Department of Neurology and Neurosurgery, University of California, Los Angeles, CA 90024, USA.
IEEE Trans Biomed Eng. 2013 Jan;60(1):235-9. doi: 10.1109/TBME.2012.2210042. Epub 2012 Jul 24.
False alarms produced by patient monitoring systems in intensive care units are a major issue that causes alarm fatigue, waste of human resources, and increased patient risks. While alarms are typically triggered by manually adjusted thresholds, the trend and patterns observed prior to threshold crossing are generally not used by current systems. This study introduces and evaluates, a smart alarm detection system for intracranial pressure signal (ICP) that is based on advanced pattern recognition methods. Models are trained in a supervised fashion from a comprehensive dataset of 4791 manually labeled alarm episodes extracted from 108 neurosurgical patients. The comparative analysis provided between spectral regression, kernel spectral regression, and support vector machines indicates the significant improvement of the proposed framework in detecting false ICP alarms in comparison to a threshold-based technique that is conventionally used. Another contribution of this work is to exploit an adaptive discretization to reduce the dimensionality of the input features. The resulting features lead to a decrease of 30% of false ICP alarms without compromising sensitivity.
重症监护病房患者监护系统产生的误报警是一个主要问题,它会导致报警疲劳、浪费人力资源和增加患者风险。虽然报警通常是由手动调整的阈值触发的,但当前系统通常不使用阈值交叉之前观察到的趋势和模式。本研究提出并评估了一种基于先进模式识别方法的颅内压信号 (ICP) 智能报警检测系统。该模型是从从 108 名神经外科患者中提取的 4791 个手动标记报警事件的综合数据集以监督方式进行训练的。与传统使用的基于阈值的技术相比,对光谱回归、核光谱回归和支持向量机进行的比较分析表明,所提出的框架在检测假 ICP 报警方面有显著的改进。这项工作的另一个贡献是利用自适应离散化来降低输入特征的维度。所得到的特征可减少 30%的假 ICP 报警,而不会降低灵敏度。