A Wearable Smart Device to Monitor Multiple Vital Parameters—VITAL ECG
Round 1
Reviewer 1 Report
The paper is of interest for the readers in the field of physiological sensing and wearable technology. Can be published as it is now after making corrections.
Author Response
Dear Reviewer,
you didn't ask us any particular revision but you indicated in the results clearity and the conclusion two possible points to be enforced. Therefore we modified our already revised revision with the following changes.
Rows 296-299 were modified to
, which means that on average there is no difference between the heart-rate measured by the two systems. Furthermore, cross-correlation (XC) between the two heart-rate detections has been evaluated. The results confirm measurement’s consistency with XC close to 90.5%.
Rows 328-332 were modified to:
In particular: half of the total information content of VITAL-ECG acquisitions is concentrated in the bandwidth 0-11.4 Hz, which means that its spectrum is concentrated on slightly lower frequencies than MAC2000 (0-13.6 Hz). Since most of ECG information is located on low frequencies [46], Table 1 shows that VITAL-ECG has better performance in that bandwidth.
Rows 344-346 were modified to
with a mean difference around 1%, and a standard deviation slightly above 12%. Table 2 further confirms the previous analyses, showing no significative differences between the acquisitions of the two devices.
Rows 362-363 were modified to
As a matter of fact, the analyses presented in the paper showed no significative difference in terms of: measured heart-rate, spectral content of information, and time domain differences.
Thank you again for your precious indications to improve the quality of our paper
Reviewer 2 Report
Dear Authors,
thank you for incorporating my earlier comments.
Regards
Reviewer
Author Response
Thank you for your careful revision. Re-organizing the paper we probably changed the figures in a wrong way and new versions of the paper were affected by errors . Now I checked every Figures and every Figure references to be sure to apply your suggestions.
Main changes are:
row 154: "The overall VITAL-ECG hardware architecture is displayed in Figure 5"
is now:"The overall VITAL-ECG hardware circuit is displayed in Figure 4 and its block diagram is shown in Figure 5"
and Figure 4 is now Figure 5.
This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.
Round 1
Reviewer 1 Report
The topic is appropriate for the journal. The title of the paper precisely stated the subject of the journal and the manner of the sequencing of the statements in the introduction leads to the objective of the study in the paper.
Overall this article isn’t very straightforward in the beginning and it’s not until the second page that you realize where the article is headed. In order to have more people be engaged and read the whole article it needs a new, more concise introduction. Once the reader gets to the examples that are relevant to the everyday life of a health monitoring and well being, a good portion of the article has already past.
While citing the references, remove the letter ‘in’ before the citation and instead use the author name. “An example of an application of such paradigm can be found in [1]”, can be rewritten as
Dominicis et al [1] reported an example of an application of such paradigm.
The subdivision of the materials are logically organized under appropriate headings and paragraphs. The piece, when taken as a whole, is relevant and very convincing in theory but starts slow and never lays out a concrete way of approaching this complex problem technically.
The method used in the study are invalid and inappropriate for the experiment, the researchers have carried out. They cannot be reproduced or duplicated because the systematic process of each method was not stated in the paper with clarity. The experimental design they used was inappropriate to the objective of the study because they were not able to have a productive flow of the subsequent methods involved.
The paper did not address the three main aspects that need to have particular attention: long-term stability; resiliency; and biocompatibility of the wearable. However, the authors have suggested for the further work in their study.
Author Response
Please see the attachment
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Dear Authors, thanks for interesting work!
Please find my comments:
Keywords: You type "ECG, EKG, Electrocardiogram" - I suggest you use only ECG
line 32: GPS->GNSS (because you may also consider Galileo or Beidouaside GPS)
line 41: ...of such an approach is the telemedicine sector.
Figure 1: the picture is very small...
Can you add some annotations? E.g. wrist strip, display, button, ...
line 76: Sec. 2, Sec. 3, Sec. 5 (don't use roman numbers like II III V, as the headings also use arabic numbers)
line 100: ...and manual readings
line 109: ...in the next section, is derived based on a specific request
line 124: transmits (!) patient location
line 129: ...application is complemented with the required tools to assess (!) the patient risk.
line 131: improve data -> analyse data (what is data improvement? Do you mean filtering?)
line 136: automatically notifies (!) the
line 140: estimation->detection (it is not so vague...)
Figure 4: Please move orange block "Motion Sensor" from right also to left
Can you align Blocks "voltage regulator", "battery Charger" and "Micro USB" all horizontally on the right ?
line 159: is shown in (!) figure 6
Figure 5: Is it right that there is no low pass filter, equal RF suppression on the INA input? This is very strange...how can you ever measure an ECG with a BT or Mobile phone transmitter nearby? What about ESD protection on INA input? If persons wear a wool pullover, the INA inputs could get destroyed... Please clarify.
line 173: Since one of (!) the main goals (!)
line 181: your comment on active electrodes is questionable. If you use active electrodes, the excellent CMRR of INA (100 dB) is severely degraded. You never can ensure active electrodes that perform equally to 10^-5 in amplitude!
line 185: ..which measures (!) the reflected light
line 189: This allows (!) to drastically
line 190: ...the manufacturing(!) complexity
line 192: ..which then will (!) require no further operation of(!) data
line 198: ...with an(!) MPU (...as you speak)
line 201: The DMP allows(!) to perform
line 211: allows(!) to safely
line 213: which reflects(!) the same cable
line 220: that allows(!) the integrated
line 223: ...a very small area and implies an easier implementation.
line 224: mode whenever possible. (Drop "is")
line 232: This not only ensures(!) the
line 233: but it also limits(!)
line 241: to assess(!) potential differences
line 256: Figure 6(!) presents(!) the Band-Altman
line 257: and it allows(!) an estimation
line 260: the two heart-rate dections(!)
line 266: in literature, asserting(!) its quality
line 278: is a monotonously raising function
line 281: it is possible to assess at which
line 283: that divides(!) the power
line 289: in accordance(!) with Figure 7(!)
line 307: caused a significant(!) 40Hz iterference
line 324: The device presented here (sentence order!)
line 325: (ECG) large letters
Some general comments:
Can you add a breakdown of each block's power consumption? I would love to see the complete power budget?
I am irritated that there is not any circuitry on the input of INA? Can you measure ECG during BT transmission? Please discuss in the paper. Is the ECG robust against mobile phone use nearby?
With references you should use rectangular brackets [1], [2]
Author Response
Dear Reviewer,
First of all, thank you for the suggested comments that, certainly, helped us to improve the quality of our paper.
In the revised version, we included the proposed changes using “Track Changes" function in Microsoft Word, so that they are easily visible.
Please find attached file with the relative comments.
Author Response File: Author Response.pdf
Reviewer 3 Report
The paper is of interest for readers and is written on a good level. However, I am concerned that the solution of electrodes is only slightly touched by authors. Electrodes are extremely important at the present application. Please explain in greater details, which kind of electrodes have been expected and tested, and what kind of dry electrodes were used in the provided experiments. I am afraid that the rigid metal electrodes cannot ensure the best performance.
The paper can be published after required amendments and corrections.
Author Response
Dear Reviewer,
First of all, thank you for the suggested comments that, certainly, helped us to improve the quality of our paper.
In the revised version, we included the proposed changes using “Track Changes" function in Microsoft Word, so that they are easily visible.
Please find attached file with the relative comments.
Author Response File: Author Response.pdf
