Not all vital signs are useful in the prediction of clinical outcomes. Vital signs had high specificity but very low sensitivity as predictors of clinical outcomes. Clinicians should always remember to treat patients and not numbers.
Traditional risk score prediction is based on vital signs and clinical assessment. In this paper, we present an intelligent scoring system for the prediction of cardiac arrest within 72 h. The patient population is represented by a set of feature vectors, from which risk scores are derived based on geometric distance calculation and support vector machine. Each feature vector is a combination of heart rate variability (HRV) parameters and vital signs. Performance evaluation is conducted on the leave-one-out cross-validation framework, and receiver operating characteristic, sensitivity, specificity, positive predictive value, and negative predictive value are reported. Experimental results reveal that the proposed scoring system not only achieves satisfactory performance on determining the risk of cardiac arrest within 72 h but also has the ability to generate continuous risk scores rather than a simple binary decision by a traditional classifier. Furthermore, the proposed scoring system works well for both balanced and imbalanced datasets, and the combination of HRV parameters and vital signs shows superiority in prediction to using HRV parameters only or vital signs only.
The ability to predict patient outcomes is important for clinical triage, which is the process of assessing severity and assigning appropriate priority of treatment for large numbers of patients. In this study, we present an automatic prognosis system for patient outcome prediction with heart rate variability (HRV) and traditional vital signs. Support vector machine (SVM) and extreme learning machine (ELM) are employed as predictors, and SVM with linear kernel is reported to perform the best in general. In the experiments, the combination of HRV measures and vital signs is found to be more closely associated with patient outcome than either HRV or vital signs. Moreover, two new segment based methods are proposed to improve the predictive accuracy, where several sets of HRV measures are calculated from non-overlapped segments for each patient and final decision is made through the majority voting rule. The results reveal that the segment based methods are able to enhance the prediction performance significantly.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.