Transcript of Explore Noxturnal 4.4 Note: This presentation is intended to summarize main changes from 3.2 up to...
- Slide 1
- Explore Noxturnal 4.4 Note: This presentation is intended to
summarize main changes from 3.2 up to 4.4. Detailed feature and bug
fixes information for only upgrading Noxturnal 4.3 to 4.4 is
addressed in the Release Bulletin for Noxturnal 4.4..
- Slide 2
- Summary of main feature changes between Noxturnal 3.2 and 4.4
Serve as a self-training guide Offer material for other information
about Noxturnal 4.4 Explain key differentiators of Noxturnal 4.4
Purpose
- Slide 3
- Software License Implementation Device Support A1 PSG recording
setup (online and ambulatory) T3 PG setup with enhanced workflow
options (ambulatory) Auxiliary device connections via Bluetooth and
IP User Interface Enhancements New Scoring and Analysis Tools New
Powerful and Flexible Report Engine Nox Calibrated RIP Technology
Extended Data Export Functionality for Scientific Users Enhanced
Network Support: Administrator / User Settings Overview
- Slide 4
- Noxturnal 4 Licensing concept Item CodeItem
DescriptionFunctionality (in addition to regular Nox T3 system
ambulatory Polygraphy use) 53 40 10 Noxturnal A1 PSG File Format
License Allows to read / write / analyze / report on any kind of
Nox A1 recordings (incl. video playback), enables preparation and
download for ambulatory Nox A1 PSG recordings. 53 60 10 Noxturnal
A1 Online Acquisition License Enables online acquisition from PSG
without video. At the same time it allows to read / write / analyze
/ report on any kind of Nox A1 recordings (incl. video playback),
enables preparation and download for ambulatory Nox A1 PSG
recordings. 60 day trial license after first installation with all
functionality open After initial 60 day period: Full T3
functionality supported (including all analysis and reporting
features) Any other optional license requires license activation 53
60 11 Noxturnal Video Online Acquisition License Required to add
online video acquisition to regular PSG online acquisition 53 61 10
Noxturnal EBM PG File Format Reading License Required to read Embla
format data in polygraphy recordings directly (raw data will be
kept in ebm format no conversion) 53 61 12 Noxturnal EBM PSG File
Format Reading License Required to read Embla format data in
Polysomnography recordings directly (raw data will be kept in ebm
format no conversion) 53 61 11 Noxturnal EDF File Format Reading
License Required to read EDF data (raw data will be kept in edf
format no conversion) Major A1 Licenses Optional Functionalities
Note: Specific Knowledge Base Article about License concept and
License activation is available on noxmedical.com
- Slide 5
- DEVICE HANDLING IN NOXTURNAL
- Slide 6
- Nox A1 and Nox T3 systems Nox A1: ambulatory setup and download
Nox A1: online acquisition via BlueGiga Access Point (optional
incl. video) Nox T3: ambulatory setup and download Supported Nox
Systems BlueGiga Access-Point for Bluetooth to LAN conversation
Noxturnal App for flexible device control and setup in all online
and ambulatory. studies
- Slide 7
- Device Access and Download General start window w/o attached
device: View Existing Recordings Start a New Recording (to start
online recordings) Access to Analysis / Report / Device Profiles
and Settings always available Attaching a Nox A1 / T3 device:
Devices show up with SN and FW status Download and View Recording
to be used for downloading Start a New Recording to be used for
setup ambulatory recordings Communication with devices similar to
USB drive (no drivers required)
- Slide 8
- Recording Templates combine Recording type Sensor selection AUX
devices (in case of ambulatory studies) Battery selection Recording
type configuration combine Customizable Workspaces (a combination
of signal sheets) Customizable Analysis Protocol Customizable
Report Nox Systems Configuration
- Slide 9
- Recording Templates Recording templates for Nox devices and
type of use (ambulatory vs online): Standard Templates offered Any
required custom profiles to be created either Based on or as New
Final device preparation now faster by using prepared recording
templates Sensor selection for bipolar and unipolar inputsNew:
Parallel recording option Cannula and mask Example A1: EEG / EMG
and bipolar channel setup Nox A1 and T3 Respiratory channel setup
Note: Specific Knowledge Base Article for Nox T3 users on Noxturnal
4.4 is available on noxmedical.com
- Slide 10
- Nox EtCO2 (ambulatory) Nonin Respsense (EtCO2) W7 - Interfaces
(online and ambulatory) Nox W7 S: Sentec (TcCO2) (incl. Sentec FW
8.0) Nox W7 R: ResMed S9 Radiometer (TcCO2) (models: TCM4, TCM4
Combi M, TCM40, TOSCA) Nonin Respsense (EtCO2) Auxiliary Device
Support Nox T3 PGNox A1 PSG LAN IP direct data access to Noxturnal
TxLink (incl. EasyCare Tx 8.2) (including ResMed Air Solutions
Devices) Sentec (TcCO2) (incl. Sentec FW 8.0) Note: Specific
Knowledge Base Articles about the Integration of auxiliary devices
is available on noxmedical.com
- Slide 11
- Nox T3 Firmware 1.5.1.4060 Noxturnal: Firmware status detection
and upgrade advice (if upgrade chosen automated procedure) Improved
robustness for T3 Oximeter connection Connection process to
oximeter faster Robust study startup connectivity to oximeter based
on repeated connectivity checks and re-attempts Likelihood of
conditional boot error in oximeters greatly reduced. Display /
devices timeout is 2 minutes (previously 40 seconds). Improved RIP
signal handling Disconnected RIP belts now displayed as flat
lines.
