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Authors: Denise Schmidt ; Jonas Chromik and Bert Arnrich

Affiliation: Hasso Plattner Institute, University of Potsdam, Germany

Keyword(s): Intensive Care Unit, Patient Monitor Alarm, Alarm Fatigue, Threshold Alarm, Threshold Forecasting, CatBoost, SHAP, MIMIC-IV.

Abstract: Intensive care unit staff relies on patient monitors to identify critical conditions. The monitors trigger alarms as soon as the patient’s vital parameters deviate from predefined threshold ranges. However, these ranges are usually not adapted to the individual patient. High numbers of false alarms burden clinical staff and pose a major risk to patient safety. We propose a recommender system for threshold values to enable a patient-centered monitoring system. This can reduce false alarms caused by default monitoring settings. We employ CatBoost – a gradient boosting algorithm – to predict blood pressure and heart rate thresholds. We use SHAP values to evaluate the importance of different patient characteristics, diagnoses, or medications. Several patient characteristics show an impact on the model output: Diagnoses, first care unit, vital parameter measurements, and the amount of general anaesthetics are the most important features in all threshold models. The recommendations of our system deviate from the actual thresholds by approximately 3.5 bpm for the heart rate and 4.9 mmHg for the blood pressure thresholds. Blood pressure thresholds have a higher variance which leads to larger errors. However, the underlying data is not very patient-centered and we require better alarm data to further improve threshold recommendation. (More)

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Paper citation in several formats:
Schmidt, D.; Chromik, J. and Arnrich, B. (2023). Recommender System for Alarm Thresholds in Medical Patient Monitors. In Proceedings of the 16th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2023) - HEALTHINF; ISBN 978-989-758-631-6; ISSN 2184-4305, SciTePress, pages 74-85. DOI: 10.5220/0011637500003414

@conference{healthinf23,
author={Denise Schmidt. and Jonas Chromik. and Bert Arnrich.},
title={Recommender System for Alarm Thresholds in Medical Patient Monitors},
booktitle={Proceedings of the 16th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2023) - HEALTHINF},
year={2023},
pages={74-85},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0011637500003414},
isbn={978-989-758-631-6},
issn={2184-4305},
}

TY - CONF

JO - Proceedings of the 16th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2023) - HEALTHINF
TI - Recommender System for Alarm Thresholds in Medical Patient Monitors
SN - 978-989-758-631-6
IS - 2184-4305
AU - Schmidt, D.
AU - Chromik, J.
AU - Arnrich, B.
PY - 2023
SP - 74
EP - 85
DO - 10.5220/0011637500003414
PB - SciTePress