US20050238538A1 - Analyte detection system with software download capabilities - Google Patents

Abstract

An analyte concentration monitoring system having network-based communication features which provide a link between an analyte detection system and a centralized computer. The analyte detection system has a processor that calculates analyte concentration in accordance with software executable by the processor. Under certain conditions, the software needs to be updated. Accordingly, when the analyte detection system is connected to the centralized computer, the centralized computer determines whether a software update is needed. If a software update is needed, then the centralized computer conveniently provides the software update to the analyte detection system without intervention from a user.

Description

BACKGROUND OF THE INVENTION
• 1. Field of the Invention
• This invention pertains, in certain embodiments, to medical equipment for measuring blood analyte levels, and more particularly to a blood analyte measuring instrument having internet-based communication features.
• 2. Description of the Related Art
• A patient, having been taught how to use an existing portable analyte monitor is generally required thereafter to independently conduct and record his or her own measurements. Furthermore, the patient typically is required to both record and assess the measurements without benefit from a practitioner or supervising authority. Numerous errors can arise from these unsupervised procedures that may result in serious health risks for patients which knowingly, or inadvertently, are not in compliance with medical directives.
• Typically, patients using an analyte monitor are given a schedule of measurements they are required to take and a notebook in which to record the measurements. Patients often forget, or in some instances forego, conducting and correctly recording their analyte levels as measured by the instrument. If patients skip a measurement they may even elect to write down a “likely” number in the notebook as if such a measurement had been taken. Patient interaction with such a manual analyte monitoring instrument therefore provides no assurance of correct measurement and recordation. Furthermore, patients in a myriad of situations may require additional information and assistance with regard to the use and maintenance of their analyte measurement instrument.
• In addition, to assure analyte measurement accuracy, a measuring instrument may require periodic calibration or software updates. Assuring calibration compliance on instruments or updating the instrument's software in the field is burdensome.
SUMMARY OF THE INVENTION
• Therefore, a need exists for an analyte monitoring system that encourages patient compliance and facilitates equipment calibration and software updates. The present invention, in certain embodiments, satisfies those needs, as well as others, and overcomes deficiencies in current monitoring systems and procedures.
• The present invention, in certain embodiments, is an analyte measuring device with remote communications capabilities. According to an aspect of the invention, a data link is provided between the equipment and a centralized station, or server. The centralized station can monitor important information, such as: equipment calibration, the diligence of a patient taking and recording measurements according to a schedule, whether a software update is needed and the actual measurements taken by the patient. The centralized station is preferably capable of forwarding information to the patient's physician for evaluation. In addition, the centralized station can have optional capability of locking out the patient if the patient has not paid his or her bills. According to another aspect of the invention, the information is communicated from the analyte measuring device directly to the physician. Accordingly to another aspect, the centralized station can determine an update status of the analyte measuring device's software and automatically send a software update to the analyte measuring device. As can be seen, therefore, the preferred embodiments link the monitoring activities performed by the patient and the assessment of those activities by the physician while reducing the chance of human error introduced into the long-term monitoring and treatment process.
• By way of example, and not of limitation, a non-invasive subsurface spectrophotometer instrument equipped with a communications link according to the invention takes the analyte measurements and communicates them over a network, such as the internet. The spectrophotometer instrument comprises data communication circuitry, such as dial-up circuitry, and additional session control protocols which integrate a number of the functions within the instrument for communication over a network connection. A destination site, or sites, on the network are configured to receive information from the instrument and to transmit information and services.
• In accordance with yet another embodiment, an analyte concentration monitoring system comprises an analyte detection system having a processor that calculates analyte concentration in accordance with software executable by the processor. The monitoring system further comprises a network interface that is configured to provide connectivity to a computer. The analyte detection system is configured to receive an update to the software from the computer.
• In accordance with yet another embodiment, a method of automatically updating software on an analyte detection system, comprises connecting an analyte detection system to a computer via a network, and checking, in the computer, an update status of software included in the analyte detection system. The method further comprises sending, when the update status indicates that a software update is needed, the software update to the analyte detection system via the network without intervention from a user. The method further comprises updating, in the analyte detection system, the software with the software update.
• In accordance with yet another embodiment, an analyte concentration monitoring system comprises an analyte detection system comprising a processor, a software, and a network interface. The processor is configured to calculate analyte concentration in accordance to the software, and the network interface is configured to provide connectivity to a computer. The analyte detection system is configured to update the software according to instructions from the computer.
• In accordance with yet another embodiment, a method of automatically updating software on an analyte detection system comprises connecting an analyte detection system to a computer via a network. The method further comprises checking, in the computer, an update status of software included in the analyte detection system. The method further comprises encrypting, when the update status indicates that a software update is needed, the software update and sending the software update to the analyte detection system via the network. The method further comprises updating, in the analyte detection system, the software with the software update.
BRIEF DESCRIPTION OF THE DRAWINGS
• FIG. 1 is a schematic view of a noninvasive optical detection system.
• FIG. 2 is a perspective view of a window assembly for use with the noninvasive detection system.
• FIG. 2A is a plan view of another embodiment of a window assembly for use with the noninvasive detection system.
• FIG. 3 is an exploded schematic view of another embodiment of a window assembly for use with the noninvasive detection system.
• FIG. 4 is a plan view of the window assembly connected to a cooling system.
• FIG. 5 is a plan view of the window assembly connected to a cold reservoir.
• FIG. 6 is a cutaway view of a heat sink for use with the noninvasive detection system.
• FIG. 6A is a cutaway perspective view of a lower portion of the noninvasive detection system ofFIG. 1.
• FIG. 6B is an exploded perspective view of a window mounting system for use with the noninvasive optical detection system.
• FIG. 6C is a partial plan view of the window mounting system ofFIG. 6B.
• FIG. 6D is a sectional view of the window mounting system ofFIG. 6C.
• FIG. 7 is a schematic view of a control system for use with the noninvasive optical detection system.
• FIG. 8 depicts a first methodology for determining the concentration of an analyte of interest.
• FIG. 9 depicts a second methodology for determining the concentration of an analyte of interest.
• FIG. 10 depicts a third methodology for determining the concentration of an analyte of interest.
• FIG. 11 depicts a fourth methodology for determining the concentration of an analyte of interest.
• FIG. 12 depicts a fifth methodology for determining the concentration of an analyte of interest.
• FIG. 13 is a schematic view of a reagentless whole-blood detection system.
• FIG. 14 is a perspective view of one embodiment of a cuvette for use with the reagentless whole-blood detection system.
• FIG. 15 is a plan view of another embodiment of a cuvette for use with the reagentless whole-blood detection system.
• FIG. 16 is a disassembled plan view of the cuvette shown inFIG. 15.
• FIG. 16A is an exploded perspective view of the cuvette ofFIG. 15.
• FIG. 17 is a side view of the cuvette ofFIG. 15.
• FIG. 18 is a functional block diagram showing an analyte monitoring system with network connectivity.
• FIG. 19 is a block diagram of the electronic circuits within the analyte monitoring system ofFIG. 18.
• FIG. 20 is a flowchart exemplifying calibration lockout according to one embodiment disclosed herein.
• FIG. 21 is a block diagram of components of an analyte monitoring system having software update capabilities.
• FIG. 22 is a flowchart exemplifying updating a analyte monitoring device's software according to another embodiment disclosed herein.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
• The devices and methods summarized above are described in greater detail below. Part I contains a description of a number of analyte detection systems, including a noninvasive system and a whole-blood system, as well as associated methods of analyte detection. Parts II and III includes a discussion of further systems and methods for, inter alia, updating software executed by analyte detection systems such as (but not limited to) those described in Part I. Accordingly, the systems and methods described in Parts II and III may (but need not) be employed by, within and/or in connection with those described in Part I.
• Although certain preferred embodiments and examples are disclosed below, it will be understood by those skilled in the art that the invention extends beyond the specifically disclosed embodiments to other alternative embodiments and/or uses of the invention and obvious modifications and equivalents thereof. Thus, it is intended that the scope of the invention herein disclosed should not be limited by the particular disclosed embodiments described below.
I. Overview of Analyte Detection Systems
• Disclosed herein are analyte detection systems, including a noninvasive system discussed largely in part A below and a whole-blood system discussed largely in part B below. Also disclosed are various methods, including methods for detecting the concentration of an analyte in a material sample. Both the noninvasive system/method and the whole-blood system/method can employ optical measurement. As used herein with reference to measurement apparatus and methods, “optical” is a broad term and is used in its ordinary sense and refers, without limitation, to identification of the presence or concentration of an analyte in a material sample without requiring a chemical reaction to take place. As discussed in more detail below, the two approaches each can operate independently to perform an optical analysis of a material sample. The two approaches can also be combined in an apparatus, or the two approaches can be used together to perform different steps of a method.
• In one embodiment, the two approaches are combined to perform calibration of an apparatus, e.g., of an apparatus that employs a noninvasive approach. In another embodiment, an advantageous combination of the two approaches performs an invasive measurement to achieve greater accuracy and a whole-blood measurement to minimize discomfort to the patient. For example, the whole-blood technique may be more accurate than the noninvasive technique at certain times of the day, e.g., at certain times after a meal has been consumed, or after a drug has been administered.
• It should be understood, however, that any of the disclosed devices may be operated in accordance with any suitable detection methodology, and that any disclosed method may be employed in the operation of any suitable device. Furthermore, the disclosed devices and methods are applicable in a wide variety of situations or modes of operation, including but not limited to invasive, noninvasive, intermittent or continuous measurement, subcutaneous implantation, wearable detection systems, or any combination thereof.
• Any method which is described and illustrated herein is not limited to the exact sequence of acts described, nor is it necessarily limited to the practice of all of the acts set forth. Other sequences of events or acts, or less than all of the events, or simultaneous occurrence of the events, may be utilized in practicing the method(s) in question.
• A. Noninvasive System
• 1. Monitor Structure
• FIG. 1 depicts a noninvasive optical detection system (hereinafter “noninvasive system”)10 in a presently preferred configuration. The depictednoninvasive system10 is particularly suited for noninvasively detecting the concentration of an analyte in a material sample S, by observing the infrared energy emitted by the sample, as will be discussed in further detail below.
• As used herein, the term “noninvasive” is a broad term and is used in its ordinary sense and refers, without limitation, to analyte detection devices and methods which have the capability to determine the concentration of an analyte in in-vivo tissue samples or bodily fluids. It should be understood, however, that thenoninvasive system10 disclosed herein is not limited to noninvasive use, as thenoninvasive system10 may be employed to analyze an in-vitro fluid or tissue sample which has been obtained invasively or noninvasively. As used herein, the term “invasive” (or, alternatively, “traditional”) is a broad term and is used in its ordinary sense and refers, without limitation, to analyte detection methods which involve the removal of fluid samples through the skin. As used herein, the term “material sample” is a broad term and is used in its ordinary sense and refers, without limitation, to any collection of material which is suitable for analysis by thenoninvasive system10. For example, the material sample S may comprise a tissue sample, such as a human forearm, placed against thenoninvasive system10. The material sample S may also comprise a volume of a bodily fluid, such as whole blood, blood component(s), interstitial fluid or intercellular fluid obtained invasively, or saliva or urine obtained noninvasively, or any collection of organic or inorganic material. As used herein, the term “analyte” is a broad term and is used in its ordinary sense and refers, without limitation, to any chemical species the presence or concentration of which is sought in the material sample S by thenoninvasive system10. For example, the analyte(s) which may be detected by thenoninvasive system10 include but not are limited to glucose, ethanol, insulin, water, carbon dioxide, blood oxygen, cholesterol, bilirubin, ketones, fatty acids, lipoproteins, albumin, urea, creatinine, white blood cells, red blood cells, hemoglobin, oxygenated hemoglobin, carboxyhemoglobin, organic molecules, inorganic molecules, pharmaceuticals, cytochrome, various proteins and chromophores, microcalcifications, electrolytes, sodium, potassium, chloride, bicarbonate, and hormones. As used herein to describe measurement techniques, the term “continuous” is a broad term and is used in its ordinary sense and refers, without limitation, to the taking of discrete measurements more frequently than about once every 10 minutes, and/or the taking of a stream or series of measurements or other data over any suitable time interval, for example, over an interval of one to several seconds, minutes, hours, days, or longer. As used herein to describe measurement techniques, the term “intermittent” is a broad term and is used in its ordinary sense and refers, without limitation, to the taking of measurements less frequently than about once every 10 minutes.
• Thenoninvasive system10 preferably comprises awindow assembly12, although in some embodiments thewindow assembly12 may be omitted. One function of thewindow assembly12 is to permit infrared energy E to enter thenoninvasive system10 from the sample S when it is placed against anupper surface12a of thewindow assembly12. Thewindow assembly12 includes a heater layer (see discussion below) which is employed to heat the material sample S and stimulate emission of infrared energy therefrom. Acooling system14, preferably comprising a Peltier-type thermoelectric device, is in thermally conductive relation to thewindow assembly12 so that the temperature of thewindow assembly12 and the material sample S can be manipulated in accordance with a detection methodology discussed in greater detail below. Thecooling system14 includes a cold surface14awhich is in thermally conductive relation to acold reservoir16 and thewindow assembly12, and ahot surface14bwhich is in thermally conductive relation to aheat sink18.
• As the infrared energy E enters thenoninvasive system10, it first passes through thewindow assembly12, then through anoptical mixer20, and then through acollimator22. Theoptical mixer20 preferably comprises a light pipe having highly reflective inner surfaces which randomize the directionality of the infrared energy E as it passes therethrough and reflects against the mixer walls. Thecollimator22 also comprises a light pipe having highly-reflective inner walls, but the walls diverge as they extend away from themixer20. The divergent walls cause the infrared energy E to tend to straighten as it advances toward the wider end of thecollimator22, due to the angle of incidence of the infrared energy when reflecting against the collimator walls.
• From thecollimator22 the infrared energy E passes through an array offilters24, each of which allows only a selected wavelength or band of wavelengths to pass therethrough. These wavelengths/bands are selected to highlight or isolate the absorptive effects of the analyte of interest in the detection methodology discussed in greater detail below. Eachfilter24 is preferably in optical communication with aconcentrator26 and aninfrared detector28. Theconcentrators26 have highly reflective, converging inner walls which concentrate the infrared energy as it advances toward thedetectors28, increasing the density of the energy incident upon thedetectors28.
