{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T03:49:22Z","timestamp":1771300162774,"version":"3.50.1"},"reference-count":31,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T00:00:00Z","timestamp":1617321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 109-2221-E-324-002-MY2 and MOST 108-2221-E-214-007-MY3"],"award-info":[{"award-number":["MOST 109-2221-E-324-002-MY2 and MOST 108-2221-E-214-007-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Deep vein thrombosis (DVT) of lower limbs can easily arise from prolonged sitting or standing. Elders and pregnant women are most likely to have this disease. When the embolus of DVT comes to pass the lung, it will become a life-threatening disease. Thus, for DVT disease, early detection and the early treatment are needed. The goal of this study was to develop an examination system to be used at non-medical places to detect the DVT of lower limbs with light reflection rheography (LRR). Consisting of a wearable device and a mobile application (APP), the system is operated in a wireless manner to control the actions of sensors and display and store the LRR signals on the APP. Then, the recorded LRR signals are processed to find the parameters of DVT examination. Twenty subjects were recruited to perform experiments. The veins of lower limbs were occluded by pressuring the cuff up to 100 mmHg and 150 mmHg to simulate the slight and serious DVT scenarios, respectively. Six characteristic parameters were defined to classify whether there was positive or negative DVT using the receiver operating characteristic curves, including the slopes of emptying and refilling curves in the LRR signal, and the changes of venous pump volume. Under the slight DVT scenario (0 mmHg vs. 100 mmHg), the first three parameters, m10, m40, and m50, had accuracies of 72%, 69%, and 69%, respectively. Under the serious DVT scenario (0 mmHg vs. 150 mmHg), m10, m40, and m50 achieved accuracies of 73%, 76%, and 73%, respectively. The experimental results show that this proposed examination system may be practical as an auxiliary tool to screen DVT in homecare settings.<\/jats:p>","DOI":"10.3390\/s21072446","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T04:13:51Z","timestamp":1617336831000},"page":"2446","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["An Examination System to Detect Deep Vein Thrombosis of a Lower Limb Using Light Reflection Rheography"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3923-4387","authenticated-orcid":false,"given":"Shing-Hong","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Computer Science and Information Engineering, Chaoyang University of Technology, Taichung 413310, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia-Jung","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, I-Shou University, Kaohsiung 84001, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7938-9033","authenticated-orcid":false,"given":"Wenxi","family":"Chen","sequence":"additional","affiliation":[{"name":"Biomedical Information Engineering Laboratory, The University of Aizu, Aizu-Wakamatsu City 965-8580, Fukushima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5418-9724","authenticated-orcid":false,"given":"Kuo-Li","family":"Pan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Chiayi Chang Gung Memorial Hospital, Chiayi City 61363, Taiwan"},{"name":"Department of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan City 33305, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun-Hung","family":"Su","sequence":"additional","affiliation":[{"name":"Institute of Medicine, School of Medicine, Chung-Shan Medical University, Taichung 40201, Taiwan"},{"name":"Department of Internal Medicine, Chung-Shan Medical University Hospital, Taichung 40201, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1788","DOI":"10.1161\/CIR.0b013e318214914f","article-title":"Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension","volume":"123","author":"Jaff","year":"2011","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1111\/j.1538-7836.2010.03873.x","article-title":"Incidence and cumulative recurrence rates of venous thromboembolism in the Taiwanese population","volume":"8","author":"Lee","year":"2010","journal-title":"J. Thromb. Haemost."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"142","DOI":"10.2310\/7060.2005.12303","article-title":"Traveler\u2019s thrombosis: A systematic review","volume":"12","author":"Ansari","year":"2005","journal-title":"J. Travel Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1016\/S0140-6736(00)04645-6","article-title":"Frequency and prevention of symptomless deep-vein thrombosis in long-haul flights: A randomised trial","volume":"357","author":"Scurr","year":"2001","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"297","DOI":"10.7326\/0003-4819-111-4-297","article-title":"Diagnosis of deep-vein thrombosis using duplex ultrasound","volume":"111","author":"White","year":"1989","journal-title":"Ann. Intern. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"08","DOI":"10.1055\/s-0038-1648130","article-title":"Contrast venography, the gold standard for the diagnosis of deep-vein thrombosis: Improvement in observer agreement","volume":"67","author":"Lensing","year":"1992","journal-title":"Thromb. Haemost."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1161\/01.CIR.53.4.696","article-title":"Impedance plethysmography using the occlusive cuff technique in the diagnostic of venous thrombosis","volume":"53","author":"Hull","year":"1976","journal-title":"Circulation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1161\/01.CIR.58.5.898","article-title":"Impedance plethysmography: The relationship between venous filling and sensitivity and specificity for proximal vein thrombosis","volume":"58","author":"Hull","year":"1978","journal-title":"Circulation"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/S0140-6736(84)92625-4","article-title":"Diagnosis of deep-vein thrombosis: Comparison of clinical evaluation, ultrasound, plethysmography, and venoscan with X-ray venogram","volume":"324","author":"Sandler","year":"1984","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1001\/archinte.1997.00440310041004","article-title":"The use of D-Dimer testing and impedance plethysmographic examination in patients with clinical indications of deep vein thrombosis","volume":"157","author":"Ginsberg","year":"1997","journal-title":"Arch. Intern. