Automated Measurement of Adherence to Traumatic Brain Injury (TBI) Guidelines using Neurological ICU Data

Anthony Stell, Ian Piper, Laura Moss

2018

Abstract

Using a combination of physiological and treatment information from neurological ICU data-sets, adherence to traumatic brain injury (TBI) guidelines on hypotension, intracranial pressure (ICP) and cerebral perfusion pressure (CPP) is calculated automatically. The ICU output is evaluated to capture pressure events and actions taken by clinical staff for patient management, and are then re-expressed as simplified process models. The official TBI guidelines from the Brain Trauma Foundation are similarly evaluated, so the two structures can be compared and a quantifiable distance between the two calculated (the measure of adherence). The methods used include: the compilation of physiological and treatment information into event logs and subsequently process models; the expression of the BTF guidelines in process models within the real-time context of the ICU; a calculation of distance between the two processes using two algorithms (“Direct” and “Weighted”) building on work conducted in the business process domain. Results are presented across two categories each with clinical utility (minute-by-minute and single patient stays) using a real ICU data-set. Results of two sample patients using a weighted algorithm show a non-adherence level of 6.25% for 42 mins and 56.25% for 708 mins and non-adherence of 18.75% for 17 minutes and 56.25% for 483 minutes. Expressed as two combinatorial metrics (duration/non-adherence (A) and duration * non-adherence (B)), which together indicate the clinical importance of the non-adherence, one has a mean of A=4.63 and B=10014.16 and the other a mean of A=0.43 and B=500.0.

Paper Citation

in Harvard Style

Stell A., Piper I. and Moss L. (2018). Automated Measurement of Adherence to Traumatic Brain Injury (TBI) Guidelines using Neurological ICU Data. In Proceedings of the 11th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2018) - Volume 5: HEALTHINF; ISBN 978-989-758-281-3, SciTePress, pages 135-146. DOI: 10.5220/0006583801350146

in Bibtex Style

@conference{healthinf18,
author={Anthony Stell and Ian Piper and Laura Moss},
title={Automated Measurement of Adherence to Traumatic Brain Injury (TBI) Guidelines using Neurological ICU Data},
booktitle={Proceedings of the 11th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2018) - Volume 5: HEALTHINF},
year={2018},
pages={135-146},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0006583801350146},
isbn={978-989-758-281-3},
}

in EndNote Style

TY - CONF

JO - Proceedings of the 11th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2018) - Volume 5: HEALTHINF
TI - Automated Measurement of Adherence to Traumatic Brain Injury (TBI) Guidelines using Neurological ICU Data
SN - 978-989-758-281-3
AU - Stell A.
AU - Piper I.
AU - Moss L.
PY - 2018
SP - 135
EP - 146
DO - 10.5220/0006583801350146
PB - SciTePress