Project Design - DukeCureBPPV/CureBPPV GitHub Wiki

_{^{CureBPPV, built by BPPV Team (Grayson, Keping, and Yilin), for Kristal Riska}}

This app is going to be a BPPV self treatment tool. The specific features include:

1. A welcome page with video, and choices for left or right type treatment.
2. A series of treatment pages for the BPPV Epley maneuver, where users are provided with text, audio, and graphical guidance to move their phone and head together in correct positions and hold for some time. Rotation sensors of smart phones will be utilized (and required) to know that the phone and head are in the correct angle.
3. In-app survey on the conditions after treatment, with survey results uploaded to REDCap.

Note that the app is not designed for diagnosis, and is not going to replace a doctor in all cases.

This app will be built using React Native for both iOS and Android, but prioritized for iOS. Uploading survey results to the survey database should be straight forward (sending HTTP requests to the REDCap database using their APIs), and authentication will rely on third party services (REDCap database tokens); thus no server hosted backend is needed.

First and foremost, our app will be used to help track the head movements of a patient, so we need to make sure that our app can reliably use the accelerometer. The core functionality of our app relies on our ability to do just that. Furthermore, we need to handle the confidentiality of our patients when they are responding to a survey, so we need to work out the best way to authenticate people within our app.

Beyond that, we want to work to make this app as intuitive as possible. We want to alert users during the maneuver with both audio and visual feedback, as they will be feeling dizzy and may need to close their eyes. In keeping with this ideal, we want to make it as quick and simple as possible to go from opening the app to starting the maneuver walkthrough. The time spent making extra clicks, or time spent working to determine the next step, is time that the user could be using to perform the maneuver and treat their dizziness, so we take this very seriously.

Lastly, we want to make the refinement of the algorithms within the app as simple as possible for anyone who may take this on in the future. For example, a doctor with no technical background should be able to check the calibration of the accelerometers and refine them fairly simply. This will allow the app to get more and more accurate the longer it is in use, and ensure the best possible product.

When a fit of BPPV strikes, there is a specific set of movements that need to be completed in the correct order and position in order to treat it. This involves specific rotations of the head and body, held for the correct amount of time. Currently, patients suffering from BPPV will go to the hospital to get it diagnosed, and then be sent home with very vague instructions on paper for how to treat it. These instructions are a set of pictures, with no words, that don't specify the minutia of the movements they need to perform. Therefore, it is common for patients to complete what they believe to be the correct movements, but still have symptoms because they did something incorrectly. As for self treatment mobile apps, we have done a simple research on app stores, and it turns out that currently there is only one BPPV self treatment app on the iOS App store which costs $8.99, and another one on the Android App store which is rated as 1 star out of 5. Although the BPPV Epley maneuver is quite simple and provides very clear instructions, self-treatment apps are neither popular nor user-friendly.

Our app aims to solve this by creating a user-friendly, informative way for the user to ensure they are performing these steps correctly. Through the use of the iPhone's accelerometers, we will be able to track the tilting of the user's head, guide them to the right position, and alert them when something isn't right. We will also use a timer to track the length of each movement for them, so they can focus on doing the movement correctly. Furthermore, we will provide the user with a survey a day after completion of the maneuver to track their outcomes and send data back to doctors, thus ensuring that doctors are able to provide accurate feedbacks for users' further treatment.

We may need the client to provide us with the following resources:

1. A short video illustrating the maneuver
2. Picture, text and audio guidance through the maneuver.
3. Survey questions, and a specific Duke REDCap project and its API access key.

For the software dependency, we need to get access to REDCap, a commonly used database for medical surveys.

Patients with BPPV may get really dizzy during the maneuver, and this may affect how they hold/place their mobile phones and make the treatment less effective. Considering this, during app design and development, we need to make user-friendly as the first priority of our app.

The initial roles and responsibilities for team members are listed as following, although the real assignment of work is quite flexible and members will help each other.

• Grayson Wise: mainly on designing and styling user interfaces for the entire app
• Keping Wang: the utility to detect the position and movement of mobile phones, and the survey part
• Yilin Gao: the overall structure and individual components of the treatment part