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<p> In this original study, we investigate the performances of machine learning algorithms on a neonatal sepsis detection task. We consider this work to be of great interest to both engineers and clinicians, as it uses non-invasive, already existing, vital signs monitoring signals in a population of very low birth weight infants at high risk of sepsis. Vital sign variability may indeed represent a general indicator of health and wellbeing and be helpful in the early detection of systematic inflammation such as sepsis. We used state of the art feature extraction technics and evaluate a large variety of binary classification models among which a neural network based generative model. The models were chosen from two main families: discriminative and generative. This enables a comprehensive study of different kinds of traditional and advanced binary classification algorithms.</p> <p> Our study reveals that advanced machine learning models are more robust to changes in the feature extraction pipeline, although linear classifiers have a comparable performance when the feature extraction is tuned. The advanced model performing the best is a neural network based generative model which is a hybrid generative and discriminative model. A large window length when computing the features is beneficial to almost all algorithms, indicating the relevance of frequency domain related features for the neonatal sepsis detection task.</p> <p> Overall we obtain a classification AUROC above 0.85, which makes our prediction models potentially relevant in clinical practice. This will enable earlier therapeutic interventions and thereby reduce morbidity and mortality in infants.</p>

Aim: Sepsis is a leading cause of morbidity and mortality in neonates. Early diagnosis is key but difficult due to non-specific signs. We investigate the predictive value of machine learning-assisted analysis of non-invasive, high frequency monitoring data and demographic factors to detect neonatal sepsis.Methods: Single centre study, including a representative cohort of 325 infants (2866 hospitalisation days). Personalised event timelines including interventions and clinical findings were generated. Time-domain features from heart rate, respiratory rate and oxygen saturation values were calculated and demographic factors included. Sepsis prediction was performed using Naïve Bayes algorithm in a maximum a posteriori framework up to 24 h before clinical sepsis suspicion.Results: Twenty sepsis cases were identified. Combining multiple vital signs improved algorithm performance compared to heart rate characteristics alone. This enabled a prediction of sepsis with an area under the receiver operating characteristics curve of 0.82, up to 24 h before clinical sepsis suspicion. Moreover, 10 h prior to clinical suspicion, the risk of sepsis increased 150-fold. Conclusion:The present algorithm using non-invasive patient data provides useful predictive value for neonatal sepsis detection. Machine learning-assisted algorithms are promising novel methods that could help individualise patient care and reduce morbidity and mortality.

<p> In this original study, we investigate the performances of machine learning algorithms on a neonatal sepsis detection task. We consider this work to be of great interest to both engineers and clinicians, as it uses non-invasive, already existing, vital signs monitoring signals in a population of very low birth weight infants at high risk of sepsis. Vital sign variability may indeed represent a general indicator of health and wellbeing and be helpful in the early detection of systematic inflammation such as sepsis. We used state of the art feature extraction technics and evaluate a large variety of binary classification models among which a neural network based generative model. The models were chosen from two main families: discriminative and generative. This enables a comprehensive study of different kinds of traditional and advanced binary classification algorithms.</p> <p> Our study reveals that advanced machine learning models are more robust to changes in the feature extraction pipeline, although linear classifiers have a comparable performance when the feature extraction is tuned. The advanced model performing the best is a neural network based generative model which is a hybrid generative and discriminative model. A large window length when computing the features is beneficial to almost all algorithms, indicating the relevance of frequency domain related features for the neonatal sepsis detection task.</p> <p> Overall we obtain a classification AUROC above 0.85, which makes our prediction models potentially relevant in clinical practice. This will enable earlier therapeutic interventions and thereby reduce morbidity and mortality in infants.</p>