Department of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada.
maxSIMhealth, Ontario Tech University, Oshawa, ON L1H 7K4, Canada.
Comput Methods Programs Biomed. 2023 Oct;240:107645. doi: 10.1016/j.cmpb.2023.107645. Epub 2023 Jun 12.
Due to the constraints of the COVID-19 pandemic, healthcare workers have reported acting in ways that are contrary to their moral values, and this may result in moral distress. This paper proposes the novel digital phenotype profile (DPP) tool, developed specifically to evaluate stress experiences within participants. The DPP tool was evaluated using the COVID-19 VR Healthcare Simulation of Stress Experience (HSSE) dataset (NCT05001542), which is composed of passive physiological signals and active mental health questionnaires. The DPP tool focuses on correlating electrocardiogram, respiration, photoplethysmography, and galvanic skin response with moral injury outcome scale (Brief MIOS).
Data-driven techniques are encompassed to develop a tool for robust evaluation of distress among participants. To accomplish this, we applied pre-processing techniques which involved normalization, data sanitation, segmentation, and windowing. During feature analysis, we extracted domain-specific features, followed by feature selection techniques to rank the importance of the feature set. Prior to classification, we employed k-means clustering to group the Brief MIOS scores to low, moderate, and high moral distress as the Brief MIOS lacks established severity cut-off scores. Support vector machine and decision tree models were used to create machine learning models to predict moral distress severities.
Weighted support vector machine with leave-one-subject-out-cross-validation evaluated the separation of the Brief MIOS scores and achieved an average accuracy, precision, sensitivity, and F1 of 98.67%, 98.83%, 99.44%, and 99.13%, respectively. Various machine learning ablation tests were performed to support our results and further enhance the understanding of the predictive model.
Our findings demonstrate the feasibility to develop a DPP tool to predict distress experiences using a combination of mental health questionnaires and passive signals. The DPP tool is the first of its kind developed from the analysis of the HSSE dataset. Additional validation is needed for the DPP tool through replication in larger sample sizes.
由于 COVID-19 大流行的限制,医护人员报告说他们的行为违反了自己的道德价值观,这可能导致道德困境。本文提出了一种新颖的数字表型谱(DPP)工具,专门用于评估参与者的压力体验。该 DPP 工具是使用 COVID-19 VR 医疗保健应激体验模拟(HSSE)数据集(NCT05001542)进行评估的,该数据集由被动生理信号和主动心理健康问卷组成。DPP 工具侧重于将心电图、呼吸、光电容积脉搏波和皮肤电反应与道德伤害结局量表(Brief MIOS)相关联。
该研究应用数据驱动技术开发了一种用于评估参与者压力的工具。为此,我们应用了预处理技术,包括归一化、数据清理、分割和窗口化。在特征分析中,我们提取了特定领域的特征,然后使用特征选择技术对特征集的重要性进行排名。在分类之前,我们采用 k-均值聚类将 Brief MIOS 评分分为低、中、高道德困境三组,因为 Brief MIOS 缺乏既定的严重程度截断分数。支持向量机和决策树模型用于创建机器学习模型,以预测道德困境的严重程度。
使用带有留一受试者交叉验证的加权支持向量机评估了 Brief MIOS 评分的分离度,平均准确率、精度、灵敏度和 F1 分别为 98.67%、98.83%、99.44%和 99.13%。进行了各种机器学习消融测试以支持我们的结果,并进一步增强对预测模型的理解。
我们的研究结果表明,使用心理健康问卷和被动信号相结合来开发 DPP 工具来预测压力体验是可行的。DPP 工具是从 HSSE 数据集的分析中开发的首例。需要通过更大的样本量进行复制来对 DPP 工具进行额外验证。