title: Statistical models for fever forecasting based on advanced body temperature monitoring.
abstract: Body temperature monitoring provides health carers with key clinical information about the physiological status of patients. Temperature readings are taken periodically to detect febrile episodes and consequently implement the appropriate medical countermeasures. However, fever is often difficult to assess at early stages, or remains undetected until the next reading, probably a few hours later. The objective of this article is to develop a statistical model to forecast fever before a temperature threshold is exceeded to improve the therapeutic approach to the subjects involved. To this end, temperature series of 9 patients admitted to a general internal medicine ward were obtained with a continuous monitoring Holter device, collecting measurements of peripheral and core temperature once per minute. These series were used to develop different statistical models that could quantify the probability of having a fever spike in the following 60 minutes. A validation series was collected to assess the accuracy of the models. Finally, the results were compared with the analysis of some series by experienced clinicians. Two different models were developed: a logistic regression model and a linear discrimination analysis model. Both of them exhibited a fever peak forecasting accuracy greater than 84%. When compared with experts' assessment, both models identified 35 (97.2%) of 36 fever spikes. The models proposed are highly accurate in forecasting the appearance of fever spikes within a short period in patients with suspected or confirmed febrile-related illnesses.
authors.affiliation: Department of Statistics, Polytechnic University of Valencia, Alcoi Campus, Plaza Ferrandiz y Carbonell, 2, 03801 Alcoi, Spain. Electronic address: jorjornu@eio.upv.es.
authors.forename: Jorge
authors.initials: J
authors.lastname: Jordan
authors.affiliation: Department of Statistics, Polytechnic University of Valencia, Alcoi Campus, Plaza Ferrandiz y Carbonell, 2, 03801 Alcoi, Spain.
authors.forename: Pau
authors.initials: P
authors.lastname: Miro-Martinez
authors.affiliation: Biomedical Science Faculty, European University of Madrid, Villaviciosa de Odon, 28670 Madrid, Spain.
authors.forename: Borja
authors.initials: B
authors.lastname: Vargas
authors.affiliation: Department of Internal Medicine, Teaching Hospital of Mostoles, Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Varela-Entrecanales
authors.affiliation: Technological Institute of Informatics, Polytechnic University of Valencia, Alcoi Campus, Plaza Ferrandiz y Carbonell, 2, 03801 Alcoi, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Cuesta-Frau
mesh_terms: D001831:Body Temperature / Q000502:physiology*; D003422:Critical Care; D016638:Critical Illness; D005334:Fever / Q000175:diagnosis*; D005544:Forecasting; D006801:Humans; D016015:Logistic Models; D015233:Models, Statistical; D015203:Reproducibility of Results
keywords: ApEn; Entropy; Fever; Infectious diseases; Temperature monitoring; Thermometry