Integrated monitoring and analysis for early warning of patient deterioration
- 1 July 2006
- journal article
- review article
- Published by Elsevier BV in British Journal of Anaesthesia
- Vol. 97 (1), 64-68
- https://doi.org/10.1093/bja/ael113
Abstract
Recently there has been an upsurge of interest in strategies for detecting at-risk patients in order to trigger the timely intervention of a Medical Emergency Team (MET), also known as a Rapid Response Team (RRT). We review a real-time automated system, BioSign, which tracks patient status by combining information from vital signs monitored non-invasively on the general ward. BioSign fuses the vital signs in order to produce a single-parameter representation of patient status, the Patient Status Index. The data fusion method adopted in BioSign is a probabilistic model of normality in five dimensions, previously learnt from the vital sign data acquired from a representative sample of patients. BioSign alerts occur either when a single vital sign deviates by close to +/-3 standard deviations from its normal value or when two or more vital signs depart from normality, but by a smaller amount. In a trial with high-risk elective/emergency surgery or medical patients, BioSign alerts were generated, on average, every 8 hours; 95% of these were classified as 'True' by clinical experts. Retrospective analysis has also shown that the data fusion algorithm in BioSign is capable of detecting critical events in advance of single-channel alerts.Keywords
This publication has 22 references indexed in Scilit:
- Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trialThe Lancet, 2005
- Impact of a critical care outreach team on critical care readmissions and mortalityActa Anaesthesiologica Scandinavica, 2004
- Use of medical emergency team responses to reduce hospital cardiopulmonary arrestsQuality and Safety in Health Care, 2004
- A prospective before‐and‐after trial of a medical emergency teamThe Medical Journal of Australia, 2003
- Editorial IIBritish Journal of Anaesthesia, 2003
- Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: preliminary studyBMJ, 2002
- The critically ill: following your MEWS.QJM: An International Journal of Medicine, 2001
- The patient‐at‐risk team: identifying and managing seriously ill ward patientsAnaesthesia, 1999
- Physiological values and procedures in the 24 h before ICU admission from the wardAnaesthesia, 1999
- Respiratory rate predicts cardiopulmonary arrest for internal medicine inpatientsJournal of General Internal Medicine, 1993