Title :
Reducing False Intracranial Pressure Alarms Using Morphological Waveform Features
Author :
Scalzo, Fabien ; Liebeskind, D. ; Xiao Hu
Author_Institution :
Dept. of Neurology & Neurosurg., Univ. of California, Los Angeles, Los Angeles, CA, USA
Abstract :
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. Models are trained in a supervised fashion from a comprehensive dataset of 4791 manually labeled alarm episodes extracted from 108 neurosurgical patients. 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.
Keywords :
alarm systems; biomedical engineering; patient monitoring; pattern recognition; regression analysis; support vector machines; alarm fatigue; false ICP alarm; false intracranial pressure alarm reduction; intensive care unit; intracranial pressure signal; kernel spectral regression; morphological waveform feature; patient monitoring system; patient risk; pattern recognition; smart alarm detection system; support vector machine; threshold crossing; Biomedical monitoring; Feature extraction; Iterative closest point algorithm; Monitoring; Morphology; Support vector machines; Brain injuries; false alarm; intensive care unit (ICU); intracranial pressure signal (ICP); patient monitoring; smart alarm; supervised learning; Area Under Curve; Artificial Intelligence; Clinical Alarms; Equipment Failure Analysis; Humans; Intensive Care Units; Intracranial Pressure; Monitoring, Physiologic; Pattern Recognition, Automated; ROC Curve; Signal Processing, Computer-Assisted;
Journal_Title :
Biomedical Engineering, IEEE Transactions on
DOI :
10.1109/TBME.2012.2210042