The Experts below are selected from a list of 750 Experts worldwide ranked by ideXlab platform
Judith Van Andel - One of the best experts on this subject based on the ideXlab platform.
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multimodal Nocturnal Seizure detection in a residential care setting a long term prospective trial
Neurology, 2018Co-Authors: Johan Arends, Roland D Thijs, Judith Van Andel, Thea Gutter, Constantin Ungureanu, P J M Cluitmans, Johannes P Van Dijk, Francis Tan, Al W De Weerd, Ben VledderAbstract:Objective To develop and prospectively evaluate a method of epileptic Seizure detection combining heart rate and movement. Methods In this multicenter, in-home, prospective, video-controlled cohort study, Nocturnal Seizures were detected by heart rate (photoplethysmography) or movement (3-D accelerometry) in persons with epilepsy and intellectual disability. Participants with >1 monthly major Seizure wore a bracelet (Nightwatch) on the upper arm at night for 2 to 3 months. Major Seizures were tonic-clonic, generalized tonic >30 seconds, hyperkinetic, or others, including clusters (>30 minutes) of short myoclonic/tonic Seizures. The video of all events (alarms, nurse diaries) and 10% completely screened nights were reviewed to classify major (needing an alarm), minor (needing no alarm), or no Seizure. Reliability was tested by interobserver agreement. We determined device performance, compared it to a bed sensor (Emfit), and evaluated the caregivers’ user experience. Results Twenty-eight of 34 admitted participants (1,826 nights, 809 major Seizures) completed the study. Interobserver agreement (major/no major Seizures) was 0.77 (95% confidence interval [CI] 0.65–0.89). Median sensitivity per participant amounted to 86% (95% CI 77%–93%); the false-negative alarm rate was 0.03 per night (95% CI 0.01–0.05); and the positive predictive value was 49% (95% CI 33%–64%). The multimodal sensor showed a better sensitivity than the bed sensor (n = 14, median difference 58%, 95% CI 39%–80%, p Conclusion Combining heart rate and movement resulted in reliable detection of a broad range of Nocturnal Seizures.
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RESEARCH ARTICLE What Makes a Good Home-Based Nocturnal Seizure Detector? A Value Sensitive Design
2016Co-Authors: Judith Van Andel, Hans Van Delden, Frans Leijten, Ghislaine Van ThielAbstract:A device for the in-home detection of Nocturnal Seizures is currently being developed in the Netherlands, to improve care for patients with severe epilepsy. It is recognized that the de-sign of medical technology is not value neutral: perspectives of users and developers are in-fluential in design, and design choices influence these perspectives. However, during development processes, these influences are generally ignored and value-related choices remain implicit and poorly argued for. In the development process of the Seizure detector we aimed to take values of all stakeholders into consideration. Therefore, we performed a parallel ethics study, using “value sensitive design. ” Analysis of stakeholder communication (in meetings and e-mail messages) identified five important values, namely, health, trust, autonomy, accessibility, and reliability. Stakeholders were then asked to give feedback on the choice of these values and how they should be interpreted. In a next step, the values were related to design choices relevant for the device, and then the consequences (risks and benefits) of these choices were investigated. Currently the process of design and test-ing of the device is still ongoing. The device will be validated in a trial in which the identifie
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what makes a good home based Nocturnal Seizure detector a value sensitive design
PLOS ONE, 2015Co-Authors: Judith Van Andel, Frans S S Leijten, Hans Van Delden, Ghislaine J M W Van ThielAbstract:A device for the in-home detection of Nocturnal Seizures is currently being developed in the Netherlands, to improve care for patients with severe epilepsy. It is recognized that the design of medical technology is not value neutral: perspectives of users and developers are influential in design, and design choices influence these perspectives. However, during development processes, these influences are generally ignored and value-related choices remain implicit and poorly argued for. In the development process of the Seizure detector we aimed to take values of all stakeholders into consideration. Therefore, we performed a parallel ethics study, using “value sensitive design.” Analysis of stakeholder communication (in meetings and e-mail messages) identified five important values, namely, health, trust, autonomy, accessibility, and reliability. Stakeholders were then asked to give feedback on the choice of these values and how they should be interpreted. In a next step, the values were related to design choices relevant for the device, and then the consequences (risks and benefits) of these choices were investigated. Currently the process of design and testing of the device is still ongoing. The device will be validated in a trial in which the identified consequences of design choices are measured as secondary endpoints. Value sensitive design methodology is feasible for the development of new medical technology and can help designers substantiate the choices in their design.
