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Article ; Online: Cost-utility Analysis of Home Mechanical Ventilation Compared to Hospital Settings in Patients with Amyotrophic Lateral Sclerosis

Gajdoš Ondřej / Rožánek Martin / Donin Gleb / Kamenský Vojtěch

Current Directions in Biomedical Engineering, Vol 8, Iss 2, Pp 149-

2022 Volume 152

Abstract: Amyotrophic lateral sclerosis is a progressive neuromuscular disease. Mechanical ventilation delays death and use at home can reduce costs and increase quality of life. The aim of the study is comparison of home mechanical ventilation with mechanical ... ...

Abstract	Amyotrophic lateral sclerosis is a progressive neuromuscular disease. Mechanical ventilation delays death and use at home can reduce costs and increase quality of life. The aim of the study is comparison of home mechanical ventilation with mechanical ventilation in a healthcare facility for adult patients with amyotrophic lateral sclerosis from the societal perspective in the Czech Republic. The Markov model from a previous Czech study was used and updated with data revelant to the societal perspective, which was obtained from the literature and opinions of experts from companies dealing with home mechanical ventilation. The cost-utility analysis was carried out over a time horizont of 10 years and results were presented in incremental cost-utility ratio. Accuracy and validity were verified by probabilistic sensitivity analysis and scenario analysis. The cumulative costs of home mechanical ventilation are CZK 6,116,394 and the cumulative utilities of home mechanical ventilation are CZK 8,195,848. The cumulative utilities of home mechanical ventilation are 3.55 QALY and the cumulative utilities of mechanical ventilation are 3.78 QALY. The incremental cost-utility ratio is CZK 9,094,042. Probabilistic sensitivity analysis and scenario analysis do not show significant changes. Home mechanical ventilation may be considered cost-effective for patients with amyotrophic lateral sclerosis from the societal perspective.
Keywords	home mechanical ventilation ; amyotrophic lateral sclerosis ; cost-utility analysis ; markov model ; Medicine ; R
Subject code	690
Language	English
Publishing date	2022-09-01T00:00:00Z
Publisher	De Gruyter
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effect of artifacts upon the pressure reactivity index.

Rozanek, Martin / Skola, Josef / Horakova, Lenka / Trukhan, Valeriia

Scientific reports

2022 Volume 12, Issue 1, Page(s) 15131

Abstract: The pressure reactivity index (PRx) is a parameter for the assessment of cerebrovascular autoregulation, but its calculation is affected by artifacts in the source biosignals-intracranial pressure (ICP) and arterial blood pressure. We sought to describe ... ...

Abstract	The pressure reactivity index (PRx) is a parameter for the assessment of cerebrovascular autoregulation, but its calculation is affected by artifacts in the source biosignals-intracranial pressure (ICP) and arterial blood pressure. We sought to describe the most common short-duration artifacts and their effect on the PRx. A retrospective analysis of 935 h of multimodal monitoring data was conducted, and five types of artifacts, characterized by their shape, duration, and amplitude, were identified: rectangular, fast impulse, isoline drift, saw tooth, and constant ICP value. Subsequently, all types of artifacts were mathematically modeled and inserted into undisturbed segments of biosignals. Fast impulse, the most common artifact, did not alter the PRx index significantly when inserted into one or both signals. Artifacts present in one signal exceeded the threshold PRx in less than 5% of samples, except for isoline drift. Compared to that, the shortest rectangular artifact inserted into both signals changed PRx to a value above the set threshold in 55.4% of cases. Our analysis shows that the effect of individual artifacts on the PRx index is variable, depending on their occurrence in one or both signals, duration, and shape. This different effect suggests that potentially not all artifacts need to be removed.
MeSH term(s)	Arterial Pressure/physiology ; Artifacts ; Brain Injuries, Traumatic ; Cerebrovascular Circulation/physiology ; Humans ; Intracranial Pressure/physiology ; Retrospective Studies
Language	English
Publishing date	2022-09-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-022-19101-y
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Article ; Online: Tidal volume significantly affects oxygenation in healthy pigs during high-frequency oscillatory ventilation compared to conventional ventilation.

Roubík, Karel / Ráfl, Jakub / Rožánek, Martin / Kudrna, Petr / Mlček, Mikuláš

Biomedical engineering online

2022 Volume 21, Issue 1, Page(s) 14

Abstract: Background: The role of high-frequency oscillatory ventilation (HFOV) has long been debated. Numerous studies documented its benefits, whereas several more recent studies did not prove superiority of HFOV over protective conventional mechanical ... ...

