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Strategies for Assessing and Addressing Confounding01:25

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Confounding is a critical issue in epidemiological studies, often leading to misleading conclusions about associations between exposures and outcomes. It occurs when the relationship between the exposure and the outcome is mixed with the effects of other factors that influence the outcome. Given that, addressing confounding is of high importance for drawing accurate inferences in research.
Confounding can be addressed at both the design phase of a study and through analytical methods after data...
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Developing a Scalable Annotation Method for Large Datasets That Enhances Alarms With Actionability Data to Increase

Sophie Anne Inès Klopfenstein1,2, Anne Rike Flint1, Patrick Heeren1,3

  • 1Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.

Journal of Medical Internet Research
|May 5, 2025
PubMed
Summary
This summary is machine-generated.

Alarm fatigue in ICUs is reduced by a new method that semi-automatically labels patient monitoring alarms for actionability. This enables faster creation of datasets for machine learning in alarm management.

Keywords:
alarm fatiguealarm informativenessalarm managementdataset annotationdigital healthintensive care unitmachine learningpatient monitoringpatient-centered caretechnological innovationtransdisciplinary research

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Area of Science:

  • Biomedical Engineering
  • Health Informatics
  • Clinical Data Science

Background:

  • Alarm fatigue in intensive care units (ICUs) stems from frequent nonactionable alarms, impacting patient safety and staff.
  • Machine learning (ML) models can potentially mitigate alarm fatigue, but require actionable alarm data, which is currently lacking.
  • Manual annotation of alarm actionability is time-consuming and resource-intensive, hindering ML development.

Purpose of the Study:

  • To propose a scalable method for annotating patient monitoring alarms based on their actionability.
  • To enable the creation of datasets for developing ML models to address alarm fatigue.
  • To provide a reusable method for other institutions and researchers.

Main Methods:

  • An interdisciplinary team employed a mixed-methods approach, including data-driven, qualitative, and empirical strategies.
  • A six-step iterative process involved defining terms, establishing consensus, defining conditions, creating mapping tables, developing a rule set, and evaluation.
  • Decisions were guided by feasibility, clinical relevance, data availability, and system specifics, informed by literature review and system analysis.

Main Results:

  • A multidisciplinary consensus led to a rule-based annotation method classifying alarms as actionable or nonactionable using patient data.
  • The method, focusing on respiratory and medication interventions, includes 8 general rules with graphical examples and mapping tables for unstructured data.
  • The developed resources and annotation method are presented for reuse.

Conclusions:

  • The proposed method allows for rapid, semi-automatic, retrospective labeling of alarms for actionability.
  • This facilitates the generation of annotated datasets crucial for ML in alarm management and fatigue research.
  • The universal nature of the method and resources supports broader applications in future ML projects.