False alarm suppression in early prediction of cardiac arrhythmia

High false alarm rates in intensive care units (ICUs) cause desensitization among care providers, thus risking patients' lives. Providing early detection of true and false cardiac arrhythmia alarms can alert hospital personnel and avoid alarm fatigue, so that they can act only on true life-threatening alarms, hence improving efficiency in ICUs. However, suppressing false alarms cannot be an excuse to suppress true alarm detection rates. In this study, we investigate a cost-sensitive approach for false alarm suppression while keeping near perfect true alarm detection rates. Our experiments on two life threatening cardiac arrhythmia datasets from Physionet's MIMIC II repository provide evidence that the proposed method is capable of identifying patterns that can distinguish false and true alarms using on average 60% of the available time series' length. Using temporal uncertainty estimates of time series predictions, we were able to estimate the confidence in our early classification predictions, therefore providing a cost-sensitive prediction model for ECG signal classification. The results from the proposed method are interpretable, providing medical personnel a visual verification of the predicted results. In conducted experiments, moderate false alarm suppression rates were achieved (34.29% for Asystole and 20.32% for Ventricular Tachycardia) while keeping near 100% true alarm detection, outperforming the state-of-the-art methods, which compromise true alarm detection rate for higher false alarm suppression rate, on these challenging applications.

[1]  T. H. Kyaw,et al.  Multiparameter Intelligent Monitoring in Intensive Care II: A public-access intensive care unit database* , 2011, Critical care medicine.

[2]  Mohamed F. Ghalwash,et al.  Extraction of Interpretable Multivariate Patterns for Early Diagnostics , 2013, 2013 IEEE 13th International Conference on Data Mining.

[3]  B. Drew,et al.  Insights into the Problem of Alarm Fatigue with Physiologic Monitor Devices: A Comprehensive Observational Study of Consecutive Intensive Care Unit Patients , 2014, PloS one.

[4]  Xiao Hu,et al.  Reducing False Intracranial Pressure Alarms Using Morphological Waveform Features , 2013, IEEE Transactions on Biomedical Engineering.

[5]  Eamonn J. Keogh,et al.  Time series shapelets: a new primitive for data mining , 2009, KDD.

[6]  Philip S. Yu,et al.  Extracting Interpretable Features for Early Classification on Time Series , 2011, SDM.

[7]  Qiao Li,et al.  ECG Signal Quality During Arrhythmia and Its Application to False Alarm Reduction , 2013, IEEE Transactions on Biomedical Engineering.

[8]  G. Clifford,et al.  Signal quality and data fusion for false alarm reduction in the intensive care unit. , 2012, Journal of electrocardiology.

[9]  Mohamed F. Ghalwash,et al.  Utilizing temporal patterns for estimating uncertainty in interpretable early decision making , 2014, KDD.

[10]  Mohammed Saeed,et al.  Reducing false alarm rates for critical arrhythmias using the arterial blood pressure waveform , 2008, J. Biomed. Informatics.

[11]  James P. Keller,et al.  Clinical alarm hazards: a "top ten" health technology safety concern. , 2012, Journal of electrocardiology.

[12]  Philip S. Yu,et al.  Early prediction on time series: a nearest neighbor approach , 2009, IJCAI 2009.

[13]  Yong Bai,et al.  False ventricular tachycardia alarm suppression in the ICU based on the discrete wavelet transform in the ECG signal. , 2014, Journal of electrocardiology.

[14]  Mohammad Bagher Shamsollahi,et al.  Life-Threatening Arrhythmia Verification in ICU Patients Using the Joint Cardiovascular Dynamical Model and a Bayesian Filter , 2011, IEEE Transactions on Biomedical Engineering.

[15]  Jeffrey M. Hausdorff,et al.  Physionet: Components of a New Research Resource for Complex Physiologic Signals". Circu-lation Vol , 2000 .

[16]  Mohamed F. Ghalwash,et al.  Early Diagnosis and Its Benefits in Sepsis Blood Purification Treatment , 2013, 2013 IEEE International Conference on Healthcare Informatics.