Exploring surgical infection prediction: A comparative study of established risk indexes and a novel model

BACKGROUND

Surgical site infections are a major health problem that deteriorates the patients' health and increases health care costs. A reliable method to identify patients with modifiable risk of surgical site infection is necessary to reduce the incidence of them but data are limited. Hence the objective is to assess the predictive validity of a logistic regression model compared to risk indexes to identify patients at risk of surgical site infections.

METHODS

In this study, we evaluated the predictive validity of a new model which incorporates important predictors based on logistic regression model compared to three state-of-the-art risk indexes to identify high risk patients, recruited from 2016 to 2020 from a medium size hospital in North Norway, prone to surgical site infection.

RESULTS

The logistic regression model demonstrated significantly higher scores, defined as high-risk, in 110 patients with surgical site infections than in 110 patients without surgical site infections (p < 0.001, CI 19-44) compared to risk indexes. The logistic regression model achieved an area under the curve of 80 %, which was better than the risk indexes SSIRS (77 %), NNIS (59 %), and JSS-SSI (52 %) for predicting surgical site infections. The logistic regression model identified operating time and length of stay as the major predictors of surgical site infections.

CONCLUSIONS

The logistic regression model demonstrated better performance in predicting surgical site infections compared to three state-of-the-art risk indexes. The model could be further developed into a decision support tool, by incorporating predictors available prior to surgery, to identify patients with modifiable risk prone to surgical site infection.

Dataset of motivational factors for using mobile health applications and systems

We created and carried out a cross-sectional anonymous structured questionnaire on what motivates users of mobile health applications and wearables to share their collected health related data. The questionnaire was distributed online in English, French, and Norwegian. In addition, a flyer with information of where to locate the online questionnaire was distributed during a Swiss health conference. We used snowball sampling and encouraged participants to forward the questionnaires to friends, family, and others. Data were collected between October 2018 and March 2020. 58.1 % (n = 473) responded to the English survey, 34.3 % (n = 279) responded to the French survey, and 7.6 % (n = 62) responded to the Norwegian survey. The questionnaire contained 38 questions divided into seven themes: Background and health goals, Wearables and sensors, Mobile applications, Logging of health data, Data sharing- and integration, Social media and entertainment, and Demographics (age, gender, country of origin, chronic disease status, and chronic disease caretaker status). Answer options were single answer, multiple-choice, open-ended, or on a 4-point Likert scale. Questions were defined based on 16 in-person interviews with people without any chronic disorder, people with diabetes, and people with sickle cell disease. All questions were optional. Data were collected from 814 participants. All answers to the open-ended questions have been translated into English. This dataset is especially interesting for researchers interesting in what motivates people with and without chronic disease across countries to use mHealth tools and share their collected health data. Only a subset of variables has been analyzed so far and new research questions on motivation can potentially be answered using this dataset.

Dataset of fitness trackers and smartwatches to measuring physical activity in research

OBJECTIVES

Accelerometer-based wrist-worn fitness trackers and smartwatches (wearables) appeared on the consumer market in 2011. Many wearable devices have been released since. The objective of this data paper is to describe a dataset of 423 wearables released before July 2017.

DATA DESCRIPTION

We identified wearables and extracted information from six online and offline databases. We also visited websites for all identified companies/brands to identify additional wearables, as well as obtained additional information for each identified device. Twelve attributes were collected: wearable name, company/brand name, release year, country of origin, whether the wearable was crowd funded, form factor (fitness tracker or smartwatch), and sensors supported. Support for the following sensors were mapped: accelerometer, magnetometer, gyroscope, altimeter or barometer, global-positioning-system, and optical pulse sensor (i.e., photoplethysmograph). The search was conducted between May 15th and July 1st, 2017. The included data gives an overview of most in-scope wearables released before July 2017 and allows researchers to conduct additional analysis not performed in the related article. Further insights can be achieved by complementing this list with wearable models released after July 2017.

mHealth: Where Is the Potential for Aiding Informal Caregivers?

The health and well-being of informal caregivers often take a backseat to those that they care for. While systems, technologies, and services that provide care and support for those with chronic illnesses are established and continuously improved, those that support informal caregivers are less explored. An international survey about motivations to use mHealth technologies was posted to online platforms related to chronic illnesses. We focused on responses regarding the facilitators and challenges of achieving health goals, including the use of mHealth technologies, for the subgroup who identified as "Caregivers". Findings indicate that mHealth technology is not yet the most important motivational factor for achieving health goals in this group, but greater future potential is suggested.