Abstract	Background: The role of high-frequency oscillatory ventilation (HFOV) has long been debated. Numerous studies documented its benefits, whereas several more recent studies did not prove superiority of HFOV over protective conventional mechanical ventilation (CV). One of the accepted explanations is that CV and HFOV act differently, including gas exchange. Methods: To investigate a different level of coupling or decoupling between oxygenation and carbon dioxide elimination during CV and HFOV, we conducted a prospective crossover animal study in 11 healthy pigs. In each animal, we found a normocapnic tidal volume (V Results: Changes in P Conclusion: A change in P
MeSH term(s)	Animals ; High-Frequency Ventilation ; Lung ; Prospective Studies ; Pulmonary Gas Exchange ; Swine ; Tidal Volume
Language	English
Publishing date	2022-02-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2084374-4
ISSN	1475-925X ; 1475-925X
ISSN (online)	1475-925X
ISSN	1475-925X
DOI	10.1186/s12938-022-00984-x
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Article: Cost-Utility Analysis of Home Mechanical Ventilation in Patients with Amyotrophic Lateral Sclerosis.

Gajdoš, Ondřej / Rožánek, Martin / Donin, Gleb / Kamenský, Vojtěch

Healthcare (Basel, Switzerland)

2021 Volume 9, Issue 2

Abstract: Amyotrophic lateral sclerosis is a disease with rapid progression. The use of mechanical ventilation helps to manage symptoms and delays death. Use in a home environment could reduce costs and increase quality of life. The aim of this study is a cost- ... ...

Abstract	Amyotrophic lateral sclerosis is a disease with rapid progression. The use of mechanical ventilation helps to manage symptoms and delays death. Use in a home environment could reduce costs and increase quality of life. The aim of this study is a cost-utility analysis of home mechanical ventilation in adult patients with amyotrophic lateral sclerosis from the perspective of healthcare payers in the Czech Republic. The study evaluates home mechanical ventilation (HMV) and mechanical ventilation (MV) in a healthcare facility. A Markov model was compiled for evaluation in a timeframe of 10 years. Model parameters were obtained from the literature and opinions of experts from companies dealing with home care and home mechanical ventilation. The cost-utility analysis was carried out at the end of the study and results are presented in incremental cost-utility ratio (ICUR) using quality-adjusted life-years. Uncertainty was assessed by one-way sensitivity analysis and scenario analysis. The cumulative costs of HMV are CZK 1,877,076 and the cumulative costs of the MV are CZK 7,386,629. The cumulative utilities of HMV are 12.57 quality-adjusted life year (QALY) and the cumulative utilities of MV are 11.32 QALY. The ICUR value is CZK-4,403,259. The results of this study suggest that HMV is cost effective.
Language	English
Publishing date	2021-02-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2721009-1
ISSN	2227-9032
ISSN	2227-9032
DOI	10.3390/healthcare9020142
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Article ; Online: Evaluation of Leading Smartwatches for the Detection of Hypoxemia: Comparison to Reference Oximeter.

Walzel, Simon / Mikus, Radek / Rafl-Huttova, Veronika / Rozanek, Martin / Bachman, Thomas E / Rafl, Jakub

Sensors (Basel, Switzerland)

2023 Volume 23, Issue 22

Abstract: Although smartwatches are not considered medical devices, experimental validation of their accuracy in detecting hypoxemia is necessary due to their potential use in monitoring conditions manifested by a prolonged decrease in peripheral blood oxygen ... ...

Abstract	Although smartwatches are not considered medical devices, experimental validation of their accuracy in detecting hypoxemia is necessary due to their potential use in monitoring conditions manifested by a prolonged decrease in peripheral blood oxygen saturation (SpO
MeSH term(s)	Humans ; Reproducibility of Results ; Oximetry/methods ; Oxygen ; Hypoxia/diagnosis ; Pulmonary Disease, Chronic Obstructive
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2023-11-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s23229164
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Article ; Online: Adherence to application technique of inhaled corticosteroid in patients with asthma and COVID-19 improves outcomes.

Tichopád, Aleš / Žigmond, Jan / Jeseňák, Miloš / Solovič, Ivan / Breciková, Katarína / Rybář, Marian / Rožánek, Martin / Sedlák, Vratislav

BMJ open respiratory research

2024 Volume 11, Issue 1

Abstract: Background: Inhaled corticosteroids have been widely reported as a preventive measure against the development of severe forms of COVID-19 not only in patients with asthma.: Methods: In 654 Czech and Slovak patients with asthma who developed COVID-19, ...

