BMC Med Inform Decis Mak - A decision support system to determine optimal ventilator settings.

Tópicos

{ blood(1257) pressur(1144) flow(957) }
{ decis(3086) make(1611) patient(1517) }
{ model(2656) set(1616) predict(1553) }
{ record(1888) medic(1808) patient(1693) }
{ medic(1828) order(1363) alert(1069) }
{ featur(3375) classif(2383) classifi(1994) }
{ system(1976) rule(880) can(841) }
{ design(1359) user(1324) use(1319) }
{ can(981) present(881) function(850) }
{ signal(2180) analysi(812) frequenc(800) }
{ network(2748) neural(1063) input(814) }
{ method(1557) propos(1049) approach(1037) }
{ state(1844) use(1261) util(961) }
{ learn(2355) train(1041) set(1003) }
{ control(1307) perform(991) simul(935) }
{ monitor(1329) mobil(1314) devic(1160) }
{ age(1611) year(1155) adult(843) }
{ group(2977) signific(1463) compar(1072) }
{ method(1969) cluster(1462) data(1082) }
{ case(1353) use(1143) diagnosi(1136) }
{ research(1085) discuss(1038) issu(1018) }
{ studi(1119) effect(1106) posit(819) }
{ process(1125) use(805) approach(778) }
{ imag(1057) registr(996) error(939) }
{ sequenc(1873) structur(1644) protein(1328) }
{ imag(2830) propos(1344) filter(1198) }
{ general(901) number(790) one(736) }
{ risk(3053) factor(974) diseas(938) }
{ research(1218) medic(880) student(794) }
{ gene(2352) biolog(1181) express(1162) }
{ activ(1138) subject(705) human(624) }
{ high(1669) rate(1365) level(1280) }
{ estim(2440) model(1874) function(577) }
{ model(3404) distribut(989) bayesian(671) }
{ inform(2794) health(2639) internet(1427) }
{ take(945) account(800) differ(722) }
{ studi(2440) review(1878) systemat(933) }
{ assess(1506) score(1403) qualiti(1306) }
{ problem(2511) optim(1539) algorithm(950) }
{ error(1145) method(1030) estim(1020) }
{ chang(1828) time(1643) increas(1301) }
{ method(984) reconstruct(947) comput(926) }
{ howev(809) still(633) remain(590) }
{ import(1318) role(1303) understand(862) }
{ perform(1367) use(1326) method(1137) }
{ spatial(1525) area(1432) region(1030) }
{ health(3367) inform(1360) care(1135) }
{ patient(2837) hospit(1953) medic(668) }
{ cost(1906) reduc(1198) effect(832) }
{ sampl(1606) size(1419) use(1276) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ implement(1333) system(1263) develop(1122) }
{ activ(1452) weight(1219) physic(1104) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ measur(2081) correl(1212) valu(896) }
{ bind(1733) structur(1185) ligand(1036) }
{ method(1219) similar(1157) match(930) }
{ imag(2675) segment(2577) method(1081) }
{ patient(2315) diseas(1263) diabet(1191) }
{ motion(1329) object(1292) video(1091) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ framework(1458) process(801) describ(734) }
{ concept(1167) ontolog(924) domain(897) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ data(1714) softwar(1251) tool(1186) }
{ model(2220) cell(1177) simul(1124) }
{ care(1570) inform(1187) nurs(1089) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ data(3963) clinic(1234) research(1004) }
{ studi(1410) differ(1259) use(1210) }
{ perform(999) metric(946) measur(919) }
{ system(1050) medic(1026) inform(1018) }
{ model(2341) predict(2261) use(1141) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ model(3480) simul(1196) paramet(876) }
{ ehr(2073) health(1662) electron(1139) }
{ data(2317) use(1299) case(1017) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ intervent(3218) particip(2042) group(1664) }
{ time(1939) patient(1703) rate(768) }
{ patient(1821) servic(1111) care(1106) }
{ use(2086) technolog(871) perceiv(783) }
{ analysi(2126) use(1163) compon(1037) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ use(1733) differ(960) four(931) }
{ survey(1388) particip(1329) question(1065) }
{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: Choosing the correct ventilator settings for the treatment of patients with respiratory tract disease is quite an important issue. Since the task of specifying the parameters of ventilation equipment is entirely carried out by a physician, physician's knowledge and experience in the selection of these settings has a direct effect on the accuracy of his/her decisions. Nowadays, decision support systems have been used for these kinds of operations to eliminate errors. Our goal is to minimize errors in ventilation therapy and prevent deaths caused by incorrect configuration of ventilation devices. The proposed system is designed to assist less experienced physicians working in the facilities without having lung mechanics like cottage hospitals.METHODS: This article describes a decision support system proposing the ventilator settings required to be applied in the treatment according to the patients' physiological information. The