A Novel Approach for Continuous Health Status Monitoring and Automatic Detection of Infection Incidences in People With Type 1 Diabetes Using Machine Learning Algorithms (Part 2): A Personalized Digital Infectious Disease Detection Mechanism

BACKGROUND

Semisupervised and unsupervised anomaly detection methods have been widely used in various applications to detect anomalous objects from a given data set. Specifically, these methods are popular in the medical domain because of their suitability for applications where there is a lack of a sufficient data set for the other classes. Infection incidence often brings prolonged hyperglycemia and frequent insulin injections in people with type 1 diabetes, which are significant anomalies. Despite these potentials, there have been very few studies that focused on detecting infection incidences in individuals with type 1 diabetes using a dedicated personalized health model.

OBJECTIVE

This study aims to develop a personalized health model that can automatically detect the incidence of infection in people with type 1 diabetes using blood glucose levels and insulin-to-carbohydrate ratio as input variables. The model is expected to detect deviations from the norm because of infection incidences considering elevated blood glucose levels coupled with unusual changes in the insulin-to-carbohydrate ratio.

METHODS

Three groups of one-class classifiers were trained on target data sets (regular days) and tested on a data set containing both the target and the nontarget (infection days). For comparison, two unsupervised models were also tested. The data set consists of high-precision self-recorded data collected from three real subjects with type 1 diabetes incorporating blood glucose, insulin, diet, and events of infection. The models were evaluated on two groups of data: raw and filtered data and compared based on their performance, computational time, and number of samples required.

RESULTS

The one-class classifiers achieved excellent performance. In comparison, the unsupervised models suffered from performance degradation mainly because of the atypical nature of the data. Among the one-class classifiers, the boundary and domain-based method produced a better description of the data. Regarding the computational time, nearest neighbor, support vector data description, and self-organizing map took considerable training time, which typically increased as the sample size increased, and only local outlier factor and connectivity-based outlier factor took considerable testing time.

CONCLUSIONS

We demonstrated the applicability of one-class classifiers and unsupervised models for the detection of infection incidence in people with type 1 diabetes. In this patient group, detecting infection can provide an opportunity to devise tailored services and also to detect potential public health threats. The proposed approaches achieved excellent performance; in particular, the boundary and domain-based method performed better. Among the respective groups, particular models such as one-class support vector machine, K-nearest neighbor, and K-means achieved excellent performance in all the sample sizes and infection cases. Overall, we foresee that the results could encourage researchers to examine beyond the presented features into other additional features of the self-recorded data, for example, continuous glucose monitoring features and physical activity data, on a large scale.

Toward Detecting Infection Incidence in People With Type 1 Diabetes Using Self-Recorded Data (Part 1): A Novel Framework for a Personalized Digital Infectious Disease Detection System

BACKGROUND

Type 1 diabetes is a chronic condition of blood glucose metabolic disorder caused by a lack of insulin secretion from pancreas cells. In people with type 1 diabetes, hyperglycemia often occurs upon infection incidences. Despite the fact that patients increasingly gather data about themselves, there are no solid findings that uncover the effect of infection incidences on key parameters of blood glucose dynamics to support the effort toward developing a digital infectious disease detection system.

OBJECTIVE

The study aims to retrospectively analyze the effect of infection incidence and pinpoint optimal parameters that can effectively be used as input variables for developing an infection detection algorithm and to provide a general framework regarding how a digital infectious disease detection system can be designed and developed using self-recorded data from people with type 1 diabetes as a secondary source of information.

METHODS

We retrospectively analyzed high precision self-recorded data of 10 patient-years captured within the longitudinal records of three people with type 1 diabetes. Obtaining such a rich and large data set from a large number of participants is extremely expensive and difficult to acquire, if not impossible. The data set incorporates blood glucose, insulin, carbohydrate, and self-reported events of infections. We investigated the temporal evolution and probability distribution of the key blood glucose parameters within a specified timeframe (weekly, daily, and hourly).

RESULTS

Our analysis demonstrated that upon infection incidence, there is a dramatic shift in the operating point of the individual blood glucose dynamics in all the timeframes (weekly, daily, and hourly), which clearly violates the usual norm of blood glucose dynamics. During regular or normal situations, higher insulin and reduced carbohydrate intake usually results in lower blood glucose levels. However, in all infection cases as opposed to the regular or normal days, blood glucose levels were elevated for a prolonged period despite higher insulin and reduced carbohydrates intake. For instance, compared with the preinfection and postinfection weeks, on average, blood glucose levels were elevated by 6.1% and 16%, insulin (bolus) was increased by 42% and 39.3%, and carbohydrate consumption was reduced by 19% and 28.1%, respectively.