• Thedetectors28 are in electrical communication with acontrol system30 which receives electrical signals from thedetectors28 and computes the concentration of the analyte in the sample S. Thecontrol system30 is also in electrical communication with thewindow12 andcooling system14, so as to monitor the temperature of thewindow12 and/orcooling system14 and control the delivery of electrical power to thewindow12 andcooling system14.
• • a. Window Assembly
• A preferred configuration of thewindow assembly12 is shown in perspective, as viewed from its underside (in other words, the side of thewindow assembly12 opposite the sample S), inFIG. 2. Thewindow assembly12 generally comprises amain layer32 formed of a highly infrared-transmissive material and aheater layer34 affixed to the underside of themain layer32. Themain layer32 is preferably formed from diamond, most preferably from chemical-vapor-deposited (“CVD”) diamond, with a preferred thickness of about 0.25 millimeters. In other embodiments alternative materials which are highly infrared-transmissive, such as silicon or germanium, may be used in forming themain layer32.
• Theheater layer34 preferably comprises bus bars36 located at opposing ends of an array ofheater elements38. The bus bars36 are in electrical communication with theelements38 so that, upon connection of the bus bars36 to a suitable electrical power source (not shown) a current may be passed through theelements38 to generate heat in thewindow assembly12. Theheater layer34 may also include one or more temperature sensors (not shown), such as thermistors or resistance temperature devices (RTDs), to measure the temperature of thewindow assembly12 and provide temperature feedback to the control system30 (seeFIG. 1).
• Still referring toFIG. 2, theheater layer34 preferably comprises a first adhesion layer of gold or platinum (hereinafter, referred to as the “gold” layer) deposited over an alloy layer which is applied to themain layer32. The alloy layer comprises a material suitable for implementation of theheater layer34, such as, by way of example, 10/90 titanium/tungsten, titanium/platinum, nickel/chromium, or other similar material. The gold layer preferably has a thickness of about 4000 Å, and the alloy layer preferably has a thickness ranging between about 300 Å and about 500 Å. The gold layer and/or the alloy layer may be deposited onto themain layer32 by chemical deposition including, but not necessarily limited to, vapor deposition, liquid deposition, plating, laminating, casting, sintering, or other forming or deposition methodologies well known to those or ordinary skill in the art. If desired, theheater layer34 may be covered with an electrically insulating coating which also enhances adhesion to themain layer32. One preferred coating material is aluminum oxide. Other acceptable materials include, but are not limited to, titanium dioxide or zinc selenide.
• Theheater layer34 may incorporate a variable pitch distance between centerlines ofadjacent heater elements38 to maintain a constant power density, and promote a uniform temperature, across theentire layer34. Where a constant pitch distance is employed, the preferred distance is at least about 50-100 microns. Although theheater elements38 generally have a preferred width of about 25 microns, their width may also be varied as needed for the same reasons stated above.
• Alternative structures suitable for use as theheater layer34 include, but are not limited to, thermoelectric heaters, radiofrequency (RF) heaters, infrared radiation heaters, optical heaters, heat exchangers, electrical resistance heating grids, wire bridge heating grids, or laser heaters. Whichever type of heater layer is employed, it is preferred that the heater layer obscures about 10% or less of thewindow assembly12.
• In a preferred embodiment, thewindow assembly12 comprises substantially only themain layer32 and theheater layer34. Thus, when installed in an optical detection system such as thenoninvasive system10 shown inFIG. 1, thewindow assembly12 will facilitate a minimally obstructed optical path between a (preferably flat)upper surface12aof thewindow assembly12 and theinfrared detectors28 of thenoninvasive system10. Theoptical path32 in the preferrednoninvasive system10 proceeds only through themain layer32 andheater layer34 of the window assembly12 (including any antireflective, index-matching, electrical insulating or protective coatings applied thereto or placed therein), through theoptical mixer20 andcollimator22 and to thedetectors28.
• FIG. 2A shows another embodiment of thewindow assembly12, that may be used in place of thewindow assembly12 depicted inFIG. 2. Thewindow assembly12 shown inFIG. 2A may be similar to that shown inFIG. 2, except as described below. In the embodiment ofFIG. 2A themain layer32 has a preferred thickness of up to about 0.012″ and more preferably about 0.010″ or less. Theheater layer34 may also include one or more resistance temperature devices (RTD's)55 to measure the temperature of thewindow assembly12 and provide temperature feedback to acontrol system30. The RTDs55 terminate inRTD connection pads57.
• In the embodiment ofFIG. 2A, theheater elements38 are typically provided with a width of about 25 microns. The pitch distance separating centerlines ofadjacent heater elements38 may be reduced, and/or the width of theheater elements38 may be increased, in the regions of thewindow assembly12 near the point(s) of contact with the thermal diffuser410 (seeFIGS. 6B-6D and discussion below). This arrangement advantageously promotes an isothermal temperature profile at the upper surface of themain layer32 despite thermal contact with the thermal diffuser.
• The embodiment shown inFIG. 2A includes a plurality ofheater elements38 of substantially equal width which are variably spaced across the width of themain layer32. In the embodiment ofFIG. 2A, the centerlines of theheater elements38 are spaced at a first pitch distance of about 0.0070″ at peripheral portions34aof theheater layer34, and at a second pitch distance of about 0.015″ at acentral portion34bof themain layer32. Theheater elements38 closest to the center are preferably sufficiently spaced to allow the RTDs55 to extend therebetween. In the embodiment ofFIG. 2A, themain layer32 includesperipheral regions32awhich extend about 0.053″ from the outermost heater element on each side of theheater layer34 to the adjacent edge of themain layer32. As shown, the bus bars36 are preferably configured and segmented to allow space for theRTDs55 and theRTD connection pads57, inintermediate gaps36a.The RTDs55 preferably extend into the array ofheater elements38 by distance that is slightly longer than half of the length of anindividual heater element38. In alternative embodiments, theRTDs55 may be located at the edges of themain layer32, or at other locations as desired for a particular noninvasive system.
• With continued reference toFIG. 2A, the peripheral regions of themain layer32 may include metallizededge portions35 for facilitating connection to the diffuser410 (discussed below in connection withFIGS. 6B-6D). The metallizededge portions35 may be formed by the same or similar processes used in forming theheater elements38 andRTDs55. In the embodiment ofFIG. 2A, theedge portions35 are typically between about 0.040″ and about 0.060″ wide by about 0.450″ and about 0.650″ long, and in one embodiment, they are about 0.050″ by about 0.550″. Other dimensions may be appropriately used so long as thewindow assembly12 may be joined in thermal communication with thediffuser410 as needed.
• In the embodiment shown inFIG. 2A, themain layer32 is about 0.690″ long by about 0.571″ wide, and the heater layer (excluding the metallized edge portions35) is about 0.640″ long by about 0.465″ wide. Themain layer32 is about 0.010″-0.012″ thick, and is advantageously thinner than about 0.010″ where possible. Eachheater element38 is about 0.570″ long, and each peripheral region34ais about 0.280″ wide. These dimensions are merely exemplary; of course, other dimensions may be used as desired.
• FIG. 3 depicts an exploded side view of an alternative configuration for thewindow assembly12, which may be used in place of the configuration shown inFIG. 2. Thewindow assembly12 depicted inFIG. 3 includes near its upper surface (the surface intended for contact with the sample S) a highly infrared-transmissive, thermallyconductive spreader layer42. Underlying thespreader layer42 is aheater layer44. A thin electrically insulating layer (not shown), such as layer of aluminum oxide, titanium dioxide or zinc selenide, may be disposed between theheater layer44 and thespreader layer42. (An aluminum oxide layer also increases adhesion of theheater layer44 to thespreader layer42.) Adjacent to theheater layer44 is a thermal insulating andimpedance matching layer46. Adjacent to the thermal insulatinglayer46 is a thermally conductiveinner layer48. Thespreader layer42 is coated on its top surface with a thin layer ofprotective coating50. The bottom surface of theinner layer48 is coated with athin overcoat layer52. Preferably, theprotective coating50 and theovercoat layer52 have antireflective properties.
• Thespreader layer42 is preferably formed of a highly infrared-transmissive material having a high thermal conductivity sufficient to facilitate heat transfer from theheater layer44 uniformly into the material sample S when it is placed against thewindow assembly12. Other effective materials include, but are not limited to, CVD diamond, diamondlike carbon, gallium arsenide, germanium, and other infrared-transmissive materials having sufficiently high thermal conductivity. Preferred dimensions for thespreader layer42 are about one inch in diameter and about 0.010 inch thick. As shown inFIG. 3, a preferred embodiment of thespreader layer42 incorporates a beveled edge. Although not required, an approximate 45-degree bevel is preferred.
• Theprotective layer50 is intended to protect the top surface of thespreader layer42 from damage. Ideally, the protective layer is highly infrared-transmissive and highly resistant to mechanical damage, such as scratching or abrasion. It is also preferred that theprotective layer50 and theovercoat layer52 have high thermal conductivity and antireflective and/or index-matching properties. A satisfactory material for use as theprotective layer50 and theovercoat layer52 is the multi-layer Broad Band Anti-Reflective Coating produced by Deposition Research Laboratories, Inc. of St. Charles, Mo. Diamondlike carbon coatings are also suitable.
• Except as noted below, theheater layer44 is generally similar to theheater layer34 employed in the window assembly shown inFIG. 2. Alternatively, theheater layer44 may comprise a doped infrared-transmissive material, such as a doped silicon layer, with regions of higher and lower resistivity. Theheater layer44 preferably has a resistance of about 2 ohms and has a preferred thickness of about 1,500 angstroms. A preferred material for forming theheater layer44 is a gold alloy, but other acceptable materials include, but are not limited to, platinum, titanium, tungsten, copper, and nickel.
• The thermal insulatinglayer46 prevents the dissipation of heat from theheater element44 while allowing thecooling system14 to effectively cool the material sample S (seeFIG. 1). Thislayer46 comprises a material having thermally insulative (e.g., lower thermal conductivity than the spreader layer42) and infrared transmissive qualities. A preferred material is a germanium-arsenic-selenium compound of the calcogenide glass family known as AMTIR-1 produced by Amorphous Materials, Inc. of Garland, Tex. The pictured embodiment has a diameter of about 0.85 inches and a preferred thickness in the range of about 0.005 to about 0.010 inches. As heat generated by theheater layer44 passes through thespreader layer42 into the material sample S, the thermal insulatinglayer46 insulates this heat.
• Theinner layer48 is formed of thermally conductive material, preferably crystalline silicon formed using a conventional floatzone crystal growth method. The purpose of theinner layer48 is to serve as a cold-conducting mechanical base for the entire layered window assembly.
• The overall optical transmission of thewindow assembly12 shown inFIG. 3 is preferably at least 70%. Thewindow assembly12 ofFIG. 3 is preferably held together and secured to thenoninvasive system10 by a holding bracket (not shown). The bracket is preferably formed of a glass-filled plastic, for example Ultem 2300, manufactured by General Electric. Ultem 2300 has low thermal conductivity which prevents heat transfer from the layeredwindow assembly12.
• • b. Cooling System
• The cooling system14 (seeFIG. 1) preferably comprises a Peltier-type thermoelectric device. Thus, the application of an electrical current to thepreferred cooling system14 causes the cold surface14ato cool and causes the opposinghot surface14bto heat up. Thecooling system14 cools thewindow assembly12 via the situation of thewindow assembly12 in thermally conductive relation to the cold surface14aof thecooling system14. It is contemplated that thecooling system14, theheater layer34, or both, can be operated to induce a desired time-varying temperature in thewindow assembly12 to create an oscillating thermal gradient in the sample S, in accordance with various analyte-detection methodologies discussed herein.
• Preferably, thecold reservoir16 is positioned between the coolingsystem14 and thewindow assembly12, and functions as a thermal conductor between thesystem14 and thewindow assembly12. Thecold reservoir16 is formed from a suitable thermally conductive material, preferably brass. Alternatively, thewindow assembly12 can be situated in direct contact with the cold surface14aof thecooling system14.
• In alternative embodiments, thecooling system14 may comprise a heat exchanger through which a coolant, such as air, nitrogen or chilled water, is pumped, or a passive conduction cooler such as a heat sink. As a further alternative, a gas coolant such as nitrogen may be circulated through the interior of thenoninvasive system10 so as to contact the underside of the window assembly12 (seeFIG. 1) and conduct heat therefrom.
• FIG. 4 is a top schematic view of a preferred arrangement of the window assembly12 (of the types shown inFIG. 2 or2A) and thecold reservoir16, andFIG. 5 is a top schematic view of an alternative arrangement in which thewindow assembly12 directly contacts thecooling system14. Thecold reservoir16/cooling system14 preferably contacts the underside of thewindow assembly12 along opposing edges thereof, on either side of theheater layer34. With thermal conductivity thus established between thewindow assembly12 and thecooling system14, the window assembly can be cooled as needed during operation of thenoninvasive system10. In order to promote a substantially uniform or isothermal temperature profile over the upper surface of thewindow assembly12, the pitch distance between centerlines ofadjacent heater elements38 may be made smaller (thereby increasing the density of heater elements38) near the region(s) of contact between thewindow assembly12 and thecold reservoir16/cooling system14. As a supplement or alternative, theheater elements38 themselves may be made wider near these regions of contact. As used herein, “isothermal” is a broad term and is used in its ordinary sense and refers, without limitation, to a condition in which, at a given point in time, the temperature of thewindow assembly12 or other structure is substantially uniform across a surface intended for placement in thermally conductive relation to the material sample S. Thus, although the temperature of the structure or surface may fluctuate over time, at any given point in time the structure or surface may nonetheless be isothermal.
• Theheat sink18 drains waste heat from thehot surface14bof thecooling system16 and stabilizes the operational temperature of thenoninvasive system10. The preferred heat sink18 (seeFIG. 6) comprises a hollow structure formed from brass or any other suitable material having a relatively high specific heat and high heat conductivity. Theheat sink18 has aconduction surface18a which, when theheat sink18 is installed in thenoninvasive system18, is in thermally conductive relation to thehot surface14bof the cooling system14 (seeFIG. 1). Acavity54 is formed in theheat sink18 and preferably contains a phase-change material (not shown) to increase the capacity of thesink18. A preferred phase change material is a hydrated salt, such as calciumchloride hexahydrate, available under the name TH29 from PCM Thermal Solutions, Inc., of Naperville, Ill. Alternatively, thecavity54 may be omitted to create aheat sink18 comprising a solid, unitary mass. Theheat sink18 also forms a number offins56 to further increase the conduction of heat from thesink18 to surrounding air.
• Alternatively, theheat sink18 may be formed integrally with theoptical mixer20 and/or thecollimator22 as a unitary mass of rigid, heat-conductive material such as brass or aluminum. In such a heat sink, themixer20 and/orcollimator22 extend axially through theheat sink18, and the heat sink defines the inner walls of themixer20 and/orcollimator22. These inner walls are coated and/or polished to have appropriate reflectivity and nonabsorbance in infrared wavelengths as will be further described below. Where such a unitary heat sink-mixer-collimator is employed, it is desirable to thermally insulate the detector array from the heat sink.
• It should be understood that any suitable structure may be employed to heat and/or cool the material sample S, instead of or in addition to thewindow assembly12/cooling system14 disclosed above, so long a proper degree of cycled heating and/or cooling are imparted to the material sample S. In addition other forms of energy, such as but not limited to light, radiation, chemically induced heat, friction and vibration, may be employed to heat the material sample S. It will be further appreciated that heating of the sample can achieved by any suitable method, such as convection, conduction, radiation, etc.
• • c. Window Mounting System
• FIG. 6B illustrates an exploded view of awindow mounting system400 which, in one embodiment, is employed as part of thenoninvasive system10 disclosed above. Where employed in connection with thenoninvasive system10, thewindow mounting system400 supplements or, where appropriate, replaces any of thewindow assembly12,cooling system14,cold reservoir16 andheat sink18 shown inFIG. 1. In one embodiment, thewindow mounting system400 is employed in conjunction with thewindow assembly12 depicted inFIG. 2A; in alternative embodiments, the window assemblies shown inFIGS. 2 and 3 and described above may also be used in conjunction with thewindow mounting system400 illustrated inFIG. 6B.