proposed model has been designed to minimize the possibility of making a mistake and to encourage more efficient use of time in support of the decision making process while the physicians make critical decisions about the patient. Artificial Neural Network (ANN) is implemented in order to calculate frequency, tidal volume, FiO2 outputs, and this classification model has been used for estimation of pressure support / volume support outputs. For the obtainment of the highest performance in both models, different configurations have been tried. Various tests have been realized for training methods, and a number of hidden layers mostly affect factors regarding the performance of ANNs.RESULTS: The physiological information of 158 respiratory patients over the age of 60 and were treated in three different hospitals between the years 2010 and 2012 has been used in the training and testing of the system. The diagnosed disease, core body temperature, pulse, arterial systolic pressure, diastolic blood pressure, PEEP, PSO2, pH, pCO2, bicarbonate data as well as the frequency, tidal volume, FiO2, and pressure support / volume support values suitable for use in the ventilator device have been recommended to the physicians with an accuracy of 98,44%. Performed experiments show that sequential order weight/bias training was found to be the most ideal ANN learning algorithm for regression model and Bayesian regulation backpropagation was found to be the most ideal ANN learning algorithm for classification models.CONCLUSIONS: This article aims at making independent of the choice of parameters from physicians in the ventilator treatment of respiratory tract patients with proposed decision support system. The rate of accuracy in prediction of systems increases with the use of data of more patients in training. Therefore, non-physician operators can use systems in determination of ventilator settings in case of emergencies.

Resumo Limpo

ckground choos correct ventil set treatment patient respiratori tract diseas quit import issu sinc task specifi paramet ventil equip entir carri physician physician knowledg experi select set direct effect accuraci hisher decis nowaday decis support system use kind oper elimin error goal minim error ventil therapi prevent death caus incorrect configur ventil devic propos system design assist less experienc physician work facil without lung mechan like cottag hospitalsmethod articl describ decis support system propos ventil set requir appli treatment accord patient physiolog inform propos model design minim possibl make mistak encourag effici use time support decis make process physician make critic decis patient artifici neural network ann implement order calcul frequenc tidal volum fio output classif model use estim pressur support volum support output obtain highest perform model differ configur tri various test realiz train method number hidden layer most affect factor regard perform annsresult physiolog inform respiratori patient age treat three differ hospit year use train test system diagnos diseas core bodi temperatur puls arteri systol pressur diastol blood pressur peep pso ph pco bicarbon data well frequenc tidal volum fio pressur support volum support valu suitabl use ventil devic recommend physician accuraci perform experi show sequenti order weightbia train found ideal ann learn algorithm regress model bayesian regul backpropag found ideal ann learn algorithm classif modelsconclus articl aim make independ choic paramet physician ventil treatment respiratori tract patient propos decis support system rate accuraci predict system increas use data patient train therefor nonphysician oper can use system determin ventil set case emerg

Resumos Similares

J Clin Monit Comput - Oxygenation advisor recommends appropriate positive end expiratory pressure and FIO2 settings: retrospective validation study. ( 0,662664303560306 )
Med Biol Eng Comput - Use of a comprehensive numerical model to improve biventricular pacemaker temporization in patients affected by heart failure undergoing to CRT-D therapy. ( 0,614372827132452 )
J Clin Monit Comput - Reference values for volumetric capnography-derived non-invasive parameters in healthy individuals. ( 0,588235754828067 )
BMC Med Inform Decis Mak - A genetic fuzzy system for unstable angina risk assessment. ( 0,585750159499124 )
Comput Math Methods Med - Follicle structure influences the availability of oxygen to the oocyte in antral follicles. ( 0,579678220266237 )
J Clin Monit Comput - Bench test assessment of mainstream capnography during high frequency oscillatory ventilation. ( 0,579320608622041 )