CONCLUSIONS

We presented the effect of infection incidence on key parameters of blood glucose dynamics along with the necessary framework to exploit the information for realizing a digital infectious disease detection system. The results demonstrated that compared with regular or normal days, infection incidence substantially alters the norm of blood glucose dynamics, which are quite significant changes that could possibly be detected through personalized modeling, for example, prediction models and anomaly detection algorithms. Generally, we foresee that these findings can benefit the efforts toward building next generation digital infectious disease detection systems and provoke further thoughts in this challenging field.

User Expectations and Willingness to Share Self-Collected Health Data

The rapid improvement in mobile health technologies revolutionized what and how people can self-record and manage data. This massive amount of information accumulated by these technologies has potentially many applications beyond personal need, i.e. for public health. A challenge with collecting this data is to motivate people to share this data for the benefit of all. The purpose of this study is to survey and examine factors that may motivate sharing this data. We asked 447 participants four questions related to health data sharing and motivation. Participants with a chronic disease were concerned about data sharing but also willing to share health data if personalized feedback is provided. Functionality, ease of use, and privacy are regarded as crucial features of health apps.

Cluster Detection Mechanisms for Syndromic Surveillance Systems: Systematic Review and Framework Development

Background

The time lag in detecting disease outbreaks remains a threat to global health security. The advancement of technology has made health-related data and other indicator activities easily accessible for syndromic surveillance of various datasets. At the heart of disease surveillance lies the clustering algorithm, which groups data with similar characteristics (spatial, temporal, or both) to uncover significant disease outbreak. Despite these developments, there is a lack of updated reviews of trends and modelling options in cluster detection algorithms.

Objective

Our purpose was to systematically review practically implemented disease surveillance clustering algorithms relating to temporal, spatial, and spatiotemporal clustering mechanisms for their usage and performance efficacies, and to develop an efficient cluster detection mechanism framework.

Methods

We conducted a systematic review exploring Google Scholar, ScienceDirect, PubMed, IEEE Xplore, ACM Digital Library, and Scopus. Between January and March 2018, we conducted the literature search for articles published to date in English in peer-reviewed journals. The main eligibility criteria were studies that (1) examined a practically implemented syndromic surveillance system with cluster detection mechanisms, including over-the-counter medication, school and work absenteeism, and disease surveillance relating to the presymptomatic stage; and (2) focused on surveillance of infectious diseases. We identified relevant articles using the title, keywords, and abstracts as a preliminary filter with the inclusion criteria, and then conducted a full-text review of the relevant articles. We then developed a framework for cluster detection mechanisms for various syndromic surveillance systems based on the review.

Results

The search identified a total of 5936 articles. Removal of duplicates resulted in 5839 articles. After an initial review of the titles, we excluded 4165 articles, with 1674 remaining. Reading of abstracts and keywords eliminated 1549 further records. An in-depth assessment of the remaining 125 articles resulted in a total of 27 articles for inclusion in the review. The result indicated that various clustering and aberration detection algorithms have been empirically implemented or assessed with real data and tested. Based on the findings of the review, we subsequently developed a framework to include data processing, clustering and aberration detection, visualization, and alerts and alarms.

Conclusions

The review identified various algorithms that have been practically implemented and tested. These results might foster the development of effective and efficient cluster detection mechanisms in empirical syndromic surveillance systems relating to a broad spectrum of space, time, or space-time.

Factors Influencing Motivation and Engagement in Mobile Health Among Patients With Sickle Cell Disease in Low-Prevalence, High-Income Countries: Qualitative Exploration of Patient Requirements

Background

Sickle cell disease (SCD) is a hematological genetic disease affecting over 25 million people worldwide. The main clinical manifestations of SCD, hemolytic anemia and vaso-occlusion, lead to chronic pain and organ damages. With recent advances in childhood care, high-income countries have seen SCD drift from a disease of early childhood mortality to a neglected chronic disease of adulthood. In particular, coordinated, preventive, and comprehensive care for adults with SCD is largely underresourced. Consequently, patients are left to self-manage. Mobile health (mHealth) apps for chronic disease self-management are now flooding app stores. However, evidence remains unclear about their effectiveness, and the literature indicates low user engagement and poor adoption rates. Finally, few apps have been developed for people with SCD and none encompasses their numerous and complex self-care management needs.

