Abstract: Disclosed techniques include monitoring a physiological characteristic of a patient with a sensor that is mounted to an inner wall of a thoracic cavity of the patient, and sending a signal based on the monitored physiological characteristic from the sensor to a remote device.

Abstract: The present invention is an esophageal stethoscope with a temperature sensor and earpiece. An esophageal stethoscope has a tube with a first end and a second end, where a sound-transmitting hydrophobic cuff covers the first end of the tube. The first end of the tube has a plurality of lateral openings and a thermistor extending from the first end but within the cuff. The second end of the tube is attached to a connector and has a temperature sensor sub-assembly that extends out of the second end and is connected to the thermistor. A monoscope tube is attached to the connector at a first end and has a memory foam earpiece at a second end. The monoscope tube also preferably has a clip near the earpiece. To facilitate sound transmission, monoscope tubes of different ID sizes are used.

Abstract: Apparatuses and methods are disclosed for monitoring and evaluating exercise-related activities performed by a subject. A health monitor comprising an accelerometer, at least one physiological sensor, and digital processor is configured to be supported by a subject and identify an activity type (e.g., running, biking, swimming) from among a plurality of different activities. The health monitor is further configured to determine from motion data and/or cardiac data levels of health benefits received from the exercise. The health benefits may be based on standards established by recognizable health entities, so that the reported health benefits are less susceptible to errors associated with conventional step counting.

Abstract: Methods, devices, and processor-readable storage media are provided for the diagnosis of heart failure. One method includes collecting, using an implantable device, reference episodes; generating an in-suspicion model-cycle and an off-suspicion model-cycle based on the reference episodes; and determining whether to generate a heart failure alert, based on a difference between the in-suspicion model-cycle and the off-suspicion model-cycle.

Abstract: The present invention provides an apparatus for detecting and monitoring obstructive sleep apnea. The apparatus measures sinus tachycardia and a change in the atrial-ventricular conduction, and includes a controller for receiving the measurement of the sinus tachycardia and the change in the atrial-ventricular conduction to detect obstructive sleep apnea based upon the sinus tachycardia and the change in the atrial-ventricular conduction.

Abstract: Methods and apparatus combine patient measurement data with demographic or physiological data of the patient to determine an output that can be used to diagnose and treat the patient. A customized output can be determined based the demographics of the patient, physiological data of the patient, and data of a population of patients. In another aspect, patient measurement data is used to predict an impending cardiac event, such as acute decompensated heart failure. At least one personalized value is determined for the patient, and a patient event prediction output is generated based at least in part on the personalized value and the measurement data. For example, bioimpedance data may be used to establish a baseline impedance specific to the patient, and the patient event prediction output generated based in part on the relationship of ongoing impedance measurements to the baseline impedance. Multivariate prediction models may enhance prediction accuracy.

Abstract: Systems, methods, and computer executable instructions for monitoring a patient's cardiopulmonary status and/or providing feedback-based control regarding the same. Such methods include, and such systems are configured for, determining a cardiopulmonary status based upon measured data, e.g., from a plurality of sensors, comparing the determined cardiopulmonary status with input data, e.g., input data indicating a target cardiopulmonary status, and providing a result signal based upon the comparison. The result signal may include a display signal for displaying an indication of the result of the comparison, an audio alert signal for audibly provided an indication of the result of the comparison, and/or a control signal for controlling an exercise apparatus in accordance with the result of the comparison.

Abstract: Embodiments are presented herein that provide early prediction of the development of necrotizing enterocolitis by a preterm infant through analysis of the high frequency component of heart rate variability, optionally with analysis of respiration rate. Methods of treatment following prediction area also reported.

Abstract: A computerized method for determining maximal oxygen uptake for a user with incomplete data with data collected from a plurality of other users with complete data. The maximal oxygen uptake can be determined by computing similarity metrics between an incomplete data set of self-reported and measured data and complete user data sets, and using a weighted sum of the similarity metrics. The results of the maximal oxygen update calculation can be cross-validated with known user data sets.

