title: Dynamic selection of models for a ventilator-management advisor.
abstract: A ventilator-management advisor (VMA) is a computer program that monitors patients who are treated with a mechanical ventilator. A VMA implements a patient-specific physiologic model to interpret patient data and to predict the effects of alternative control settings for the ventilator. Because a VMA evaluates its physiologic model repeatedly during each cycle of data interpretation, highly complex models may require more computation time than is available in this time-critical application. On the other hand, less complex models may be inaccurate if they are unable to represent a patient's physiologic abnormalities. For each patient, a VMA should select a model that balances the tradeoff of prediction accuracy and computation-time complexity. I present a method to select models that are at an appropriate level of detail for time-constrained decision tasks. The method is based on a local search in a graph of models (GoM) for a model that maximizes the tradeoff of computation-time complexity and prediction accuracy. For each model under consideration, a belief network computes a probability of model adequacy given the qualitative prior information, and the goodness of fit of the model to the data provides a measure of the conditional probability of adequacy given the quantitative observations. I apply this method to the problem of model selection for a VMA. I describe an implementation of a graph of physiologic models that range in complexity from VentPlan, a simple model with 3 compartments, to VentSim, a multicompartment model with detailed airway, circulation and mechanical ventilator components.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Medicine, Stanford University, California 94305-5479.
authors.forename: G W
authors.initials: GW
authors.lastname: Rutledge
mesh_terms: D003198:Computer Simulation; D006801:Humans; D008954:Models, Biological; D008991:Monitoring, Physiologic / Q000379:methods*; D012121:Respiration, Artificial; D012984:Software; D013813:Therapy, Computer-Assisted