Monitoring (medicine)

Vital parameters

A medical monitor or physiological monitor is a medical device used for monitoring. It can consist of one or more sensors, processing components, display devices (which are sometimes in themselves called "monitors"), as well as communication links for displaying or recording the results elsewhere through a monitoring network.^{[citation needed]}

Components

Sensor

Sensors of medical monitors include biosensors and mechanical sensors. For example, photodiode is used in pulse oximetry, Pressure sensor used in Non Invasive bood pressure measurement.

Translating component

The translating component of medical monitors is responsible for converting the signals from the sensors to a format that can be shown on the display device or transferred to an external display or recording device.

Display device

Physiological data are displayed continuously on a

Besides the tracings of physiological parameters along time (X axis), digital medical displays have automated numeric readouts of the peak and/or average parameters displayed on the screen.

Modern medical display devices commonly use digital signal processing (DSP), which has the advantages of miniaturization, portability, and multi-parameter displays that can track many different vital signs at once.^{[citation needed]}

Old

Several models of multi-parameter monitors are networkable, i.e., they can send their output to a central ICU monitoring station, where a single staff member can observe and respond to several bedside monitors simultaneously. Ambulatory telemetry can also be achieved by portable, battery-operated models which are carried by the patient and which transmit their data via a wireless data connection.

Digital monitoring has created the possibility, which is being fully developed, of integrating the physiological data from the patient monitoring networks into the emerging hospital

In practice, the possibility that a difference is due to test-retest variability can almost certainly be excluded if the difference is larger than a predefined "critical difference". This "critical difference" (CD) is calculated as:[2]

${\displaystyle CD=K\times {\sqrt {CV_{a}^{2}+CV_{i}^{2}}}}$

, where:^[2]

• K, is a factor dependent on the preferred probability level. Usually, it is set at 2.77, which reflects a 95% prediction interval, in which case there is less than 5% probability that a test result would become higher or lower than the critical difference by test-retest variability in the absence of other factors.
• CV_a is the analytical variation
• CV_i is the
  intra-individual variability

For example, if a patient has a hemoglobin level of 100 g/L, the analytical variation (CV_a) is 1.8% and the intra-individual variability CV_i is 2.2%, then the critical difference is 8.1 g/L. Thus, for changes of less than 8 g/L since a previous test, the possibility that the change is completely caused by test-retest variability may need to be considered in addition to considering effects of, for example, diseases or treatments.

Critical differences for other tests include early morning urinary albumin concentration, with a critical difference of 40%.^[2]

Delta check

In a clinical laboratory, a delta check is a laboratory quality control method that compares a current test result with previous test results of the same person, and detects whether there is a substantial difference, as can be defined as a critical difference as per previous section, or defined by other pre-defined criteria. If the difference exceeds the pre-defined criteria, the result is reported only after manual confirmation by laboratory personnel, in order to exclude a laboratory error as a cause of the difference.^[4] In order to flag samples as deviating from previously, the exact cutoff values are chosen to give a balance between sensitivity and the risk of being overwhelmed by false-positive flags.^[5] This balance, in turn, depends on the different kinds of clinical situations where the cutoffs are used, and hence, different cutoffs are often used at different departments even in the same hospital.^[5]

Techniques in development

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The development of new techniques for monitoring is an advanced and developing field in

In many medical problems, drugs offer temporary relief of symptoms while the root of a medical problem remains unknown without enough data of all our biological systems^[10] . Our body is equipped with sub-systems for the purpose of maintaining balance and self healing functions. Intervention without sufficient data might damage those healing sub systems.^[10] Monitoring medicine fills the gap to prevent diagnosis errors and can assist in future medical research by analyzing all data of many patients.

Examples and applications

The development cycle in medicine is extremely long, up to 20 years, because of the need for U.S. Food and Drug Administration (FDA) approvals, therefore many of monitoring medicine solutions are not available today in conventional medicine.

Blood glucose monitoring

diabetes mellitus type 2 .^[11]

Stress monitoring

Bio sensors may provide warnings when stress levels signs are rising before human can notice it and provide alerts and suggestions.[12] Deep neural network models using photoplethysmography imaging (PPGI) data from mobile cameras can assess stress levels with a high degree of accuracy (86%).^[13]

Serotonin biosensor

Future serotonin biosensors may assist with mood disorders and depression.^[14]

Continuous blood test based nutrition

In the field of

evidence-based nutrition, a lab-on-a-chip implant that can run 24/7 blood tests

may provide a continuous results and a computer can provide nutrition suggestions or alerts.

Psychiatrist-on-a-chip

In clinical brain sciences drug delivery and in vivo Bio-MEMS based biosensors may assist with preventing and early treatment of mental disorders

Epilepsy monitoring

In

epileptic seizure and prevent them with changes of daily life activity like sleep, stress, nutrition and mood management.^[15]

Toxicity monitoring

Smart biosensors may detect toxic materials such mercury and lead and provide alerts.^[16]

See also

• Medical equipment
• Medical test
• MECIF Protocol
• Nanoelectromechanical system
  (NEMS)
• Functional medicine
• Wireless ambulatory ECG

References