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March 21, 2011,[object Object],Copyright 2011: Team Triangle,[object Object],Kinect Abnormal Movement Assessment System (KAMAS),[object Object],Team TriangleClaus C Becker, MSc, PhD, MBA Greg Borenstein, MPS (candidate) Johnny Hujol, MSCS Daniel Karlin, MD, MA Greg Kust, MPH, MBA,[object Object]
March 21, 2011,[object Object],Copyright 2011: Team Triangle,[object Object],Executive Summary,[object Object],Conceived and developed in 8 hours at Boston Code-a-Thon ,[object Object],Symptomatic diseases with excess of movement,[object Object],Microsoft Kinect-based application to automate assessment ,[object Object],Home-grown and integrated open-source code,[object Object],Multiple stakeholder perspectives (clinicians, payers, patients),[object Object],Framework for future development,[object Object]
March 21, 2011,[object Object],Copyright 2011: Team Triangle,[object Object],Overview of Movement Disorders,[object Object],Focused on hyperkinetic movement disorders,[object Object],Dyskinesias, Choreas, Akathesias,[object Object],Neurological conditions affecting speed, fluency, and ease of movement; and the ability to stop movement,[object Object],KAMAS matches & complements existing clinical practices for the diagnosis & assessment of movement disorders,[object Object]
March 21, 2011,[object Object],Chorea van Sydenham,[object Object],http://www.youtube.com/watch?v=RsIQFeYOkAg,[object Object]
March 21, 2011,[object Object],Copyright 2011: Team Triangle,[object Object],Prevalence and Severity ,[object Object]
March 21, 2011,[object Object],Copyright 2011: Team Triangle,[object Object],Problem in Current Practice,[object Object],Inadequate assessment of movement disorders (AIMS test),[object Object],Standardization,[object Object],Frequency,[object Object],Inter-rater reliability poor, masking progression ,[object Object],Disease progression, on a more granular & temporal basis,[object Object],Current assessment every 3-6 months, at best,[object Object],Gaps between assessments allow development of severe disease ,[object Object],Response to therapy (e.g. efficacy, dosing, adverse events),[object Object],Adherence to therapy,[object Object],Remote monitoring,[object Object]
March 21, 2011,[object Object],Copyright 2011: Team Triangle,[object Object],Our Approach,[object Object],Leverage MS Kinect,[object Object],Processing application using PrimeSense’s OpenNI middleware and OSCeleton library ,[object Object],Tracks spatial hand & knee movement ,[object Object],Calculates score based upon degree of involuntary motion,[object Object],Clinical scorecard: Severity score compared to baseline,[object Object],MPR* + Patient self-report + KAMAS** = Health Score ,[object Object], *MPR: Medicine possession ratio,[object Object]
March 21, 2011,[object Object],Copyright 2011: Team Triangle,[object Object],KAMAS Demonstration,[object Object]
March 21, 2011,[object Object],Copyright 2011: Team Triangle,[object Object],Clinical Benefits ,[object Object],Patient,[object Object],Less disruptive / more convenient,[object Object],Engaged participation and self care,[object Object],Improved care,[object Object],Closed feedback loops,[object Object],Earlier detection of non-response and disease progression,[object Object],Provider,[object Object],Clinical effectiveness & dose modification,[object Object],Adherence measures (prescription status),[object Object],Time efficient,[object Object],Reliable, quantifiable scoring,[object Object],EMR integration (video & data),[object Object],At home or in clinic,[object Object]
March 21, 2011,[object Object],Copyright 2011: Team Triangle,[object Object],Payer Benefits,[object Object],Less $ waste (quick detection of ineffective therapy) ,[object Object],Avoid a lifetime of advanced disease costs,[object Object],Reduce risk of expensive side effects and irreversible disease,[object Object],Reduce hospitalizations and all cause total costs (1),[object Object],Clinical assessment without an office visit,[object Object],Telemedicine compatible,[object Object],Low cost, transparent, reproducible, auditable,[object Object],Start-up costs not capital intensive,[object Object],“Efforts to promote medication adherence…may lead to cost savings for managed care systems”3,[object Object],1) Delea et al. CNS Drugs. 2011 Jan 1;25(1):53-66,  2) Wei et al. Amer J Ger Pharm.  2010 Aug;8(4):384-394, 3) Davis KL et al. Prevalence and cost of medication nonadherence in Parkinson's disease: evidence from administrative claims data. Mov Disord. 2010 Mar 15;25(4):474-80.,[object Object]
March 21, 2011,[object Object],Copyright 2011: Team Triangle,[object Object],Issues we wrestled with,[object Object],Short timeline (ad hoc project),[object Object],Kinect development environment rapidly changing,[object Object],Investment needed to further validate and develop for clinical use ,[object Object]
March 21, 2011,[object Object],Copyright 2011: Team Triangle,[object Object],Next Steps,[object Object],With interest from investors, refine software to include directions, progression measures, and increased range of movements,[object Object],Data archiving and security compliance,[object Object],Improve statistical treatment of data,[object Object],Clinical validation possible at Tufts Medical Center,[object Object]
March 21, 2011,[object Object],Copyright 2011: Team Triangle,[object Object],References,[object Object],http://www.neurologychannel.com/movementdisorders/overview-of-movement-disorders.shtml,[object Object],http://www.nlm.nih.gov/medlineplus/movementdisorders.html,[object Object],http://www.atlantapsychiatry.com/forms/AIMS.pdf,[object Object],http://www.webmd.com,[object Object],Delea et al. CNS Drugs. 2011 Jan 1;25(1):53-66,  ,[object Object],Wei et al. Amer J Ger Pharm.  2010 Aug;8(4):384-394,[object Object],Davis KL et al. Prevalence and cost of medication nonadherence in Parkinson's disease: evidence from administrative claims data. Mov Disord. 2010 Mar 15;25(4):474-80.,[object Object],Rosenheck, RA.  Evaluating the cost-effectiveness of reduced tardive dyskinesia with secong-generation antipsychotics. B J Psychiatry.  2007 (191): 238-245.,[object Object]

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KAMAS Health 2.0 Presentation

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