Shameek Ghosh1, Jinyan Li2, Longbing Cao3, Kotagiri Ramamohanarao4. 1. Advanced Analytics Institute, Faculty of Engineering and IT, University of Technology Sydney (UTS), Australia. Electronic address: Shameek.Ghosh@student.uts.edu.au. 2. Advanced Analytics Institute, Faculty of Engineering and IT, University of Technology Sydney (UTS), Australia. Electronic address: Jinyan.Li@uts.edu.au. 3. Advanced Analytics Institute, Faculty of Engineering and IT, University of Technology Sydney (UTS), Australia. Electronic address: Longbing.Cao@uts.edu.au. 4. Department of Computing and Information Systems, The University of Melbourne, Parkville, VIC 3010, Australia. Electronic address: kotagiri@unimelb.edu.au.
Abstract
BACKGROUND AND OBJECTIVE: Critical care patient events like sepsis or septic shock in intensive care units (ICUs) are dangerous complications which can cause multiple organ failures and eventual death. Preventive prediction of such events will allow clinicians to stage effective interventions for averting these critical complications. METHODS: It is widely understood that physiological conditions of patients on variables such as blood pressure and heart rate are suggestive to gradual changes over a certain period of time, prior to the occurrence of a septic shock. This work investigates the performance of a novel machine learning approach for the early prediction of septic shock. The approach combines highly informative sequential patterns extracted from multiple physiological variables and captures the interactions among these patterns via coupled hidden Markov models (CHMM). In particular, the patterns are extracted from three non-invasive waveform measurements: the mean arterial pressure levels, the heart rates and respiratory rates of septic shock patients from a large clinical ICU dataset called MIMIC-II. EVALUATION AND RESULTS: For baseline estimations, SVM and HMM models on the continuous time series data for the given patients, using MAP (mean arterial pressure), HR (heart rate), and RR (respiratory rate) are employed. Single channel patterns based HMM (SCP-HMM) and multi-channel patterns based coupled HMM (MCP-HMM) are compared against baseline models using 5-fold cross validation accuracies over multiple rounds. Particularly, the results of MCP-HMM are statistically significant having a p-value of 0.0014, in comparison to baseline models. Our experiments demonstrate a strong competitive accuracy in the prediction of septic shock, especially when the interactions between the multiple variables are coupled by the learning model. CONCLUSIONS: It can be concluded that the novelty of the approach, stems from the integration of sequence-based physiological pattern markers with the sequential CHMM model to learn dynamic physiological behavior, as well as from the coupling of such patterns to build powerful risk stratification models for septic shock patients. Crown Copyright Â
BACKGROUND AND OBJECTIVE: Critical care patient events like sepsis or septic shock in intensive care units (ICUs) are dangerous complications which can cause multiple organ failures and eventual death. Preventive prediction of such events will allow clinicians to stage effective interventions for averting these critical complications. METHODS: It is widely understood that physiological conditions of patients on variables such as blood pressure and heart rate are suggestive to gradual changes over a certain period of time, prior to the occurrence of a septic shock. This work investigates the performance of a novel machine learning approach for the early prediction of septic shock. The approach combines highly informative sequential patterns extracted from multiple physiological variables and captures the interactions among these patterns via coupled hidden Markov models (CHMM). In particular, the patterns are extracted from three non-invasive waveform measurements: the mean arterial pressure levels, the heart rates and respiratory rates of septic shockpatients from a large clinical ICU dataset called MIMIC-II. EVALUATION AND RESULTS: For baseline estimations, SVM and HMM models on the continuous time series data for the given patients, using MAP (mean arterial pressure), HR (heart rate), and RR (respiratory rate) are employed. Single channel patterns based HMM (SCP-HMM) and multi-channel patterns based coupled HMM (MCP-HMM) are compared against baseline models using 5-fold cross validation accuracies over multiple rounds. Particularly, the results of MCP-HMM are statistically significant having a p-value of 0.0014, in comparison to baseline models. Our experiments demonstrate a strong competitive accuracy in the prediction of septic shock, especially when the interactions between the multiple variables are coupled by the learning model. CONCLUSIONS: It can be concluded that the novelty of the approach, stems from the integration of sequence-based physiological pattern markers with the sequential CHMM model to learn dynamic physiological behavior, as well as from the coupling of such patterns to build powerful risk stratification models for septic shockpatients. Crown Copyright Â
Authors: Shamim Nemati; Andre Holder; Fereshteh Razmi; Matthew D Stanley; Gari D Clifford; Timothy G Buchman Journal: Crit Care Med Date: 2018-04 Impact factor: 7.598
Authors: Joost D J Plate; Rutger R van de Leur; Luke P H Leenen; Falco Hietbrink; Linda M Peelen; M J C Eijkemans Journal: BMC Med Res Methodol Date: 2019-10-26 Impact factor: 4.615