Abstract: A method of estimating the maximal oxygen uptake of an individual on the basis of heart rate data, biometric data, biomechanical data, and geophysical data is described. These data can be collected as the individual engages in activities requiring various levels of exertion, without modifying those activities from the ordinary manner in which they are performed. In particular, in some embodiments the method described here obviates the conventional need for a laboratory setting when estimating maximal oxygen uptake and the method can be applied to estimate maximal oxygen uptake under more natural conditions than conventional testing protocols requiring treadmills or stationary ergometers typically permit. Furthermore, it is described how such estimates of maximal oxygen uptake can be used to estimate other quantities of interest, including fat and carbohydrate metabolism, lactate production, and water and electrolyte loss during exercise.

Abstract: Physiological monitoring can be provided through a wearable monitor that includes two components, a flexible extended wear electrode patch and a removable reusable monitor recorder. The wearable monitor sits centrally on the patient's chest along the sternum oriented top-to-bottom. The placement of the wearable monitor in a location at the sternal midline (or immediately to either side of the sternum) benefits extended wear by removing the requirement that ECG electrodes be continually placed in the same spots on the skin throughout the monitoring period. The wearable monitor can interoperate wirelessly with other physiology and activity sensors and mobile devices. An application executed by the sensor or device can trigger the dispatch of a wearable monitor to the patient upon detecting potentially medically-significant events. The dispatched wearable monitor would then be capable of providing precise medically-actionable data, not merely an alert that some abnormality may be present.

Abstract: Described herein are methods for determining a target musculoskeletal activity cycle (MSKC) to cardiac cycle (CC) timing relationship. The method may include detecting a first characteristic of a signal responsive to a CC timing of a user that repeats at a frequency that corresponds to a heart rate of the user; detecting a second characteristic of a signal responsive to a rhythmic musculoskeletal cycle activity (MSKC) timing of the user that repeats at a frequency that corresponds to the MSKC rate of the user; determining a value representative of an actual timing relationship between the first characteristic and the second characteristic; detecting a third characteristic of a signal corresponding to a physiological metric that varies with the actual timing relationship between the first and second characteristics; and determining a target value representative of a preferred timing relationship between the first and second characteristics.

Abstract: A method includes receiving cardiac data and determining a cardiac index based upon the cardiac data; determining an increased risk of death associated with epilepsy if the indices are extreme, issuing a warning of the increased risk of death and logging information related to the increased risk of death. A second method comprises receiving at least one of arousal data, responsiveness data or awareness data and determining an arousal index, a responsiveness index or an awareness index, where the indices are based on arousal data, responsiveness data or awareness data respectively; determining an increased risk of death related to epilepsy if indices are extreme values, issuing a warning of the increased risk of death and logging information related to the increased risk of death. A non-transitory computer readable program storage device encoded with instructions that, when executed by a computer, perform a method is also provided.

Abstract: A sleepiness assessment value P1 is set to be an average heart rate HR (S130). A sleepiness assessment value P2 is set to be a standard deviation ? of a respiration interval RespI for one minute (S150). A sleepiness assessment value P3 is set to be a value that is obtained by dividing, by one minute, an integrated value of a square of an average heartbeat interval RRIavg in a case where a variation in which a heartbeat interval RRI increases occurs (in a case where an RRI count value Xi is a value of one) (S190). A sleepiness assessment value P4 is set to a value that is obtained by averaging a variation ratio in a case where a variation in which the respiration interval RespI increases occurs (in a case where an RRI count value Yi is a value of one) (S210).

Abstract: The invention provides a system for measuring respiratory rate (RR) from a patient. The system includes an impedance pneumography (IP) sensor, connected to at least two electrodes, and a processing system that receives and processes signals from the electrodes to measure an IP signal. A motion sensor (e.g. an accelerometer) measures at least one motion signal (e.g. an ACC waveform) describing movement of a portion of the patient's body to which it is attached. The processing system receives the IP and motion signals, and processes them to determine, respectfully, frequency-domain IP and motion spectra. Both spectra are then collectively processed to remove motion components from the IP spectrum and determine RR. For example, during the processing, an algorithm determines motion frequency components from the frequency-domain motion spectrum, and then using a digital filter removes these, or parameters calculated therefrom, from the IP spectrum.

Abstract: Methods, systems, and apparatus for detecting an epileptic event, for example, a seizure in a patient using a medical device. The determination is performed by providing an autonomic signal indicative of the patient's autonomic activity; providing a neurologic signal indicative of the patient's neurological activity; and detecting an epileptic event based upon the autonomic signal and the neurologic signal.

