A Personal Health System for Self-Management of Congestive Heart Failure (HeartMan): Development, Technical Evaluation, and Proof-of-Concept Randomized Controlled Trial

Mitja Lugtrek*, Marko Bohanec, Carlos Cavero Barca, Maria Costanza Ciancarelli, Els Clays, Amos Adeyemo Dawodu, Jan Derboven, Delphine De Smedt, Erik Dovganl, Jure Lampe, Flavia Marino, Miha Mlakar, Giovanni Pioggia, Paolo Emilio Puddu, Juan Mario Rodriguez, Michele Schiariti, Gagper Slapnicar, Karin Slegers, Gennaro Tartarisco, Jakob ValicAljoga Vodopija

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background: Congestive heart failure (CHF) is a disease that requires complex management involving multiple medications, exercise, and lifestyle changes. It mainly affects older patients with depression and anxiety, who commonly find management difficult. Existing mobile apps supporting the self-management of CHF have limited features and are inadequately validated.

Objective: The HeartMan project aims to develop a personal health system that would comprehensively address CHF self-management by using sensing devices and artificial intelligence methods. This paper presents the design of the system and reports on the accuracy of its patient-monitoring methods, overall effectiveness, and patient perceptions.

Methods: A mobile app was developed as the core of the HeartMan system, and the app was connected to a custom wristband and cloud services. The system features machine learning methods for patient monitoring: continuous blood pressure (BP) estimation, physical activity monitoring, and psychological profile recognition. These methods feed a decision support system that provides recommendations on physical health and psychological support. The system was designed using a human-centered methodology involving the patients throughout development. It was evaluated in a proof-of-concept trial with 56 patients.

Results: Fairly high accuracy of the patient-monitoring methods was observed. The mean absolute error of BP estimation was 9.0 mm Hg for systolic BP and 7.0 mm Hg for diastolic BP. The accuracy of psychological profile detection was 88.6%. The F-measure for physical activity recognition was 71%. The proof-of-concept clinical trial in 56 patients showed that the HeartMan system significantly improved self-care behavior (P=.02), whereas depression and anxiety rates were significantly reduced (P

Conclusions: The HeartMan project combined a range of advanced technologies with human-centered design to develop a complex system that was shown to help patients with CHF. More psychological than physical benefits were observed.

Original languageEnglish
Article number24501
Number of pages19
JournalJMIR Medical Informatics
Volume9
Issue number3
DOIs
Publication statusPublished - Mar 2021

Keywords

  • congestive heart failure
  • personal health system
  • mobile application
  • mobile phone
  • wearable electronic devices
  • decision support techniques
  • psychological support
  • human centered design

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