IEEE transactions on bio-medical engineering
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IEEE Trans Biomed Eng · Jan 2013
Reducing false intracranial pressure alarms using morphological waveform features.
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. ⋯ 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.
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IEEE Trans Biomed Eng · Jan 2013
Smart Anesthesia Manager™ (SAM)--a real-time decision support system for anesthesia care during surgery.
Anesthesia information management systems (AIMS) are being increasingly used in the operating room to document anesthesia care. We developed a system, Smart Anesthesia Manager™ (SAM) that works in conjunction with an AIMS to provide clinical and billing decision support. SAM interrogates AIMS database in near real time, detects issues related to clinical care, billing and compliance, and material waste. ⋯ Inadvertent gaps (>15 min) in blood pressure monitoring were reduced to 34 ± 30 min/1000 cases from 192 ± 58 min/1000 cases. Additional billing charge capture of invasive lines procedures worth $144,732 per year and 1,200 compliant records were achieved with SAM. SAM was also able to reduce wastage of inhalation anesthetic agents worth $120,168 per year.
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IEEE Trans Biomed Eng · Jan 2013
Surface electrocardiogram reconstruction from intracardiac electrograms using a dynamic time delay artificial neural network.
This study proposes a method to facilitate the remote follow up of patients suffering from cardiac pathologies and treated with an implantable device, by synthesizing a 12-lead surface ECG from the intracardiac electrograms (EGM) recorded by the device. Two methods (direct and indirect), based on dynamic time-delay artificial neural networks (TDNNs) are proposed and compared with classical linear approaches. The direct method aims to estimate 12 different transfer functions between the EGM and each surface ECG signal. ⋯ Correlation coefficients calculated between the synthesized and the real ECG show that the proposed TDNN methods represent an efficient way to synthesize 12-lead ECG, from two or four EGM and perform better than the linear ones. We also evaluate the results as a function of the EGM configuration. Results are also supported by the comparison of extracted features and a qualitative analysis performed by a cardiologist.
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IEEE Trans Biomed Eng · Dec 2012
Perk Tutor: an open-source training platform for ultrasound-guided needle insertions.
Image-guided needle placement, including ultrasound (US)-guided techniques, have become commonplace in modern medical diagnosis and therapy. To ensure that the next generations of physicians are competent using this technology, efficient and effective educational programs need to be developed. This paper presents the Perk Tutor: a configurable, open-source training platform for US-guided needle insertions. ⋯ The Perk Tutor provides the trainee with quantitative feedback on progress toward the specific learning objectives of each configuration. Configurations were implemented through simple rearrangement of hardware and software components, attesting to the modularity and ease of configuration. The Perk Tutor is provided as a free resource to enable research and development of educational programs for US-guided intervention.
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IEEE Trans Biomed Eng · Oct 2012
A real-time automated point-process method for the detection and correction of erroneous and ectopic heartbeats.
The presence of recurring arrhythmic events (also known as cardiac dysrhythmia or irregular heartbeats), as well as erroneous beat detection due to low signal quality, significantly affects estimation of both time and frequency domain indices of heart rate variability (HRV). A reliable, real-time classification and correction of ECG-derived heartbeats is a necessary prerequisite for an accurate online monitoring of HRV and cardiovascular control. We have developed a novel point-process-based method for real-time R-R interval error detection and correction. ⋯ The benchmark MIT-BIH Arrhythmia database is further considered to test the detection procedure of real arrhythmic events and compare it with results from previously published algorithms. Our automated algorithm represents an improvement over previous procedures, with best specificity for the detection of correct beats, as well as highest sensitivity to missed and extra beats, artificially misplaced beats, and for real arrhythmic events. A near-optimal heartbeat classification and correction, together with the ability to adapt to time-varying changes of heartbeat dynamics in an online fashion, may provide a solid base for building a more reliable real-time HRV monitoring device.