Abstract: Real-time, short-term analysis of ECG, by using multiple signal processing and machine learning techniques, is used to determine counter shock success in defibrillation. Combinations of measures when used with machine learning algorithms readily predict successful resuscitation, guide therapy and predict complications. In terms of guiding resuscitation, they may serve as indicators and when to provide counter shocks and at what energy levels they should be provided as well as to serve as indicators of when certain drugs should be provided (in addition to their doses). For cardiac arrest, the system is meant to run in real time during all current resuscitation procedures including post-resuscitation care to detect deterioration for guiding care such as therapeutic hypothermia.

Abstract: An apparatus for determining information indicative of cardiac malfunctions and abnormalities includes a processing device (502) configured to detect amplitude variation from a signal indicative of cardiovascular motion, where the amplitude variation element variation of the amplitude of a wave pattern, e.g. the AO-peak, repeating on the heart-beat rate on the signal. The processing device is configured to determine, at least partly on the basis of the detected amplitude variation, an indicator of cardiac malfunction and abnormality.

Abstract: The invention is directed to a system for acquiring electrical footprint of the heart, electrocardiogram (EKG or ECG), heart sound, heart rate, nasal airflow and pulse oximetry incorporated into a mobile device accessory. The ECG and heart sound signals are conveniently acquired and transmitted to a server via the mobile device, offering accurate heart failure analysis, and sleep disorder breathing indication.

Abstract: An implantable medical device system and associated method receive a signal from an implantable sensor operatively positioned relative to a vein, the signal being responsive to changes in a diameter of the vein. A diameter of the vein is determined in response to the sensor signal and used in estimating central venous pressure (CVP).

Abstract: The invention provides a body-worn monitor that measures a patient's vital signs (e.g. blood pressure, SpO2, heart rate, respiratory rate, and temperature) while simultaneously characterizing their activity state (e.g. resting, walking, convulsing, falling). The body-worn monitor processes this information to minimize corruption of the vital signs by motion-related artifacts. A software framework generates alarms/alerts based on threshold values that are either preset or determined in real time. The framework additionally includes a series of ‘heuristic’ rules that take the patient's activity state and motion into account, and process the vital signs accordingly. These rules, for example, indicate that a walking patient is likely breathing and has a regular heart rate, even if their motion-corrupted vital signs suggest otherwise.

Abstract: The invention provides a body-worn monitor that measures a patient's vital signs (e.g. blood pressure, SpO2, heart rate, respiratory rate, and temperature) while simultaneously characterizing their activity state (e.g. resting, walking, convulsing, falling). The body-worn monitor processes this information to minimize corruption of the vital signs by motion-related artifacts. A software framework generates alarms/alerts based on threshold values that are either preset or determined in real time. The framework additionally includes a series of ‘heuristic’ rules that take the patient's activity state and motion into account, and process the vital signs accordingly. These rules, for example, indicate that a walking patient is likely breathing and has a regular heart rate, even if their motion-corrupted vital signs suggest otherwise.

Abstract: Devices and methods for sleep detection involve the use of an adjustable threshold for detecting sleep onset and termination. A method for detecting sleep includes adjusting a sleep threshold associated with a first sleep-related signal using a second sleep-related signal. The first sleep-related signal is compared to the adjusted threshold and sleep is detected based on the comparison. The sleep-related signals may be derived from implantable or external sensors. Additional sleep-related signals may be used to confirm the sleep condition. A sleep detector device implementing a sleep detection method may be a component of an implantable pulse generator such as a pacemaker or defibrillator.

Abstract: A pressure wound prevention system operable to prompt at least one caregiver to reposition a subject at risk of developing pressure wounds. A pressure detection apparatus comprising a plurality of sensors monitors pressure exerted upon the subject by a surface. A processor is operable to interpret and analyze data from the sensors and a notification mechanism such as a display, an alert, alarm or the like is provided to notify a caregiver when the subject requires repositioning.

Abstract: A method and apparatus for assessment of cardiac contractility in a subject by recording precordial acceleration signals. This includes, but is not limited to, the method and apparatus of seismocardiography (SCG).

Abstract: Systems and methods for detecting a worsening of patient's heart failure condition based, at least in part, on an increasing trend in a representative rapid shallow breathing index (RSBI) value over multiple days. The RSBI value may be a minimum RSBI, and more particularly may be a minimum RSBI value determined for an afternoon portion of each of the multiple days. The minimum RSBI value measured during an afternoon portion of the day may be more sensitive to changes in a patient's respiration, particularly when a patient is expected to be more active, and thus, may more readily exhibit an increasing trend when patient's heart failure is in decline.