• In thewindow mounting system400, thewindow assembly12 is physically and electrically connected (typically by soldering) to a first printed circuit board (“first PCB”)402. Thewindow assembly12 is also in thermally conductive relation (typically by contact) to athermal diffuser410. The window assembly may also be fixed to thediffuser410 by soldering.
• Thethermal diffuser410 generally comprises aheat spreader layer412 which, as mentioned, preferably contacts thewindow assembly12, and aconductive layer414 which is typically soldered to theheat spreader layer412. Theconductive layer414 may then be placed in direct contact with a cold side418aof a thermoelectric cooler (TEC)418 or other cooling device. TheTEC418, which in one embodiment comprises a 25 W TEC manufactured by MELCOR, is in electrical communication with asecond PCB403, which includes TEC power leads409 andTEC power terminals411 for connection of theTEC418 to an appropriate power source (not shown). Thesecond PCB403 also includescontacts408 for connection with RTD terminals407 (seeFIG. 6C) of thefirst PCB402. Aheat sink419, which may take the form of the illustrated water jacket, theheat sink18 shown inFIG. 6, any other heat sink structures mentioned herein, or any other appropriate device, is in thermal communication with ahot side418bof the TEC418 (or other cooling device), in order to remove any excess heat created by theTEC418.
• FIG. 6C illustrates a plan view of the interconnection of thewindow assembly12, thefirst PCB402, thediffuser410 and thethermoelectric cooler418. The first PCB includes RTD bonding leads406 andheater bonding pads404 which permit attachment of theRTDs55 andbus bars36, respectively, of thewindow assembly12 to thefirst PCB402 via soldering or other conventional techniques. Electrical communication is thus established between theheater elements38 of theheater layer34, andheater terminals405 formed in theheater bonding pads404. Similarly, electrical communication is established between the RTDs55 andRTD terminals407 formed at the ends of the RTD bonding leads406. Electrical connections can be established with theheater elements38 and theRTDs55 via simple connection to theterminals405,407 of thefirst PCB402.
• With further reference to FIGS.2A and6B-6C, theheat spreader layer412 of thethermal diffuser410 contacts the underside of themain layer32 of thewindow assembly12 via a pair ofrails416. Therails416 may contact themain layer32 at the metallizededge portions35, or at any other appropriate location. The physical and thermal connection between therails416 and the windowmain layer32 may be achieved by soldering, as indicated above. Alternatively, the connection may be achieved by an adhesive such as epoxy, or any other appropriate method. The material chosen for the windowmain layer32 is preferably sufficiently thermally conductive that heat may be quickly removed from themain layer32 through therails416, thediffuser410, and the TEC128.
• FIG. 6D shows a cross-sectional view of the assembly ofFIG. 6C through line22-22. As can be seen inFIG. 6D, thewindow assembly12 contacts therails416 of theheat spreader layer412. Theconductive layer414 underlies thespreader layer412 and may compriseprotrusions426 configured to extend throughopenings424 formed in thespreader layer412. Theopenings424 andprotrusions426 are sized to leave sufficient expansion space therebetween, to allow expansion and contraction of theconductive layer414 without interference with, or causing deformation of, thewindow assembly12 or theheat spreader layer412. Moreover, theprotrusions426 andopenings424 coact to prevent displacement of thespreader layer412 with respect to theconductive layer414 as theconductive layer414 expands and contracts.
• Thethermal diffuser410 provides a thermal impedance between theTEC418 and thewindow assembly12, which impedance is selected to drain heat from the window assembly at a rate proportional to the power output of theheater layer34. In this way, the temperature of themain layer32 can be rapidly cycled between a “hot” and a “cold” temperatures, thereby allowing a time-varying thermal gradient to be induced in a sample S placed against thewindow assembly12.
• Theheat spreader layer412 is preferably made of a material which has substantially the same coefficient of thermal expansion as the material used to form the window assemblymain layer32, within the expected operating temperature range. Preferably, both the material used to form themain layer32 and the material used to form theheat spreader layer412 have substantially the same, extremely low, coefficient of thermal expansion. For this reason, CVD diamond is preferred for the main layer32 (as mentioned above); with a CVD diamondmain layer32 the preferred material for theheat spreader layer412 is Invar. Invar advantageously has an extremely low coefficient of thermal expansion and a relatively high thermal conductivity. Because Invar is a metal, themain layer32 and theheat spreader layer412 can be thermally bonded to one another with little difficulty. Alternatively, other materials may be used for theheat spreader layer412; for example, any of a number of glass and ceramic materials with low coefficients of thermal expansion may be employed.
• Theconductive layer414 of thethermal diffuser410 is typically a highly thermally conductive material such as copper (or, alternatively, other metals or non-metals exhibiting comparable thermal conductivities). Theconductive layer414 is typically soldered or otherwise bonded to the underside of theheat spreader layer412.
• In the illustrated embodiment, theheat spreader layer412 may be constructed according to the following dimensions, which are to be understood as exemplary; accordingly the dimensions may be varied as desired. Theheat spreader layer412 has an overall length and width of about 1.170″, with a central opening of about 0.590″ long by 0.470″ wide. Generally, theheat spreader layer412 is about 0.030″ thick; however, therails416 extend a further 0.045″ above the basic thickness of theheat spreader layer412. Eachrail416 has an overall length of about 0.710″; over the central 0.525″ of this length eachrail416 is about 0.053″ wide. On either side of the central width eachrail416 tapers, at a radius of about 0.6″, down to a width of about 0.023″. Eachopening424 is about 0.360″ long by about 0.085″ wide, with comers rounded at a radius of about 0.033″.
• In the illustrated embodiment,conductive layer414 may be constructed according to the following dimensions, which are to be understood as exemplary; accordingly the dimensions may be varied as desired. Theconductive layer414 has an overall length and width of about 1.170″, with a central opening of about 0.590″ long by 0.470″ wide. Generally, theconductive layer412 is about 0.035″ thick; however, theprotrusions426 extend a further 0.075″-0.085″ above the basic thickness of theconductive layer414. Eachprotrusion426 is about 0.343″ long by about 0.076″ wide, with corners rounded at a radius of about 0.035″.
• As shown inFIG. 6B, first andsecond clamping plates450 and452 may be used to clamp the portions of thewindow mounting system400 to one another. For example, thesecond clamping plate452 is configured to clamp thewindow assembly12 and thefirst PCB402 to thediffuser410 with screws or other fasteners extending through the openings shown in thesecond clamping plate452, theheat spreader layer412 and theconductive layer414. Similarly, thefirst clamping plate450 is configured overlie thesecond clamping plate452 and clamp the rest of thewindow mounting system400 to theheat sink419, thus sandwiching thesecond clamping plate452, thewindow assembly12, thefirst PCB402, thediffuser410, thesecond PCB403, and theTEC418 therebetween. Thefirst clamping plate450 prevents undesired contact between the sample S and any portion of thewindow mounting system400, other than thewindow assembly12 itself. Other mounting plates and mechanisms may also be used as desired.
• • d. Optics
• As shown inFIG. 1, theoptical mixer20 comprises a light pipe with an inner surface coating which is highly reflective and minimally absorptive in infrared wavelengths, preferably a polished gold coating, although other suitable coatings may be used where other wavelengths of electromagnetic radiation are employed. The pipe itself may be fabricated from a another rigid material such as aluminum or stainless steel, as long as the inner surfaces are coated or otherwise treated to be highly reflective. Preferably, theoptical mixer20 has a rectangular cross-section (as taken orthogonal to the longitudinal axis A-A of themixer20 and the collimator22), although other cross-sectional shapes, such as other polygonal shapes or circular or elliptical shapes, may be employed in alternative embodiments. The inner walls of theoptical mixer20 are substantially parallel to the longitudinal axis A-A of themixer20 and thecollimator22. The highly reflective and substantially parallel inner walls of themixer20 maximize the number of times the infrared energy E will be reflected between the walls of themixer20, thoroughly mixing the infrared energy E as it propagates through themixer20. In a presently preferred embodiment, themixer20 is about 1.2 inches to 2.4 inches in length and its cross-section is a rectangle of about 0.4 inches by about 0.6 inches. Of course, other dimensions may be employed in constructing themixer20. In particular it is be advantageous to miniaturize the mixer or otherwise make it as small as possible
• Still referring toFIG. 1, thecollimator22 comprises a tube with an inner surface coating which is highly reflective and minimally absorptive in infrared wavelengths, preferably a polished gold coating. The tube itself may be fabricated from a another rigid material such as aluminum, nickel or stainless steel, as long as the inner surfaces are coated or otherwise treated to be highly reflective. Preferably, thecollimator22 has a rectangular cross-section, although other cross-sectional shapes, such as other polygonal shapes or circular, parabolic or elliptical shapes, may be employed in alternative embodiments. The inner walls of thecollimator22 diverge as they extend away from themixer20. Preferably, the inner walls of thecollimator22 are substantially straight and form an angle of about 7 degrees with respect to the longitudinal axis A-A. Thecollimator22 aligns the infrared energy E to propagate in a direction that is generally parallel to the longitudinal axis A-A of themixer20 and thecollimator22, so that the infrared energy E will strike the surface of thefilters24 at an angle as close to 90 degrees as possible.
• In a presently preferred embodiment, the collimator is about 7.5 inches in length. At itsnarrow end22a,the cross-section of thecollimator22 is a rectangle of about 0.4 inches by 0.6 inches. At itswide end22b,thecollimator22 has a rectangular cross-section of about 1.8 inches by 2.6 inches. Preferably, thecollimator22 aligns the infrared energy E to an angle of incidence (with respect to the longitudinal axis A-A) of about 0-15 degrees before the energy E impinges upon thefilters24. Of course, other dimensions or incidence angles may be employed in constructing and operating thecollimator22.
• With further reference toFIGS. 1 and 6A, each concentrator26 comprises a tapered surface oriented such that itswide end26ais adapted to receive the infrared energy exiting the correspondingfilter24, and such that itsnarrow end26bis adjacent to the correspondingdetector28. The inward-facing surfaces of theconcentrators26 have an inner surface coating which is highly reflective and minimally absorptive in infrared wavelengths, preferably a polished gold coating. Theconcentrators26 themselves may be fabricated from a another rigid material such as aluminum, nickel or stainless steel, so long as their inner surfaces are coated or otherwise treated to be highly reflective.
• Preferably, theconcentrators26 have a rectangular cross-section (as taken orthogonal to the longitudinal axis A-A), although other cross-sectional shapes, such as other polygonal shapes or circular, parabolic or elliptical shapes, may be employed in alternative embodiments. The inner walls of the concentrators converge as they extend toward thenarrow end26b.Preferably, the inner walls of thecollimators26 are substantially straight and form an angle of about 8 degrees with respect to the longitudinal axis A-A. Such a configuration is adapted to concentrate infrared energy as it passes through theconcentrators26 from thewide end26ato thenarrow end26b,before reaching thedetectors28.
• In a presently preferred embodiment, each concentrator26 is about 1.5 inches in length. At thewide end26a,the cross-section of each concentrator26 is a rectangle of about 0.6 inches by 0.57 inches. At thenarrow end26b,each concentrator26 has a rectangular cross-section of about 0.177 inches by 0.177 inches. Of course, other dimensions or incidence angles may be employed in constructing theconcentrators26.
• • e. Filters
• Thefilters24 preferably comprise standard interference-type infrared filters, widely available from manufacturers such as Optical Coating Laboratory, Inc. (“OCLI”) of Santa Rosa, Calif. In the embodiment illustrated inFIG. 1, a 3×4 array offilters24 is positioned above a 3×4 array ofdetectors28 andconcentrators26. As employed in this embodiment, thefilters24 are arranged in four groups of three filters having the same wavelength sensitivity. These four groups have bandpass center wavelengths of 7.15 μm±0.03 μm, 8.40 μm±0.03 μm, 9.48 μm±0.04 μm, and 11.10 μm±0.04 μm, respectively, which correspond to wavelengths around which water and glucose absorb electromagnetic radiation. Typical bandwidths for these filters range from 0.20 μm to 0.50 μm.
• In an alternative embodiment, the array of wavelength-specific filters24 may be replaced with a single Fabry-Perot interferometer, which can provide wavelength sensitivity which varies as a sample of infrared energy is taken from the material sample S. Thus, this embodiment permits the use of only onedetector28, the output signal of which varies in wavelength specificity over time. The output signal can be de-multiplexed based on the wavelength sensitivities induced by the Fabry-Perot interferometer, to provide a multiple-wavelength profile of the infrared energy emitted by the material sample S. In this embodiment, theoptical mixer20 may be omitted, as only onedetector28 need be employed.
• In still other embodiments, the array offilters24 may comprise a filter wheel that rotates different filters with varying wavelength sensitivities over asingle detector24. Alternatively, an electronically tunable infrared filter may be employed in a manner similar to the Fabry-Perot interferometer discussed above, to provide wavelength sensitivity which varies during the detection process. In either of these embodiments, theoptical mixer20 may be omitted, as only onedetector28 need be employed.
• • f. Detectors
• Thedetectors28 may comprise any detector type suitable for sensing infrared energy, preferably in the mid-infrared wavelengths. For example, thedetectors28 may comprise mercury-cadmium-telluride (MCT) detectors. A detector such as a Fermionics (Simi Valley, Calif.) model PV-9.1 with a PVA481-1 pre-amplifier is acceptable. Similar units from other manufacturers such as Graseby (Tampa, Fla.) can be substituted. Other suitable components for use as thedetectors28 include pyroelectric detectors, thermopiles, bolometers, silicon microbolometers and lead-salt focal plane arrays.
• • g. Control System
• FIG. 7 depicts thecontrol system30 in greater detail, as well as the interconnections between the control system and other relevant portions of the noninvasive system. The control system includes a temperature control subsystem and a data acquisition subsystem.
• In the temperature control subsystem, temperature sensors (such as RTDs and/or thermistors) located in thewindow assembly12 provide a window temperature signal to a synchronous analog-to-digital conversion system70 and an asynchronous analog-to-digital conversion system72. The A/D systems70,72 in turn provide a digital window temperature signal to a digital signal processor (DSP)74. Theprocessor74 executes a window temperature control algorithm and determines appropriate control inputs for theheater layer34 of thewindow assembly12 and/or for thecooling system14, based on the information contained in the window temperature signal. Theprocessor74 outputs one or more digital control signals to a digital-to-analog conversion system76 which in turn provides one or more analog control signals tocurrent drivers78. In response to the control signal(s), thecurrent drivers78 regulate the power supplied to theheater layer34 and/or to thecooling system14. In one embodiment, theprocessor74 provides a control signal through a digital I/O device77 to a pulse-width modulator (PWM)control80, which provides a signal that controls the operation of thecurrent drivers78. Alternatively, a low-pass filter (not shown) at the output of the PWM provides for continuous operation of thecurrent drivers78.
• In another embodiment, temperature sensors may be located at thecooling system14 and appropriately connected to the A/D system(s) and processor to provide closed-loop control of the cooling system as well.
• In yet another embodiment, adetector cooling system82 is located in thermally conductive relation to one or more of thedetectors28. Thedetector cooling system82 may comprise any of the devices disclosed above as comprising thecooling system14, and preferably comprises a Peltier-type thermoelectric device. The temperature control subsystem may also include temperature sensors, such as RTDs and/or thermistors, located in or adjacent to thedetector cooling system82, and electrical connections between these sensors and the asynchronous A/D system72. The temperature sensors of thedetector cooling system82 provide detector temperature signals to theprocessor74. In one embodiment, thedetector cooling system82 operates independently of the window temperature control system, and the detector cooling system temperature signals are sampled using the asynchronous A/D system72. In accordance with the temperature control algorithm, theprocessor74 determines appropriate control inputs for thedetector cooling system82, based on the information contained in the detector temperature signal. Theprocessor74 outputs digital control signals to the D/A system76 which in turn provides analog control signals to thecurrent drivers78. In response to the control signals, thecurrent drivers78 regulate the power supplied to thedetector cooling system14. In one embodiment, theprocessor74 also provides a control signal through the digital I/O device77 and thePWM control80, to control the operation of thedetector cooling system82 by thecurrent drivers78. Alternatively, a low-pass filter (not shown) at the output of the PWM provides for continuous operation of thecurrent drivers78.
