Critical Care Informatics

描述（由申请人提供）：医院重症监护室（ICU）中的患者生理脆弱且不稳定，通常有危及生命的情况，需要密切观察。 监测和快速治疗干预。它们连接到一系列设备和监视器，并由临床工作人员仔细护理。ICU中的每位患者每天都会收集大量数据：每秒采样数百次的多通道波形数据、每秒或每分钟更新的生命体征时间序列、警报和警告、实验室结果、成像结果、药物和液体管理记录、工作人员笔记等。在该国ICU的护理期间，每天都会捕获数PB的数据;然而，这些数据中的大多数并不用于生成证据或发现新知识。现在的技术可以收集、存档和组织非常详细的ICU数据，从而产生巨大潜力的研究资源。 自2003年以来，我们的团队一直在构建重症监护多参数智能监测II（MIMIC II）数据库，该数据库目前保存了波士顿Beth Israel Deaconess Medical Center（BIDMC）ICU中约40，000次完整住院的临床数据，包括其中一部分住院的波形数据（生理信号和生命体征的连续多通道记录）。我们已经仔细地去识别数据，并通过PhysioNet网站与研究社区免费共享。 该数据库是一个无与伦比的研究资源，其价值得到广泛认可。超过725名研究人员根据数据使用协议（DUA）免费访问临床数据。这个全球社区包括来自32个国家的学术，临床和工业研究人员，每年增长超过50%。此外，数千名研究人员、教育工作者和学生使用了我们免费向所有人提供的波形数据，不受限制。 MIMIC II已被证明与以下方面具有实质性相关性： 通过纳入新的数据，反映患者群体的变化，公共卫生挑战，可用药物，临床干预措施和护理指南，以及通过开发先进的软件以方便用户访问MIMIC II，可以加强研究。它的价值可以通过整合来自多个中心的数据来进一步提高。 该提案寻求资金：a）维护、增强和记录我们为构建和更新MIMIC II而创建的开放源代码软件，纳入已建立和新兴的标准，并提供在其他中心创建并行数据收集所需的工具; B）建立第一个公共、多中心、国际、可扩展、可持续更新的高分辨率数据档案 重症监护研究;以及c）基于数据档案创建新知识并开发临床工具，以告知和支持重症监护中的临床决策和实践。

DESCRIPTION (provided by applicant): Patients in hospital intensive care units (ICUs) are physiologically fragile and unstable, generally have life-threatening conditions, and require close monitoring and rapid therapeutic interventions. They are connected to an array of equipment and monitors, and are carefully attended by the clinical staff. Staggering amounts of data are collected daily on each patient in an ICU: multi-channel waveform data sampled hundreds of times each second, vital sign time series updated each second or minute, alarms and alerts, lab results, imaging results, records of medication and fluid administration, staff notes and more. Petabytes of data are captured daily during care delivery in the country's ICUs; however, most of these data are not used to generate evidence or to discover new knowledge. The technology now exists to collect, archive and organize finely detailed ICU data, resulting in research resources of enormous potential. Since 2003, our group has been building the Multi-parameter Intelligent Monitoring in Intensive Care II (MIMIC II) Database, which now holds clinical data from about 40,000 entire stays in the ICUs of the Beth Israel Deaconess Medical Center (BIDMC) in Boston, including waveform data (continuous multi-channel recordings of physiologic signals and vital signs) for a subset of these stays. We have meticulously de-identified the data and freely shared them with the research community via the PhysioNet web site. The database is an unparalleled research resource and its value is widely recognized. More than 725 researchers have no-cost access to the clinical data under data use agreements (DUAs). This worldwide community includes academic, clinical, and industrial investigators from more than 32 countries and is growing by over 50% per year. In addition, thousands of investigators, educators, and students have used the waveform data, which we have made freely available to all without restriction. MIMIC II's demonstrated and substantial relevance for research can be enhanced by incorporation of new data, reflecting changes in patient populations, public health challenges, available medications, clinical interventions, and care guidelines, and by development of advanced software to facilitate user access to MIMIC II. Its value can be further enhanced by integration of data from multiple centers. This proposal seeks funding: a) to maintain, enhance, and document the open-source software that we have created to build and update MIMIC II, to incorporate established and emerging standards, and to provide the tools needed to create parallel data collections at other centers; b) to establish the first public, multi-center, international, scalable, continuously updatable, high-resolution data archive for critical care research; and c) to create new knowledge and to develop clinical tools, based on the data archive, to inform and support clinical decisions and practice in critical care.