Abstract: A method of obtaining a consistent evaluation of the state of the system which has been monitored by measurement of multiple parameters of that system. The multiple parameters are used to calculate a single dimensional value based on the distance between the current state and normal states of the system using a Parzen Windows probability function. Consistent single dimensional values regardless of the dimensionality of the original data set can be obtained by finding a relationship between the single dimensional value and the probability of status of the system. Different relationships are obtained for different dimensionalities of data sets. Sensor malfunction can also be detected by testing the probability of the state implied by measuring all of the available parameters against the probability of the state implied by ignoring different individual ones of the parameters. A significant disparity in the two probabilities indicate possible sensor malfunction.

Abstract: Non-invasive monitoring of cardiovascular health is performed by monitoring changes in the volume of blood in the venous side of the vascular system. The blood volume changes are determined from measurements of bioimpedance of limbs or neck, in particular changes in bioimpedance in response to blood modulating events performed on the limbs or neck, where bioimpedance is measured and compared before and after such events.

Abstract: In a breathing analysis method using an electrocardiogram of a user, a breathing curve is generated according to R waves in the electrocardiogram, and whether the user is currently taking a breathing out action or a breathing in action is detected according to the breathing curve. A duration of the breathing in action or the breathing out action of the user is computed according to the breathing curve, and a ratio of the duration and a standard time of the breathing in action or the breathing out action is computed. A breathing in or out progress is displayed in a progress demonstration bar on the display device according to the ratio.

Abstract: The present disclosure provides a method and system for stimulating and monitoring intensity of pain experienced by one or more users. The method includes measuring the intensity of pain experienced by the one or more users on a pre-determined scale and augmented chart or physician's personal assessment using a plurality of one or more bio-markers, determining co-relation between the plurality of one or more bio-markers and the intensity of pain experienced by the one or more users, refining the co-relation between the plurality of one or more bio-markers and the intensity of pain experienced by the one or more users by learning from responses of one or more similar users, generating a pain profile for each of the one or more users and utilizing the learned information and the generated profile for monitoring, evaluating and treating the one or more users.

Abstract: Easy to use, cost-effective methods and devices for evaluating and treating stress and thereby disorders caused or exacerbated by stress are provided. More particularly methods and devices for identifying RSA waves during respiration which provide a subject with near real-time RSA wave information are provided. This information can be used in biofeedback settings to assist subjects in reducing levels of stress by achieving rhythmic breathing patterns.

Abstract: Resuscitation assembly (101) comprising a patient mask (107), a ventilation bag (105), an inflation valve (113), an exhalation valve (111), and an expiration indicator (119). The expiration indicator (119) is a positive end expiratory pressure valve in the form of a slit valve that exhibits a slit (131) in a flexible sheet part (125). Also disclosed is a resuscitation assembly (101) comprising a patient mask (107), a ventilation bag (105), an inflation valve (113), an exhalation valve (111), a positive end expiratory pressure valve (119), and a pressure sensor (133) adapted to measure pressure on the patient side (127) of the positive end expiratory pressure valve (119).

Abstract: Systems and methods related to the field of cardiac resuscitation, and in particular to devices for assisting rescuers in performing cardio-pulmonary resuscitation (CPR) are described herein.

Abstract: The disclosed embodiments relate to a patient monitor for evaluating a patient. The patient monitor may comprise a capnometer that is adapted to receive at least a portion of exhaled flow from the patient and to produce a first output indicative of exhaled carbon dioxide associated with the exhaled flow, an oximeter that is adapted to receive an input from the patient and to produce a second output indicative of oxygen saturation of blood of the patient, and a processor adapted to receive at least the first output and the second output and to correlate the first output with the second output.

Abstract: A method of monitoring variation in either or both respiration and heartbeat of an animal comprising the steps of vibrating a piezoelectric vibrator by continuously or intermittently applying an AC voltage of a frequency corresponding to a natural resonance frequency of the vibrator to the piezoelectric vibrator under such condition that the vibrator is placed directly or indirectly in contact with the surface of the animal's body; collecting a current generated by the vibrator under vibration; and calculating an impedance of the vibrator from a value of the current and a value of the AC voltage applied to the vibrator so as to continuously or intermittently detect variation of the impedance by lapse of time is effective to monitor variation of respiration and/or heartbeat of animals including humans who are in sleep or under exercise and take a variety of positions with high sensitivity.