• In the data acquisition subsystem, thedetectors28 respond to the infrared energy E incident thereon by passing one or more analog detector signals to apreamp84. Thepreamp84 amplifies the detector signals and passes them to the synchronous A/D system70, which converts the detector signals to digital form and passes them to theprocessor74. Theprocessor74 determines the concentrations of the analyte(s) of interest, based on the detector signals and a concentration-analysis algorithm and/or phase/concentration regression model stored in amemory module88. The concentration-analysis algorithm and/or phase/concentration regression model may be developed according to any of the analysis methodologies discussed herein. The processor may communicate the concentration results and/or other information to adisplay controller86, which operates a display (not shown), such as an LCD display, to present the information to the user.
• Awatchdog timer94 may be employed to ensure that theprocessor74 is operating correctly. If thewatchdog timer94 does not receive a signal from theprocessor74 within a specified time, thewatchdog timer94 resets theprocessor74. The control system may also include a JTAG interface96 to enable testing of thenoninvasive system10.
• In one embodiment, the synchronous A/D system70 comprises a 20-bit, 14 channel system, and the asynchronous A/D system72 comprises a 16-bit, 16 channel system. The preamp may comprise a 12-channel preamp corresponding to an array of 12detectors28.
• The control system may also include aserial port90 or other conventional data port to permit connection to apersonal computer92. The personal computer can be employed to update the algorithm(s) and/or phase/concentration regression model(s) stored in thememory module88, or to download a compilation of analyte-concentration data from the noninvasive system. A real-time clock or other timing device may be accessible by theprocessor74 to make any time-dependent calculations which may be desirable to a user.
• 2. Analysis Methodology
• The detector(s)28 of thenoninvasive system10 are used to detect the infrared energy emitted by the material sample S in various desired wavelengths. At each measured wavelength, the material sample S emits infrared energy at an intensity which varies over time. The time-varying intensities arise largely in response to the use of the window assembly12 (including its heater layer34) and thecooling system14 to induce a thermal gradient in the material sample S. As used herein, “thermal gradient” is a broad term and is used in its ordinary sense and refers, without limitation, to a difference in temperature and/or thermal energy between different locations, such as different depths, of a material sample, which can be induced by any suitable method of increasing or decreasing the temperature and/or thermal energy in one or more locations of the sample. As will be discussed in detail below, the concentration of an analyte of interest (such as glucose) in the material sample S can be determined with a device such as thenoninvasive system10, by comparing the time-varying intensity profiles of the various measured wavelengths.
• Analysis methodologies are discussed herein within the context of detecting the concentration of glucose within a material sample, such as a tissue sample, which includes a large proportion of water. However, it will evident that these methodologies are not limited to this context and may be applied to the detection of a wide variety of analytes within a wide variety of sample types. It should also be understood that other suitable analysis methodologies and suitable variations of the disclosed methodologies may be employed in operating an analyte detection system, such as thenoninvasive system10.
• As shown inFIG. 8, a first reference signal P may be measured at a first reference wavelength. The first reference signal P is measured at a wavelength where water strongly absorbs (e.g., 2.9 μm or 6.1 μm). Because water strongly absorbs radiation at these wavelengths, the detector signal intensity is reduced at those wavelengths. Moreover, at these wavelengths water absorbs the photon emissions emanating from deep inside the sample. The net effect is that a signal emitted at these wavelengths from deep inside the sample is not easily detected. The first reference signal P is thus a good indicator of thermal-gradient effects near the sample surface and may be known as a surface reference signal. This signal may be calibrated and normalized, in the absence of heating or cooling applied to the sample, to a baseline value of1. For greater accuracy, more than one first reference wavelength may be measured. For example, both 2.9 μm and 6.1 μm may be chosen as first reference wavelengths.
• As further shown inFIG. 8, a second reference signal R may also be measured. The second signal R may be measured at a wavelength where water has very low absorbance (e.g., 3.6 μm or 4.2 μm). This second reference signal R thus provides the analyst with information concerning the deeper regions of the sample, whereas the first signal P provides information concerning the sample surface. This signal may also be calibrated and normalized, in the absence of heating or cooling applied to the sample, to a baseline value of 1. As with the first (surface) reference signal P, greater accuracy may be obtained by using more than one second (deep) reference signal R.
• In order to determine analyte concentration, a third (analytical) signal Q is also measured. This signal is measured at an IR absorbance peak of the selected analyte. The IR absorbance peaks for glucose are in the range of about 6.5 μm to 11.0 μm. This detector signal may also be calibrated and normalized, in the absence of heating or cooling applied to the material sample S, to a baseline value of 1. As with the reference signals P, R, the analytical signal Q may be measured at more than one absorbance peak.
• Optionally, or additionally, reference signals may be measured at wavelengths that bracket the analyte absorbance peak. These signals may be advantageously monitored at reference wavelengths which do not overlap the analyte absorbance peaks. Further, it is advantageous to measure reference wavelengths at absorbance peaks which do not overlap the absorbance peaks of other possible constituents contained in the sample.
• • a. Basic Thermal Gradient
• As further shown inFIG. 8, the signal intensities P, Q, R are shown initially at the normalized baseline signal intensity of 1. This of course reflects the baseline radiative behavior of a test sample in the absence of applied heating or cooling. At a time t_C, the surface of the sample is subjected to a temperature event which induces a thermal gradient in the sample. The gradient can be induced by heating or cooling the sample surface. The example shown inFIG. 8 uses cooling, for example, using a 10° C. cooling event. In response to the cooling event, the intensities of the detector signals P, Q, R decrease over time.
• Since the cooling of the sample is neither uniform nor instantaneous, the surface cools before the deeper regions of the sample cool. As each of the signals P, Q, R drop in intensity, a pattern emerges. Signal intensity declines as expected, but as the signals P, Q, R reach a given amplitude value (or series of amplitude values:150,152,154,156,158), certain temporal effects are noted. After the cooling event is induced at t_C, the first (surface) reference signal P declines in amplitude most rapidly, reaching acheckpoint150 first, at time t_P. This is due to the fact that the first reference signal P mirrors the sample's radiative characteristics near the surface of the sample. Since the sample surface cools before the underlying regions, the surface (first) reference signal P drops in intensity first.
• Simultaneously, the second reference signal R is monitored. Since the second reference signal R corresponds to the radiation characteristics of deeper regions of the sample, which do not cool as rapidly as the surface (due to the time needed for the surface cooling to propagate into the deeper regions of the sample), the intensity of signal R does not decline until slightly later. Consequently, the signal R does not reach themagnitude150 until some later time t_R. In other words, there exists a time delay between the time t_Pat which the amplitude of the first reference signal P reaches thecheckpoint150 and the time t_Rat which the second reference signal R reaches thesame checkpoint150. This time delay can be expressed as a phase difference Φ(λ). Additionally, a phase difference may be measured between the analytical signal Q and either or both reference signals P, R.
• As the concentration of analyte increases, the amount of absorbance at the analytical wavelength increases. This reduces the intensity of the analytical signal Q in a concentration-dependent way. Consequently, the analytical signal Q reachesintensity150 at some intermediate time t_Q. The higher the concentration of analyte, the more the analytical signal Q shifts to the left inFIG. 8. As a result, with increasing analyte concentration, the phase difference Φ(λ) decreases relative to the first (surface) reference signal P and increases relative to the second (deep tissue) reference signal R. The phase difference(s) Φ(λ) are directly related to analyte concentration and can be used to make accurate determinations of analyte concentration.
• The phase difference Φ(λ) between the first (surface) reference signal P and the analytical signal Q is represented by the equation:
  Φ(λ)=|t_P−t_Q|
  The magnitude of this phase difference decreases with increasing analyte concentration.
• The phase difference Φ(λ) between the second (deep tissue) reference signal R and the analytical signal Q signal is represented by the equation:
  Φ(λ)=|t_Q−t_R|
  The magnitude of this phase difference increases with increasing analyte concentration.
• Accuracy may be enhanced by choosing several checkpoints, for example,150,152,154,156, and158 and averaging the phase differences observed at each checkpoint. The accuracy of this method may be further enhanced by integrating the phase difference(s) continuously over the entire test period. Because in this example only a single temperature event (here, a cooling event) has been induced, the sample reaches a new lower equilibrium temperature and the signals stabilize at a new constant level I_F. Of course, the method works equally well with thermal gradients induced by heating or by the application or introduction of other forms of energy, such as but not limited to light, radiation, chemically induced heat, friction and vibration.
• This methodology is not limited to the determination of phase difference. At any given time (for example, at a time t_X) the amplitude of the analytical signal Q may be compared to the amplitude of either or both of the reference signals P, R. The difference in amplitude may be observed and processed to determine analyte concentration.
• This method, the variants disclosed herein, and the apparatus disclosed as suitable for application of the method(s), are not limited to the detection of in-vivo glucose concentration. The method and disclosed variants and apparatus may be used on human, animal, or even plant subjects, or on organic or inorganic compositions in a non-medical setting. The method may be used to take measurements of in-vivo or in-vitro samples of virtually any kind. The method is useful for measuring the concentration of a wide range of additional chemical analytes, including but not limited to, glucose, ethanol, insulin, water, carbon dioxide, blood oxygen, cholesterol, bilirubin, ketones, fatty acids, lipoproteins, albumin, urea, creatinine, white blood cells, red blood cells, hemoglobin, oxygenated hemoglobin, carboxyhemoglobin, organic molecules, inorganic molecules, pharmaceuticals, cytochrome, various proteins and chromophores, microcalcifications, hormones, as well as other chemical compounds. To detect a given analyte, one needs only to select appropriate analytical and reference wavelengths.
• The method is adaptable and may be used to determine chemical concentrations in samples of body fluids (e.g., blood, urine or saliva) once they have been extracted from a patient. In fact, the method may be used for the measurement of in-vitro samples of virtually any kind.
• • b. Modulated Thermal Gradient
• In some embodiments of the methodology described above, a periodically modulated thermal gradient can be employed to make accurate determinations of analyte concentration.
• As previously shown inFIG. 8, once a thermal gradient is induced in the sample, the reference and analytical signals P, Q, R fall out of phase with respect to each other. This phase difference Φ(λ) is present whether the thermal gradient is induced through heating or cooling. By alternatively subjecting the test sample to cyclic pattern of heating, cooling, or alternately heating and cooling, an oscillating thermal gradient may be induced in a sample for an extended period of time.
• An oscillating thermal gradient is illustrated using a sinusoidally modulated gradient.FIG. 9 depicts detector signals emanating from a test sample. As with the methodology shown inFIG. 8, one or more reference signals J, L are measured. One or more analytical signals K are also monitored. These signals may be calibrated and normalized, in the absence of heating or cooling applied to the sample, to a baseline value of1.FIG. 9 shows the signals after normalization. At some time t_C, a temperature event (e.g., cooling) is induced at the sample surface. This causes a decline in the detector signal. As shown inFIG. 8, the signals (P, Q, R) decline until the thermal gradient disappears and a new equilibrium detector signal I_Fis reached. In the method shown inFIG. 9, as the gradient begins to disappear at asignal intensity160, a heating event, at a time t_W, is induced in the sample surface. As a result the detector output signals J, K, L will rise as the sample temperature rises. At some later time t_C2, another cooling event is induced, causing the temperature and detector signals to decline. This cycle of cooling and heating may be repeated over a time interval of arbitrary length. Moreover, if the cooling and heating events are timed properly, a periodically modulated thermal gradient may be induced in the test sample.
• As previously explained in the discussions relating toFIG. 8, the phase difference Φ(λ) may be measured and used to determine analyte concentration.FIG. 9 shows that the first (surface) reference signal J declines and rises in intensity first. The second (deep tissue) reference signal L declines and rises in a time-delayed manner relative to the first reference signal J. The analytical signal K exhibits a time/phase delay dependent on the analyte concentration. With increasing concentration, the analytical signal K shifts to the left inFIG. 9. As withFIG. 8, the phase difference Φ(λ) may be measured. For example, a phase difference Φ(λ) between the second reference signal L and the analytical signal K, may be measured at aset amplitude162 as shown inFIG. 9. Again, the magnitude of the phase signal reflects the analyte concentration of the sample.
• The phase-difference information compiled by any of the methodologies disclosed herein can correlated by the control system30 (seeFIG. 1) with previously determined phase-difference information to determine the analyte concentration in the sample. This correlation could involve comparison of the phase-difference information received from analysis of the sample, with a data set containing the phase-difference profiles observed from analysis of wide variety of standards of known analyte concentration. In one embodiment, a phase/concentration curve or regression model is established by applying regression techniques to a set of phase-difference data observed in standards of known analyte concentration. This curve is used to estimate the analyte concentration in a sample based on the phase-difference information received from the sample.
• Advantageously, the phase difference Φ(λ) may be measured continuously throughout the test period. The phase-difference measurements may be integrated over the entire test period for an extremely accurate measure of phase difference Φ(λ). Accuracy may also be improved by using more than one reference signal and/or more than one analytical signal.
• As an alternative or as a supplement to measuring phase difference(s), differences in amplitude between the analytical and reference signal(s) may be measured and employed to determine analyte concentration. Additional details relating to this technique and not necessary to repeat here may be found in the Assignee's U.S. patent application Ser. No. 09/538,164, incorporated by reference below.
• Additionally, these methods may be advantageously employed to simultaneously measure the concentration of one or more analytes. By choosing reference and analyte wavelengths that do not overlap, phase differences can be simultaneously measured and processed to determine analyte concentrations. AlthoughFIG. 9 illustrates the method used in conjunction with a sinusoidally modulated thermal gradient, the principle applies to thermal gradients conforming to any periodic function. In more complex cases, analysis using signal processing with Fourier transforms or other techniques allows accurate determinations of phase difference D(k) and analyte concentration.
• As shown inFIG. 10, the magnitude of the phase differences may be determined by measuring the time intervals between the amplitude peaks (or troughs) of the reference signals J, L and the analytical signal K. Alternatively, the time intervals between the “zero crossings” (the point at which the signal amplitude changes from positive to negative, or negative to positive) may be used to determine the phase difference between the analytical signal K and the reference signals J, L. This information is subsequently processed and a determination of analyte concentration may then be made. This particular method has the advantage of not requiring normalized signals.
• As a further alternative, two or more driving frequencies may be employed to determine analyte concentrations at selected depths within the sample. A slow (e.g., 1 Hz) driving frequency creates a thermal gradient which penetrates deeper into the sample than the gradient created by a fast (e.g., 3 Hz) driving frequency. This is because the individual heating and/or cooling events are longer in duration where the driving frequency is lower. Thus, the use of a slow driving frequency provides analyte-concentration information from a deeper “slice” of the sample than does the use of a fast driving frequency.
