رسالة جامعية

Early Detection of Transition to Multiple Organ Dysfunction Syndrome Using Physiological Time Series Data

التفاصيل البيبلوغرافية
العنوان: Early Detection of Transition to Multiple Organ Dysfunction Syndrome Using Physiological Time Series Data
المؤلفون: Chyn, Michelle
المساهمون: Sarma, Sridevi V, Winslow, Raimond L, Bembea, Melania M
بيانات النشر: Johns Hopkins University
USA
سنة النشر: 2018
المجموعة: Johns Hopkins University, Baltimore: JScholarship
مصطلحات موضوعية: multiple organ dysfunction syndrome, time series data, early detection, generalized linear model, pediatric
الوصف: Multiple organ dysfunction syndrome (MODS) has an incidence rate of between 11 to 56\% in the PICU. Early prevention and treatment of MODS is important in the pediatric population as it increases mortality and leads to possible negative functional outcomes in adulthood. MODS severity is measured using a few different metrics, among which the Pediatric Logistic Organ Dysfunction 2 Score (PELOD-2) is the most recent, pediatric multi-center validated scoring system. This study attempted to build a generalized linear model to detect risk of PICU patients at Johns Hopkins Children's Center from a retrospectively gathered cohort, using PELOD-2 Score>=6 to define MODS severity and minute to minute physiological data as model covariates. Patient specific models were built with a two hour window for transitioning into severe state, the positive class, and the non-severe state was undersampled to balance classes. A global model was built across the majority of the patient population with similar parameters in order to create a more useful, clinical applicable model. The accuracy, sensitivity, and specificity of training and testing sets were calculated for each model. Patient specific models performed well, but performance decayed for the global model, where predictions at the patient level for risk of transitioning had high sensitivity and very low specificity. Future research should continue to refine the definition of a severe state of MODS and calibrate the sampling scheme with regards to ratio of data points labeled as healthy versus at risk in order to improve global model performance.
نوع الوثيقة: thesis
وصف الملف: application/pdf
اللغة: English
العلاقة: http://jhir.library.jhu.edu/handle/1774.2/60166Test
الإتاحة: http://jhir.library.jhu.edu/handle/1774.2/60166Test
رقم الانضمام: edsbas.E006F497
قاعدة البيانات: BASE