Abstract: The invention relates to a method for determining a cardiovascular performance reserve for each individual patient, comprising the steps of: a) receiving input physiological data from the patient for obtaining a parameter Z which is or approximates the product of the Stroke Volume (SV) by the Systemic Vascular Resistance (SVR); b) providing a value representing the Respiratory Rate (RR) of said patient, wherein the Respiratory Rate (RR) value is provided by measurements using dedicated device(s), calculations from the input physiological data or manually by using best estimate; c) providing anthropometric data of said patient for calculating the Body Surface Area (BSA) of said individual, wherein the anthropometric data includes at least body dimensions (such as height and weight) of said patient; d) calculating the Cardiovascular Reserve (CVR) by using said Z parameter and said RR according to following formula: CVR=(Z/RR); e) calculating a Cardiovascular Reserve Index (CVRI) by standardizing said CVR (by sa

Abstract: Method and apparatus for quantitative and qualitative determination of heart rate, stroke volume, cardiac output, and central fluid volume. Phonocardiography based technique using multiple transducers and multi-sensor processing algorithms provides a non-invasive method of evaluating the output of the heart. This basic system coupled with additional sensor elements provides a wide range of potential capabilities. A system comprising these techniques in a wearable form provides a non-invasive method of determining hydration status and blood volume status. Phonocardiography augmented with multi-sensor signal processing techniques improves signal quality to analyze heart sounds and associated features (e.g. S1 and S2, amongst others). Noise compensation and cancellation techniques for phonocardiography further improve signal to noise ratio to reject external disturbances.

Abstract: Provided are an apparatus and a method for monitoring a dangerous situation of a human body. The dangerous situation such as the apnea or suffocation of the human body is determined based on variations in one of a cardiac impulse amplitude signal and a respiration amplitude signal of the human body and is transmitted to a wired or wireless terminal, thereby monitoring the dangerous situation of the human body in a sleep state.

Abstract: An exercise and communications system includes an interactive device, a remote device, and an external device, wherein the interactive device is configured to gather data relating to a user of the system and transmit the same to the remote device, and the remote device is configured to provide analyze the data and transmit a response to the interactive device, which in turn communicates the response to the user and additionally communication with an external device for retrieval of instructions, programs, and data, inter alia. An exercise and communications system facilitates communication between a plurality of users, each having an interactive device and a remote device.

Abstract: Improved apparatus and methods for monitoring, diagnosing and treating at least one medical respiratory condition of a patient are provided, including a medical data input interface adapted to provide at least one medical parameter relating at least to the respiration of the patient, and a medical parameter interpretation functionality (104, 110) adapted to receive the at least one medical parameter relating at least to the respiration (102) of the patient and to provide at least one output indication (112) relating to a degree of severity of at least one medical condition indicated by the at least one medical parameter.

Abstract: Methods and apparatus to determine the presence of and track functional chronotropic incompetence (hereinafter “CI”) in an in-home setting under conditions of daily living. The functional CI of the patient may be determined with one or more of a profile of measured patient heart rates, a measured maximum patient heart rate, or a peak of the heart rate profile. The functional CI of the patient may be determined with the measured heart rate profile, in which the measured heart rate profile may correspond to heart rates substantially less than the maximum heart rate of the patient, such that the heart rate can be safely measured when the patient is remote from a health care provider. The functional CI of the patient may be determined based a peak of the remotely measured heart rate profile, for example a peak corresponding to the mode of the heart rate distribution profile.

Abstract: Devices and systems provide methods of detecting a heart failure condition of a patient that may be based on one or more respiratory parameters of a patient. In an example embodiment, a monitoring device determines one or more heart failure condition indicators based on a measure of the patient respiratory airflow and/or a measure of treatment pressure. Respiratory parameters such as respiration rate, hypopneas, apneas, Cheyne-Stokes breathing patterns or apnea-hypopnea counts may be compared to thresholds that are selected to represent a change in the condition of a heart failure patient such as an onset of a decompensation event. Results of the comparisons may trigger a pressure treatment change and/or one or more warnings or messages to notify a patient or physician of a pending change to the patient's heart failure condition so that the patient may more immediately seek medical attention to treat the heart failure condition.

