title: Toward a two-tier clinical warning system for hospitalized patients.
abstract: Clinical study has found early detection and intervention to be essential for preventing clinical deterioration in patients at general hospital units. In this paper, we envision a two-tiered early warning system designed to identify the signs of clinical deterioration and provide early warning of serious clinical events. The first tier of the system automatically identifies patients at risk of clinical deterioration from existing electronic medical record databases. The second tier performs real-time clinical event detection based on real-time vital sign data collected from on-body wireless sensors attached to those high-risk patients. We employ machine-learning techniques to analyze data from both tiers, assigning scores to patients in real time. The assigned scores can then be used to trigger early-intervention alerts. Preliminary study of an early warning system component and a wireless clinical monitoring system component demonstrate the feasibility of this two-tiered approach.
authors.affiliation: Department of Computer Science and Engineering, Washington University, St. Louis, MO, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Hackmann
authors.forename: Minmin
authors.initials: M
authors.lastname: Chen
authors.forename: Octav
authors.initials: O
authors.lastname: Chipara
authors.forename: Chenyang
authors.initials: C
authors.lastname: Lu
authors.forename: Yixin
authors.initials: Y
authors.lastname: Chen
authors.forename: Marin
authors.initials: M
authors.lastname: Kollef
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Bailey
mesh_terms: D000465:Algorithms; D001185:Artificial Intelligence; D003199:Computer Systems; D042241:Early Diagnosis; D005240:Feasibility Studies; D006757:Hospital Units; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods; D012372:ROC Curve; D055986:Vital Signs; D059015:Wireless Technology