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Information Based Similarity Analysis of Oxygen Saturation Recordings to Detect Pulmonary Hypertension in Preterm
Pravitha Ramanand1, Premananda Indic1, Samuel J Gentle2
1Department of Electrical & Computer Engineering, The University of Texas at Tyler, Tyler, TX.
Insights
Early screening for pulmonary hypertension (PH) in preterm infants with bronchopulmonary dysplasia (BPD) is crucial. A novel signal analysis of oxygen saturation patterns shows promise for accurate PH detection in this vulnerable population.
Area of Science:
- Neonatal Medicine
- Cardiovascular Research
- Biomedical Engineering
Background:
- Pulmonary hypertension (PH) is a serious complication in preterm infants, particularly those with bronchopulmonary dysplasia (BPD).
- Early detection and management of PH are recommended but challenging in neonates.
- Current screening methods may not be sufficiently defined for this population.
Purpose of the Study:
- To propose and evaluate a novel screening method for PH in infants with BPD using signal analysis of oxygen saturation (SpO2).
- To assess the accuracy, sensitivity, and specificity of this SpO2-based screening technique.
Main Methods:
- Analysis of SpO2 data from preterm infants (41 with PH, 60 without PH) diagnosed with BPD.
- Application of an information-based similarity approach to quantify SpO2 fluctuation regularity using binary words.
- Evaluation of Similarity Indices (SI) for PH screening performance.
Main Results:
- Similarity indices (SI) were significantly lower in infants with PH compared to those with BPD alone (p<0.001).
- SI of 7-bit words demonstrated 80% detection accuracy, 76% sensitivity, and 83% specificity.
- A cross-validated F1-score of 0.80 (0.08) indicated a balanced sensitivity and recall.
Conclusions:
- Similarity analysis of oxygen saturation patterns offers a novel, signal-based approach for early PH detection in infants with BPD.
- This technique has the potential to support clinical decision-making and improve care for vulnerable neonates.
- Further development could lead to a valuable tool for identifying PH in at-risk infant populations.
Abstract:
Pulmonary hypertension (PH) is a complex cardiovascular condition associated with multiple morbidities and mortality risk in preterm infants. PH often complicates the clinical course of infants who have bronchopulmonary dysplasia (BPD), a more common lung disease in these neonates, causing respiratory deterioration and an even higher risk of mortality. While risk factors and prevalence of PH are not yet well defined, early screening and management of PH in infants with BPD are recommended by consensus guidelines from the American Heart Association. In this study, we propose a screening method for PH by applying a signal analysis technique to oxygen saturation in infants. Oxygen saturation data from infant groups with BPD (41 with and 60 without PH), recorded prior to their clinical PH diagnosis were analyzed in this study. An information-based similarity approach was applied to quantify the regularity of SpO2 fluctuations represented as binary words between adjacent five-minute segments. Similarity indices (SI) were observed to be lower in subjects with PH compared to those with BPD alone (p<0.001). These measures were also assessed for performance in screening for PH. SI of 7-bit words, exhibited 80% detection accuracy, 76% sensitivity and specificity of 83%. This index also exhibited a cross-validated mean (SD) F1-score of 0.80 (0.08) ensuring that sensitivity and recall of the screening were balanced. Similarity analysis of oxygen saturation patterns is a novel technique that can be potentially developed into a signal based early PH detection method to support clinical decision and care in this vulnerable population.
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