Objective

This study aimed to identify factors that may influence the long-term engagement and user adoption of mHealth among the particularly isolated community of adult patients with SCD living in low-prevalence, high-income countries.

Methods

Semistructured interviews were conducted. Interviews were audiotaped, transcribed verbatim, and analyzed using thematic analysis. Analysis was informed by the Braun and Clarke framework and mapped to the COM-B model (capability, opportunity, motivation, and behavior). Results were classified into high-level functional requirements (FRs) and nonfunctional requirements (NFRs) to guide the development of future mHealth interventions.

Results

Overall, 6 males and 4 females were interviewed (aged between 21 and 55 years). Thirty FRs and 31 NFRs were extracted from the analysis. Most participants (8/10) were concerned about increasing their physical capabilities being able to stop pain symptoms quickly. Regarding the psychological capability aspects, all interviewees desired to receive trustworthy feedback on their self-care management practices. About their physical opportunities, most (7/10) expressed a strong desire to receive alerts when they would reach their own physiological limitations (ie, during physical activity). Concerning social opportunity, most (9/10) reported wanting to learn about the self-care practices of other patients. Relating to motivational aspects, many interviewees (6/10) stressed their need to learn how to avoid the symptoms and live as normal a life as possible. Finally, NFRs included inconspicuousness and customizability of user experience, automatic data collection, data shareability, and data privacy.

Conclusions

Our findings suggest that motivation and engagement with mHealth technologies among the studied population could be increased by providing features that clearly benefit them. Self-management support and self-care decision aid are patients’ major demands. As the complexity of SCD self-management requires a high cognitive load, pervasive health technologies such as wearable sensors, implantable devices, or inconspicuous conversational user interfaces should be explored to ease it. Some of the required technologies already exist but must be integrated, bundled, adapted, or improved to meet the specific needs of people with SCD.

Design and Prestudy Assessment of a Dashboard for Presenting Self-Collected Health Data of Patients With Diabetes to Clinicians: Iterative Approach and Qualitative Case Study

Background

Introducing self-collected health data from patients with diabetes into consultation can be beneficial for both patients and clinicians. Such an initiative can allow patients to be more proactive in their disease management and clinicians to provide more tailored medical services. Optimally, electronic health record systems (EHRs) should be able to receive self-collected health data in a standard representation of medical data such as Fast Healthcare Interoperability Resources (FHIR), from patients systems like mobile health apps and display the data directly to their users—the clinicians. However, although Norwegian EHRs are working on implementing FHIR, no solution or graphical interface is available today to display self-collected health data.

Objective

The objective of this study was to design and assess a dashboard for displaying relevant self-collected health data from patients with diabetes to clinicians.

Methods

The design relied on an iterative participatory process involving workshops with patients, clinicians, and researchers to define which information should be available and how it should be displayed. The assessment is based on a case study, presenting an instance of the dashboard populated with data collected from one patient with diabetes type 1 (in-house researcher) face-to-face by 14 clinicians. We performed a qualitative analysis based on usability, functionality, and expectation by using responses to questionnaires that were distributed to the 14 clinicians at the end of the workshops and collected before the participants left. The qualitative assessment was guided by the Standards for Reporting Qualitative Research.

Results

We created a dashboard permitting clinicians to assess the reliability of self-collected health data, list all collected data including medical calculations, and highlight medical situations that need to be investigated to improve the situation of the patients. The dashboard uses a combination of tables, graphs, and other visual representations to display the relevant information. Clinicians think that this type of solution will be useful during consultations every day, especially for patients living in remote areas or those who are technologically interested.

Conclusions

Displaying self-collected health data during consultations is not enough for clinicians; the data reliability has to be assured and the relevant information needs to be extracted and displayed along with the data to ease the introduction during a medical encounter. The prestudy assessment showed that the system provides relevant information to meet clinicians’ need and that clinicians were eager to start using it during consultations. The system has been under testing in a medical trial since November 2018, and the first results of its assessment in a real-life situation are expected in the beginning of next year (2020).