• It has been found that when analyzing a sample of human skin, a temperature event of 10° C. creates a thermal gradient which penetrates to a depth of about 150 μm, after about 500 ms of exposure. Consequently, a cooling/heating cycle or driving frequency of 1 Hz provides information to a depth of about 150 μm. It has also been determined that exposure to a temperature event of 10° C. for about 167 ms creates a thermal gradient that penetrates to a depth of about 50 μm. Therefore, a cooling/heating cycle of 3 Hz provides information to a depth of about 50 μm. By subtracting the detector signal information measured at a 3 Hz driving frequency from the detector signal information measured at a 1 Hz driving frequency, one can determine the analyte concentration(s) in the region of skin between 50 and 150 μm. Of course, a similar approach can be used to determine analyte concentrations at any desired depth range within any suitable type of sample.
• As shown inFIG. 11, alternating deep and shallow thermal gradients may be induced by alternating slow and fast driving frequencies. As with the methods described above, this variation also involves the detection and measurement of phase differences Φ(λ) between reference signals G, G′ and analytical signals H, H′. Phase differences are measured at both fast (e.g., 3 Hz) and slow (e.g., 1 Hz) driving frequencies. The slow driving frequency may continue for an arbitrarily chosen number of cycles (in region SL₁), for example, two full cycles. Then the fast driving frequency is employed for a selected duration, in region F₁. The phase difference data is compiled in the same manner as disclosed above. In addition, the fast frequency (shallow sample) phase difference data may be subtracted from the slow frequency (deep sample) data to provide an accurate determination of analyte concentration in the region of the sample between the gradient penetration depth associated with the fast driving frequency and that associated with the slow driving frequency.
• The driving frequencies (e.g., 1 Hz and 3 Hz) can be multiplexed as shown inFIG. 12. The fast (3 Hz) and slow (1 Hz) driving frequencies can be superimposed rather than sequentially implemented. During analysis, the data can be separated by frequency (using Fourier transform or other techniques) and independent measurements of phase delay at each of the driving frequencies may be calculated. Once resolved, the two sets of phase delay data are processed to determine absorbance and analyte concentration.
• Additional details not necessary to repeat here may be found in U.S. Pat. No. 6,198,949, titled SOLID-STATE NON-INVASIVE INFRARED ABSORPTION SPECTROMETER FOR THE GENERATION AND CAPTURE OF THERMAL GRADIENT SPECTRA FROM LIVING TISSUE, issued Mar. 6, 2001; U.S. Pat. No. 6,161,028, titled METHOD FOR DETERMINING ANALYTE CONCENTRATION USING PERIODIC TEMPERATURE MODULATION AND PHASE DETECTION, issued Dec. 12, 2000; U.S. Pat. No. 5,877,500, titled MULTICHANNEL INFRARED DETECTOR WITH OPTICAL CONCENTRATORS FOR EACH CHANNEL, issued on Mar. 2, 1999; U.S. patent application Ser. No. 09/538,164, filed Mar. 30, 2000 and titled METHOD AND APPARATUS FOR DETERMINING ANALYTE CONCENTRATION USING PHASE AND MAGNITUDE DETECTION OF A RADIATION TRANSFER FUNCTION; U.S. Provisional Patent Application No. 60/336,404, filed Oct. 29, 2001, titled WINDOW ASSEMBLY; U.S. Provisional Patent Application No. 60/340,435, filed Dec. 12, 2001, titled CONTROL SYSTEM FOR BLOOD CONSTITUENT MONITOR; U.S. Provisional Patent Application No. 60/340,654, filed Dec. 12, 2001, titled SYSTEM AND METHOD FOR CONDUCTING AND DETECTING INFRARED RADIATION; U.S. Provisional Patent Application No. 60/336,294, filed Oct. 29, 2001, titled METHOD AND DEVICE FOR INCREASING ACCURACY OF BLOOD CONSTITUENT MEASUREMENT; and U.S. Provisional Patent Application No. 60/339,116, filed Nov. 7, 2001, titled METHOD AND APPARATUS FOR IMPROVING CLINICALLY SIGNIFICANT ACCURACY OF ANALYTE MEASUREMENTS. The entire disclosure of all of the above-mentioned patents, patent applications and publications is hereby incorporated by reference herein and made a part of this specification.
• B. Whole-Blood Detection System
• FIG. 13 is a schematic view of a reagentless whole-blood analyte detection system200 (hereinafter “whole-blood system”) in a preferred configuration. The whole-blood system200 may comprise aradiation source220, afilter230, acuvette240 that includes asample cell242, and aradiation detector250. The whole-blood system200 preferably also comprises asignal processor260 and adisplay270. Although acuvette240 is shown here, other sample elements, as described below, could also be used in the system200. The whole-blood system200 can also comprise asample extractor280, which can be used to access bodily fluid from an appendage, such as thefinger290, forearm, or any other suitable location.
• As used herein, the terms “whole-blood analyte detection system” and “whole-blood system” are broad, synonymous terms and are used in their ordinary sense and refer, without limitation, to analyte detection devices which can determine the concentration of an analyte in a material sample by passing electromagnetic radiation into the sample and detecting the absorbance of the radiation by the sample. As used herein, the term “whole-blood” is a broad term and is used in its ordinary sense and refers, without limitation, to blood that has been withdrawn from a patient but that has not been otherwise processed, e.g., it has not been hemolysed, lyophilized, centrifuged, or separated in any other manner, after being removed from the patient. Whole-blood may contain amounts of other fluids, such as interstitial fluid or intracellular fluid, which may enter the sample during the withdrawal process or are naturally present in the blood. It should be understood, however, that the whole-blood system200 disclosed herein is not limited to analysis of whole-blood, as the whole-blood system10 may be employed to analyze other substances, such as saliva, urine, sweat, interstitial fluid, intracellular fluid, hemolysed, lyophilized, or centrifuged blood or any other organic or inorganic materials.
• The whole-blood system200 may comprise a near-patient testing system. As used herein, “near-patient testing system” is a broad term and is used in its ordinary sense, and includes, without limitation, test systems that are configured to be used where the patient is rather than exclusively in a laboratory, e.g., systems that can be used at a patient's home, in a clinic, in a hospital, or even in a mobile environment. Users of near-patient testing systems can include patients, family members of patients, clinicians, nurses, or doctors. A “near-patient testing system” could also include a “point-of-care” system.
• The whole-blood system200 may in one embodiment be configured to be operated easily by the patient or user. As such, the system200 is preferably a portable device. As used herein, “portable” is a broad term and is used in its ordinary sense and means, without limitation, that the system200 can be easily transported by the patient and used where convenient. For example, the system200 is advantageously small. In one preferred embodiment, the system200 is small enough to fit into a purse or backpack. In another embodiment, the system200 is small enough to fit into a pants pocket. In still another embodiment, the system200 is small enough to be held in the palm of a hand of the user.
• Some of the embodiments described herein employ a sample element to hold a material sample, such as a sample of biological fluid. As used herein, “sample element” is a broad term and is used in its ordinary sense and includes, without limitation, structures that have a sample cell and at least one sample cell wall, but more generally includes any of a number of structures that can hold, support or contain a material sample and that allow electromagnetic radiation to pass through a sample held, supported or contained thereby; e.g., a cuvette, test strip, etc. As used herein, the term “disposable” when applied to a component, such as a sample element, is a broad term and is used in its ordinary sense and means, without limitation, that the component in question is used a finite number of times and then discarded. Some disposable components are used only once and then discarded. Other disposable components are used more than once and then discarded.
• Theradiation source220 of the whole-blood system200 emits electro-magnetic radiation in any of a number of spectral ranges, e.g., within infrared wavelengths; in the mid-infrared wavelengths; above about 0.8 μm; between about 5.0 μm and about 20.0 μm; and/or between about 5.25 μm and about 12.0 μm. However, in other embodiments the whole-blood system200 may employ aradiation source220 which emits in wavelengths found anywhere from the visible spectrum through the microwave spectrum, for example anywhere from about 0.4 μm to greater than about 100 μm. In still further embodiments the radiation source emits electromagnetic radiation in wavelengths between about 3.5 μm and about 14 μm, or between about 0.8 μm and about 2.5 μm, or between about 2.5 μm and about 20 μm, or between about 20 μm and about 100 μm, or between about 6.85 μm and about 10.10 μm.
• The radiation emitted from thesource220 is in one embodiment modulated at a frequency between about one-half hertz and about one hundred hertz, in another embodiment between about 2.5 hertz and about 7.5 hertz, in still another embodiment at about 50 hertz, and in yet another embodiment at about 5 hertz. With a modulated radiation source, ambient light sources, such as a flickering fluorescent lamp, can be more easily identified and rejected when analyzing the radiation incident on thedetector250. One source that is suitable for this application is produced by ION OPTICS, INC. and sold under the part number NL5LNC.
• Thefilter230 permits electromagnetic radiation of selected wavelengths to pass through and impinge upon the cuvette/sample element240. Preferably, thefilter230 permits radiation at least at about the following wavelengths to pass through to the cuvette/sample element: 3.9, 4.0 μm, 4.05 μm, 4.2 μm, 4.75, 4.95 μm, 5.25 μm, 6.12 μm, 7.4 μm, 8.0 μm, 8.45 μm, 9.25 μm, 9.5 μm, 9.65 μm, 10.4 μm, 12.2 μm. In another embodiment, thefilter230 permits radiation at least at about the following wavelengths to pass through to the cuvette/sample element: 5.25 μm, 6.12 μm, 6.8 μm, 8.03 μm, 8.45 μm, 9.25 μm, 9.65 μm, 10.4 μm, 12 μm. In still another embodiment, thefilter230 permits radiation at least at about the following wavelengths to pass through to the cuvette/sample element: 6.85 μm, 6.97 μm, 7.39 μm, 8.23 μm, 8.62 μm, 9.02 μm, 9.22 μm, 9.43 μm, 9.62 μm, and 10.10 μm. The sets of wavelengths recited above correspond to specific embodiments within the scope of this disclosure. Furthermore, other subsets of the foregoing sets or other combinations of wavelengths can be selected. Finally, other sets of wavelengths can be selected within the scope of this disclosure based on cost of production, development time, availability, and other factors relating to cost, manufacturability, and time to market of the filters used to generate the selected wavelengths, and/or to reduce the total number of filters needed.
• In one embodiment, thefilter230 is capable of cycling its passband among a variety of narrow spectral bands or a variety of selected wavelengths. Thefilter230 may thus comprise a solid-state tunable infrared filter, such as that available from ION OPTICS INC. Thefilter230 could also be implemented as a filter wheel with a plurality of fixed-passband filters mounted on the wheel, generally perpendicular to the direction of the radiation emitted by thesource220. Rotation of the filter wheel alternately presents filters that pass radiation at wavelengths that vary in accordance with the filters as they pass through the field of view of thedetector250.
• Thedetector250 preferably comprises a 3 mm long by 3 mm wide pyroelectric detector. Suitable examples are produced by DIAS Angewandte Sensorik GmbH of Dresden, Germany, or by BAE Systems (such as its TGS model detector). Thedetector250 could alternatively comprise a thermopile, a bolometer, a silicon microbolometer, a lead-salt focal plane array, or a mercury-cadmium-telluride (MCT) detector. Whichever structure is used as thedetector250, it is desirably configured to respond to the radiation incident upon itsactive surface254 to produce electrical signals that correspond to the incident radiation.
• In one embodiment, the sample element comprises acuvette240 which in turn comprises asample cell242 configured to hold a sample of tissue and/or fluid (such as whole-blood, blood components, interstitial fluid, intercellular fluid, saliva, urine, sweat and/or other organic or inorganic materials) from a patient within its sample cell. Thecuvette240 is installed in the whole-blood system200 with thesample cell242 located at least partially in theoptical path243 between theradiation source220 and thedetector250. Thus, when radiation is emitted from thesource220 through thefilter230 and thesample cell242 of thecuvette240, thedetector250 detects the radiation signal strength at the wavelength(s) of interest. Based on this signal strength, thesignal processor260 determines the degree to which the sample in thecell242 absorbs radiation at the detected wavelength(s). The concentration of the analyte of interest is then determined from the absorption data via any suitable spectroscopic technique.
• As shown inFIG. 13, the whole-blood system200 can also comprise asample extractor280. As used herein, the term “sample extractor” is a broad term and is used in its ordinary sense and refers, without limitation, to any device which is suitable for drawing a sample material, such as whole-blood, other bodily fluids, or any other sample material, through the skin of a patient. In various embodiments, the sample extractor may comprise a lance, laser lance, iontophoretic sampler, gas-jet, fluid-jet or particle-jet perforator, ultrasonic enhancer (used with or without a chemical enhancer), or any other suitable device.
• As shown inFIG. 13, thesample extractor280 could form an opening in an appendage, such as thefinger290, to make whole-blood available to thecuvette240. It should be understood that other appendages could be used to draw the sample, including but not limited to the forearm. With some embodiments of thesample extractor280, the user forms a tiny hole or slice through the skin, through which flows a sample of bodily fluid such as whole-blood. Where thesample extractor280 comprises a lance (seeFIG. 14), thesample extractor280 may comprise a sharp cutting implement made of metal or other rigid materials. One suitable laser lance is the Lasette Plus® produced by Cell Robotics International, Inc. of Albuquerque, N.M. If a laser lance, iontophoretic sampler, gas-jet or fluid-jet perforator is used as thesample extractor280, it could be incorporated into the whole-blood system200 (seeFIG. 13), or it could be a separate device.
• Additional information on laser lances can be found in U.S. Pat. No. 5,908,416, issued Jun. 1, 1999, titled LASER DERMAL PERFORATOR; the entirety of this patent is hereby incorporated by reference herein and made a part of this specification. One suitable gas-jet, fluid-jet or particle-jet perforator is disclosed in U.S. Pat. No. 6,207,400, issued Mar. 27, 2001, titled NON- OR MINIMALLY INVASIVE MONITORING METHODS USING PARTICLE DELIVERY METHODS; the entirety of this patent is hereby incorporated by reference herein and made a part of this specification. One suitable iontophoretic sampler is disclosed in U.S. Pat. No. 6,298,254, issued Oct. 2, 2001, titled DEVICE FOR SAMPLING SUBSTANCES USING ALTERNATING POLARITY OF IONTOPHORETIC CURRENT; the entirety of this patent is hereby incorporated by reference herein and made a part of this specification. One suitable ultrasonic enhancer, and chemical enhancers suitable for use therewith, are disclosed in U.S. Pat. No. 5,458,140, titled ENHANCEMENT OF TRANSDERMAL MONITORING APPLICATIONS WITH ULTRASOUND AND CHEMICAL ENHANCERS, issued Oct. 17, 1995, the entire disclosure of which is hereby incorporated by reference and made a part of this specification.
• FIG. 14 shows one embodiment of a sample element, in the form of acuvette240, in greater detail. Thecuvette240 further comprises asample supply passage248, apierceable portion249, afirst window244, and asecond window246, with thesample cell242 extending between thewindows244,246. In one embodiment, thecuvette240 does not have asecond window246. The first window244 (or second window246) is one form of a sample cell wall; in other embodiments of the sample elements and cuvettes disclosed herein, any sample cell wall may be used that at least partially contains, holds or supports a material sample, such as a biological fluid sample, and which is transmissive of at least some bands of electromagnetic radiation, and which may but need not be transmissive of electromagnetic radiation in the visible range. Thepierceable portion249 is an area of thesample supply passage248 that can be pierced by suitable embodiments of thesample extractor280. Suitable embodiments of thesample extractor280 can pierce theportion249 and theappendage290 to create a wound in theappendage290 and to provide an inlet for the blood or other fluid from the wound to enter thecuvette240. (Thesample extractor280 is shown on the opposite side of the sample element inFIG. 14, as compared toFIG. 13, as it may pierce theportion249 from either side.)
• Thewindows244,246 are preferably optically transmissive in the range of electromagnetic radiation that is emitted by thesource220, or that is permitted to pass through thefilter230. In one embodiment, the material that makes up thewindows244,246 is completely transmissive, i.e., it does not absorb any of the electromagnetic radiation from thesource220 and filter230 that is incident upon it. In another embodiment, the material of thewindows244,246 has some absorption in the electromagnetic range of interest, but its absorption is negligible. In yet another embodiment, the absorption of the material of thewindows244,246 is not negligible, but it is known and stable for a relatively long period of time. In another embodiment, the absorption of thewindows244,246 is stable for only a relatively short period of time, but the whole-blood system200 is configured to observe the absorption of the material and eliminate it from the analyte measurement before the material properties can change measurably.
• Thewindows244,246 are made of polypropylene in one embodiment. In another embodiment, thewindows244,246 are made of polyethylene. Polyethylene and polypropylene are materials having particularly advantageous properties for handling and manufacturing, as is known in the art. Also, polypropylene can be arranged in a number of structures, e.g., isotactic, atactic and syndiotactic, which may enhance the flow characteristics of the sample in the sample element. Preferably thewindows244,246 are made of durable and easily manufactureable materials, such as the above-mentioned polypropylene or polyethylene, or silicon or any other suitable material. Thewindows244,246 can be made of any suitable polymer, which can be isotactic, atactic or syndiotactic in structure.