Comput Methods Programs Biomed - Validation of subject-specific cardiovascular system models from porcine measurements. ( 0,576626986993913 )
Med Biol Eng Comput - Subject-specific estimation of central aortic blood pressure via system identification: preliminary in-human experimental study. ( 0,574357855433251 )
IEEE J Biomed Health Inform - Signal quality measures on pulse oximetry and blood pressure signals acquired from self-measurement in a home environment. ( 0,565915475162065 )
Comput Methods Programs Biomed - Machine learning-based assessment tool for imbalance and vestibular dysfunction with virtual reality rehabilitation system. ( 0,559643234079131 )
AMIA Annu Symp Proc - Supporting shared decision making within the MobiGuide project. ( 0,559487349522842 )
Comput. Biol. Med. - Noninvasive diagnosis of pulmonary hypertension using heart sound analysis. ( 0,558911350039813 )
Comput. Biol. Med. - A general model for continuous noninvasive pulmonary artery pressure estimation. ( 0,55533229640966 )
Med Biol Eng Comput - Cardiovascular control and stabilization via inclination and mobilization during bed rest. ( 0,554497778520912 )
Comput Math Methods Med - Investigation on cardiovascular risk prediction using physiological parameters. ( 0,551543011978234 )
Comput. Biol. Med. - PcHD: personalized classification of heartbeat types using a decision tree. ( 0,549218468954684 )
J Clin Monit Comput - A model-based decision support system for critiquing mechanical ventilation treatments. ( 0,549198108300394 )
J Med Syst - An improved medical decision support system to identify the diabetic retinopathy using fundus images. ( 0,549172638216574 )
Med Biol Eng Comput - Deriving respiration from photoplethysmographic pulse width. ( 0,548121615398709 )
Telemed J E Health - The informative contribution of the virtual medical visit in a new heart failure telemedicine integrated system. ( 0,546257841219539 )
J Am Med Inform Assoc - Use of IndiGO individualized clinical guidelines in primary care. ( 0,545708310839041 )
BMC Med Inform Decis Mak - The design of a low literacy decision aid about rheumatoid arthritis medications developed in three languages for use during the clinical encounter. ( 0,542168770491784 )
J Clin Monit Comput - Thoracic impedance measures tissue characteristics in the vicinity of the electrodes, not intervening lung water: implications for heart failure monitoring. ( 0,538367423561549 )
J Clin Monit Comput - Parallel particle filters for online identification of mechanistic mathematical models of physiology from monitoring data: performance and real-time scalability in simulation scenarios. ( 0,537529613584306 )
Med Biol Eng Comput - Characterization of skin dermis microcirculation in flow-mediated dilation using optical sensor with pressurization mechanism. ( 0,532136222736345 )
Comput. Biol. Med. - A computerized decision support system to predict the variations in the cerebral blood flow of mechanically ventilated infants. ( 0,530133273044456 )
J Med Syst - Comparison of AI techniques for prediction of liver fibrosis in hepatitis patients. ( 0,529659673050983 )
J Clin Monit Comput - On laparoscopic photoplethysmography and pulse oximetry. ( 0,5285102718473 )
J Clin Monit Comput - New concept using Passive Infrared (PIR) technology for a contactless detection of breathing movement: a pilot study involving a cohort of 169 adult patients. ( 0,528135749420051 )
Med Decis Making - Are standard diagnostic test characteristics sufficient for the assessment of continual patient monitoring? ( 0,526504313605587 )
Comput Methods Programs Biomed - Impact of pulmonary vascular stiffness and vasodilator treatment in pediatric pulmonary hypertension: 21 patient-specific fluid-structure interaction studies. ( 0,526465234354198 )
Neural Comput - Learning active fusion of multiple experts' decisions: an attention-based approach. ( 0,52644457323172 )
J Clin Monit Comput - The use of a noninvasive hemoglobin monitor for determining fluid distribution and elimination in pediatric patients undergoing minor surgery. ( 0,523819712266651 )
J Telemed Telecare - A pilot study of a novel home telemonitoring system for oncology patients receiving chemotherapy. ( 0,522428113963308 )
J Clin Monit Comput - The mean prehospital machine; accurate prehospital non-invasive blood pressure measurement in the critically ill patient. ( 0,522134569358325 )
BMC Med Inform Decis Mak - User needs elicitation via analytic hierarchy process (AHP). A case study on a Computed Tomography (CT) scanner. ( 0,521454360499509 )
J Clin Monit Comput - Cutaneous mitochondrial respirometry: non-invasive monitoring of mitochondrial function. ( 0,521286456230634 )
