Title :
Quantitative description of the state of awareness of patients in vegetative and minimally conscious state
Author :
Wieser, M. ; Buetler, L. ; Koenig, A. ; Riener, R.
Author_Institution :
Sensory-Motor Syst. (SMS) Lab., ETH Zurich, Zurich, Switzerland
fDate :
Aug. 31 2010-Sept. 4 2010
Abstract :
Clinical scales represent the golden standard in characterizing awareness for patients in vegetative or in a minimally conscious state. Clinical scales suffer from problems of sensitivity, specificity, subjectivity, and inter-rater reliability. This leads to a misdiagnosis rate of up to 40% and consequences associated with inappropriate treatment decisions. In this study, objective measures including physiological and neurological signals are used to quantify the patient status. Using linear backward regression analysis, 13 variables (based on frequency analysis of the electrocardiogram, heart rate variability, amplitude and latency of the P300, skin conductance responses, changes in the blood pressure and respiration signal) were found to be sufficient to describe 74.7% of the variability of the scores. In this regression model, the P300, electrocardiogram and the blood pressure signal account for most of the variability. More patient data and additional measures will enable refinement of the methods. This new objective-measurement based model of the state of awareness will complement the clinical scales in order to increase the quality of diagnosis.
Keywords :
bioelectric phenomena; blood pressure measurement; electrocardiography; neurophysiology; patient diagnosis; pneumodynamics; regression analysis; skin; awareness state; blood pressure; electrocardiogram; heart rate variability; linear backward regression analysis; minimally conscious state; objective-measurement based model; physiology; respiration; skin conductance; vegetative state; Biomedical monitoring; Blood pressure; Electrocardiography; Electrodes; Electroencephalography; Heart rate variability; Resonant frequency; Adult; Awareness; Female; Glasgow Coma Scale; Humans; Male; Middle Aged; Persistent Vegetative State; Young Adult;
Conference_Titel :
Engineering in Medicine and Biology Society (EMBC), 2010 Annual International Conference of the IEEE
Conference_Location :
Buenos Aires
Print_ISBN :
978-1-4244-4123-5
DOI :
10.1109/IEMBS.2010.5626763