Ghislaine J M W Van Thiel - One of the best experts on this subject based on the ideXlab platform.
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what makes a good home based Nocturnal Seizure detector a value sensitive design
PLOS ONE, 2015Co-Authors: Judith Van Andel, Frans S S Leijten, Hans Van Delden, Ghislaine J M W Van ThielAbstract:A device for the in-home detection of Nocturnal Seizures is currently being developed in the Netherlands, to improve care for patients with severe epilepsy. It is recognized that the design of medical technology is not value neutral: perspectives of users and developers are influential in design, and design choices influence these perspectives. However, during development processes, these influences are generally ignored and value-related choices remain implicit and poorly argued for. In the development process of the Seizure detector we aimed to take values of all stakeholders into consideration. Therefore, we performed a parallel ethics study, using “value sensitive design.” Analysis of stakeholder communication (in meetings and e-mail messages) identified five important values, namely, health, trust, autonomy, accessibility, and reliability. Stakeholders were then asked to give feedback on the choice of these values and how they should be interpreted. In a next step, the values were related to design choices relevant for the device, and then the consequences (risks and benefits) of these choices were investigated. Currently the process of design and testing of the device is still ongoing. The device will be validated in a trial in which the identified consequences of design choices are measured as secondary endpoints. Value sensitive design methodology is feasible for the development of new medical technology and can help designers substantiate the choices in their design.
Roland D Thijs - One of the best experts on this subject based on the ideXlab platform.
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multimodal Nocturnal Seizure detection in a residential care setting a long term prospective trial
Neurology, 2018Co-Authors: Johan Arends, Roland D Thijs, Judith Van Andel, Thea Gutter, Constantin Ungureanu, P J M Cluitmans, Johannes P Van Dijk, Francis Tan, Al W De Weerd, Ben VledderAbstract:Objective To develop and prospectively evaluate a method of epileptic Seizure detection combining heart rate and movement. Methods In this multicenter, in-home, prospective, video-controlled cohort study, Nocturnal Seizures were detected by heart rate (photoplethysmography) or movement (3-D accelerometry) in persons with epilepsy and intellectual disability. Participants with >1 monthly major Seizure wore a bracelet (Nightwatch) on the upper arm at night for 2 to 3 months. Major Seizures were tonic-clonic, generalized tonic >30 seconds, hyperkinetic, or others, including clusters (>30 minutes) of short myoclonic/tonic Seizures. The video of all events (alarms, nurse diaries) and 10% completely screened nights were reviewed to classify major (needing an alarm), minor (needing no alarm), or no Seizure. Reliability was tested by interobserver agreement. We determined device performance, compared it to a bed sensor (Emfit), and evaluated the caregivers’ user experience. Results Twenty-eight of 34 admitted participants (1,826 nights, 809 major Seizures) completed the study. Interobserver agreement (major/no major Seizures) was 0.77 (95% confidence interval [CI] 0.65–0.89). Median sensitivity per participant amounted to 86% (95% CI 77%–93%); the false-negative alarm rate was 0.03 per night (95% CI 0.01–0.05); and the positive predictive value was 49% (95% CI 33%–64%). The multimodal sensor showed a better sensitivity than the bed sensor (n = 14, median difference 58%, 95% CI 39%–80%, p Conclusion Combining heart rate and movement resulted in reliable detection of a broad range of Nocturnal Seizures.