• The distance between thewindows244,246 comprises an optical pathlength and can be between about 1 μm and about 100 μm. In one embodiment, the optical pathlength is between about 10 μm and about 40 μm, or between about 25 μm and about 60 μm, or between about 30 μm and about 50 μm. In still another embodiment, the optical pathlength is about 25 μm. The transverse size of each of thewindows244,246 is preferably about equal to the size of thedetector250. In one embodiment, the windows are round with a diameter of about 3 mm. In this embodiment, where the optical pathlength is about 25 μm the volume of thesample cell242 is about 0.177 μL. In one embodiment, the length of thesample supply passage248 is about 6 mm, the height of thesample supply passage248 is about 1 mm, and the thickness of thesample supply passage248 is about equal to the thickness of the sample cell, e.g., 25 μm. The volume of the sample supply passage is about 0.150 μL. Thus, the total volume of thecuvette240 in one embodiment is about 0.327 μL. Of course, the volume of thecuvette240/sample cell242/etc. can vary, depending on many variables, such as the size and sensitivity of thedetectors250, the intensity of the radiation emitted by thesource220, the expected flow properties of the sample, and whether flow enhancers (discussed below) are incorporated into thecuvette240. The transport of fluid to thesample cell242 is achieved preferably through capillary action, but may also be achieved through wicking, or a combination of wicking and capillary action.
• FIGS. 15-17 depict another embodiment of acuvette305 that could be used in connection with the whole-blood system200. Thecuvette305 comprises asample cell310, asample supply passage315, anair vent passage320, and avent325. As best seen inFIGS. 16,16A and17, the cuvette also comprises a firstsample cell window330 having aninner side332, and a secondsample cell window335 having aninner side337. As discussed above, the window(s)330/335 in some embodiments also comprise sample cell wall(s). Thecuvette305 also comprises anopening317 at the end of thesample supply passage315 opposite thesample cell310. Thecuvette305 is preferably about ¼-⅛ inch wide and about ¾ inch long; however, other dimensions are possible while still achieving the advantages of thecuvette305.
• Thesample cell310 is defined between theinner side332 of the firstsample cell window330 and theinner side337 of the secondsample cell window335. The perpendicular distance T between the twoinner sides332,337 comprises an optical pathlength that can be between about 1 μm and about 1.22 mm. The optical pathlength can alternatively be between about 1 μm and about 100 μm. The optical pathlength could still alternatively be about 80 μm, but is preferably between about 10 μm and about 50 μm. In another embodiment, the optical pathlength is about 25 μm. Thewindows330,335 are preferably formed from any of the materials discussed above as possessing sufficient radiation transmissivity. The thickness of each window is preferably as small as possible without overly weakening thesample cell310 orcuvette305.
• Once a wound is made in theappendage290, theopening317 of thesample supply passage315 of thecuvette305 is placed in contact with the fluid that flows from the wound. In another embodiment, the sample is obtained without creating a wound, e.g. as is done with a saliva sample. In that case, theopening317 of thesample supply passage315 of thecuvette305 is placed in contact with the fluid obtained without creating a wound. The fluid is then transported through thesample supply passage315 and into thesample cell310 via capillary action. Theair vent passage320 improves the capillary action by preventing the buildup of air pressure within the cuvette and allowing the blood to displace the air as the blood flows therein.
• Other mechanisms may be employed to transport the sample to thesample cell310. For example, wicking could be used by providing a wicking material in at least a portion of thesample supply passage315. In another variation, wicking and capillary action could be used together to transport the sample to thesample cell310. Membranes could also be positioned within thesample supply passage315 to move the blood while at the same time filtering out components that might complicate the optical measurement performed by the whole-blood system200.
• FIGS. 16 and 16A depict one approach to constructing thecuvette305. In this approach, thecuvette305 comprises afirst layer350, asecond layer355, and athird layer360. Thesecond layer355 is positioned between thefirst layer350 and thethird layer360. Thefirst layer350 forms the firstsample cell window330 and thevent325. As mentioned above, thevent325 provides an escape for the air that is in thesample cell310. While thevent325 is shown on thefirst layer350, it could also be positioned on thethird layer360, or could be a cutout in the second layer, and would then be located between thefirst layer360 and thethird layer360 Thethird layer360 forms the secondsample cell window335.
• Thesecond layer355 may be formed entirely of an adhesive that joins the first andthird layers350,360. In other embodiments, the second layer may be formed from similar materials as the first and third layers, or any other suitable material. Thesecond layer355 may also be formed as a carrier with an adhesive deposited on both sides thereof. Thesecond layer355 forms thesample supply passage315, theair vent passage320, and thesample cell310. The thickness of thesecond layer355 can be between about 1 μm and about 1.22 mm. This thickness can alternatively be between about 1 μm and about 100 μm. This thickness could alternatively be about 80 μm, but is preferably between about 10 μm and about 50 μm. In another embodiment, the second layer thickness is about 25 μm.
• In other embodiments, thesecond layer355 can be constructed as an adhesive film having a cutout portion to define thepassages315,320, or as a cutout surrounded by adhesive.
• Further information can be found in U.S. patent application Ser. No. 10/055,875, filed Jan. 21, 2002, titled REAGENT-LESS WHOLE-BLOOD GLUCOSE METER. The entire contents of this patent application are hereby incorporated by reference herein and made a part of this specification.
II. Analyte Monitoring Instrument Having Network Connectivity
• Referring toFIG. 18, ananalyte detection system500 is shown connected toremote stations524,528 over anetwork520, which may comprise one or more wireless or hardwired links, or a combination of wireless and hardwired links, and/or the Internet. In the illustrated embodiment, theanalyte detection system500 comprises thenoninvasive system10 described above. In other embodiments, the analyte detection system may comprise any other suitable noninvasive system such as (but not limited to) those described in U.S. Pat. No. 5,900,632 to Sterling et al. and U.S. Pat. No. 5,615,972 to Braig et al., the entirety of each of which is hereby incorporated by reference herein and made a part of this specification. In still other embodiments, theanalyte detection system500 may comprise any suitable invasive system such as (but not limited to) the whole-blood system200 disclosed above.
• Because thenoninvasive system10 is depicted in the embodiment ofFIG. 18, the hand andforearm512 of a patient is shown positioned to allow a measurement to be performed by ananalyte detector element514 of theanalyte detection system500. Theanalyte detection system500 includes asignal processing system516 which collects the measurements and/or other suitable information from thedetector element514 and processes the data into a set of results. In the illustrated embodiment, theanalyte detection system500 includes input and output devices, such as a display and a set of control inputs (not shown) for communicating information directly to and from the patient. Thesignal processing system516 is equipped with anetwork interface517 along with one ormore processing elements519 for processing the measurement signals and for control of network communications.
• Data is communicated over thenetwork520 as determined by the configuration of thesystem500 and the state and condition of the measurement being performed. Measurement data may accordingly be communicated to the remote station(s)524,528 at the time the measurement is performed, or it may be retained within thesystem500 and sent to the remote station(s) according to a schedule or other selection criterion. Thesystem500 and/or remote station(s)524,284 may be capable of comparing each measurement with a set of limits and providing alerts to a supervisory authority regarding excursions therefrom.
• InFIG. 18 the measurement data is shown passing through aconnection518 to thenetwork520, and from there through anotherconnection522 to acentralized monitoring computer524 or to a server. Thecentralized computer524 may be capable of checking the data for emergency conditions and logging the data for later use. In addition, thecentralized computer524 may monitor the status of the system(s)500 for proper operation and calibration. It will be appreciated that multiplecentralized computers524 or servers can be provided for communicating with the system(s)500. In one embodiment, thenetwork interface517 is a wireless interface (and theconnection518 is a wireless connection), such as but not limited to a Bluetooth interface, an IEEE 802.11 (b) interface or a cellular interface, implemented through appropriate hardware built into thesystem500.
• Furthermore, thecentralized computer524 may simultaneously transfer or route the data (e.g., measurements, system status, etc.) viaconnection526 to acomputer528 in the office of a medical practitioner over thenetwork520. Instead of or in addition to themedical practitioner computer528, the network may include connections to acomputer528′ located at the manufacturer of theanalyte detection system500, to acomputer528″ located at the patient's home, and/or to acomputer528′″ located at the home or place of business of a parent of the patient. Alternatively, the data may be directly sent over thenetwork520 to themedical practitioner528/manufacturer528′/patient'shome528″/patient'sparent528′″ from thesignal processing system516; in this instance thecentralized computer524 is not necessary and may be omitted from thenetwork520. Where thecentralized computer524 is omitted, any of the computer(s)528/528′/528″/528′″ (hereinafter, collectively “528”) may be capable of checking the data received from thesystem500 for emergency conditions, logging the data for later use, and/or monitoring the status of thesystem500 for proper operation and calibration. It will be appreciated that the foregoing data routing is provided as an example, and not as a limitation, of the data routing utilized to provide the network services in support of a patient's use of thesystem500.
• In one embodiment, thesystem500 includes apanic button530 which permits the patient to alert a medical practitioner should an important concern arise. In addition, sound and/or visual output may be provided by thesystem500 for signaling the patient when the time arrives to perform a measurement, or of a directive from a supervisory authority as received over thenetwork520.
• In another embodiment, thesystem500 includes alocation button531 which permits the patient to signal his or her location (as well as the location of the system500) to any of the remote station(s)524,528. When so signaled, a remote user at aremote station524/528 can direct emergency assistance to the location of the patient/system, should the remote user discover that the patient's condition merits immediate medical attention. In one embodiment, the location information is generated via GPS (Global Positioning System) equipment built into thesystem500 and accessible by the processing element(s)519. In another embodiment, thesystem500 continually, intermittently or otherwise automatically transmits its location to any or all of the remote station(s)524,528, and thelocation button531 may be omitted. In still another embodiment, thesystem500 is configured to transmit its location to remote station(s)524,528 in response to a query sent from the remote station(s) to thesystem500.
• In another embodiment, the GPS equipment is supplemented by storage, within appropriate memory accessible by the processing element(s)519 and/or the GPS equipment, of favorite locations frequented by the patient. Examples of favorite locations include Home, Work, School, etc. and/or a widely recognizable expression thereof, such as the associated street address, nearest cross streets, ZIP or postal code, and/or longitude and latitude. The purpose of such storage is to counteract the tendency of GPS equipment to lose contact with the GPS satellite(s) when the GPS device in question is located inside of a building or other large structure.
• Accordingly, when thesystem500 loses contact with the GPS satellite(s) and a need arises, under any of the circumstances discussed herein, to transmit the location of the patient/system to a remote user, thesystem500 recognizes the loss of contact with the GPS satellite(s) and selects for transmission one of the patient's favorite locations based on the last GPS-computed position of the user/system prior to loss of contact with the GPS satellite(s). In one embodiment, thesystem500 selects and transmits whichever favorite location is nearest the last GPS-computed position of thesystem500. In another embodiment, thesystem500 selects and transmits this nearest favorite location only when the nearest favorite location is within a given minimum distance (e.g., 10 miles, 5 miles, 1 mile, 0.5 miles) from the last GPS-computed position of thesystem500. In still another embodiment, thesystem500 displays a list of the patient's stored favorite locations on a suitable display, and the patient can select, using an appropriate input device (keypad, button, touchscreen, mouse, voice recognition system, etc.) built into or connected to thesystem500, his or her present location from a list of favorites and prompt thesystem500 to transmit the selected location.
• Any of the location-transmission processes discussed above may be implemented in an algorithm or program instructions executable by, and residing within memory accessible by, the processing element(s)519 of the system500 (in particular, by thesignal processor74/260 where thesystem500 comprises thenoninvasive system10 or the whole-blood system200, respectively).
• In any of the embodiments discussed herein, thesystem500 and/or one or more of the remote station(s)524,528 may be configured to encrypt any or all of the data that it transmits over thenetwork520. Where the user of any of thesystem500 and the remote station(s)524,528 (or the system/remote station itself) is authorized to receive, read and/or otherwise use the encrypted data, therecipient system500/remote station524,528 is configured to decrypt the encrypted data, to make the data available to the device and/or the user thereof. By encrypting the data, physician-patient confidentiality, or any physician-patient privilege may be preserved, preventing unauthorized reading or use of the data. Encryption also permits transmission of data over wireless networks or public networks such as the Internet while preserving confidentiality of the transmitted data.
• It is contemplated that the encryption and decryption may be performed in any suitable manner, with any suitable methods, software and/or hardware presently known or hereafter developed. In thesystem500, the encryption and/or decryption processes may be implemented in an algorithm or program instructions executable by, and residing within memory accessible by, the processing element(s)519 of the system500 (in particular, by thesignal processor74/260 where thesystem500 comprises thenoninvasive system10 or the whole-blood system200, respectively). In the remote station(s)524,528, the encryption and/or decryption processes may be implemented in an algorithm or program instructions executable by, and residing within memory accessible by, processing element(s) (not shown) of theremote station524/528 in question.
• The connection of thesystem500 to thenetwork520, provides either a direct or indirect link from the patient to the practitioner. The practitioner is thereby accorded an ability to monitor the status of the patient and may elect to be alerted should deviations in the measurement values the or timeliness thereof arise. The system may be configured to transmit measurement data at predetermined intervals, or at the time each measurement is performed. The measurements can be transmitted using various network protocols which include standard internet protocols, encrypted protocols, or email protocols.
• In one embodiment, thesignal processing system516 is additionally capable of providing visual or audible cues to the patient when the time arrives to conduct a measurement. These alerts may be augmented by requests, transmitted over thenetwork520 to the instrument, from the practitioner. Errors introduced within measurements and recordation within a manual system can thereby be eliminated with the electronically logged measurements. It will be appreciated that the system provides enhanced utility and measurement credibility in comparison to the use of an instrument that requires manual logging of the measurements and permits no practitioner interaction therewith.
• Secretive non-compliance may also be eliminated as the patient is not conferred the responsibility of manually logging measurements. In using thesystem500, the measurements collected within the instrument by the patient are capable of being transmitted to a practitioner, or a centralized computer, such that if a patient is not being diligent in conducting measurements, the practitioner may immediately contact the patient to reinforce the need for compliance. In addition, the information provided over the network can be used to warn the practitioner when measurement readings appear abnormal, so that the practitioner may then investigate the situation and verify the status of the patient.
• It will be appreciated that the invention has particular utility for patients preferring to receive direct guidance from a practitioner. The information that flows between the patient and the practitioner increases the ability of the practitioner to provide knowledgeable patient guidance.
