Document Detail


Integration of early physiological responses predicts later illness severity in preterm infants.
MedLine Citation:
PMID:  20826840     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Physiological data are routinely recorded in intensive care, but their use for rapid assessment of illness severity or long-term morbidity prediction has been limited. We developed a physiological assessment score for preterm newborns, akin to an electronic Apgar score, based on standard signals recorded noninvasively on admission to a neonatal intensive care unit. We were able to accurately and reliably estimate the probability of an individual preterm infant's risk of severe morbidity on the basis of noninvasive measurements. This prediction algorithm was developed with electronically captured physiological time series data from the first 3 hours of life in preterm infants (< or =34 weeks gestation, birth weight < or =2000 g). Extraction and integration of the data with state-of-the-art machine learning methods produced a probability score for illness severity, the PhysiScore. PhysiScore was validated on 138 infants with the leave-one-out method to prospectively identify infants at risk of short- and long-term morbidity. PhysiScore provided higher accuracy prediction of overall morbidity (86% sensitive at 96% specificity) than other neonatal scoring systems, including the standard Apgar score. PhysiScore was particularly accurate at identifying infants with high morbidity related to specific complications (infection: 90% at 100%; cardiopulmonary: 96% at 100%). Physiological parameters, particularly short-term variability in respiratory and heart rates, contributed more to morbidity prediction than invasive laboratory studies. Our flexible methodology of individual risk prediction based on automated, rapid, noninvasive measurements can be easily applied to a range of prediction tasks to improve patient care and resource allocation.
Authors:
Suchi Saria; Anand K Rajani; Jeffrey Gould; Daphne Koller; Anna A Penn
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Science translational medicine     Volume:  2     ISSN:  1946-6242     ISO Abbreviation:  Sci Transl Med     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-09     Completed Date:  2010-12-13     Revised Date:  2013-04-11    
Medline Journal Info:
Nlm Unique ID:  101505086     Medline TA:  Sci Transl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  48ra65     Citation Subset:  IM    
Affiliation:
Department of Computer Science, Stanford University, Stanford, CA 94305, USA.
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Apgar Score
Birth Weight
Cardiovascular Diseases / physiopathology*
Female
Gestational Age
Humans
Infant, Newborn / physiology*
Infant, Premature / physiology*
Intensive Care Units, Neonatal
Morbidity
Pregnancy
ROC Curve
Risk Factors
Severity of Illness Index*
Grant Support
ID/Acronym/Agency:
DP2 OD006457/OD/NIH HHS; M01 RR000070/RR/NCRR NIH HHS
Comments/Corrections

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