Data-Driven Blood Glucose Pattern Classification and Anomalies Detection: Machine-Learning Applications in Type 1 Diabetes

Background

Diabetes mellitus is a chronic metabolic disorder that results in abnormal blood glucose (BG) regulations. The BG level is preferably maintained close to normality through self-management practices, which involves actively tracking BG levels and taking proper actions including adjusting diet and insulin medications. BG anomalies could be defined as any undesirable reading because of either a precisely known reason (normal cause variation) or an unknown reason (special cause variation) to the patient. Recently, machine-learning applications have been widely introduced within diabetes research in general and BG anomaly detection in particular. However, irrespective of their expanding and increasing popularity, there is a lack of up-to-date reviews that materialize the current trends in modeling options and strategies for BG anomaly classification and detection in people with diabetes.

Objective

This review aimed to identify, assess, and analyze the state-of-the-art machine-learning strategies and their hybrid systems focusing on BG anomaly classification and detection including glycemic variability (GV), hyperglycemia, and hypoglycemia in type 1 diabetes within the context of personalized decision support systems and BG alarm events applications, which are important constituents for optimal diabetes self-management.

Methods

A rigorous literature search was conducted between September 1 and October 1, 2017, and October 15 and November 5, 2018, through various Web-based databases. Peer-reviewed journals and articles were considered. Information from the selected literature was extracted based on predefined categories, which were based on previous research and further elaborated through brainstorming.

Results

The initial results were vetted using the title, abstract, and keywords and retrieved 496 papers. After a thorough assessment and screening, 47 articles remained, which were critically analyzed. The interrater agreement was measured using a Cohen kappa test, and disagreements were resolved through discussion. The state-of-the-art classes of machine learning have been developed and tested up to the task and achieved promising performance including artificial neural network, support vector machine, decision tree, genetic algorithm, Gaussian process regression, Bayesian neural network, deep belief network, and others.

Conclusions

Despite the complexity of BG dynamics, there are many attempts to capture hypoglycemia and hyperglycemia incidences and the extent of an individual’s GV using different approaches. Recently, the advancement of diabetes technologies and continuous accumulation of self-collected health data have paved the way for popularity of machine learning in these tasks. According to the review, most of the identified studies used a theoretical threshold, which suffers from inter- and intrapatient variation. Therefore, future studies should consider the difference among patients and also track its temporal change over time. Moreover, studies should also give more emphasis on the types of inputs used and their associated time lag. Generally, we foresee that these developments might encourage researchers to further develop and test these systems on a large-scale basis.

Using Fitness Trackers and Smartwatches to Measure Physical Activity in Research: Analysis of Consumer Wrist-Worn Wearables

Background

New fitness trackers and smartwatches are released to the consumer market every year. These devices are equipped with different sensors, algorithms, and accompanying mobile apps. With recent advances in mobile sensor technology, privately collected physical activity data can be used as an addition to existing methods for health data collection in research. Furthermore, data collected from these devices have possible applications in patient diagnostics and treatment. With an increasing number of diverse brands, there is a need for an overview of device sensor support, as well as device applicability in research projects.

Objective

The objective of this study was to examine the availability of wrist-worn fitness wearables and analyze availability of relevant fitness sensors from 2011 to 2017. Furthermore, the study was designed to assess brand usage in research projects, compare common brands in terms of developer access to collected health data, and features to consider when deciding which brand to use in future research.

Methods

We searched for devices and brand names in six wearable device databases. For each brand, we identified additional devices on official brand websites. The search was limited to wrist-worn fitness wearables with accelerometers, for which we mapped brand, release year, and supported sensors relevant for fitness tracking. In addition, we conducted a Medical Literature Analysis and Retrieval System Online (MEDLINE) and ClinicalTrials search to determine brand usage in research projects. Finally, we investigated developer accessibility to the health data collected by identified brands.

Results

We identified 423 unique devices from 132 different brands. Forty-seven percent of brands released only one device. Introduction of new brands peaked in 2014, and the highest number of new devices was introduced in 2015. Sensor support increased every year, and in addition to the accelerometer, a photoplethysmograph, for estimating heart rate, was the most common sensor. Out of the brands currently available, the five most often used in research projects are Fitbit, Garmin, Misfit, Apple, and Polar. Fitbit is used in twice as many validation studies as any other brands and is registered in ClinicalTrials studies 10 times as often as other brands.

Conclusions

The wearable landscape is in constant change. New devices and brands are released every year, promising improved measurements and user experience. At the same time, other brands disappear from the consumer market for various reasons. Advances in device quality offer new opportunities for research. However, only a few well-established brands are frequently used in research projects, and even less are thoroughly validated.

