The principles of whole-hospital predictive analytics monitoring for clinical medicine originated in the neonatal ICU.

The principles of whole-hospital predictive analytics monitoring for clinical medicine originated in the neonatal ICU.
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DOI:
10.1038/s41746-022-00584-y
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发表时间:
2022-03-31
影响因子:
15.2
通讯作者:
Randall Moorman J
Randall Moorman J
中科院分区:
医学1区
文献类型:
--
作者:
Randall Moorman J

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2011 年,弗吉尼亚大学牵头的一个多中心研究小组证明,利用我们现在所说的人工智能、大数据和机器学习,在新生儿 ICU 中进行实时连续心肺监测可以降低​​死亡率。据我们所知,这项大型随机心率特征试验首次实现了早期发现疾病将允许更早、更有效的干预并改善患者治疗效果的承诺。然而,目前,在随后快速发展的预测分析监控领域,我们听到的失败和成功的声音一样多。本视角旨在描述我们如何开发新生儿败血症心率特征监测的原理,然后将其应用到成人 ICU 和医院医学中。它主要反映了弗吉尼亚大学小组自 20 世纪 90 年代以来的工作:主题是,在连续心肺监测和电子健康记录中明显的亚临床但可测量的生理变化可能会导致突然和灾难性的恶化。
In 2011, a multicenter group spearheaded at the University of Virginia demonstrated reduced mortality from real-time continuous cardiorespiratory monitoring in the neonatal ICU using what we now call Artificial Intelligence, Big Data, and Machine Learning. The large, randomized heart rate characteristics trial made real, for the first time that we know of, the promise that early detection of illness would allow earlier and more effective intervention and improved patient outcomes. Currently, though, we hear as much of failures as we do of successes in the rapidly growing field of predictive analytics monitoring that has followed. This Perspective aims to describe the principles of how we developed heart rate characteristics monitoring for neonatal sepsis and then applied them throughout adult ICU and hospital medicine. It primarily reflects the work since the 1990s of the University of Virginia group: the theme is that sudden and catastrophic deteriorations can be preceded by subclinical but measurable physiological changes apparent in the continuous cardiorespiratory monitoring and electronic health record.
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