- Slide 12
- USER INTERFACE ENHANCEMENTS
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- Recording Result Page new features PSG View (including
spectrogram) Directly accessible artifact location (signal
information) Directly accessible period markers (enter, delete
period markers) Possibility for manual sleep scoring based on
spectrogram Direct introduction and improved visibility for Invalid
data periods General Sheet Layout Quick change access to analysis
start / stop synchronized with Recording Results Quick introduction
for all period markers (analysis, PAP, NAP ) Quick Split screen
setup and access (incl. sheet synchronization) Special sheet
templates for A1 impedance data and TxLink Workspace Concept
Combination of multiple sheet templates to allow for different user
preferences All additional special views owned by Workspaces User
Interface Enhancements
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- Permanent access to view / switch Scorer and Periods New view
options Spectrogram Flow Volume Loops Support for Nox A1 impedance
check and information Setting Changes: All settings unified in
Tools Settings menu New setting available for Navigation for flip
full page / half page Others Customizable name properties for
recording folder Customizable name properties for exported reports
Patient Document Control within the recording folder User Interface
Enhancements
- Slide 15
- Recording Results and Scorer / Window Period Access Access and
change for Scoring sessions.Special Sleep Information (Spectrogram,
Hypnogram). Direct Print option for Results Page. Access and change
for Time Periods.
- Slide 16
- Periods Definition / Scoring Access in Recording Results Manual
Sleep Scoring from Spectrogram.Definition and identification of
Period markers. Invalid data definition / improved period
visibility.Information: Artefact location and duration.
- Slide 17
- Sheet Layout, Analysis (and others) Period Markers Access to
general sheet layout options. Analysis Start: can be easily shifted
on both shown locations. Synchronizes with Recording Results.
Analysis End: can be easily shifted on both shown locations.
Synchronizes with Recording Results. Red bar indicates time outside
of the analysis window. All Period Markers: facilitated access and
introduction (right mouse click on synchro-arrow in the time
bar).
- Slide 18
- Split Screen and Window Synchronization Synchronization
MarkersWindow length indicator Window Sync- / Unsync- Option Window
Split Marker (after drag and drop)
- Slide 19
- Workspace Layouts and Direct Scoring Access Workspace and Sheet
templates Access Custom Workspace Default Workspace Access and
change for Scoring sessions
- Slide 20
- New View Options Whole night spectrogram as special view Quick
channel selection and color scheme adjustment Note: previously
offered derived trace spectrograms still available EEG -
Spectrogram Visualization of inspiratory and expiratory flow and
effort Differentiation between kind and severity of obstruction
Powerful titration support Flow-Volume-Loop and Konno-Mead Loop * *
Specific presentation for this topic is in preparation.
