Teletechnology Accuracy for Real-time Tele-video Assessment of Physical Function
身体机能实时远程视频评估的远程技术准确性
基本信息
- 批准号:8399436
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2013
- 资助国家:美国
- 起止时间:2013-01-01 至 2015-12-31
- 项目状态:已结题
- 来源:
- 关键词:AdherenceAffectAmbulatory Care FacilitiesButtocksCaringChronicChronic DiseaseClinicalCollaborationsCommunitiesConsultationsCountryDataData CompressionDevelopmentDevicesDimensionsDiseaseElectronicsEngineeringEnsureEnvironmentEnvironmental Risk FactorEquipmentExerciseFacial ExpressionFeedbackFutureGaitGoalsGoldHeart DiseasesHome environmentHumanImageIndiumInternetLocationMeasurementMeasuresMedicalMental HealthMeta-AnalysisModelingMotionMotorMovementMusculoskeletalNeurologicNeurologistNorth CarolinaOccupational TherapyOutcomePatientsPerformancePersonsPhysical FunctionPhysical RehabilitationPhysical therapyPhysically HandicappedProtocols documentationProviderRehabilitation therapyResearchResearch DesignResearch Project GrantsResolutionResourcesRuralSample SizeSamplingSampling StudiesSingaporeSolutionsSourceSystemTechnologyTestingTimeTrainingVeteransVideo RecordingWalkersWireless Technologybaseclinical practicedesignhealth administrationimprovedlensmedical specialtiesmeetingsnervous system disordernew technologyprogramspublic health relevancerural areaspatial relationshipstandard measurestandard of carestereoscopicsystematic reviewtelehealthtelerehabilitationtransmission processuptakeurban areausabilitywound
项目摘要
DESCRIPTION (provided by applicant):
Primary Objective: The overarching goal of the proposed research project is to study technology for Real Time Tele Video (RTTV), ascertaining its ability to meet basic physical therapy (PT) and occupational therapy (OT) needs (displaying movement, the physical surroundings, and the patient-environmental interface). Specific Objectives: We will determine the effects of currently available teletechnology on (a) reliability, (b) validity and (c) overall quality for standard measures used by PTs and OTs to assess physical function (e.g., fine motor coordination, gross motor coordination and spatial relationships. We hypothesize that the following technological parameters will affect measurement accuracy for standard measures of physical function: (1) internet bandwidth, (2) camera settings (e.g., camera resolution, stereoscopic lenses, etc.), and (3) programming parameters (e.g., refresh rate, compression algorithms, etc.) These specific objectives and hypotheses will be examined through 3 sequential sub-studies. Anticipated Outcomes: A better understanding of the ability of existing teletechnology to meet typical rehabilitation clinical needs will help ensure optimal use of extant technology and will uptake by OTs and PT, availability of which is particularly limited in rural locations. The results will help
VHA Office of Telehealth determine the best types of telehealth equipment to deploy to meet specific clinical needs and will provide guidance to engineers developing new technology. Study Design: Repeated Measures to compare performance under different technological configurations. Study Sample: 3 convenience samples with 50 ambulatory veterans each (150 total) who have diverse mobility disorders (e.g., musculoskeletal, neurological). Teletechnology Configurations: (1) internet bandwidth, testing the Internet bandwidth range typical of VA and home internet connections (e.g., 64, 384 and 768 kps).; (2) camera parameters which differ in ability to capture spatial relationships and camera resolutions typical of currently used televideo
technology (e.g., 320X240, 1280X720, 1920X1080), and (3) programming to optimize accurate measurement according to type of physical function while minimizing needed bandwidth (e.g., refresh rate, compression algorithms, transport protocol). Measurement under each configuration will be compared with in person OT/PT ratings (i.e., "standard of care") and slow motion review of the videorecordings (i.e., "gold standard" criterion). Measures: Six standard clinical measures will be used that assess 3 different dimensions of physical function: (1) fine motor coordination; (2) gross motor coordination; and (3) spatial relationships (still and moving).
In addition, the raters will provide a global assessment of image quality and human factors will be measured using the Rapid Assessment of Product Usability & Universal Design (RAPUUD). Analysis: Validity: An estimate of bias for each measurement will be obtained by both the difference and the absolute value of the difference between the "gold standard" and our sample estimates, and Mixed Models used to determine the effect sizes for various predictors of bias (e.g., technology). Reliability: The mixed model will estimate sources of variance from which intraclass correlations can be derived. Power: A sample size of 50 provides adequate precision in making these comparisons (e.g., the 95% CIs for reliabilities of 0.8 are 0.67 - 0.88 and for validities, we will have 80% power to detect standardized differences (SD) of 0.40 or greater between our gold standard and results of the different technological configurations. Replication: We will replicate tests of solutions from Sub-study 3 using 3-G wireless Internet with a convenience sample of 10 homes located in urban and rural areas in North Carolina, which will verify functionality under the variable bandwidth typical of wireless Internet required for RTTV in
the home. Our Singapore collaboration allows for future replication in another country with a differing Internet system.