Abstract	Background: Inhaled corticosteroids have been widely reported as a preventive measure against the development of severe forms of COVID-19 not only in patients with asthma. Methods: In 654 Czech and Slovak patients with asthma who developed COVID-19, we investigated whether the correct use of inhaler containing corticosteroids was associated with a less severe course of COVID-19 and whether this had an impact on the need for hospitalisation, measurable lung functions and quality of life (QoL). Results: Of the studied cohort 51.4% had moderate persistent, 29.9% mild persistent and 7.2% severe persistent asthma. We found a significant adverse effect of poor inhaler adherence on COVID-19 severity (p=0.049). We also observed a lower hospitalisation rate in patients adequately taking the inhaler with OR of 0.83. Vital capacity and forced expiratory lung volume deterioration caused by COVID-19 were significantly reversed, by approximately twofold to threefold, in individuals who inhaled correctly. Conclusion: Higher quality of inhalation technique of corticosteroids measured by adherence to an inhaled medication application technique (A-AppIT) score had a significant positive effect on reversal of the vital capacity and forced expiratory lung volume in 1 s worsening (p=0.027 and p<0.0001, respectively) due to COVID-19. Scoring higher in the A-AppIT was also associated with significantly improved QoL. All measured variables concordantly and without exception showed a positive improvement in response to better adherence. We suggest that corticosteroids provide protection against the worsening of lungs in patients with COVID-19 and that correct and easily assessable adherence to corticosteroids with appropriate inhalation technique play an important role in preventing severe form of COVID-19.
MeSH term(s)	Humans ; Quality of Life ; COVID-19 ; Asthma/drug therapy ; Adrenal Cortex Hormones ; Forced Expiratory Volume
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2024-01-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2736454-9
ISSN	2052-4439 ; 2052-4439
ISSN (online)	2052-4439
ISSN	2052-4439
DOI	10.1136/bmjresp-2023-001874
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Article ; Online: Dependence of SpO2 signal noise on the pulse oximeter averaging time

Rafl-Huttova Veronika / Hlavac Vit / Rafl Jakub / Rozanek Martin

Current Directions in Biomedical Engineering, Vol 7, Iss 2, Pp 351-

2021 Volume 354

Abstract: A model of the pulse oximeter, which consists of a transfer function between arterial and peripheral blood oxygen saturation (SpO2) and the noise typical for SpO2 records, is an important part of a mathematical model of oxygenation in neonates that is ... ...

Abstract	A model of the pulse oximeter, which consists of a transfer function between arterial and peripheral blood oxygen saturation (SpO2) and the noise typical for SpO2 records, is an important part of a mathematical model of oxygenation in neonates that is designed to test and compare different algorithms of oxygen control. The noise level in the SpO2 signal is affected by the averaging time setting of the pulse oximeter. This study aimed to characterize the noise level in the SpO2 signal at the set pulse oximeter averaging times of 2- 4, 8, and 16 seconds. We evaluated SpO2 records of 17 healthy volunteers who underwent a laboratory experiment in which they evoked different types of artifacts. The noise level in the SpO2 signal was characterized by two parameters, the deviation of SpO2 from the true value and the SpO2 time stability, defined as the interval during which the measured SpO2 value remained unchanged. Statistical properties of the noise level for the three averaging times were represented by normalized histograms of both the parameters and varied according to the type of artifact. With motion artifacts, the SpO2 readings deviated from the true value by more than ±2% SpO2 in 10%, 7%, or 5% of the measurements when the set averaging time was 2-4 s, 8 s, or 16 s. The length of the interval over which the SpO2 value remained unchanged was most frequently 2 seconds for all set averaging times. Implementation of the noise characteristics into the computer model of oxygenation in neonates will allow more faithful simulations of the output SpO2 signal that better match clinical observations.
Keywords	computer model ; peripheral oxygen saturation ; averaging time ; noise model ; Medicine ; R
Subject code	612
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	De Gruyter
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Commercial smartwatch with pulse oximeter detects short-time hypoxemia as well as standard medical-grade device: Validation study.

Rafl, Jakub / Bachman, Thomas E / Rafl-Huttova, Veronika / Walzel, Simon / Rozanek, Martin

Digital health

2022 Volume 8, Page(s) 20552076221132127

Abstract: Objective: We investigated how a commercially available smartwatch that measures peripheral blood oxygen saturation (SpO: Methods: We recruited 24 healthy participants. Each participant wore a smartwatch (Apple Watch Series 6) on the left wrist and a ...

