Patient-Specific Physiological Monitoring and Prediction Using Structured Gaussian Processes

The management of patient well-being can be performed by monitoring continuous time-series vital-sign data via low-cost wearable devices. Automated algorithms may then be used with the resulting data to provide early warning of deterioration of the health of an individual. Such algorithms are typically trained for a large population without considering the time-variability and inter-subject variability of the data being collected. In the case where limited numbers of subjects are available, it is difficult to create a generalized population model from a small sample size. Furthermore, some “normal” patients may exhibit different physiological patterns when compared to other “normal” patients, forming multiple “normal” clusters/subgroups. This also makes inferring a population model difficult. It is, therefore, preferable to develop patient/subgroup-specific time-series models to overcome these challenges. We propose using Bayesian hierarchical Gaussian processes to infer the hidden latent structure of the vital sign’s trajectory for each individual patient or group of patients who share similar patterns. We further demonstrate the feasibility of such a model in novelty detection, using the symmetric Kullback–Leibler divergence. This allows us to identify any patterns that correspond to “normal” or “abnormal” physiology, and further classifying “abnormal” patterns from a model of “normal” latent trajectories. We tested our approach using two real datasets for different monitoring scenarios. Our model was compared to the performance of the state-of-the-art unsupervised clustering algorithms, demonstrating at least 10% improvement in accuracy. We further benchmarked against two one-class classifiers and showed at least 5% accuracy improvement when using the proposed metrics in identifying abnormal physiological episodes.

[1]  F. Ismail,et al.  Integrated monitoring and analysis for early warning of patient deterioration. , 2007, British journal of anaesthesia.

[2]  David A. Clifton,et al.  Bayesian optimisation of Gaussian processes for identifying the deteriorating patient , 2017, 2017 IEEE EMBS International Conference on Biomedical & Health Informatics (BHI).

[3]  Ying Wah Teh,et al.  Time-series clustering - A decade review , 2015, Inf. Syst..

[4]  David A. Clifton,et al.  Gaussian Processes for Personalized e-Health Monitoring With Wearable Sensors , 2013, IEEE Transactions on Biomedical Engineering.

[5]  Carl E. Rasmussen,et al.  Gaussian processes for machine learning , 2005, Adaptive computation and machine learning.

[6]  Jennifer G. Dy,et al.  Nonparametric Mixture of Gaussian Processes with Constraints , 2013, ICML.

[7]  David A. Clifton,et al.  Gaussian process clustering for the functional characterisation of vital-sign trajectories , 2013, 2013 IEEE International Workshop on Machine Learning for Signal Processing (MLSP).

[8]  Sunho Park,et al.  Hierarchical Gaussian Process Regression , 2010, ACML.

[9]  Tian Zhang,et al.  BIRCH: an efficient data clustering method for very large databases , 1996, SIGMOD '96.

[10]  C. MacEwen Can data fusion techniques predict adverse physiological events during haemodialysis , 2016 .

[11]  Jitendra Malik,et al.  Normalized cuts and image segmentation , 1997, Proceedings of IEEE Computer Society Conference on Computer Vision and Pattern Recognition.

[12]  Michael I. Jordan,et al.  Sharing Features among Dynamical Systems with Beta Processes , 2009, NIPS.

[13]  Fei Tony Liu,et al.  Isolation-Based Anomaly Detection , 2012, TKDD.

[14]  John A. Quinn,et al.  Factorial Switching Linear Dynamical Systems Applied to Physiological Condition Monitoring , 2009, IEEE Transactions on Pattern Analysis and Machine Intelligence.

[15]  David A. Clifton,et al.  Likelihood-based artefact detection in continuously-acquired patient vital signs , 2017, 2017 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[16]  David A. Clifton,et al.  Identifying patient-specific trajectories in haemodialysis using Bayesian Hierarchical Gaussian Processes , 2018, 2018 IEEE EMBS International Conference on Biomedical & Health Informatics (BHI).

[17]  L. Tarassenko,et al.  BIOSIGN/spl trade/ : multi-parameter monitoring for early warning of patient deterioration , 2005 .

[18]  Suchi Saria,et al.  A Bayesian Nonparametic Approach for Estimating Individualized Treatment-Response Curves , 2016, ArXiv.

[19]  Yvonne Freer,et al.  A Hierarchical Switching Linear Dynamical System Applied to the Detection of Sepsis in Neonatal Condition Monitoring , 2014, UAI.

[20]  Shamim Nemati,et al.  Discovering shared dynamics in physiological signals: Application to patient monitoring in ICU , 2012, 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[21]  Jaewook Lee,et al.  Clustering Based on Gaussian Processes , 2007, Neural Computation.

[22]  Chih-Jen Lin,et al.  LIBSVM: A library for support vector machines , 2011, TIST.

[23]  Neil D. Lawrence,et al.  Hierarchical Bayesian modelling of gene expression time series across irregularly sampled replicates and clusters , 2013, BMC Bioinformatics.

[24]  Neil D. Lawrence,et al.  Fast Nonparametric Clustering of Structured Time-Series , 2014, IEEE Transactions on Pattern Analysis and Machine Intelligence.

[25]  D. Harrison,et al.  Systematic review and evaluation of physiological track and trigger warning systems for identifying at-risk patients on the ward , 2007, Intensive Care Medicine.

[26]  David A. Clifton,et al.  Modelling physiological deterioration in post-operative patient vital-sign data , 2013, Medical & Biological Engineering & Computing.

[27]  Oliver Stegle,et al.  Gaussian Process Robust Regression for Noisy Heart Rate Data , 2008, IEEE Transactions on Biomedical Engineering.