论文标题

院外心脏骤停期间基于加速度计的循环状态分类

Accelerometry-based classification of circulatory states during out-of-hospital cardiac arrest

论文作者

Kern, Wolfgang J., Orlob, Simon, Bohn, Andreas, Toller, Wolfgang, Wnent, Jan, Gräsner, Jan-Thorsten, Holler, Martin

论文摘要

目的:利用加速度计数据以自动,可靠和迅速检测心脏骤停过程中自发循环,因为这对于患者生存既重要又至关重要。方法:我们开发了一种机器学习算法,以自动预测从加速度计和心电图和心电图(ECG)数据的心肺复苏期间的循环状态(ECG)数据,从暂停现实世界中除纤维剂记录的胸部压缩的停顿中。该算法是根据德国复苏登记处的422例病例进行培训的,该算法是通过医师的手动注释为其创建的。它使用基于49个功能的内核支持向量机分类器,该特征部分反映了加速度计和心电图数据之间的相关性。结果:评估50种不同的测试培训数据拆分,该算法的平衡精度为81.2%,敏感性为80.6%,特异性为81.8%,而仅使用ECG的特异性则导致平衡精度为76.5%,敏感性为80.2%,特定于72.8%。结论:与单个ECG信号使用相比,采用加速度计的第一种方法进行脉冲/无脉冲决策的方法显着增加。意义:这表明加速度计为脉搏/无脉冲决策提供了相关信息。在应用中,这种算法可用于简化质量管理的回顾性注释,此外,还可以支持临床医生在心脏骤停治疗期间评估循环状态。

Objective: Exploit accelerometry data for an automatic, reliable, and prompt detection of spontaneous circulation during cardiac arrest, as this is both vital for patient survival and practically challenging. Methods: We developed a machine learning algorithm to automatically predict the circulatory state during cardiopulmonary resuscitation from 4-second-long snippets of accelerometry and electrocardiogram (ECG) data from pauses of chest compressions of real-world defibrillator records. The algorithm was trained based on 422 cases from the German Resuscitation Registry, for which ground truth labels were created by a manual annotation of physicians. It uses a kernelized Support Vector Machine classifier based on 49 features, which partially reflect the correlation between accelerometry and electrocardiogram data. Results: Evaluating 50 different test-training data splits, the proposed algorithm exhibits a balanced accuracy of 81.2%, a sensitivity of 80.6%, and a specificity of 81.8%, whereas using only ECG leads to a balanced accuracy of 76.5%, a sensitivity of 80.2%, and a specificity of 72.8%. Conclusion: The first method employing accelerometry for pulse/no-pulse decision yields a significant increase in performance compared to single ECG-signal usage. Significance: This shows that accelerometry provides relevant information for pulse/no-pulse decisions. In application, such an algorithm may be used to simplify retrospective annotation for quality management and, moreover, to support clinicians to assess circulatory state during cardiac arrest treatment.

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