Researchers from different fields at the University of Pennsylvania, including neurocritical care, engineering, and informatics experts, have developed a new way through which the risk of a serious adverse event following ruptured brain aneurysm in stroke patients can be detected.
This new, data-driven machine learning model, involves an algorithm for computers to combine results from various uninvasive tests to predict a secondary event. Preliminary results were released at the Neurocritical Care Society Annual Meeting in Philadelphia.
Comparing 89 patient cases retrospectively, the team found that automated features of existing ICU data were as effective as the transcranial doppler procedure currently used to detect a dangerous constriction of blood vessels in the brain. Transcranial doppler tests require a skilled technician to be available and are often only conducted once a day, and while the test is selective and accurately detects people who are risk, it is not as efficient (sensitivity of 56%) at ruling out which patients are not at greater risk of this serious adverse event .
"There is a great opportunity to utilize abundant existing data to provide guidance and clinical decision support, as this model was as effective and much less resource-intensive," said senior author Soojin Park, MD, assistant professor of Neurology at Penn. "However, while this simple method may be valuable, most ICUs don't have the IT infrastructure to synergize data in such a way."
The team plans to look at prospective cases to compare this method directly with other assessments and clinical decisions.
This study is one of a dozen Penn Medicine studies and talks being presented at the Neurocritical Care Society Annual Meeting. In addition to studies being presented on cerebral blood flow and end of life care in the Neuro Intensive Care Unit, Penn experts are also leading talks on traumatic brain injury, airway management and therapeutic temperature management. Monisha Kumar, MD, assistant professor of Neurology, is also serving on the Society's consensus conference on multimodal monitoring.
Penn's Neurocritical Care Division, formally established in 2004 and led by Joshua Levine, MD, associate professor of Neurology, cares for patients while training the next generation of experts. The program has the second largest number of fellows training in neurocritical care in the United States. In the Hospital of the University of Pennsylvania's Neurocritical Care Unit, a Level I Trauma Center and Acute Brain Injury Center, the team works within one of the most technologically sophisticated neurocritical care units in the nation, the only academic facility of its kind in the region.
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