• FIG. 19 illustrates the functional blocks of an embodiment ofcircuitry532 for implementing thesignal processing hardware516 shown inFIG. 18. Anetwork connection534 connects to a network processing circuit, exemplified by an Internet Protocol (IP) circuit orprocessor536. Numerous circuits are available for providing internet connectivity, such as the SX-Stack™ chip from Scenix Semiconductor, and the iChip™ from Connect One Electronics. These integrated circuit chips and other available chips provide interface layers for supporting a Transmission Control Protocol/Internet Protocol (TCP/IP). Theinternet protocol chip536 has aninterface538 with acontrol processor section540, which preferably comprises a microcontroller or the like. Thecontrol processor section540 in turn has access toconventional memory542. To provide security and fault tolerance of the instrument it is preferable for the control processor, or the internet protocol circuit, to encrypt and provide verification strings or tokens within the data being sent across the network, and accordingly to decrypt information being received and verify the received strings or tokens. Thecontrol processor540 has aninterface544 with theinstrumentation circuits546, which is in turn configured with an interface548 to theanalyte detection element514 shown inFIG. 18.
• The network link provides a mechanism to facilitate performing and recording analyte measurements under supervision, while it additionally provides for periodic instrument calibration, and the ability to assure both measurement and calibration compliance. Calibration data can be communicated fromsystems500 in the field to the system manufacturer, or a service organization, so that thesystems500 and their calibrations may be logged. The disclosed network link can be utilized to provide various mechanisms for assuring calibration compliance. Generally the mechanisms are of two categories, those that provide information or a warning about calibration, and those that prevent use of an instrument which is out of calibration. In one embodiment,systems500 which have exceeded their calibration interval, or schedule, are to be locked out from further use until recalibration is performed. For example, thesystem500 may be set to operate for thirteen months for a given calibration interval of twelve months. Thesystem500 may issue warnings prior to the expiration of calibration, and warnings of increased severity after the expiration of the calibration interval. If thesystem500, however, is not properly calibrated by the end of the thirteen months, normal operation ceases, thereby locking out the user after providing an appropriate error message in regard to the expired calibration. Upon recalibration, the calibrated operation interval is restored to provide for another thirteen month period of calibrated operation.
• Alternatively, or in addition thereto, a “lockout command” can be sent to thesystem500 over thenetwork520 from the manufacturer, practitioner or system maintenance organization, thereby engaging a lockout mode of thesystem500, so that operation may not be continued until thesystem500 has been serviced. The lockout command could also be sent in the event that the patient has not paid his or her bills, or be sent under other circumstances warranting lockout of thesystem500.
• Another mode is that of locking out normal system use after the expiration of calibration, and allowing limited use thereafter only after a code, or token, has been downloaded from a supervisory site. Although many variations are possible, the code could for instance be provided when a calibration appointment is made for thesystem500. To provide continued service and minimize cost, the patient may be allowed to perform calibration checks of thesystem500. The patient is supplied with a small set of analyte calibration standards which are read by thesystem500 once it is put into a calibration mode and preferably connected to a remote site for supervising the process. Should the calibration check pass, wherein the instrument readings fall within normal levels, or be capable of being automatically adjusted thereto, the calibration interval may be extended. Failure of the calibration check would typically necessitate returning thesystem500 for service.
• FIG. 20 illustrates an embodiment of aprocess550 for assuring calibration compliance within theanalyte detection system500 by utilizing a lockout mechanism. The programmed instructions associated with theanalyte detection system500 are started atblock552 and initialized atblock554, and a check is made on a lockout flag atblock556 to determine if it was set during a prior session by a command received via thenetwork520, or due to being out of calibration. Not having been locked out from a prior session, the real-time clock (RTC) of thesystem500 is read atblock558 and a calculation is performed atblock560 comparing the current date with the stored calibration date and calibration interval. If upon checking calibration atblock562 the calibration interval has not yet expired, then a calculation is performed atblock564 comparing the current date with the stored calibration date and near-calibration interval. Near-calibration is checked atblock566 and, if calibration is to expire soon, then a user warning is issued atblock568, preferably informing the user of the date of the upcoming expiration of the calibration interval. The lockout flag is cleared atblock570 and processing within thesystem500 continues with normal instrument functions being accessible atblock572, along with calibration and other limited functions atblock574, until the user shuts down the instrument and processing ends atblock576. If the lockout flag was set from a prior instrument operation, or the calibration interval was exceeded, then a lockout flag would be set atblock578, and the instrument functionality would thereby be restricted to execution of the calibration procedures and other limited functions atblock578 while the normal instrument functionality would not be accessible. The calibration procedure itself may be augmented and improved by providing interaction between the servicing party and the manufacturer, such interaction may include providing guidance information to the servicing party, and the collection of measurement information by the manufacturer.
• It will be appreciated that the present invention provides functionality beyond that which can be provided by a stand-alone analyte detection system, as the practitioner, or practitioner's office, is involved in the analyte measurement process to confer a portion of the benefits normally associated with an office visit. The aforesaid description illustrates how these features provide the capability for two-way data flow which facilitates the conducting and recording of correct measurements while encouraging compliance in regard to both measurements and instrument calibration. Furthermore, the data collected by the system may be utilized by others in addition to the practitioner, such as pharmaceutical companies which may be provided data access to alter or administer medication programs, and insurance companies which may require data regarding patient diligence according to the specified treatment program.
III. Software Download Capabilities
• FIG. 21 illustrates one embodiment of asoftware update system600. Thesoftware update system600 includes ananalyte detection system602 that is connectable to acentralized computer604 via anetwork606. Theanalyte detection system602 may comprise a portable, near-patient device that is capable of optically measuring analytes in a material sample. Other examples of theanalyte measuring device602 include, but not limited to, thenoninvasive system10 discussed in this disclosure, the whole-blood system200 discussed in this disclosure, or any other suitable invasive or noninvasive analyte detection system.
• As used herein, the term “computer” is a broad term and is used in its ordinary sense and refers, without limitation, to any programmable electronic device that can store, retrieve and process data. Examples of computers include terminal devices, such as personal computers, workstations, servers, mini computers, main-frame computers, laptop computers, a network of individual computers, mobile computers, palm top computers, hand held computers, set top for a TV, an interactive television, an interactive kiosk, a personal digital assistant (“PDA”), an interactive wireless communications device, or a combination thereof. The computers may further possess storage devices, input devices such as a keyboard, mouse or scanner, and output devices such as a computer screen or a speaker. Furthermore, the computers may serve as clients, servers, or a combination thereof.
• As used herein, the term “network” is a broad term and is used in its ordinary sense and refers, without limitation, to a series of points or nodes interconnected by communication paths, such as a group of interconnected computers. Examples of networks are the Internet, storage networks, local area networks and wide area networks.
• Further toFIG. 21, theanalyte detection system602 includes anetwork interface608, aprocessor610 andsoftware612. Thecentralized computer604 includes at least onesoftware update614. In one embodiment, when theanalyte measuring device602 is connected to thenetwork606, theanalyte detection system602 and thecentralized computer604 are in two-way communication. Consequently, theanalyte detection system602 may send information (e.g., analyte measurements) to thecentralized computer604 and thecentralized computer604 may send information (e.g., a software update614) to theanalyte measuring device602. Other architectures of networked systems, as known by those skilled in the art, may also be used in place of the architecture set forth inFIG. 21. For example, the architecture shown inFIG. 18, and/or any of the variants thereof discussed above in connection withFIG. 18. may be used instead of thesystem600 shown inFIG. 21. For example, one or more of thecomputers528/528′/528″/528′″ may share the herein-described functions of, or replace entirely, thecentralized computer604, in which case thecentralized computer604 may be omitted.
• As used herein, the term “processor” is a broad term and is used in its ordinary sense and refers, without limitation, to the part of a computer that operates on data. Examples of processors are central processing units (“CPU”) and microprocessors.
• As used herein, the term “software” is a broad term and is used in its ordinary sense and refers, without limitation, to instructions executable by a computer or related device. Examples of software include computer programs and operating systems.
• As used herein, the term “software update” or “update” is a broad term and is used in its ordinary sense and refers, without limitation, to information used by a computer to modify software. A software update may be, for example, data, algorithms or programs.
• A process flow diagram of a preferredsoftware update process700 is shown inFIG. 22. First, in anact702, a user performs analyte measurements with theanalyte detection system602. Advantageously, as discussed above, the user may perform analyte measurements using theanalyte detection system602 at a remote location (e.g., the user's home).
• Further to theact702, theanalyte detection system602 detects analytes in a material sample and calculates an analyte concentration in accordance to the analyte detection system'ssoftware612. Additionally, the analyte detection system may issue alerts to the user, for example, in response to exceeded tolerances defined in thesoftware612. The alerts may be visually displayed to the user and/or audibly sounded to the user. For instance, theanalyte detection system602 may issue an alert in response to an elapsed calibration time tolerance defined in thesoftware612. Other alerts may be issued when the software or analyte-concentration calculation algorithm is out of date, or when the analyte concentration readings made by thedetection system602 are higher or lower than defined safe limits or ranges.
• In one embodiment, thesoftware612 is contained in theanalyte detection system602 internally. In another embodiment, thesoftware612 is retained external to theanalyte detection system602.
• Next, in anact704, theanalyte detection system602 is connected to thecentralized computer604 via thenetwork606. Advantageously, thenetwork interface608 readily connects theanalyte detection system602 to thenetwork606. Furthermore, once theanalyte measuring device602 is connected to thenetwork606, theanalyte measuring device602 is, in one embodiment, in two-way communication with thecentralized computer604. In one embodiment, the communication between theanalyte measuring device602 and thecentralized computer604 is established without any intervention from a user.
• Theprocess700 then proceeds to adecision act706 where thecentralized computer604 determines an update status for the analyte measuring device'ssoftware612. Various conditions may trigger thecentralized computer604 to update thesoftware612. In one embodiment, a condition for updating thesoftware612 is the presence of a new drug in the material sample (e.g., a new drug taken by the user) that alters the analyte calculations. Specifically, thecentralized computer604 determines whether thesoftware612 currently in use accounts for the use of the new drug. If the current software does not account for the new drug, thecentralized computer604 sends asoftware update614 over thenetwork706 that does account for the new drug, and as a result, corrects future analyte calculations performed by theanalyte measuring device602. In another embodiment, a condition for updating thesoftware612 is where a new analyte-detection algorithm is developed. For example, the new algorithm may improve the accuracy or speed of theanalyte detection system602 over thesoftware612 currently in use. In another embodiment, a condition for updating thesoftware612 is where theanalyte detection system602 should display a new warning or where the monitoring device should display an existing warning in response to new or different events. The existing warning or the new warning may be displayed, for instance, in response to new information learned from a subset of a customer population. Advantageously, other conditions not specifically mentioned herein may also trigger thecentralized computer604 to update thesoftware612.
• If thecentralized computer604 decides that thesoftware612 does not need to be updated in thedecision act706, then theupdate process700 proceeds via the “No” path to anact708. In theact708, the user disconnects theanalyte detection system602 from the network and thesoftware612 is not updated. Thus, theanalyte detection system602 operates in the same manner as theanalyte detection system602 previously operated in theact702.
• If thecentralized computer604 decides that thesoftware612 needs to be updated in thedecision act706, then theupdate process700 proceeds via the “Yes” path to anact710. In theact710, thecentralized computer604 sends asoftware update614 to theanalyte detection system602. In one embodiment, thecentralized computer604 contains a database ofvarious software updates614, and consequently, thecentralized computer604 selects theappropriate software update614 from the database and then sends thesoftware update614 to theanalyte detection system602.
• Next, in anact712, theanalyte detection system602 receives (e.g. downloads) thesoftware update614. Theanalyte detection system602 then preferably modifies thesoftware612 to an updated version of thesoftware612. The process then proceeds to anact714.
• In theact714, the user performs analyte measurements in accordance with the updatedsoftware612. Thus, depending upon thesoftware update614, theanalyte measuring device602 operates differently than the manner in which theanalyte measuring device602 previously operated inact702. One example is that theanalyte detection system602 may calculate analyte concentrations differently. Another example is that theanalyte detection system602 may displays new warnings to the user. A further example is that theanalyte detection system602 may display the same warnings, but the warnings are triggered by different events.
• In any of the embodiments of thesoftware update system600 discussed herein, theanalyte detection system602 and/or the centralized computer604 (or, where applicable, the computer(s)528) may be configured to encrypt any or all of the data that it transmits over thenetwork606. Where the user of any of theanalyte detection system602 and the centralized computer604 (or the analyte detection system/centralized computer itself) is authorized to receive, read and/or otherwise use the encrypted data, therecipient system602/computer604 is configured to decrypt the encrypted data, to make the data available to the device and/or the user thereof. By encrypting the data, physician-patient confidentiality, or any physician-patient privilege may be preserved, preventing unauthorized reading or use of the data. Encryption also permits transmission of data over wireless networks or public networks such as the Internet while preserving confidentiality of the transmitted data.
• It is contemplated that the encryption and decryption may be performed in any suitable manner, with any suitable methods, software and/or hardware presently known or hereafter developed. In theanalyte detection system602, the encryption and/or decryption processes may be implemented in an algorithm or program instructions executable by, and residing within memory accessible by, theprocessor610 of the analyte detection system602 (in particular, by thesignal processor74/260 where theanalyte detection system602 comprises thenoninvasive system10 or the whole-blood system200, respectively). In the centralized computer604 (or, where applicable, the computer(s)528), the encryption and/or decryption processes may be implemented in an algorithm or program instructions executable by, and residing within memory accessible by, processing element(s) (not shown) of thecomputer604/528 in question.
• Thesoftware update process700 has many advantages. One advantage is that thesoftware612 of theanalyte measuring device602 may be updated without requiring significant user participation. Another advantage is that thesoftware612 may be quickly and conveniently updated at a remote location (e.g., the user's home) rather than requiring the user to travel to, for example, a doctor's office or other administrative center.
• Although described above in connection with particular embodiments of the present invention, it should be understood the descriptions of the embodiments are illustrative of the invention and are not intended to be limiting. Various modifications and applications may occur to those skilled in the art without departing from the true spirit and scope of the invention. Furthermore, any method which is described and/or illustrated herein is not limited to the exact sequence of acts described, nor is it necessarily limited to the practice of all of the acts set forth. Other sequences of events or acts, or less than all of the events, or simultaneous occurrence of the events, may be utilized in practicing the method(s) in question.

