Improving the accuracy and efficiency of respiratory rate measurements in children using mobile devices

PLoS One. 2014 Jun 11;9(6):e99266. doi: 10.1371/journal.pone.0099266. eCollection 2014.

Abstract

The recommended method for measuring respiratory rate (RR) is counting breaths for 60 s using a timer. This method is not efficient in a busy clinical setting. There is an urgent need for a robust, low-cost method that can help front-line health care workers to measure RR quickly and accurately. Our aim was to develop a more efficient RR assessment method. RR was estimated by measuring the median time interval between breaths obtained from tapping on the touch screen of a mobile device. The estimation was continuously validated by measuring consistency (% deviation from the median) of each interval. Data from 30 subjects estimating RR from 10 standard videos with a mobile phone application were collected. A sensitivity analysis and an optimization experiment were performed to verify that a RR could be obtained in less than 60 s; that the accuracy improves when more taps are included into the calculation; and that accuracy improves when inconsistent taps are excluded. The sensitivity analysis showed that excluding inconsistent tapping and increasing the number of tap intervals improved the RR estimation. Efficiency (time to complete measurement) was significantly improved compared to traditional methods that require counting for 60 s. There was a trade-off between accuracy and efficiency. The most balanced optimization result provided a mean efficiency of 9.9 s and a normalized root mean square error of 5.6%, corresponding to 2.2 breaths/min at a respiratory rate of 40 breaths/min. The obtained 6-fold increase in mean efficiency combined with a clinically acceptable error makes this approach a viable solution for further clinical testing. The sensitivity analysis illustrating the trade-off between accuracy and efficiency will be a useful tool to define a target product profile for any novel RR estimation device.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cell Phone*
  • Child
  • Female
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Physiologic / instrumentation
  • Monitoring, Physiologic / standards*
  • Respiration*

Grants and funding

WK is supported by the Swiss National Science Foundation (www.snf.ch) and a Grand Challenges Canada Rising Stars in Global Health grant (www.grandchallenges.ca). The research was conducted using internal University funds. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.