ArticleAnesthesiology2024
Comparison of Differences in Cohort (Forward) and Case Control (Backward) Methodologic Approaches for Validation of the Hypotension Prediction Index.
Article in Anesthesiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Guideline
- Beyond the debut: unpacking six years of Hypotension Prediction Index software in intraoperative hypotension prevention - a systematic review and meta-analysis.Journal of clinical monitoring and computing · 2024Pooled it
- Hypotension prediction in elective caesarean section: a reply.Anaesthesia · 2026Article
- Reflection on the Integration of Artificial Intelligence in Anaesthesiology: Beyond Algorithmic Performance.Turkish journal of anaesthesiology and reanimation · 2026Article
- Mechanical ventilation in ARDS: navigating the fine line with real-time monitoring.Critical care (London, England) · 2026Review
- Performance of the Hypotension Prediction Index as an indicator of hypotensive haemodynamic instability in surgical patients.Perioperative medicine (London, England) · 2026Article
- Towards reliable prediction of intraoperative hypotension: a cross-center evaluation of deep learning-based and MAP-derived methods.Journal of clinical monitoring and computing · 2026Article
- Accuracy of Quantifying Hypotension During Surgery Using Physiological Sensor Data.IEEE journal of translational engineering in health and medicine · 2026Article
- Artificial intelligence-based predictive hemodynamic monitoring in conjunction with goal-directed therapy reduces duration, frequency, and severity of intraoperative hypotension in major maxillofacial and otolaryngological surgery-a prospective randomized controlled pilot trial.Journal of anesthesia, analgesia and critical care · 2025Article
- Artificial Intelligence in Anaesthesiology: Current Applications, Challenges, and Future Directions.Turkish journal of anaesthesiology and reanimation · 2025Article
- Ability of the hypotension prediction index to predict hypotension in patients with septic shock in the intensive care unit.Scientific reports · 2025Article
- Article
- What is new in cardiac anesthesia in 2024?Journal of anesthesia and translational medicine · 2025Review
- Blood Pressure Management Using the Hypotension Prediction Index During Paraganglioma Resection: A Case Report.Cureus · 2025Article
- Hypotension prediction index: comparison between invasive and non-invasive pressure inputs.BMC anesthesiology · 2025Observational
- AI for the hemodynamic assessment of critically ill and surgical patients: focus on clinical applications.Annals of intensive care · 2025Review
- Deep learning model to identify and validate hypotension endotypes in surgical and critically ill patients.British journal of anaesthesia · 2025Article
- Forecasting intraoperative hypotension during hepatobiliary surgery.Journal of clinical monitoring and computing · 2025Article
- Prediction of intraoperative hypotension using deep learning models based on non-invasive monitoring devices.Journal of clinical monitoring and computing · 2024Article
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Authors and funding
14 authors.
Funding
Abstract
backgroundThe Hypotension Prediction Index (the index) software is a machine learning algorithm that detects physiologic changes that may lead to hypotension. The original validation used a case control (backward) analysis that has been suggested to be biased. This study therefore conducted a cohort (forward) analysis and compared this to the original validation technique.
methodsA retrospective analysis of data from previously reported studies was conducted. All data were analyzed identically with two different methodologies, and receiver operating characteristic curves were constructed. Both backward and forward analyses were performed to examine differences in area under the receiver operating characteristic curves for the Hypotension Prediction Index and other hemodynamic variables to predict a mean arterial pressure (MAP) less than 65 mmHg for at least 1 min 5, 10, and 15 min in advance.
resultsThe analysis included 2,022 patients, yielding 4,152,124 measurements taken at 20-s intervals. The area under the curve for the index predicting hypotension analyzed by backward and forward methodologies respectively was 0.957 (95% CI, 0.947 to 0.964) versus 0.923 (95% CI, 0.912 to 0.933) 5 min in advance, 0.933 (95% CI, 0.924 to 0.942) versus 0.923 (95% CI, 0.911 to 0.933) 10 min in advance, and 0.929 (95% CI, 0.918 to 0.938) versus 0.926 (95% CI, 0.914 to 0.937) 15 min in advance. No variable other than MAP had an area under the curve greater than 0.7. The areas under the curve using forward analysis for MAP predicting hypotension 5, 10, and 15 min in advance were 0.932 (95% CI, 0.920 to 0.940), 0.929 (95% CI, 0.918 to 0.938), and 0.932 (95% CI, 0.921 to 0.940), respectively. The R2 for the variation in the index due to MAP was 0.77.
conclusionsUsing an updated methodology, the study found that the utility of the Hypotension Prediction Index to predict future hypotensive events is high, with an area under the receiver operating characteristics curve similar to that of the original validation method. EDITOR’S PERSPECTIVE:
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