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Dead in the Night: Sleep-Wake and Time-Of-Day Influences on Sudden Unexpected Death in Epilepsy
Frontiers Media S.A., 2018Co-Authors: Roland D Thijs, Benton S. Purnell, Gordon F. BuchananAbstract:Sudden unexpected death in epilepsy (SUDEP) is the leading cause of epilepsy-related death in patients with refractory epilepsy. Convergent lines of evidence suggest that SUDEP occurs due to Seizure induced perturbation of respiratory, cardiac, and electrocerebral function as well as potential predisposing factors. It is consistently observed that SUDEP happens more during the night and the early hours of the morning. The aim of this review is to discuss evidence from patient cases, clinical studies, and animal research which is pertinent to the Nocturnality of SUDEP. There are a number of factors which might contribute to the nighttime predilection of SUDEP. These factors fall into four categories: influences of (1) being unwitnessed, (2) lying prone in bed, (3) sleep-wake state, and (4) circadian rhythms. During the night, Seizures are more likely to be unwitnessed; therefore, it is less likely that another person would be able to administer a lifesaving intervention. Patients are more likely to be prone on a bed following a Nocturnal Seizure. Being prone in the accouterments of a bed during the postictal period might impair breathing and increase SUDEP risk. Sleep typically happens at night and Seizures which emerge from sleep might be more dangerous. Lastly, there are circadian changes to physiology during the night which might facilitate SUDEP. These possible explanations for the Nocturnality of SUDEP are not mutually exclusive. The increased rate of SUDEP during the night is likely multifactorial involving both situational factors, such as being without a witness and prone, and physiological changes due to the influence of sleep and circadian rhythms. Understanding the causal elements in the Nocturnality of SUDEP may be critical to the development of effective preventive countermeasures
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value of video monitoring for Nocturnal Seizure detection in a residential setting
Epilepsia, 2016Co-Authors: Marije Van Der Lende, Fieke M E Cox, Gerhard H Visser, Josemir W Sander, Roland D ThijsAbstract:SummaryObjective Following a sudden death at a residential care unit, the Dutch Health and Care Inspectorate advised intensification of the use of video monitoring (VM) at the unit. We assessed whether VM resulted in increased identification of Seizures that required clinical intervention. Methods The unit provides care for 340 individuals with refractory epilepsy and severe learning disabilities. Acoustic detection systems (ADSs) cover all individuals; 37 people also have a bed motion sensor (BMS) and 46 people with possible Nocturnal Seizures are now monitored by VM. During a 6-month period, in all cases of a suspected Seizure we asked the caregivers to specify which device alerted them and to indicate whether this led to an intervention. Staff costs of VM were estimated using payroll information. Results We identified 1,208 Seizures in 37 individuals: 4 had no Nocturnal Seizures and 393 (33%) Seizures were seen only on video. In 169 (14%) of 1,208 Seizures an intervention was made and this included 39 (10%) of 393 Seizures seen only on video. When compared to Seizures observed with an ADS or BMS, Seizures seen only on video were more often tonic Seizures (71% vs. 22%, p < 0.001) and occurred mostly in the beginning or at the end of the night (40% vs. 26%, p < 0.001). The extra staff costs of monitoring was 7,035 euro per Seizure seen only on video and leading to an intervention. Significance VM facilitates Nocturnal surveillance, but the costs are high. This underscores the need for development of reliable Seizure detection devices.
Hans Van Delden - One of the best experts on this subject based on the ideXlab platform.
