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Real-time Multidimensional Temporal Analysis of Complex High Volume Physiological Data Streams in the Neonatal Intensive Care Unit Carolyn McGregor, Andrew.

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Presentation on theme: "Real-time Multidimensional Temporal Analysis of Complex High Volume Physiological Data Streams in the Neonatal Intensive Care Unit Carolyn McGregor, Andrew."— Presentation transcript:

1 Real-time Multidimensional Temporal Analysis of Complex High Volume Physiological Data Streams in the Neonatal Intensive Care Unit Carolyn McGregor, Andrew James, Mike Eklund, Daby Sow, Maria Ebling, Marion Blount Canada Research Chair in Health Informatics, Professor, Associate Dean of Research Faculty of Business and IT, University of Ontario Institute of Technology

2 Outline Neonatal Big Data Clinical Problem and Motivation Artemis LONS Clinical Application

3 Care of the Preterm Infant 3

4 Neonatal Care Multiple devices are attached to the baby or humidicrib Medical devices output via serial port in a range of formats Indicative readings are recorded on paper every 30 or 60 minutes Cost of care per baby is approx $ K not including morbidity related care

5 Neonatal ICU Big Data Heart beats –Average 130/minute| 7800/hour Breathing –Average 35/minute | 2100/hour Blood oxygen levels –60/minute | 3600/hour

6 Neonatal ICU Big Data Heart beats –1 value /hour (7799 lost) Breathing –Average 35/minute | 2100/hour Blood oxygen levels –60/minute | 3600/hour

7 Neonatal ICU Big Data Heart beats –1 value /hour (7799 lost) Breathing –1 value /hour (2099 lost) Blood oxygen levels –60/minute | 3600/hour

8 Neonatal ICU Big Data Heart beats –1 value /hour (7799 lost) Breathing –1 value /hour (2099 lost) Blood oxygen levels –1 value /hour (3599 lost)

9 Condition Onset Predictors Behaviour of physiological data streams that describe respiratory and cardiac function... Pneumothorax (McIntosh et al, 2000) Nosocomial infection (Griffin and Moorman, 2001) Periventricular leucomalacia (Shankaran et al, 2006) Intraventricular haemorrhage (Fabres et al, 2006; Tuzcu et al, 2009) 9

10 10 LONS

11 11 LONS

12 12

13 Knowledge Translation Challenge Retrospective Analysis Not implemented in clinical practice Not scalable Either or combination of: –Patient centric –Condition centric –Stream centric

14 ARTEMIS

15 Health Informatics Health and Medicine Experts Information Technology and Computer Systems Research

16 16 Data Integration Mgr Knowledge Extraction Data Miner HIR Data Mover InfoSphere Streams Runtime Ontology Driven Rule Modifier Deployment Server Alert Sink Op QRS BP RR PT FA WT AR Sepsis BPA EP WTA HR Source Op SpO2 Source Op BP Source Op CIS Source Op Patient Stream SPADE IDE USER INTERFACE Medical Data Hub CIS Adapter Configuration Server CapsuleTech Server MP50 Babylog8000 Clinical Information System ECGSpO2BPHR Cognos Data Aquisition Online Analysis Knowledge Extraction (Re)deployment Result Presentation Stream Persistency Artemis McGregor, C., Catley, C., James, A., Padbury, J., “Next Generation Neonatal Health Informatics with Artemis”, Medical Informatics Europe, Oslo, Norway, pp

17 Current Status of Artemis Deployed August, 2009 The Hospital for Sick Children, Toronto Maximum 8 concurrent Neonatal ICU patients Enabling new Nosocomial Infection Clinical Research YouTube: IBM commercial data baby

18 Artemis Upscaling to all patients within SickKids NICU 2 Hospitals Online Cloud Computing Version Other conditions and events Expand to other ICUs beyond Neonatal YouTube: IBM commercial data baby

19 Artemis Heart rate (HR) (1 Hz); Transcutaneous blood oxygen saturation (SpO 2 ) (1 Hz) Respiration rate (RR) (1 Hz) Blood pressure [systolic, diastolic, and mean] (BP) (1Hz)

20 ARTEMIS: CLINICAL RESEARCH - LONS

21 LONS Phase 0: no infection present Phase 1: infection present but no detectable clinical symptoms and signs Phase 2: subtle clinical symptoms and signs present Phase 3: definite clinical symptoms and signs present Phase 4: very obvious clinical symptoms and signs present

22 LONS Phase 0: no infection present Phase 1: infection present but no detectable clinical symptoms and signs Phase 2: subtle clinical symptoms and signs present Phase 3: definite clinical symptoms and signs present Phase 4: very obvious clinical symptoms and signs present

23 LONS Phase 0: no infection present Phase 1: infection present but no detectable clinical symptoms and signs Phase 2: subtle clinical symptoms and signs present Phase 3: definite clinical symptoms and signs present Phase 4: very obvious clinical symptoms and signs present

24 Level 0: No specified features present. Level 1: Presence of features reporting reduced heart rate variability (HRV), or bradycardia, or a significant downward drift of heart rate. Level 2: Presence of level 1 features plus the presence of a respiratory pause as determined by fall in respiratory rate below the defined threshold.

25 Level 3: Presence of level 2 features plus a blood oxygen desaturation threshold breach or a significant downward drift of blood oxygen desaturation Level 4: Presence of level 3 features plus a blood pressure threshold breach on any of the readings or a significant downward drift of any of the blood pressure readings

26

27 Artemis Clinical Partners Nepean Hospital Westmead Hospital Shenzhen Maternity & Child Health Hospital 深圳市妇幼保健院

28 Funding Acknowledgements TJ Watson Research Center, NY Canada

29 Team Acknowledgements Dr Andrew James Assoc Prof Mikael Eklund Assoc Prof Jennifer Percival Dr J. Edward Pugh Dr Christina Catley Dr Nadja Mench-Bressan Shermeen Nizami Rishikesan Kamaleswaran Agam Dhanoa Kathy Smith Anirudh Thommandram Wenlan Huang Sascha Tuuha Nathan Percival

30 Real-time Multidimensional Temporal Analysis of Complex High Volume Physiological Data Streams in the Neonatal Intensive Care Unit Carolyn McGregor, Andrew James, Mike Eklund, Daby Sow, Maria Ebling, Marion Blount Canada Research Chair in Health Informatics, Professor, Associate Dean of Research Faculty of Business and IT, University of Ontario Institute of Technology


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