Discrete Heart Rate Values or Continuous Streams? Representation, Variability, and Meaningful Use of Vital Sign Data

Area of Science:

• Biomedical Engineering
• Clinical Informatics
• Physiological Monitoring

Background:

• Manual documentation of patient heart rate is standard practice, despite continuous data from bedside monitors.
• Current charting methods capture only snapshots, leading to discrepancies with real-time streaming data.
• Previous research identified differences between charted vitals and continuous monitoring data.

Purpose of the Study:

• To investigate the temporal properties of differences between manual charting and continuous heart rate monitoring data.
• To explore how these differences in variability manifest and relate to clinical applications.
• To demonstrate the utility of variability metrics for personalized patient care.

Main Methods:

• Analysis of temporal properties of heart rate variability metrics derived from continuous monitoring data.
• Comparison of variability measures between discrete charted data and complete streaming data.
• Association of variability metrics with clinical measures, including severity scores.

Main Results:

• Differences in charting techniques significantly impact measures of heart rate variability.
• Variability metrics demonstrate a relationship with temporal elements of charting timing.
• Personalized care can be facilitated by contextualizing deviations in magnitude using variability metrics.

Conclusions:

• Charting techniques influence the assessment of patient heart rate variability.
• Variability metrics derived from complete monitoring data offer valuable clinical insights.
• This approach can enhance personalized care and improve the association with clinical severity scores.