Comput Methods Programs Biomed - Mechanical ventilation and thoracic artificial lung assistance during mechanical circulatory support with PUCA pump: in silico study. ( 0,520098480518275 )
J Clin Monit Comput - Generic and patient-specific models of the arterial tree. ( 0,51908714865887 )
J Clin Monit Comput - Bedside assessment of passive leg raising effects on venous return. ( 0,518596413272312 )
J Clin Monit Comput - An evaluation and comparison of intraventricular, intraparenchymal, and fluid-coupled techniques for intracranial pressure monitoring in patients with severe traumatic brain injury. ( 0,517927101230061 )
J Telemed Telecare - Approaches to economic evaluation in telemedicine. ( 0,517910924088149 )
Comput. Biol. Med. - Automatic evaluation of pressure sore status by combining information obtained from high-frequency ultrasound and digital photography. ( 0,517567444225421 )
Comput Methods Programs Biomed - Modeling the glucose regulatory system in extreme preterm infants. ( 0,51735334537681 )
J Clin Monit Comput - Heart sounds analysis via esophageal stethoscope system in beagles. ( 0,516487806632884 )
BMC Med Inform Decis Mak - Development and initial evaluation of a treatment decision dashboard. ( 0,516365507658557 )
Artif Intell Med - Non-invasive estimate of blood glucose and blood pressure from a photoplethysmograph by means of machine learning techniques. ( 0,516230336328759 )
Med Biol Eng Comput - A novel online method to monitor autonomic nervous activity based on arterial wall impedance and heart rate variability. ( 0,516213538798827 )
J Clin Monit Comput - Relations between respiratory changes in R-wave amplitude and arterial pulse pressure in mechanically ventilated patients. ( 0,513763237687452 )
Artif Intell Med - Evaluating the effects of cognitive support on psychiatric clinical comprehension. ( 0,513554137893194 )
J Clin Monit Comput - Elucidating the fuzziness in physician decision making in ARDS. ( 0,512699345328268 )
Comput Math Methods Med - Evaluating the hemodynamical response of a cardiovascular system under support of a continuous flow left ventricular assist device via numerical modeling and simulations. ( 0,512274035336731 )
Int J Med Inform - Electre Tri-C, a multiple criteria decision aiding sorting model applied to assisted reproduction. ( 0,512265582360753 )
BMC Med Inform Decis Mak - Arriba-lib: evaluation of an electronic library of decision aids in primary care physicians. ( 0,511770721401949 )
Neural Comput - Reinforcement-based decision making in corticostriatal circuits: mutual constraints by neurocomputational and diffusion models. ( 0,511334198034529 )
J Clin Monit Comput - A comparative study of pulse rate variability and heart rate variability in healthy subjects. ( 0,510769856491612 )
Med Decis Making - Content coding for contextualization of care: evaluating physician performance at patient-centered decision making. ( 0,509828238380832 )
Methods Inf Med - Computerized diagnosis of respiratory disorders. SVM based classification of VAR model parameters of respiratory sounds. ( 0,509465588211899 )
Appl Clin Inform - Cognitive analysis of decision support for antibiotic ordering in a neonatal intensive care unit. ( 0,507437866157916 )
Med Biol Eng Comput - A coupled flow-acoustic computational study of bruits from a modeled stenosed artery. ( 0,50608420055267 )
J Clin Monit Comput - Noninvasive continuous hemodynamic monitoring. ( 0,506056236027821 )
J Clin Monit Comput - Fluid responsiveness is about stroke volume, and not pulse pressure Yogi: the power of Doppler fluid management and cardiovascular monitoring. ( 0,50579794674419 )
Med Biol Eng Comput - Non-invasive monitoring of central blood pressure by electrical impedance tomography: first experimental evidence. ( 0,505739174756275 )
Med Decis Making - Sequential value-of-information assessment for prospective drug safety monitoring using claims databases: the comparative safety of prasugrel v. clopidogrel. ( 0,505055815254354 )
Med Decis Making - Contributions of Second Opinions, Outcome Forecasts, and Testimonials to Patient Decisions about Knee Replacement Surgery. ( 0,503204815115376 )
J Med Syst - Accuracy enhancement in a fuzzy expert decision making system through appropriate determination of membership functions and its application in a medical diagnostic decision making system. ( 0,50271161530712 )
Comput Math Methods Med - Impact of competitive flow on hemodynamics in coronary surgery: numerical study of ITA-LAD model. ( 0,50256733533532 )
J Clin Monit Comput - In-line pressure within a HOTLINE? Fluid Warmer, under various flow conditions. ( 0,501972010145369 )
Med Biol Eng Comput - Aortic pressure wave reconstruction during exercise is improved by adaptive filtering: a pilot study. ( 0,501611253627008 )
