BackgroundOcclusions of intravenous (IV) tubing can prevent vital and time-critical medication or solutions from being delivered into the bloodstream of patients receiving IV therapy. At low flow rates (≤ 1 ml/h) the alarm delay (time to an alert to the user) can be up to 2 h using conventional pressure threshold algorithms. In order to reduce alarm delays we developed and evaluated the performance of two new real-time occlusion detection algorithms and one co-occlusion detector that determines the correlation in trends in pressure changes for multiple pumps.MethodsBench-tested experimental runs were recorded in triplicate at rates of 1, 2, 4, 8, 16, and 32 ml/h. Each run consisted of 10 min of non-occluded infusion followed by a period of occluded infusion of 10 min or until a conventional occlusion alarm at 400 mmHg occurred. The first algorithm based on binary logistic regression attempts to detect occlusions based on the pump’s administration rate Q(t) and pressure sensor readings P(t). The second algorithm continuously monitored whether the actual variation in the pressure exceeded a threshold of 2 standard deviations (SD) above the baseline pressure. When a pump detected an occlusion using the SD algorithm, a third algorithm correlated the pressures of multiple pumps to detect the presence of a shared occlusion. The algorithms were evaluated using 6 bench-tested baseline single-pump occlusion scenarios, 9 single-pump validation scenarios and 7 multi-pump co-occlusion scenarios (i.e. with flow rates of 1 + 1, 1 + 2, 1 + 4, 1 + 8, 1 + 16, and 1 + 32 ml/h respectively). Alarm delay was the primary performance measure.ResultsIn the baseline single-pump occlusion scenarios, the overall mean ± SD alarm delay of the regression and SD algorithms were 1.8 ± 0.8 min and 0.4 ± 0.2 min, respectively. Compared to the delay of the conventional alarm this corresponds to a mean time reduction of 76% (P = 0.003) and 95% (P = 0.001), respectively. In the validation scenarios the overall mean ± SD alarm delay of the regression and SD algorithms were respectively 1.8 ± 1.6 min and 0.3 ± 0.2 min, corresponding to a mean time reduction of 77% and 95%. In the multi-pump scenarios a correlation > 0.8 between multiple pump pressures after initial occlusion detection by the SD algorithm had a mean ± SD alarm delay of 0.4 ± 0.2 min. In 2 out of the 9 validation scenarios an occlusion was not detected by the regression algorithm before a conventional occlusion alarm occurred. Otherwise no occlusions were missed.ConclusionsIn single pumps, both the regression and SD algorithm considerably reduced alarm delay compared to conventional pressure limit-based detection. The SD algorithm appeared to be more robust than the regression algorithm. For multiple pumps the correlation algorithm reliably detected co-occlusions. The latter may be used to localize the segment of tubing in which the occlusion occurs.
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In my previous post on AI engineering I defined the concepts involved in this new discipline and explained that with the current state of the practice, AI engineers could also be named machine learning (ML) engineers. In this post I would like to 1) define our view on the profession of applied AI engineer and 2) present the toolbox of an AI engineer with tools, methods and techniques to defy the challenges AI engineers typically face. I end this post with a short overview of related work and future directions. Attached to it is an extensive list of references and additional reading material.
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Abstract for World Physiotherapy Congress 2021Title Ethical Considerations of Using Machine Learning for Decision Support in Occupational Physical Therapy: a narrative literature study and ethical deliberation. Authors Marianne W. M. C. Six Dijkstra1,4,7 · Egbert Siebrand2 · Steven Dorrestijn2 · Etto L. Salomons3 ·Michiel F. Reneman4 · Frits G. J. Oosterveld1 · Remko Soer1,5 · Douglas P. Gross6 · Hendrik J. Bieleman1 Presenter and contactName: Marianne W. M. C. Six DijkstraEmail: w.m.c.sixdijkstra@saxion.nlAdres: School of Health, Saxion University of Applied Sciences/AGZ, M.H. Tromplaan 28, 7500 KB, Enschede, The NetherlandsTel: +31(0)612379329 1 School of Health, Saxion University of AppliedSciences, Enschede, The Netherlands2 Research Group Ethics & Technology, Saxion Universityof Applied Sciences, Enschede, The Netherlands3 School of Ambient Intelligence, Saxion Universityof Applied Sciences, Enschede, The Netherlands4 Department of Rehabilitation Medicine, University MedicalCenter Groningen, University of Groningen, Groningen,The Netherlands5 University Medical Center Groningen, Pain Centre,University of Groningen, Groningen, The Netherlands6 Department of Physical Therapy, University of Alberta,Edmonton, Canada7 University of Groningen, Groningen, The Netherlands Funding This study was funded by Netherlands Organisation for Scientific Research (NWO) (023.011.076) and Saxion University of Applied Sciences in The Netherlands. The funding source had no involvementin study design, data collection, analysis or interpretation, in the writing of the report, or the decision to submit the article for publication.Ethical approvalThis study is part of a PhD project entitled “Development of a Decision Support System – Artificial Intelligence advices for Sustainable Employability”. The Ethics Board at the University Medical Center Groningen in The Netherlands decided that formal approval of the study was not necessary because all workers were subjected to care as usual only.AbstractBackground Computer algorithms and Machine Learning (ML) will be integrated into clinical decision support within physical therapy. This will change the interaction between therapists and their clients, with unknown consequences.Purpose The aim of this study was to explore ethical considerations and potential consequences of using ML based decision support tools (DSTs). We used an example in the context of occupational physical therapy.Methods We conducted an ethical deliberation. This was supported by a narrative literature review of publications about ML and DSTs in occupational health and by an assessment of the potential impact of ML-DSTs according to frameworks from medical ethics and philosophy of technology. We introduce a hypothetical clinical scenario in occupational physical therapy to reflect on biomedical ethical principles: respect for autonomy, beneficence, non-maleficence and justice. The reflection was guided by the Product Impact Tool.
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Veel ouderen ervaren tijdens en na ziekenhuisopname functieverlies. ‘Function Focused Care in Hospital’, ook wel bekend als bewegingsgerichte zorg, is een interventie gericht op het voorkomen en verminderen van functieverlies bij ouderen tijdens een ziekenhuisopname. Verpleegkundigen moedigen patiënten aan tot actieve betrokkenheid in de dagelijkse zorgmomenten.
In het project werken onderzoekers van het Lectoraat samen met publieke organisaties toe naar een tool waarmee onderstromen in het publieke debat rondom issues eerder kunnen worden opgemerkt. We exploreren met welk algoritme we patronen in geruchtvorming en mobilisatie kunnen opsporen, en tevens hoe we de interactie tussen newsroom-analisten en de output van een monitoring tool het beste kunnen vormgeven.
Heb je wel eens gemerkt dat de premie voor je autoverzekering verandert als je in een andere wijk gaat wonen? Verzekeraars berekenen dit met een algoritme, wat kan leiden tot indirecte discriminatie. Dit project onderzoekt hoe zulke digitale differentiatie (DD) zowel eerlijk als rendabel kan.
