A better way to evaluate remote monitoring programs in chronic disease care: receiver operating characteristic analysis.

Abstract Background: This foundational study applies the process of receiver operating characteristic (ROC) analysis to evaluate utility and predictive value of a disease management (DM) model that uses RM devices for chronic obstructive pulmonary disease (COPD). The literature identifies a need for a more rigorous method to validate and quantify evidence-based value for remote monitoring (RM) systems being used to monitor persons with a chronic disease. ROC analysis is an engineering approach widely applied in medical testing, but that has not been evaluated for its utility in RM. Classifiers (saturated peripheral oxygen [SPO2], blood pressure [BP], and pulse), optimum threshold, and predictive accuracy are evaluated based on patient outcomes. Materials and Methods: Parametric and nonparametric methods were used. Event-based patient outcomes included inpatient hospitalization, accident and emergency, and home health visits. Statistical analysis tools included Microsoft (Redmond, WA) Excel® and MedCalc® (...

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