Deriving High Performance Alerts from Reduced Sensor Data for Timely Intervention in Acute Hypotensive Episodes

摘要

Alerting critical health conditions ahead of time leads to reduced mortality rates. Recently wirelessly enabled medical sensors have become pervasive in both hospital and ambulatory settings. These sensors pour out voluminous data that are generally not amenable to direct interpretation. For this data to be practically useful for patients, they must be translatable into alerts that enable doctors to intervene in a timely fashion. In this paper we present a novel three-step technique to derive high performance alerts from voluminous sensor data: A data reduction algorithm that takes into account the medical condition at personalized patient level and thereby converts raw multi-sensor data to patient and disease specific severity representation, which we call as the Personalized Health Motifs (PHM). The PHMs are then modulated by criticality factors derived from interventional time and severity frequency to yield a Criticality Measure Index (CMI). In the final step we generate alerts whenever the CMI crosses patientdisease-specific thresholds. We consider one medical condition called Acute Hypotensive Episode (AHE). We evaluate the performance of our CMI derived alerts using 7,200 minutes of data from the MIMIC II [7] database. We show that the CMI generates valid alerts up to 180 minutes prior to onset of AHE with accuracy, specificity, and sensitivity of 0.76, 1.0 and 0.67 respectively, outperforming alerts from raw data.