners may have their own cultures and processes. Thus, interorganisational collaboration is not necessarily a panacea, but has advantages and disadvantages. The challenges are somewhat heightened in the MedTech sector where collaborative working cuts across established professional boundaries, brings together diverse knowledge from an array of disciplines, and often disrupts existing medical practice. Given these factors, this article presents a review of the extant management literature examining the complexities within multi-party collaboration and ways to drive these partnerships forwards. The article emphasises the critical value of interpersonal relationships within collaborations and offers means of strengthening them.

This paper provides an overview of the usability engineering process and relevant standards informing the development of medical devices, together with adaptations to accommodate situations such as global pandemics where use of traditional face-to-face methods is restricted. To highlight some of those adaptations, a case study of a project developing a novel electronic rehabilitation device is referenced, which commenced in November 2020 amidst the COVID-19 pandemic. The Sheffield Adaptive Patterned Electrical Stimulation (SHAPES) project, led by Sheffield Teaching Hospitals NHS Foundation Trust (STH), aimed to design, manufacture and trial an intervention for use to treat upper arm spasticity after stroke. Presented is an outline and discussion of the challenges experienced in developing the SHAPES health technology intended for at-home use by stroke survivors and in implementing usability engineering approaches. Also highlighted, are the benefits that arose, which can offer easier involvement of vulnerable users and add flexibility in the ways that user feedback is sought. Challenges included: restricted travel; access to usual prototyping facilities; social distancing; infection prevention and control; availability of components; and changing work pressures and demands. Whereas benefits include: less travel; less time commitment; and greater scope for participants with restricted mobility to participate in the process. The paper advocates a more flexible approach to usability engineering and outlines the onward path for development and trialling of the SHAPES technology.

Long-term neurological conditions (LTNCs) cause physical and psychological symptoms that have a significant impact on activities of daily living and quality of life. Multidisciplinary teams are effective at providing treatment for people with LTNCs; however, access to such services by people with disabilities can be difficult and as a result, good quality care is not universal. One potential solution is telehealth. This review describes the potential of telehealth to support people with LTNCs, the challenges of designing and implementing these systems, and the key recommendations for those involved in telehealth to facilitate connected services that can benefit patients, carers and healthcare professionals. These recommendations include understanding the problems posed by LTNCs and the needs of the end-user through a person-centred approach. We discuss how to work collaboratively and use shared learning, and consider how to effectively evaluate the intervention at every stage of the development process.