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Entropy quantification algorithms are becoming a prominent tool for the physiological monitoring of individuals through the effective measurement of irregularity in biological signals. However, to ensure their effective adaptation in monitoring applications, the performance of these algorithms needs to be robust when analysing time-series containing missing and outlier samples, which are common occurrence in physiological monitoring setups such as wearable devices and intensive care units. This paper focuses on augmenting Dispersion Entropy (DisEn) by introducing novel variations of the algorithm for improved performance in such applications. The original algorithm and its variations are tested under different experimental setups that are replicated across heart rate interval, electroencephalogram, and respiratory impedance time-series. Our results indicate that the algorithmic variations of DisEn achieve considerable improvements in performance while our analysis signifies that, in consensus with previous research, outlier samples can have a major impact in the performance of entropy quantification algorithms. Consequently, the presented variations can aid the implementation of DisEn to physiological monitoring applications through the mitigation of the disruptive effect of missing and outlier samples.

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Network physiology has emerged as a promising paradigm for the extraction of clinically relevant information from physiological signals by moving from univariate to multivariate analysis, allowing for the inspection of interdependencies between organ systems. However, for its successful implementation, the disruptive effects of artifactual outliers, which are a common occurrence in physiological recordings, have to be studied, quantified, and addressed. Within the scope of this study, we utilize Dispersion Entropy (DisEn) to initially quantify the capacity of outlier samples to disrupt the values of univariate and multivariate features extracted with DisEn from physiological network segments consisting of synchronised, electroencephalogram, nasal respiratory, blood pressure, and electrocardiogram signals. The DisEn algorithm is selected due to its efficient computation and good performance in the detection of changes in signals for both univariate and multivariate time-series. The extracted features are then utilised for the training and testing of a logistic regression classifier in univariate and multivariate configurations in an effort to partially automate the detection of artifactual network segments. Our results indicate that outlier samples cause significant disruption in the values of extracted features with multivariate features displaying a certain level of robustness based on the number of signals formulating the network segments from which they are extracted. Furthermore, the deployed classifiers achieve noteworthy performance, where the percentage of correct network segment classification surpasses 95% in a number of experimental setups, with the effectiveness of each configuration being affected by the signal in which outliers are located. Finally, due to the increase in the number of features extracted within the framework of network physiology and the observed impact of artifactual samples in the accuracy of their values, the implementation of algorithmic steps capable of effective feature selection is highlighted as an important area for future research.

Physiological monitoring in intensive care units generates data that can be used to aid clinical decision making facilitating early interventions. However, the low data quality of physiological signals due to the recording conditions in clinical settings limits the automated extraction of relevant information and leads to significant numbers of false alarms. This paper investigates the utilization of a hybrid artifact detection system that combines a Variational Autoencoder with a statistical detection component for the labeling of artifactual samples to automate the costly process of cleaning physiological recordings. The system is applied to mean blood pressure signals from an intensive care unit dataset recorded within the scope of the KidsBrainIT project. Its performance is benchmarked to manual annotations made by trained researchers. Our preliminary results indicate that the system is capable of consistently achieving sensitivity and specificity levels that surpass 90%. Thus, it provides an initial foundation that can be expanded upon to partially automate data cleaning in offline applications and reduce false alarms in online applications.

Multivariate Entropy quantification algorithms are becoming a prominent tool for the extraction of information from multi-channel physiological time-series. However, during the analysis of physiological signals from heterogeneous organ systems, certain channels may overshadow the patterns of others, resulting in information loss. Here, we introduce the framework of Stratified Entropy to control the prioritization of each channels' dynamics based on their allocation to respective strata, leading to a richer description of the multi-channel signal. As an implementation of the framework, three algorithmic variations of the Stratified Multivariate Multiscale Dispersion Entropy are introduced. These variations and the original algorithm are applied to synthetic and physiological time-series, formulated from electroencephalogram, arterial blood pressure, electrocardiogram, and nasal respiratory signals. The results of experiments conducted on synthetic time-series indicate that the variations successfully prioritize channels based on their strata allocation while maintaining the low computation time of the original algorithm. Based on the physiological time-series results, the distributions of features extracted from healthy sleep versus sleep with obstructive sleep apnea display increased statistical difference for certain strata allocations in the variations.This suggests improved physiological state monitoring by the variations. Furthermore, stratified algorithms can be modified to utilize a priori knowledge for the stratification of channels. Thus, our research provides a novel approach of multivariate analysis for the extraction of previously inaccessible information from heterogeneous systems.