Phoenix Ambulatory Blood Pressure Monitor Project
9/10/2006 Meeting Notes




Status Review:

* Larry Akre joined us.
* Germaine: New papers showing how to get arterial stiffness by measuring blood pressure using a regression between systolic and diastolic pressure seeking the resting point, plot measurements in diastolic-systolic pressure pairs, they form a line and calculating stiffness=1-slope. Think it was in one of the hypertension journals, as a set of three papers, two papers and one editorial. Chris said it is important that Phoenix comply or establish a standard so that our data can be used for such purposes through comparison with other measurement sources.
* Mike: working on a conceptual model for the pulse wave flow in the artery, so we understand what we are measuring, especially since Franz said the diastolic is very important to get right. Wants to understand the cuff, what it is measuring, what it means and what is the conceptual model, and the relationship between the restricted flow model and the unrestricted flow model.
* Gerry: Been practicing primary care, computer support for clinical care, error reduction from automated systems in research system isn't replicated in commercial systems, and they may induce new errors.
* Dave: Carl did some further experimenting with LabView, some missing data due to data dropouts, the device driver or a system tuning issue. The Sensor Team is meeting next Sunday, 9/17, 1 p.m. in the lab, 2-110 EECS.
* Bob Schlentz: has been thinking about measuring the diastolic blood pressure. May be able to apply the systolic blood pressure techniques to the diastolic by filtering to locate the time at which the diastolic occurs. Germaine suggested that it might be easier to get the diastolic from a model. Started
* Chris: Completed papers on Privacy and HIPAA for publication, citing Phoenix as the organization citation. In 4 weeks, hope to have a structure for a presentation and 8 weeks the presentation on Germaine's Data Analysis Methods.
* Larry: Final-tested program was sent to Germaine in, Sphymochron ver 2, six weeks ago, looking for her feedback. Germaine wants to use it on several data sets. It won't happen until after China, 9/28, the meeting after that, possibly Oct 8th. He has a couple of questions, 1) Version Control, Sourceforge, ask Dennis, 2) for the Quality System for the Sphymochron SW, are we ready to go with it. Germaine has IRB approval for data collection. Does Phoenix need a quality system for work in this area? Grand Avenue Avenue Software has a potential solution.

Clinical Information Mini-topic - Gerry Werth

Position Coded Data
Physician shorthand Notation for Lab Results.

* Position Coded Data
* Position Coded Electrolytes
* Position Coded Blood Counts
* PatientKeeper: example.

Position-Coded Data
* Physicians use position-co9ded shorthand notation to record olab results, Electrolytes
- Lytes / CBC / ABG
(This may be an under-researched area of user interface.)
* This shorthand is known and used frequently by all medical students and resident physicians (at least in the US).
* There is no formal name for this notation.
* This notation is almost never used by electronic clinical record systems.

Position-Coded Electrolytes
* Chem 7 : Basic Metabolic Profile
Na | C1 | BUN /
------------ Glucose
K | HCO3 | Cr \

1403 | 101 | 14 /
------------- 110
4.2 | 28 | 0.7\

* CBC : Com;lete Blood Count
\ Hgb /
WBC --------- Plateletes
/ Hct \

\ Hgb /
Plt ------------- WBC S% B% L% ...
/ Hct \

\ 12.6 /
220 -------- 7.6 S 65 B8 L23
/ 35 \

PatientKeeper : example

Bioinformatic Issues
* This is not formally discussed.
* It carries a lot of information.
* Practitioners cannot understand it without laying it out in this pattern.
* Why is this so useful, distinctive?
* Are there cognitive psychological characteristics of this that should be incorporated in other bioinformatic displays?

Next Phoenix Project Coordinating Team Meeting: Sunday, September 24th at 2:30 p.m. in Mayo 748



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