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RESEARCH ARTICLE What Makes a Good Home-Based Nocturnal Seizure Detector? A Value Sensitive Design
2016Co-Authors: Judith Van Andel, Hans Van Delden, Frans Leijten, Ghislaine Van ThielAbstract:A device for the in-home detection of Nocturnal Seizures is currently being developed in the Netherlands, to improve care for patients with severe epilepsy. It is recognized that the de-sign of medical technology is not value neutral: perspectives of users and developers are in-fluential in design, and design choices influence these perspectives. However, during development processes, these influences are generally ignored and value-related choices remain implicit and poorly argued for. In the development process of the Seizure detector we aimed to take values of all stakeholders into consideration. Therefore, we performed a parallel ethics study, using “value sensitive design. ” Analysis of stakeholder communication (in meetings and e-mail messages) identified five important values, namely, health, trust, autonomy, accessibility, and reliability. Stakeholders were then asked to give feedback on the choice of these values and how they should be interpreted. In a next step, the values were related to design choices relevant for the device, and then the consequences (risks and benefits) of these choices were investigated. Currently the process of design and test-ing of the device is still ongoing. The device will be validated in a trial in which the identifie
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what makes a good home based Nocturnal Seizure detector a value sensitive design
PLOS ONE, 2015Co-Authors: Judith Van Andel, Frans S S Leijten, Hans Van Delden, Ghislaine J M W Van ThielAbstract:A device for the in-home detection of Nocturnal Seizures is currently being developed in the Netherlands, to improve care for patients with severe epilepsy. It is recognized that the design of medical technology is not value neutral: perspectives of users and developers are influential in design, and design choices influence these perspectives. However, during development processes, these influences are generally ignored and value-related choices remain implicit and poorly argued for. In the development process of the Seizure detector we aimed to take values of all stakeholders into consideration. Therefore, we performed a parallel ethics study, using “value sensitive design.” Analysis of stakeholder communication (in meetings and e-mail messages) identified five important values, namely, health, trust, autonomy, accessibility, and reliability. Stakeholders were then asked to give feedback on the choice of these values and how they should be interpreted. In a next step, the values were related to design choices relevant for the device, and then the consequences (risks and benefits) of these choices were investigated. Currently the process of design and testing of the device is still ongoing. The device will be validated in a trial in which the identified consequences of design choices are measured as secondary endpoints. Value sensitive design methodology is feasible for the development of new medical technology and can help designers substantiate the choices in their design.
Ben Vledder - One of the best experts on this subject based on the ideXlab platform.
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multimodal Nocturnal Seizure detection in a residential care setting a long term prospective trial
Neurology, 2018Co-Authors: Johan Arends, Roland D Thijs, Judith Van Andel, Thea Gutter, Constantin Ungureanu, P J M Cluitmans, Johannes P Van Dijk, Francis Tan, Al W De Weerd, Ben VledderAbstract:Objective To develop and prospectively evaluate a method of epileptic Seizure detection combining heart rate and movement. Methods In this multicenter, in-home, prospective, video-controlled cohort study, Nocturnal Seizures were detected by heart rate (photoplethysmography) or movement (3-D accelerometry) in persons with epilepsy and intellectual disability. Participants with >1 monthly major Seizure wore a bracelet (Nightwatch) on the upper arm at night for 2 to 3 months. Major Seizures were tonic-clonic, generalized tonic >30 seconds, hyperkinetic, or others, including clusters (>30 minutes) of short myoclonic/tonic Seizures. The video of all events (alarms, nurse diaries) and 10% completely screened nights were reviewed to classify major (needing an alarm), minor (needing no alarm), or no Seizure. Reliability was tested by interobserver agreement. We determined device performance, compared it to a bed sensor (Emfit), and evaluated the caregivers’ user experience. Results Twenty-eight of 34 admitted participants (1,826 nights, 809 major Seizures) completed the study. Interobserver agreement (major/no major Seizures) was 0.77 (95% confidence interval [CI] 0.65–0.89). Median sensitivity per participant amounted to 86% (95% CI 77%–93%); the false-negative alarm rate was 0.03 per night (95% CI 0.01–0.05); and the positive predictive value was 49% (95% CI 33%–64%). The multimodal sensor showed a better sensitivity than the bed sensor (n = 14, median difference 58%, 95% CI 39%–80%, p Conclusion Combining heart rate and movement resulted in reliable detection of a broad range of Nocturnal Seizures.