Evidence map›Paper›PMID 37191988›Full record

ArticleJMIR cardio2023

Continuous Data-Driven Monitoring in Critical Congenital Heart Disease: Clinical Deterioration Model Development.

Ruben S Zoodsma, Rian Bosch, Thomas Alderliesten, Casper W Bollen, Teus H Kappen, Erik Koomen, Arno Siebes, Joppe Nijman

Open access · goldAbstract read
In one paragraph

Article in JMIR cardio, 2023. 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
1.9field-weighted citation impact, top 13% of its field
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, 9 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
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

8 authors at 2 institutions in 1 country.

Ruben S ZoodsmaDepartment of Paediatric Intensive Care, University Medical Center Utrecht, Utrecht, Netherlands.ORCID https://orcid.org/0000-0002-6549-6567
Rian BoschDepartment of Paediatric Intensive Care, University Medical Center Utrecht, Utrecht, Netherlands.ORCID https://orcid.org/0000-0002-3594-9596
Thomas AlderliestenDepartment of Paediatric Intensive Care, University Medical Center Utrecht, Utrecht, Netherlands.ORCID https://orcid.org/0000-0003-3306-1830
Casper W BollenDepartment of Paediatric Intensive Care, University Medical Center Utrecht, Utrecht, Netherlands.ORCID https://orcid.org/0000-0003-2840-5635
Teus H KappenDepartment of Anaesthesiology, University Medical Center Utrecht, Utrecht, Netherlands.ORCID https://orcid.org/0000-0003-1895-0998
Erik KoomenDepartment of Paediatric Intensive Care, University Medical Center Utrecht, Utrecht, Netherlands.ORCID https://orcid.org/0000-0001-7192-1227
Arno SiebesDepartment of Information and Computing Sciences, Utrecht University, Utrecht, Netherlands.ORCID https://orcid.org/0000-0002-5108-7965
Joppe NijmanDepartment of Paediatric Intensive Care, University Medical Center Utrecht, Utrecht, Netherlands.ORCID https://orcid.org/0000-0002-9843-0740
University Medical Center Utrecht · NLUtrecht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCritical congenital heart disease (cCHD)-requiring cardiac intervention in the first year of life for survival-occurs globally in 2-3 of every 1000 live births. In the critical perioperative period, intensive multimodal monitoring at a pediatric intensive care unit (PICU) is warranted, as their organs-especially the brain-may be severely injured due to hemodynamic and respiratory events. These 24/7 clinical data streams yield large quantities of high-frequency data, which are challenging in terms of interpretation due to the varying and dynamic physiology innate to cCHD. Through advanced data science algorithms, these dynamic data can be condensed into comprehensible information, reducing the cognitive load on the medical team and providing data-driven monitoring support through automated detection of clinical deterioration, which may facilitate timely intervention.

objectiveThis study aimed to develop a clinical deterioration detection algorithm for PICU patients with cCHD.

methodsRetrospectively, synchronous per-second data of cerebral regional oxygen saturation (rSO

resultsA retrospective query yielded 4600 hours and 209 hours of per-second data in 78 and 10 neonates for, respectively, training and testing purposes. During testing, stable episodes occurred 153 times, of which 134 (88%) were correctly detected. Unstable episodes were correctly noted in 46 of 57 (81%) observed episodes. Twelve expert-confirmed unstable episodes were missed in testing. Time-percentual accuracy was 93% and 77% for, respectively, stable and unstable episodes. A total of 138 sensorial dysfunctions were detected, of which 130 (94%) were correct.

conclusionsIn this proof-of-concept study, a clinical deterioration detection algorithm was developed and retrospectively evaluated to classify clinical stability and instability, achieving reasonable performance considering the heterogeneous population of neonates with cCHD. Combined analysis of baseline (ie, patient-specific) deviations and simultaneous parameter-shifting (ie, population-specific) proofs would be promising with respect to enhancing applicability to heterogeneous critically ill pediatric populations. After prospective validation, the current-and comparable-models may, in the future, be used in the automated detection of clinical deterioration and eventually provide data-driven monitoring support to the medical team, allowing for timely intervention.

Indexed as

aberration detectionartificial intelligencecardiac monitoringclassification modelclinical deteriorationcongenital heart diseasemachine learningpaediatric intensive carepediatric intensive careperi-operativeperioperativesurgery

Identifiers

PMID37191988
PMCPMC10230358
OpenAlexW4366958738

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.