Forensiska Undersökningar av Molntjänster

Användning av molntjänster har gjort forensiska undersökningar mer komplicerade. Däremot finns det goda förutsättningar om molnleverantörerna skapar tjänster för att få ut all information. Det skulle göra det enklare och mer tillförlitligt. Informationen som ska tas ut från molntjänsterna är svår att få ut på ett korrekt sätt. Undersökningen görs inte på en skrivskyddad kopia, utan i en miljö som riskerar att förändras. Det är då möjligt att ändringar görs under tiden datan hämtas ut, vilket inte alltid syns. Det går heller inte att jämföra skillnaderna genom att ta hashsummor på filerna som görs vid forensiska undersökningar av datorer. Därför är det viktigt att dokumentera hur informationen har tagits ut, helst genom att filma datorskärmen under tiden informationen tas ut. Informationen finns sparad på flera platser då molntjänsterna Office 365 och Google Apps används, både i molnet och på den eller de datorer som har använts för att ansluta till molntjänsten. Webbläsare sparar mycket information om vad som har gjorts. Därför är det viktigt att det går att ta reda på vilka datorer som har använts för att ansluta sig till molntjänsten, vilket idag inte möjligt. Om det är möjligt att undersöka de datorer som använts kan bevis som inte finns kvar i molnet hittas. Det bästa ur forensisk synvinkel skulle vara om leverantörerna av molntjänster erbjöd en tjänst som hämtar ut all data som rör en användare, inklusive alla relevanta loggar. Då skulle det ske på ett mycket säkrare sätt, då det inte skulle gå att ändra informationen under tiden den hämtas ut. 

A web application for follow-up of results from a mobile device test battery for parkinson’s disease patients

Background: A test battery consisting of self-assessments and motor tests (tapping and spiral drawing) was developed for a hand computer with touch screen in a telemedicine setting. Objectives: To develop and evaluate a web-based system that delivers decision support information to the treating clinical staff for assessing PD symptoms in their patients based on the test battery data. Methods: The test battery is currently being used in a clinical trial (DAPHNE, EudraCT No. 2005-002654-21) by sixty five patients with advanced Parkinson’s disease (PD) on 9991 test occasions (four tests per day during in all 362 week-long test periods) at nine clinics around Sweden. Test results are sent continuously from the hand unit over a mobile net to a central computer and processed with statistical methods. They are summarized into scores for different dimensions of the symptom state and an ‘overall test score’ reflecting the overall condition of the patient during a test period. The information in the web application is organized and presented graphically in a way that the general overview of the patient performance per test period is emphasized. Focus is on the overall test score, symptom dimensions and daily summaries. In a recent preliminary user evaluation, the web application was demonstrated to the fifteen study nurses who had used the test battery in the clinical trial. At least one patient per clinic was shown. Results: In general, the responses from nurses were positive. They claimed that the test results shown in the system were consistent with their own clinical observations. They could follow complications, changes and trends within their patients. Discussion: In conclusion, the system is able to summarise the various time series of motor test results and self-assessments during test periods and present them in a useful manner. Its main contribution is a novel and reliable way to capture and easily access symptom information from patients’ home environment. The convenient access to current symptom profile as well as symptom history provides a basis for individualized evaluation and adjustment of treatments.

Mobile systems for monitoring Parkinson's disease

A challenge for the clinical management of Parkinson's disease (PD) is the large within- and between-patient variability in symptom profiles as well as the emergence of motor complications which represent a significant source of disability in patients. This thesis deals with the development and evaluation of methods and systems for supporting the management of PD by using repeated measures, consisting of subjective assessments of symptoms and objective assessments of motor function through fine motor tests (spirography and tapping), collected by means of a telemetry touch screen device. One aim of the thesis was to develop methods for objective quantification and analysis of the severity of motor impairments being represented in spiral drawings and tapping results. This was accomplished by first quantifying the digitized movement data with time series analysis and then using them in data-driven modelling for automating the process of assessment of symptom severity. The objective measures were then analysed with respect to subjective assessments of motor conditions. Another aim was to develop a method for providing comparable information content as clinical rating scales by combining subjective and objective measures into composite scores, using time series analysis and data-driven methods. The scores represent six symptom dimensions and an overall test score for reflecting the global health condition of the patient. In addition, the thesis presents the development of a web-based system for providing a visual representation of symptoms over time allowing clinicians to remotely monitor the symptom profiles of their patients. The quality of the methods was assessed by reporting different metrics of validity, reliability and sensitivity to treatment interventions and natural PD progression over time. Results from two studies demonstrated that the methods developed for the fine motor tests had good metrics indicating that they are appropriate to quantitatively and objectively assess the severity of motor impairments of PD patients. The fine motor tests captured different symptoms; spiral drawing impairment and tapping accuracy related to dyskinesias (involuntary movements) whereas tapping speed related to bradykinesia (slowness of movements). A longitudinal data analysis indicated that the six symptom dimensions and the overall test score contained important elements of information of the clinical scales and can be used to measure effects of PD treatment interventions and disease progression. A usability evaluation of the web-based system showed that the information presented in the system was comparable to qualitative clinical observations and the system was recognized as a tool that will assist in the management of patients.