Do Temporal Changes in Facial Expressions Help Identify Patients at Risk of Deterioration in Hospital Wards? A Post Hoc Analysis of the Visual Early Warning Score Study

Critical Care Explorations
Maria Isabel Madrigal-GarciaJeronimo Moreno-Cuesta

Abstract

To determine whether time-series analysis and Shannon information entropy of facial expressions predict acute clinical deterioration in patients on general hospital wards. Post hoc analysis of a prospective observational feasibility study (Visual Early Warning Score study). General ward patients in a community hospital. Thirty-four patients at risk of clinical deterioration. A 3-minute video (153,000 frames) for each of the patients enrolled into the Visual Early Warning Score study database was analyzed by a trained psychologist for facial expressions measured as action units using the Facial Action Coding System. Three-thousand six-hundred eighty-eight action unit were analyzed over the 34 3-minute study periods. The action unit time variables considered were onset, apex, offset, and total time duration. A generalized linear regression model and time-series analyses were performed. Shannon information entropy (Hn) and diversity (Dn) were calculated from the frequency and repertoire of facial expressions. Patients subsequently admitted to critical care displayed a reduced frequency rate (95% CI moving average of the mean: 9.5-10.9 vs 26.1-28.9 in those not admitted), a higher Shannon information entropy (0.30 ± 0.06 vs 0.26 ± ...Continue Reading

References

Dec 17, 2011·Journal of Critical Care·Beverly BradleyAndrew J E Seely
Sep 15, 2012·Critical Care Medicine·Jeronimo M Cuesta, Mervyn Singer
Jan 8, 2014·American Journal of Primatology·Linda ScheiderBridget Waller
Jan 5, 2018·Proceedings. Biological Sciences·John AxelssonMats Lekander
Mar 27, 2018·Critical Care Medicine·Maria Isabel Madrigal-GarciaJeronimo Moreno-Cuesta

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R Foundation for Statistical Computing
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Facial Action Coding System ( FACS )
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