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1056\/NEJM198902093200602","article-title":"Detection of deep-vein thrombosis by real-time B-mode ultrasonography","volume":"320","author":"Lensing","year":"1989","journal-title":"N. Engl. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta10150","article-title":"Measurement of the clinical and cost-effectiveness of non-invasive diagnostic testing strategies for deep vein thrombosis","volume":"10","author":"Goodacre","year":"2006","journal-title":"Health Technol. Assess."},{"key":"ref_13","first-page":"266","article-title":"Light reflection rheography: A new non-invasive test of venous function","volume":"8","author":"Shepard","year":"1984","journal-title":"Bruit"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1111\/j.1524-4725.1992.tb03696.x","article-title":"Light reflection rheography: A non-Invasive diagnostic tool for screening for venous disease","volume":"18","author":"Neumann","year":"1992","journal-title":"J. Dermatol. Surg. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/0741-5214(93)90330-O","article-title":"Light reflection rheography: A simple noninvasive screening test for deep vein thrombosis","volume":"18","author":"Arora","year":"1993","journal-title":"J. Vasc. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1002\/bjs.1800780225","article-title":"Light reflection rheography: An effective non-invasive technique for screening patients with suspected deep venous thrombosis","volume":"78","author":"Thomas","year":"1991","journal-title":"Br. J. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1109\/MCE.2018.2880829","article-title":"A wearable system that detects posture and heart rate: Designing an integrated device with multi-parameter measurements for better health care","volume":"8","author":"Prawiro","year":"2019","journal-title":"IEEE Consum. Electron. Mag."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"35558","DOI":"10.1109\/ACCESS.2018.2848936","article-title":"Personalized health monitoring system of elderly wellness at the community level in Hong Kong","volume":"6","author":"Yu","year":"2018","journal-title":"IEEE Access"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1007\/s40846-018-0369-y","article-title":"Development of a patch-type electrocardiographic monitor for real time heartbeat detection and heart rate variability analysis","volume":"38","author":"Liu","year":"2018","journal-title":"J. Med. Biol. Eng."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Liu, S.-H., Lin, C.-B., Chen, Y., Chen, W., Huang, T.-S., and Hsu, C.-Y. (2019). An EMG patch for the real-time monitoring of muscle-fatigue conditions during exercise. Sensors, 19.","DOI":"10.3390\/s19143108"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ijaz, M.F., Attique, M., and Son, Y. (2020). Data-driven cervical cancer prediction model with outlier detection and over-sampling methods. Sensors, 20.","DOI":"10.3390\/s20102809"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.inffus.2020.06.008","article-title":"A smart healthcare monitoring system for heart disease prediction based on ensemble deep learning and feature fusion","volume":"63","author":"Alia","year":"2020","journal-title":"Inf. Fusion"},{"key":"ref_23","unstructured":"(2021, March 31). Analog Devices. AD8232. Available online: http:\/\/www.analog.com\/en\/products\/amplifiers\/instrumentation-amplifiers\/ad8232.html#product-overview."},{"key":"ref_24","unstructured":"(2021, March 31). MAX30101 Datasheet and Product Info Maxim Integrated. Available online: https:\/\/www.maximintegrated.com\/en\/products\/sensors\/MAX30101.html."},{"key":"ref_25","unstructured":"(2021, March 31). Analog Devices. ADXL325. Available online: http:\/\/www.analog.com\/en\/products\/sensors-mems\/accelerometers\/adxl325.html."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"132S","DOI":"10.1378\/chest.119.1_suppl.132S","article-title":"Prevention of venous thromboembolism","volume":"119","author":"Geerts","year":"2001","journal-title":"Chest"},{"key":"ref_27","first-page":"328","article-title":"Diagnostic imaging in deep vein thrombosis of the limbs","volume":"21","author":"Salcuni","year":"1996","journal-title":"Rays"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1259\/0007-1285-68-810-593","article-title":"Comparison of light reflection rheography with ascending venography in the diagnosis of lower limb deep vein thrombosis","volume":"68","author":"Abbott","year":"1995","journal-title":"Br. J. Radiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1053\/ejvs.1999.0886","article-title":"Digital photoplethysmography in the diagnosis of suspected lower limb DVT: Is it useful?","volume":"18","author":"Tan","year":"1999","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/0002-9610(91)91248-H","article-title":"Detection of clinically suspected deep vein thrombosis using light reflection rheography","volume":"161","author":"Mitrani","year":"1991","journal-title":"Am. J. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.1109\/TBME.2018.2874957","article-title":"Multi-wavelength photoplethysmography enabling continuous blood pressure measurement with compact wearable electronics","volume":"66","author":"Liu","year":"2019","journal-title":"IEEE Trans. Biomed. Eng."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/7\/2446\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:26:03Z","timestamp":1760361963000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/7\/2446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,2]]},"references-count":31,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["s21072446"],"URL":"https:\/\/doi.org\/10.3390\/s21072446","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,2]]}}}