Critical Care Informatics

描述(申请人提供)：医院重症监护病房(ICU)的病人生理脆弱且不稳定，通常有危及生命的情况，需要关闭 监测和快速治疗干预。它们连接到一系列设备和监视器上，并由临床工作人员仔细护理。ICU中的每个患者每天都会收集到数量惊人的数据：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、警报和警报、实验室结果、成像结果、药物和液体给药记录、工作人员笔记等。在该国的ICU提供护理期间，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。这项技术现在可以收集、存档和组织详细的ICU数据，从而产生了具有巨大潜力的研究资源。自2003年以来，我们的团队一直在建立重症监护多参数智能监护II(MIMIC II)数据库，该数据库现在保存了波士顿贝丝以色列女执事医疗中心(BIDMC)ICU中约40,000个完整住院日的临床数据，包括这些住院日的子集的波形数据(生理信号和生命体征的连续多通道记录)。我们已经仔细地识别了这些数据，并通过PhysioNet网站与研究社区免费分享。该数据库是无与伦比的研究资源，其价值得到广泛认可。根据数据使用协议(DUA)，725多名研究人员可以免费访问临床数据。这一全球社区包括来自32多个国家和地区的学术、临床和工业研究人员，并以每年50%以上的速度增长。此外，数以千计的研究人员、教育工作者和学生使用了波形数据，我们免费向所有人提供这些数据，不受限制。MIMIC II已证明与 可以通过纳入反映患者群体、公共卫生挑战、可用药物、临床干预和护理指南的变化的新数据，以及通过开发便于用户访问MIMIC II的先进软件来加强研究。通过整合来自多个中心的数据，可以进一步提高其价值。这项提议寻求资金：a)维护、加强和记录我们为建立和更新Mimic II而创建的开源软件，纳入已建立的和新兴的标准，并提供在其他中心创建并行数据收集所需的工具；b)建立第一个公共的、多中心的、国际的、可扩展的、可持续更新的高分辨率数据档案 用于重症护理研究；(C)根据数据档案创造新的知识和开发临床工具，以通报和支持重症护理的临床决策和实践。

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.