Claims (26)

1-45. (canceled)

46. An analyte concentration monitoring system, comprising:

a non-interferometric analyte detection system comprising:

a source capable of emitting a beam of radiation along an optical path;

a detector located in said optical path, wherein said analyte detection system is configured to hold a sample element situated in said optical path;

a processor that calculates an analyte concentration in a sample in said sample element in accordance with software executable by said processor; and

a network interface that is configured to provide a connection to a computing network and to support communication between said computing network and said analyte detection system;

wherein said analyte detection system is configured to receive an update from said computing network without intervention from a user, said update being configured to alter the calculation of said analyte concentration by said processor.

47. The monitoring system ofclaim 46, wherein the analyte detection system is configured to automatically receive an update from said computing network.

48. The monitoring system ofclaim 46, further comprising a computing network configured to send said update to said analyte detection system.

49. The monitoring system ofclaim 46, wherein said analyte detection system is dimensioned for handheld portability.

50. The monitoring system ofclaim 46, wherein said analyte detection system is configured to continuously calculate said analyte concentration in said sample in said sample element.

51. An analyte concentration monitoring system, comprising:

a non-interferometric, optical analyte detection system comprising:

a housing;

a sample extractor configured to draw a sample through a patient's skin;

a processor that calculates an analyte concentration in a sample in accordance with software executable by said processor; and

a network interface that is configured to provide connectivity to a computing network;

wherein said analyte detection system is configured to receive an update to said software from a computing network via said network interface, the update is configured to update said software which is executable by said processor.

52. The monitoring system ofclaim 51, wherein said optical analyte detection system is configured to calculate an analyte concentration of a sample of a patient, when said sample is positioned within said analyte detection system.

53. The monitoring system ofclaim 51, wherein said analyte detection system executes said software to calculate an analyte concentration in a sample of blood.

54. The monitoring system ofclaim 51, wherein the optical analyte detection system is dimensioned for handheld portability.

55. The monitoring system ofclaim 51, wherein said software comprises one selected from the group consisting of algorithm, data, instructions, programs, and combinations thereof.

56. The monitoring system ofclaim 51, further comprising a computing network configured to send said update to said analyte detection system, the computing network checks an update status of said analyte detection system and selects said update based on said update status.

57. The monitoring system ofclaim 56, wherein said computing network automatically checks said update status upon connection of said computing network to said analyte detection system via said network interface.

58. The monitoring system ofclaim 51, further comprising a computing network at a remote location and said network interface connects to said computing network via an Internet connection.

59. The monitoring system ofclaim 51, wherein said network interface comprises a wireless interface.

60. The monitoring system ofclaim 59, wherein said wireless interface comprises a Bluetooth interface or IEEE 802.11(b) interface.

61. The monitoring system ofclaim 59, wherein said analyte detection system uses optical transmission spectroscopy to determine said analyte concentration.

62. A method of updating software on an analyte detection system, comprising:

providing a computer;

in said computer checking an update status of software included in a non-interferometric, optical analyte detection system, the analyte detection system having a sample extractor, the analyte detection system being configured to calculate an analyte concentration;

when said update status indicates that a software update is needed, sending said software update to said analyte detection system without intervention from a user; and

wherein said software update is configured to update said software in said analyte detection system.

63. The method ofclaim 62, further comprising in said analyte detection system, updating said software with said software update.

64. The method ofclaim 62, further comprising receiving information from said analyte detection system via a network connected to said computer.

65. The method ofclaim 64, wherein said information includes analyte concentration measurements.

66. The method ofclaim 62, wherein said software update includes at least one warning and instructions for communication of said at least one warning to a user of said analyte detection system.

67. The method ofclaim 62, further comprising displaying a warning on said analyte detection system.

68. The method ofclaim 62, further comprising calculating the analyte concentration, wherein said software update alters said calculating.

69. The method ofclaim 62, further comprising encrypting said software update.

70. The method ofclaim 69, further comprising decrypting said software update.

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