Opportunities for machine learning to improve surgical ward safety.

American Journal of Surgery
Tyler J LoftusAzra Bihorac

Abstract

Delayed recognition of decompensation and failure-to-rescue on surgical wards are major sources of preventable harm. This review assimilates and critically evaluates available evidence and identifies opportunities to improve surgical ward safety. Fifty-eight articles from Cochrane Library, EMBASE, and PubMed databases were included. Only 15-20% of patients suffering ward arrest survive. In most cases, subtle signs of instability often occur prior to critical illness and arrest, and underlying pathology is reversible. Coarse risk assessments lead to under-triage of high-risk patients to wards, where surveillance for complications depends on time-consuming manual review of health records, infrequent patient assessments, prediction models that lack accuracy and autonomy, and biased, error-prone decision-making. Streaming electronic heath record data, wearable continuous monitors, and recent advances in deep learning and reinforcement learning can promote efficient and accurate risk assessments, earlier recognition of instability, and better decisions regarding diagnosis and treatment of reversible underlying pathology.

References

Mar 1, 1991·Annals of Emergency Medicine·J R HoffmanJ S Luo
Dec 1, 1990·Chest·R M ScheinC L Sprung
Feb 28, 1997·Science·A BecharaA R Damasio
Jun 19, 1998·BMJ : British Medical Journal·P McQuillanC H Collins
Feb 23, 1999·Acta Anaesthesiologica Scandinavica·E SkogvollS E Gisvold
Nov 27, 1999·Respiration; International Review of Thoracic Diseases·S P ChangLaiK K Liao
Oct 6, 2001·QJM : Monthly Journal of the Association of Physicians·C P SubbeL Gemmel
Jun 14, 2003·Science·Alan G SanfeyJonathan D Cohen
May 29, 2004·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Giorgio BerlotUmberto Lucangelo
Aug 2, 2005·Annals of the Royal College of Surgeons of England·C P SubbeL Gemmell
Jun 6, 2006·Critical Care : the Official Journal of the Critical Care Forum·Rupert M PearseE David Bennett
Oct 5, 2006·Intensive Care Medicine·Claudio SandroniMassimo Antonelli
Sep 25, 2007·Medical Care·Jeffrey H SilberKevin G Volpp
Feb 6, 2008·Resuscitation·Gary B SmithPeter I Featherstone
Jun 14, 2008·Neuron·Ben Seymour, Ray Dolan
Mar 21, 2009·Surgical Infections·Todd R VogelStephen F Lowry
Feb 6, 2010·Lancet·Ann Van den BruelUNKNOWN European Research Network on Recognising Serious Infection investigators
Aug 31, 2010·Journal of the American College of Surgeons·Amir A GhaferiJustin B Dimick
Jun 10, 2011·Chest·Jennifer L Martin, Alex D Hakim
Jun 28, 2011·Critical Care Medicine·Raina M MerchantUNKNOWN American Heart Association Get With The Guidelines-Resuscitation Investigators
Mar 1, 2012·Neuron·Joseph LeDoux
Jul 13, 2012·The New England Journal of Medicine·Edward W Boyer
Aug 10, 2012·BMJ : British Medical Journal·Ann McGinley, Rupert M Pearse
Sep 28, 2012·BMJ : British Medical Journal·Ann Van den BruelDavid Mant
May 16, 2013·Critical Care : the Official Journal of the Critical Care Forum·Carol L HodgsonRinaldo Bellomo
Jul 9, 2013·Journal of Biomedical Informatics·Michael J RothmanJoseph Beals
Dec 18, 2013·The American Journal of Medicine·Harvey BrownEyal Zimlichman
Feb 11, 2014·Journal of the American College of Surgeons·Thomas S HellingMarc E Mitchell
Aug 5, 2014·American Journal of Respiratory and Critical Care Medicine·Matthew M ChurpekDana P Edelson
May 21, 2015·Critical Care : the Official Journal of the Critical Care Forum·Gooske DouwJohannes G van der Hoeven
Nov 11, 2015·Journal of General Internal Medicine·Susan L CalcaterraIngrid A Binswanger
Jan 29, 2016·Nature·David SilverDemis Hassabis
Feb 24, 2016·JAMA : the Journal of the American Medical Association·Mervyn SingerDerek C Angus
Jun 17, 2016·Journal of Multidisciplinary Healthcare·Margot GreenBernie Bissett
Jun 19, 2016·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Mirela PrgometKen Hillman

❮ Previous
Next ❯

Citations

Nov 24, 2020·American Journal of Surgery·Michael P RogersPaul C Kuo

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

© 2021 Meta ULC. All rights reserved