A probabilistic model for early prediction of abnormal clinical events using vital sign correlations in home-based monitoring

摘要

Chronic diseases are major causes of deaths in Australia and throughout the world. This necessitates the need for a self-care, preventive, predictive and protective assisted living system where a patient can be monitored continuously using wearable and wireless sensors. In real-time home monitoring system, various biological signals of a patient are obtained continuously using a mobile device (smart phone or tablet) and sent to the cloud to discover patient-specific abnormalities. The objective of this work is to develop a probabilistic model that identifies the future clinical abnormalities of a patient using recent and past values of multiple vital signs (e.g. heart rate, blood pressure, respiratory rate). Chronic patients living alone in home die of various diseases for the lack of an efficient automated system having prior prediction ability in the irregularities of vital signs. In this paper, Hidden Markov Model (HMM) is adopted to predict different clinical onsets using the temporal behaviours of six biosignals. The HMM models are trained and evaluated using continuous monitoring data of more than 1000 patients collected from the MIMIC-II database of MIT physiobank archive. The best models are selected using expectation maximisation (EM) algorithm and used in personalized remote monitoring system to forecast the most probable forthcoming clinical states of a continuously monitored patient. The scalable power of cloud computing is utilized for fast learning of various clinical events from large samples. The results obtained from the innovative home-based monitoring application show a new approach of detecting clinical anomalies using multi-parameter trends.