PUBLIC HEALTH RELEVANCE:
The Secretary for Veterans Affairs identified telehealth as a critical element in his Strategic Pla. Teletechnology may allow persons with chronic illness to stay at home longer. It also can be used to provide cutting-edge specialty care in rural areas. Occupational and Physical Therapy (OT/PT) is especially limited in rural locations. Teletechnology has enormous potential to meet this need, but it is underused by OT/PT. The proposed study will provide information needed to ensure proper, safe use of currently available Real Time Tele Video (RTTV) technology by OT/PT. The results will help VHA Office of Telehealth determine the best types of telehealth equipment to deploy to meet specific clinical needs. Last, but not least, it will help guide engineers developing technology to better meet clinical needs.
描述(由申请人提供):
主要目标:拟议研究项目的总体目标是研究实时远程视频 (RTTV) 技术,确定其满足基本物理治疗 (PT) 和职业治疗 (OT) 需求的能力(显示运动、物理环境、以及患者与环境的界面)。具体目标:我们将确定当前可用的远程技术对 PT 和 OT 用于评估身体功能(例如精细运动协调性、粗大运动协调性)的标准测量的 (a) 可靠性、(b) 有效性和 (c) 整体质量的影响我们假设以下技术参数将影响身体功能标准测量的测量精度:(1)互联网带宽,(2)相机设置(例如相机分辨率、立体镜头等),以及(3)编程参数(例如,刷新率、压缩算法等)这些具体目标和假设将通过 3 个连续的子研究进行检验。 预期结果:更好地了解现有远程技术满足典型康复临床需求的能力将有助于确保最佳使用。现有技术将被 OT 和 PT 采用,而这些技术在农村地区的可用性特别有限。结果将有所帮助。
VHA 远程医疗办公室确定部署的最佳远程医疗设备类型,以满足特定的临床需求,并将为开发新技术的工程师提供指导。研究设计:重复测量以比较不同技术配置下的性能。研究样本:3 个便利样本,每个样本包含 50 名患有多种活动障碍(例如肌肉骨骼、神经系统疾病)的流动退伍军人(总共 150 名)。电信技术配置:(1) 互联网带宽,测试 VA 和家庭互联网连接的典型互联网带宽范围(例如 64、384 和 768 kps)。 (2) 相机参数,其捕捉空间关系的能力和当前使用的电视典型的相机分辨率不同
技术(例如 320X240、1280X720、1920X1080),以及 (3) 编程以根据物理功能类型优化精确测量,同时最大限度地减少所需带宽(例如刷新率、压缩算法、传输协议)。每种配置下的测量结果将与现场 OT/PT 评级(即“护理标准”)和视频记录的慢动作审查(即“黄金标准”标准)进行比较。测量:将使用六种标准临床测量来评估身体机能的 3 个不同维度:(1)精细运动协调性; (2)粗大运动协调性; (3)空间关系(静止和运动)。
此外,评估者将对图像质量进行全球评估,并使用产品可用性和通用设计快速评估 (RAPUUD) 来衡量人为因素。分析:有效性:每次测量的偏差估计将通过“黄金标准”与我们的样本估计之间的差异和绝对值来获得,并且混合模型用于确定各种偏差预测因子的效应大小(例如技术)。可靠性:混合模型将估计方差来源,从中可以得出类内相关性。功效:50 个样本量可以为进行这些比较提供足够的精度(例如,可靠性为 0.8 的 95% CI 为 0.67 - 0.88,对于有效性,我们将有 80% 的功效来检测 0.40 或更大的标准化差异 (SD)我们的黄金标准和不同技术配置的结果之间的比较 复制:我们将使用 3-G 无线互联网复制子研究 3 的解决方案测试。位于北卡罗来纳州城市和农村地区的 10 个家庭的便利样本,将验证 RTTV 所需的典型无线互联网可变带宽下的功能
家。我们与新加坡的合作允许将来在具有不同互联网系统的另一个国家进行复制。
公共卫生相关性:
退伍军人事务部部长将远程医疗视为其战略计划中的一个关键要素。远程技术可以让患有慢性病的人在家里呆更长时间。它还可用于在农村地区提供尖端的专业护理。职业和物理治疗 (OT/PT) 在农村地区尤其有限。远程技术在满足这一需求方面具有巨大潜力,但 OT/PT 并未充分利用它。拟议的研究将提供确保 OT/PT 正确、安全地使用当前可用的实时远程视频 (RTTV) 技术所需的信息。结果将帮助 VHA 远程医疗办公室确定部署的最佳远程医疗设备类型,以满足特定的临床需求。最后但并非最不重要的一点是,它将有助于指导工程师开发技术,以更好地满足临床需求。
项目成果
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Helen M. Hoenig其他文献
Helen M. Hoenig的其他文献
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{{ truncateString('Helen M. Hoenig', 18)}}的其他基金
Teletechnology Accuracy for Real-time Tele-video Assessment of Physical Function
身体机能实时远程视频评估的远程技术准确性
- 批准号:
8977504 - 财政年份:2013
- 资助金额:
-- - 项目类别:
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