- Slide 21
- Nox A1 - Impedance Information Impedance Check: available only
during Nox A1 running online acquisition Specific impedance test
mode Accessible via icon (only during running online recording)
Support for EEG hookup (continuous data until stop view) Always
available information: Views: Continuous impedance data view
including numeric data Signal labels with impedance-feedback for
the (re-referenced) signal (see color of the underlining)
- Slide 22
- Patient Document Control Within the Recording Folder All
recording and patient related information with icon access
Documents can be attached to a patient: Noxturnal derived reports
with destination Recording Folder will automatically appear hear
Additional patient documents (questionnaires, insurance papers )
can be selected and copied into the Recording Folder Result:
centralized access for patient documents New design for Recording
properties Attachments as part of the recording folder
- Slide 23
- ANALYSIS AND SCORING
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- Automatic Analysis Automatic Sleep Staging Automatic Arousal
Scoring (rec. EEG and ChinEMG) Pulse Wave (Amplitude Drop) Analysis
Improved sound derived Snoring analysis Automatic PAP analysis
based on recorded pressure Desaturation Detection independent from
Hypopnea Desaturation Link Manual Scoring Visual distinction of
manual vs automatic events Powerful sleep scoring with centered
epoch handling Improved access to Single Click Scoring Possibility
to compare multiple sleep staging within one sheet New Analysis and
Scoring Tools
- Slide 25
- Automatic Analysis Changes - EEG New / Enhanced
AnalysisAnalysis Results Sleep Scoring (AASM classification): C3,
C4, O1, O2, 2 x Eyes, EMG Chin Automatic scoring also possible with
less or adjusted input signals Arousal detection: C3, C4, O1, O2,
EMG Chin Input signals selection customizable Quality threshold
scale: -10 +10 -10 more specific / +10 less specific
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- Analysis Changes - Others New / Enhanced AnalysisAnalysis
Results Derivation of a Set Pressure signal Signal derived from
Mask Pressure New signal available for custom PAP reporting
purposes
- Slide 27
- Desaturation vs. Hypopnea Detection Customizable Desaturation
detector (AASM: default 3% drop) ODI value based on these events
scored Desaturation-Events Link Flow Amplitude Drop (AASM: 30%
drop) to Desaturation Drop (AASM: default 3%) all customizable
Hypopneas detected by this threshold which is independent from the
Desaturation-Events Independent detector for Desaturation vs.
Apnea/Hypopnea (Hypopnea link to Desaturation)
- Slide 28
- Event Control and Sleep Scoring Start / Stop Scoring Easier:
Click into the scoring bar start ESC stop Automatically centered
scoring epochSleep Scoring Support views Stage score shown as
automatic / manual w/ scorer information and confidence level
Events with scorer information and automatic / manual
differentiation
- Slide 29
- Nox Calibrated RIP Technology* RIP signals vary, based on
patients size, shape and placement of belts RIP amplitudes must be
weighted for correct flow derivation Generating clear effort
signals (no ECG disturbance) Calibration for amplitude summation
Accurate Flow Curve Calculation Summation of effort signals
Estimated corrective factor (based on phase shift) Estimated Flow
Curve (RIP Flow) * Specific presentation for this topic is in
preparation.
- Slide 30
- Nox Calibrated RIP Technology Cannula Flow Calibrated RIP Flow
Un-calibrated RIP Flow Accurate flow information based on
respiratory effort (RIP) accurate scoring for flow limitation /
hypopnea and apnea
- Slide 31
- REPORT ENGINE
- Slide 32
- Powerful custom reporting and default reports (incl. legacy
reports) Report customization in WYSIWYG editor (similar to
MS-Word) Full text formatting choices Integrating bitmaps Creating
tables and graphic charts Intuitive handling for report sections
and interpretation notes Creating of any custom variables to report
on Custom report fields based on signals and events properties
Fields show logical explanation within templates and final reports
New: Arousal Association Table prepared for custom reports Import
reports from custom Word templates of Embla with automatic
variables interpretation Report Export with filename and
destination settings Powerful and Flexible Report Engine
- Slide 33
- Default and Custom Reports Selection of Default Reports
available Custom Reports can get categorized and created either as
based on or as new User and standard default reports also
accessible via Win-Explorer All Reports fully customizable (no
limitation to previous default sections) Legacy Reports (Noxturnal
3.2) have been partly converted into the new format and will get
supported (limitation apply)
- Slide 34
- Report Customization in WYSIWYG Editor Word style look and feel
Report categories and available sections (fully customizable) Full
text search in section names Complete MS-Word style report editing
create your own report library Design your own header / footer
Design your own graphics, tables, any kind of sections, add
pictures Drag and Drop: Add / save sections as new Report
Parts
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- Chart Customization in WYSIWYG Editor Define titles of
variables Select required fields from the field library Preview
result Customize color scheme and / or special chart formats
Library of charts available to draw: Signals and/or events
Hypnogram / Spectrogram / position like graphics Create custom
charts, format size in MS-Word style Save all your report parts and
charts and organize your categories Result
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- Custom Report Fields for Events Derive new reportable fields
based on any possible event configuration (including associations
with other events and / or signal conditions) Example: Desat Count
with >= desats of 4% in Non-Supine during Sleep Choose primary
new event condition, compare expected logic to the example given at
the right side Edit step by step all required conditions (see the
custom entries in blue)
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- Custom Report Fields for Signals Derive new reportable fields
based on any possible signal condition (including associations with
other events) Example: Total time with Saturation