Abstract	Objective: We investigated how a commercially available smartwatch that measures peripheral blood oxygen saturation (SpO Methods: We recruited 24 healthy participants. Each participant wore a smartwatch (Apple Watch Series 6) on the left wrist and a pulse oximeter sensor (Masimo Radical-7) on the left middle finger. The participants breathed via a breathing circuit with a three-way non-rebreathing valve in three phases. First, in the 2-minute initial stabilization phase, the participants inhaled the ambient air. Then in the 5-minute desaturation phase, the participants breathed the oxygen-reduced gas mixture (12% O Results: There were 642 individual pairs of SpO Conclusions: Apple Watch Series 6 can reliably detect states of reduced blood oxygen saturation with SpO Trial registration: ClinicalTrials.gov NCT04780724.
Language	English
Publishing date	2022-10-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2819396-9
ISSN	2055-2076
ISSN	2055-2076
DOI	10.1177/20552076221132127
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Article ; Online: Sensitivity analysis of a computer model of neonatal oxygen transport

Huttova Veronika / Rafl Jakub / Bachman Thomas E. / Kudrna Petr / Rozanek Martin / Möller Knut

Current Directions in Biomedical Engineering, Vol 6, Iss 3, Pp 99-

2020 Volume 102

Abstract: Computer models of neonatal oxygenation could serve as a tool for a comprehensive comparison of closed-loop automated oxygen control systems. The behaviour of such models depends, besides the input data of the inspired fraction of oxygen and the ... ...

Abstract	Computer models of neonatal oxygenation could serve as a tool for a comprehensive comparison of closed-loop automated oxygen control systems. The behaviour of such models depends, besides the input data of the inspired fraction of oxygen and the premature infant's breath pattern, on internal parameters of the model. The aim of this study was to perform a sensitivity analysis of a computer model of neonatal oxygen transport to clarify the influence of its internal physiological parameters on the output signal of peripheral oxygen saturation (SpO2). We performed a multi-parameter sensitivity analysis using Monte Carlo simulations for randomly generated values of eight internal parameters. The influence on the model output SpO2 signal was evaluated using five characteristics of the output signal. The relations between the parameters and the output characteristics were displayed using scatter plots and analysed by linear correlation, standardized regression, and partial correlation. The main result of the study is that in our model the oxygen consumption in the tissue and the cardiac output have the greatest influence on the SpO2 drop and minimal SpO2 value during simulated desaturation. The rate of development of desaturation and its duration are most affected by the diffusion resistance of the alveolar-capillary membrane. The results of the sensitivity analysis will help to optimize the performance of the computer model of neonatal oxygen transport.
Keywords	automated control ; computer model ; peripheral oxygen saturation ; preterm infant ; sensitivity analysis ; Medicine ; R
Subject code	551
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	De Gruyter
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: The way to data: opinions and recommendations for the provision of health data for secondary use.

Tichopád, Aleš / Augustynek, Martin / Beneš, Jiří / Dlouhý, Martin / Doležal, Tomáš / Horáková, Dana / Kršek, Michal / Lhotska, Lenka / Panzner, Petr / Penhaker, Marek / Petr, Miroslav / Piťha, Jan / Popesko, Boris / Rožánek, Martin / Táborský, Miloš / Vrablík, Michal

Casopis lekaru ceskych

2023 Volume 162, Issue 2-3, Page(s) 61–66

Abstract: Healthcare data held by state-run organisations is a valuable intangible asset for society. Its use should be a priority for its administrators and the state. A completely paternalistic approach by administrators and the state is undesirable, however ... ...

Title translation	Cesta k datům: Stanoviska a doporučení pro poskytování zdravotních dat pro sekundární využití.
Abstract	Healthcare data held by state-run organisations is a valuable intangible asset for society. Its use should be a priority for its administrators and the state. A completely paternalistic approach by administrators and the state is undesirable, however much it aims to protect the privacy rights of persons registered in databases. In line with European policies and the global trend, these measures should not outweigh the social benefit that arises from the analysis of these data if the technical possibilities exist to sufficiently protect the privacy rights of individuals. Czech society is having an intense discussion on the topic, but according to the authors, it is insufficiently based on facts and lacks clearly articulated opinions of the expert public. The aim of this article is to fill these gaps. Data anonymization techniques provide a solution to protect individuals' privacy rights while preserving the scientific value of the data. The risk of identifying individuals in anonymised data sets is scalable and can be minimised depending on the type and content of the data and its use by the specific applicant. Finding the optimal form and scope of deidentified data requires competence and knowledge on the part of both the applicant and the administrator. It is in the interest of the applicant, the administrator, as well as the protected persons in the databases that both parties show willingness and have the ability and expertise to communicate during the application and its processing.
MeSH term(s)	Humans ; Data Anonymization ; Confidentiality ; Privacy
Language	English
Publishing date	2023-06-21
Publishing country	Czech Republic
Document type	Journal Article
ZDB-ID	413441-2
ISSN	1805-4420 ; 0008-7335
ISSN (online)	1805-4420
ISSN	0008-7335
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