Using a Quality-Controlled Dataset From ViSi Mobile Monitoring for Analyzing Posture Patterns of Hospitalized...

ViSi Mobile has the capability of monitoring a patient's posture continuously during hospitalization. Analysis of ViSi telemetry data enables researchers and health care providers to quantify an individual patient's movement and investigate collective patterns of many patients. However, erroneous values can exist in routinely collected ViSi telemetry data. Data must be scrutinized to remove erroneous records before statistical analysis.

The objectives of this study were to (1) develop a data cleaning procedure for a 1-year inpatient ViSi posture dataset, (2) consolidate posture codes into categories, (3) derive concise summary statistics from the continuous monitoring data, and (4) study types of patient posture habits using summary statistics of posture duration and transition frequency.

This study examined the 2019 inpatient ViSi posture records from Atrium Health Wake Forest Baptist Medical Center. First, 2 types of errors, record overlap and time inconsistency, were identified. An automated procedure was designed to search all records for these errors. A data cleaning procedure removed erroneous records. Second, data preprocessing was conducted. Each patient's categorical time series was simplified by consolidating the 185 ViSi codes into 5 categories (Lying, Reclined, Upright, Unknown, User-defined). A majority vote process was applied to remove bursts of short duration. Third, statistical analysis was conducted. For each patient, summary statistics were generated to measure average time duration of each posture and rate of posture transitions during the whole day and separately during daytime and nighttime. A k-means clustering analysis was performed to divide the patients into subgroups objectively.

The analysis used a sample of 690 patients, with a median of 3 days of extensive ViSi monitoring per patient. The median of posture durations was 10.2 hours/day for Lying, 8.0 hours/day for Reclined, and 2.5 hours/day for Upright. Lying had similar percentages of patients in low and high durations. Reclined showed a decrease in patients for higher durations. Upright had its peak at 0-2 hours, with a decrease for higher durations. Scatter plots showed that patients could be divided into several subgroups with different posture habits. This was reinforced by the k-means analysis, which identified an active subgroup and two sedentary ones with different resting styles.

Using a 1-year ViSi dataset from routine inpatient monitoring, we derived summary statistics of posture duration and posture transitions for each patient and analyzed the summary statistics to identify patterns in the patient population. This analysis revealed several types of patient posture habits. Before analysis, we also developed methodology to clean and preprocess routinely collected inpatient ViSi monitoring data, which is a major contribution of this study. The procedure developed for data cleaning and preprocessing can have broad application to other monitoring systems used in hospitals.