Proceedings / AMIA ... Annual Symposium. AMIA Symposium
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We present a prototype of a decision support system for anesthesia that applies set covering theory. The system is designed to generate dynamically configured check-lists for intra-operative problems. These lists have the potential to help anesthesiologists detect and manage problems in a timely manner. ⋯ A set covering algorithm that accommodates multiple problem sets was used to implement the prototype. A simulated case and the system behavior are presented. The ultimate goals of a system such as the one presented are to function as an intelligent alarm module for electronic monitors and to facilitate the task of correcting intra-operative problems.
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Nowadays a great number of applications are used to compile and transmit casualties and disasters information but there are many troubles associated with the technology as can be the communications reliability and the size and weight of the devices medical staff has to carry with. Telecommunication infrastructures support information movement among geographically dispersed locations. Recently a large family of little devices has appeared in the buyer's market. ⋯ As for the communications reliability, many technologies have been developed in the last years but it is necessary to find a solution that can be used in whatever situation independently of the emergency circumstances. Facing this reality, the Spanish government funded REMAF, an ATYCA (Initiative of Support for the Technology, Security and Quality in the Industry) project. REMAF joined research groups (UPM), phone operators (Fundación Airtel Móvil) and end users (SAMUR) to build a disaster data management system conceived to use modern telemedicine systems to optimize the management in these situations, taking the advantage of the above mentioned mobile communication tools and networks.
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Automated physiologic event detection and alerting is a challenging task in the ICU. Ideally care providers should be alerted only when events are clinically significant and there is opportunity for corrective action. However, the concepts of clinical significance and opportunity are difficult to define in automated systems, and effectiveness of alerting algorithms is difficult to measure. ⋯ During a 6-month test period in the trauma ICU at Vanderbilt University Medical Center, 530 alerts were detected in 2280 hours of data spanning 14 patients. Clinical users electronically documented 81% of these alerts as they occurred. Retrospectively classifying documentation based on therapeutic actions taken, or reasons why actions were not taken, provided useful information about ways to potentially improve event definitions and enhance system utility.
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In intensive care physiological variables of the critical-ly ill are measured and recorded in short time intervals. The existing alarm systems based on fixed thresholds produce a large number of false alarms. ⋯ There are various approaches to modeling time-dependent data and also several methodologies for pattern detection in time series. We compare several methodologies de-signed for online detection of measurement artifacts, level changes, and trends for a proper classification of the patient s state by means of a comparative case-study.
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Patient safety assessment in anaesthesia increasingly relies on the monitoring of frequent but merely undesirable events, like hypotension. We report on the design and implementation of such a monitoring system, where 8032 patients were included over a three years period. Thirty two 'Significant Anaesthetic Events' were defined and their occurrence was routinely collected for each patient. ⋯ The system sensitivity to change in the frequency of significant anaesthetic events was investigated by a controlled intervention, designed to increase the incidence of bradycardia by changing anxyolitic medication. During the intervention, the incidence of bradycardia doubled, while the incidence of other undesirable events was not affected. The system described for the collection of significant anaesthetic events was easy to set up, sensitive to changes and provided valuable tools in performance monitoring.