Abstract: Implantable medical devices and techniques are implemented that use bio-impedance to measure aspects of patient physiology. A signal separation method is performed at least in part in an implantable device. The method involves detecting a plurality of impedance signals using a plurality of implantable electrodes coupled to the implantable device. The method further involves separating one or more signals from the plurality of impedance signals using a signal separation technique, such as an algorithm-based separation technique.

Abstract: A sleep monitoring system includes an ECG device (2) and a respiration inductance plethysmogram (3) which monitor cardiac activity and physical (ribcage) respiration respectively and feed representative signals to a digital data processor. Operations (5-9) process the beat interval data, while in a second thread, operations (20-24) independently process the amplitude modulation of the ECG data caused by the respiratory motion of the subject. The inductance plethysmogram device (3) provides an input to the processor which represents respiration as directly monitored independently of the ECG. Operations (30-34) process this direct respiration data independently and in parallel, in a third thread. All extracted features are fed to a classifier which in step (10) combines selected combinations of features to make decisions in real time.

Abstract: This patent document discusses, among other things, systems, devices, and methods for predicting an occurrence of impending thoracic fluid accumulation and in one example, invoking a responsive therapy, such as to prevent or minimize the consequences of the impending thoracic fluid accumulation. One example of the present systems, devices, and methods senses or receives at least one parameter that is statistically associated with impending thoracic fluid accumulation from a subject. Using such parameter(s), a probability of impending thoracic fluid accumulation is estimated. A list of parameters determines which values are recurrently sensed or received at various desired time intervals. Another example of the present systems, devices, and methods weights the sensed or received parameter value(s) to compute the probability estimate of impending thoracic fluid accumulation.

Abstract: A differential or relative measurement between an orthogonal measurement vector and another measurement vector can be used to determine the location where fluid accumulation is occurring or the local change in such fluid accumulation. This can help diagnose or treat infection or hematoma or seroma at a pocket of an implanted cardiac rhythm management device, other implanted medical device, or prosthesis. It can also help diagnose or treat pulmonary edema, pneumonia, pulmonary congestion, pericardial effusion, pericarditis, pleural effusion, hemodilution, or another physiological condition.

Abstract: A method of monitoring a patient to identify a sleep breathing disorder, comprising: a) Collecting, using a handheld monitoring device, a plurality of respiratory sounds of a patient using one or more sensors which are connected to the handheld monitoring device. b) Recording environment noise during the sleep session and averaging the environment noise to set an average noise level. c) Calculating a dynamic threshold according to the average noise level. d) Deriving a plurality of amplitudes from the plurality of respiratory sounds according to the dynamic threshold. e) Identifying a sleep breathing disorder event by analyzing a pattern of the plurality of amplitudes.

Abstract: Devices and methods for detecting physiological target event such as events indicative of HF decompensation status are described. A medical device is configured to receive at least a first and a second chronic condition indictors of a patient, receive one or more physiologic signals from the patient, and generate a plurality of signal metrics when the first and the second chronic condition indicators meet their respective criterion. The medical device can detect the target event or condition using one or more patient-specific signal metrics selected from a group including both the first and the second set of the signal metrics. The medical device and the methods can be configured to detect an event indicative of HF decompensation.

Abstract: Improved apparatus and methods for monitoring, diagnosing and treating at least one medical respiratory condition of a patient are provided, including a medical data input interface adapted to provide at least one medical parameter relating at least to the respiration of the patient, and a medical parameter interpretation functionality (104, 110) adapted to receive the at least one medical parameter relating at least to the respiration (102) of the patient and to provide at least one output indication (112) relating to a degree of severity of at least one medical condition indicated by the at least one medical parameter.

Abstract: Devices and methods for identifying patient at elevated risk of developing future heart failure (HF) events, such as events indicative of HF decompensation status, are described. The devices and methods can stratify the risk using sensor signals or signal metrics selected in accordance with patient chronic conditions. A medical device can receive a patient status input including at least a first and a second chronic condition indicators, sense one or more physiologic signals from the patient, and generate a plurality of signal metrics from the physiologic signals when the first chronic condition indicator and the second chronic condition indicator meets respective criterion. One or more patient-specific signal metrics can be selected from a group including the signal metrics selected for both the first and the second chronic conditions.