J Clin Monit Comput - Impact of central hypovolemia on photoplethysmographic waveform parameters in healthy volunteers. Part 1: time domain analysis. ( 0,501536454191384 )
Med Biol Eng Comput - Arterial reservoir-excess pressure and ventricular work. ( 0,501427244603466 )
BMC Med Inform Decis Mak - Genders of patients and clinicians and their effect on shared decision making: a participant-level meta-analysis. ( 0,501073244775888 )
Med Decis Making - Cost-effectiveness on a local level: whether and when to adopt a new technology. ( 0,500732064813709 )
AMIA Annu Symp Proc - Constructing Clinical Decision Support Systems for Adverse Drug Event Prevention: A Knowledge-based Approach. ( 0,500441501189774 )
Comput. Biol. Med. - Mechanistic electronic model to simulate and predict the effect of heat stress on the functional genomics of HO-1 system: Vasodilation. ( 0,500182715153184 )
J Med Syst - Human cardiovascular model and applications. ( 0,499884817375083 )
Comput Math Methods Med - Linear and nonlinear heart rate variability indexes in clinical practice. ( 0,499792551878486 )
Med Decis Making - Are medical outcomes fungible? A survey of voters, medical administrators, and physicians. ( 0,499755140093522 )
J Clin Monit Comput - Continuous real time endotracheal tube cuff pressure waveform. ( 0,499629201423469 )
Comput Math Methods Med - A new high-resolution spectral approach to noninvasively evaluate wall deformations in arteries. ( 0,499513924417634 )
Med Biol Eng Comput - Application of the RIMARC algorithm to a large data set of action potentials and clinical parameters for risk prediction of atrial fibrillation. ( 0,499169971128041 )
Comput. Biol. Med. - Fluid-dynamics modelling of the human left ventricle with dynamic mesh for normal and myocardial infarction: preliminary study. ( 0,498545008952022 )
J Med Syst - Developing and using expert systems and neural networks in medicine: a review on benefits and challenges. ( 0,498381276302973 )
Comput Math Methods Med - Investigating properties of the cardiovascular system using innovative analysis algorithms based on ensemble empirical mode decomposition. ( 0,497785744864844 )
J Clin Monit Comput - Arterial pressure waveform derived cardiac output FloTrac/Vigileo system (third generation software): comparison of two monitoring sites with the thermodilution cardiac output. ( 0,496924421698877 )
Med Biol Eng Comput - Impact of atrial fibrillation on the cardiovascular system through a lumped-parameter approach. ( 0,496232634504867 )
AMIA Annu Symp Proc - Identifying Deviations from Usual Medical Care using a Statistical Approach. ( 0,496128132169782 )
AMIA Annu Symp Proc - Revisiting the EBM decision model to formalize non-compliance with computerized CPGs: results in the management of breast cancer with OncoDoc2. ( 0,496035434817493 )
Med Biol Eng Comput - The effect of aortic wall and aortic leaflet stiffening on coronary hemodynamic: a fluid-structure interaction study. ( 0,496004781709969 )
AMIA Annu Symp Proc - Social network analysis of physician interactions: the effect of institutional boundaries on breast cancer care. ( 0,495690324480165 )
Med Biol Eng Comput - Effect of respiration on Korotkoff sounds and oscillometric cuff pressure pulses during blood pressure measurement. ( 0,495241005454912 )
Healthc (Amst) - Incentivizing shared decision making in the USA--where are we now? ( 0,495205193485336 )
J Clin Monit Comput - Decrease in pulmonary artery pressure after administration of thoracic epidural anesthesia in a patient with Marfan syndrome awaiting aortic valve replacement procedure. ( 0,494731209891109 )
Med Biol Eng Comput - Myocardial-vessel interaction: role of LV pressure and myocardial contractility. ( 0,494707158584587 )
Int J Med Inform - Design of decision support interventions for medication prescribing. ( 0,494538843132803 )
Med Biol Eng Comput - Model-based correction of the influence of body position on continuous segmental and hand-to-foot bioimpedance measurements. ( 0,494193798412112 )
J Clin Monit Comput - Radial-femoral concordance in time and frequency domain-based estimates of systemic arterial respiratory variation. ( 0,493505448180957 )
J Clin Monit Comput - Impact of central hypovolemia on photoplethysmographic waveform parameters in healthy volunteers part 2: frequency domain analysis. ( 0,493370435911404 )
Comput Math Methods Med - Plasma volume expansion resulting from intravenous glucose tolerance test. ( 0,493127791448199 )
J Clin Monit Comput - Capability of a new paediatric oesophageal Doppler monitor to detect changes in cardiac output during testing of external pacemakers after cardiac surgery. ( 0,4923883213062 )