Evidence map›Paper›PMID 32485685›Full record

ArticleJournal of neural engineering2020

Improved tracking of sevoflurane anesthetic states with drug-specific machine learning models.

Kimia Kashkooli, Sam L Polk, Eunice Y Hahm, James Murphy, Breanna R Ethridge, Jacob Gitlin, Reine Ibala, Jennifer Mekonnen, Juan C Pedemonte, Haoqi Sun and 4 more

Abstract read
In one paragraph

Article in Journal of neural engineering, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Kimia KashkooliDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.ORCID 0000-0001-6872-3406
Sam L PolkDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.ORCID 0000-0002-9482-0258
Eunice Y HahmDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.
James MurphyDepartment of Mathematics at Tufts University, Medford, United States of America.ORCID 0000-0001-6598-044X
Breanna R EthridgeDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.
Jacob GitlinDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.
Reine IbalaDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.
Jennifer MekonnenDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.
Juan C PedemonteDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.
Haoqi SunDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.
M Brandon WestoverDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.
Riccardo BarbieriDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.
Oluwaseun AkejuDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.
Shubham ChamadiaDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.ORCID 0000-0002-7055-8048

Funding

Pathophysiology of postoperative delirium and the use of biomimetic sleep as a treatment strategy in the CSICUR01AG053582 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI JOHNSON-AKEJU, OLUWASEUN · 2016 to 2020
$4.0M
Investigation of Sleep in the Intensive Care Unit (ICU-SLEEP)R01NS102190 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI WESTOVER, MICHAEL BRANDON · 2018 to 2022
$3.2M
Big Data and Deep Learning for the Interictal-Ictal-Injury ContiuumR01NS107291 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI WESTOVER, MICHAEL BRANDON · 2018 to 2022
$2.8M
NIA NIH HHS R01 AG053582NINDS NIH HHS R01 NS102190NINDS NIH HHS R01 NS107291
6 · The paper itself

Abstract

objectiveThe ability to monitor anesthetic states using automated approaches is expected to reduce inaccurate drug dosing and side-effects. Commercially available anesthetic state monitors perform poorly when ketamine is administered as an anesthetic-analgesic adjunct. Poor performance is likely because the models underlying these monitors are not optimized for the electroencephalogram (EEG) oscillations that are unique to the co-administration of ketamine. APPROACH: In this work, we designed two k-nearest neighbors algorithms for anesthetic state prediction. MAIN

resultsThe first algorithm was trained only on sevoflurane EEG data, making it sevoflurane-specific. This algorithm enabled discrimination of the sevoflurane general anesthesia (GA) state from sedated and awake states (true positive rate = 0.87, [95% CI, 0.76, 0.97]). However, it did not enable discrimination of the sevoflurane-plus-ketamine GA state from sedated and awake states (true positive rate = 0.43, [0.19, 0.67]). In our second algorithm, we implemented a cross drug training paradigm by including both sevoflurane and sevoflurane-plus-ketamine EEG data in our training set. This algorithm enabled discrimination of the sevoflurane-plus-ketamine GA state from sedated and awake states (true positive rate = 0.91, [0.84, 0.98]). SIGNIFICANCE: Instead of a one-algorithm-fits-all-drugs approach to anesthetic state monitoring, our results suggest that drug-specific models are necessary to improve the performance of automated anesthetic state monitors.

Indexed as

Anesthetics, InhalationPharmaceutical PreparationsElectroencephalographyMachine LearningSevofluraneAnesthetics, InhalationPharmaceutical PreparationsSevoflurane

Identifiers

PMID32485685
PMCPMC7540939

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.