Motivational Factors for User Engagement with mHealth Apps

The widespread adoption of smartphones creates an enormous potential to improve healthcare services. Numerous apps, sensors, and devices are developed for health self-management purposes. However, adoption rates remain low and long-term user engagement is a major issue. The goal of this study is to identify major motivational factors that can facilitate prolonged use of mobile health systems. To this end, we conducted 16 interviews with representatives of various cultural backgrounds, disease history, age, and gender. Participants' experiences indicated that existing systems were unable to answer their self-management needs properly. People with a disease history favored learning from data, as well as from others via social media integration. People without chronic disease felt more reserved about social media integration. In conclusion, systems that collect and share personal data should have a clear opt-in or opt-out option to motivate usage. Additionally, researchers and mobile health system developers could achieve long-term adoption by giving clear answers to privacy and trust issues, while offering people strong added value according to their individual needs.

Telemedicine Services for the Arctic: A Systematic Review

BACKGROUND

Telemedicine services have been successfully used in areas where there are adequate infrastructures such as reliable power and communication lines. However, despite the increasing number of merchants and seafarers, maritime and Arctic telemedicine have had limited success. This might be linked with various factors such as lack of good infrastructure, lack of trained onboard personnel, lack of Arctic-enhanced telemedicine equipment, extreme weather conditions, remoteness, and other geographical challenges.

OBJECTIVE

The purpose of this review was to assess and analyze the current status of telemedicine services in the context of maritime conditions, extreme weather (ie, Arctic weather), and remote accidents and emergencies. Moreover, the paper aimed to identify successfully implemented telemedicine services in the Arctic region and in maritime settings and remote emergency situations and present state of the art systems for these areas. Finally, we identified the status quo of telemedicine services in the context of search and rescue (SAR) scenarios in these extreme conditions.

METHODS

A rigorous literature search was conducted between September 7 and October 28, 2015, through various online databases. Peer reviewed journals and articles were considered. Relevant articles were first identified by reviewing the title, keywords, and abstract for a preliminary filter with our selection criteria, and then we reviewed full-text articles that seemed relevant. Information from the selected literature was extracted based on some predefined categories, which were defined based on previous research and further elaborated upon via iterative brainstorming.

RESULTS

The initial hits were vetted using the title, abstract, and keywords, and we retrieved a total of 471 papers. After removing duplicates from the list, 422 records remained. Then, we did an independent assessment of the articles and screening based on the inclusion and exclusion criteria, which eliminated another 219 papers, leaving 203 relevant papers. After a full-text assessment, 36 articles were left, which were critically analyzed. The inter-rater agreement was measured using Cohen Kappa test, and disagreements were resolved through discussion.

CONCLUSIONS

Despite the increasing number of fishermen and other seafarers, Arctic and maritime working conditions are mainly characterized by an absence of access to health care facilities. The condition is further aggravated for fishermen and seafarers who are working in the Arctic regions. In spite of the existing barriers and challenges, some telemedicine services have recently been successfully delivered in these areas. These services include teleconsultation (9/37, 24%), teleradiology (8/37, 22%), teledermatology and tele-education (3/37, 8%), telemonitoring and telecardiology (telesonography) (1/37, 3%), and others (10/37, 27%). However, the use of telemedicine in relation to search and rescue (SAR) services is not yet fully exploited. Therefore, we foresee that these implemented and evaluated telemedicine services will serve as underlying models for the successful implementation of future search and rescue (SAR) services.

An Early Infectious Disease Outbreak Detection Mechanism Based on Self-Recorded Data from People with Diabetes

People with diabetes experience elevated blood glucose (BG) levels at the time of an infection. We propose to utilize patient-gathered information in an Electronic Disease Surveillance Monitoring Network (EDMON), which may support the identification of a cluster of infected people with elevated BG levels on a spatiotemporal basis. The system incorporates data gathered from diabetes apps, continuous glucose monitoring (CGM) devices, and other appropriate physiological indicators from people with type 1 diabetes. This paper presents a novel approach towards modeling of the individual's BG dynamics, a mechanism to track and detect deviations of elevated BG readings. The models were developed and validated using self-recorded data in the non-infection status using Dexcom CGM devices, from two type 1 diabetes individuals over a 1-month period. The models were also tested using simulated datasets, which resemble the individual's BG evolution during infections. The models accurately simulated the individual's normal BG fluctuations and further detected statistically significant BG elevations.