title: Reducing false intracranial pressure alarms using morphological waveform features.
abstract: False alarms produced by patient monitoring systems in intensive care units are a major issue that causes alarm fatigue, waste of human resources, and increased patient risks. While alarms are typically triggered by manually adjusted thresholds, the trend and patterns observed prior to threshold crossing are generally not used by current systems. This study introduces and evaluates, a smart alarm detection system for intracranial pressure signal (ICP) that is based on advanced pattern recognition methods. Models are trained in a supervised fashion from a comprehensive dataset of 4791 manually labeled alarm episodes extracted from 108 neurosurgical patients. The comparative analysis provided between spectral regression, kernel spectral regression, and support vector machines indicates the significant improvement of the proposed framework in detecting false ICP alarms in comparison to a threshold-based technique that is conventionally used. Another contribution of this work is to exploit an adaptive discretization to reduce the dimensionality of the input features. The resulting features lead to a decrease of 30% of false ICP alarms without compromising sensitivity.
authors.affiliation: Department of Neurology and Neurosurgery, University of California, Los Angeles, CA 90024, USA. fscalzo@mednet.ucla.edu
authors.forename: Fabien
authors.initials: F
authors.lastname: Scalzo
authors.forename: David
authors.initials: D
authors.lastname: Liebeskind
authors.forename: Xiao
authors.initials: X
authors.lastname: Hu
mesh_terms: D019540:Area Under Curve; D001185:Artificial Intelligence; D056902:Clinical Alarms; D019544:Equipment Failure Analysis / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units; D007427:Intracranial Pressure / Q000502:physiology*; D008991:Monitoring, Physiologic / Q000379:methods*; D010363:Pattern Recognition, Automated / Q000379:methods*; D012372:ROC Curve; D012815:Signal Processing, Computer-Assisted